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Biblical Reflections on Modern Medicine

Vol. 7, No. 2 (38) 

Contents:


Antibiotics for Colds!
or
"First of all, do something!" A Changing Orthodoxy

"Doc, I've had this cold for a couple of days. I can't shake it and want to catch it early before it goes into my chest. I have a lot of work to do and can't afford to be sick."

I once wrote an article, "The Medicalization of America," that had to do with some major problems, such as re-classifying sins as psychological problems, government intrusion into medicine, and the high costs of medicine. However, there are some other, seemingly more mundane problems, that may destroy any efficacy that modern medicine might claim.

In January 1996, 35 major medical journals around the world focused on the problem of emerging infectious diseases that threaten to overwhelm any antibiotics or antiviral drugs that are currently available. A recurring and consistent lament was the over-prescribing of antibiotics. This overuse has presented bacteria and viruses with a challenge to their own health. These micro-organisms are able to make enzymes to destroy the drug that is designed to destroy them. They are winning!

Simple, Unwanted Solutions

In response to such articles in The Journal of the American Medical Association (JAMA), I wrote a Letter-to-the-Editor suggesting three simple steps that would impact and possibly reverse this trend. (Don't hold your breath that it will be published.)

1) "Stop accepting drug samples unless the drugs have been on the market for at least 10 years." Residents and students have ready access to the latest (and most costly) antibiotics (and other drugs, but this article focuses on antibiotics). Do you think that their prescribing habits will change when they graduate and begin their practices?

2) "Stop this silly notion that yellow or green stuff coming from a nose or a mild cough needs an antibiotic." To my knowledge, there is no scientific study that shows that antibiotics help a common cold or allergic rhinitis (often, they are indistinguishable). If any of you know one, let me know.

3) "Stop pretending that marriage and sexual continence are dinosaurs of the past." Sexually transmitted diseases, including AIDS, are a major part of this infectious assault. There is a simple solution: sexual purity before marriage and sexual fidelity after marriage.

The first suggestion strikes at the trinkets, meals, money, and more that drug "reps" (representatives) give to students, physicians, and residents. 

The second suggestion merely directs physicians to practice medicine according to their own science.

The third suggestion confronts an atheistic and evolutionary worldview. But, they still ignore their own science that demonstrates that sexually transmitted diseases require multiple sexual liaisons for their spread. That is, sexual morality is far more healthy than sexual immorality.

The Blind Leading the Blind

You see, the practice of medicine has become an orthodoxy that ignores its only hope of efficacy -- its only hope to separate itself from its own "unscientific" past (humors, blood-letting, potions, etc.) and from all alternative medicine approaches.

Primum non nocere -- "First of all, do no harm." This maxim has been at the forefront of medicine for two thousand years. However, today, it has become, "First of all, do something." Order a test. Prescribe an antibiotic in spite of medical science.

This change is apparent within my career. I remember the scoffs of my professors at the LMDs (local medical doctors) who gave penicillin for colds. Many of these same professors now prescribe the antibiotics and have set the standard of orthodoxy for all other practitioners.

So What? Only the Issue of Truth

You may ask, "So what, Ed? Why bring this issue within the context of Biblical ethics. Just this. "I am the way, the truth, and the life..." Biblical ethics is about truth. Modern medicine is not about truth but about personal gain (#1 above), societal and peer pressure (#2 above), and the current zeitgeist (#3). 

The closest that medical practice comes to truth is its science. Such empirical evidence does not approach the status of truth, but such research is all that separates medical practice from pure opinion, personal preference, and any reason to believe that it actually effects good. Alas, virtually all physicians (including Christians) have sacrificed their only hope of efficacy for trifling influences.

In spite of all that I have said here, I have great admiration for modern medical science. What physiology we have learned! What great technology we have (MRI, CAT, lasers, flexible scopes, etc., etc.)! We have a chance to place medical practice on a solid foundation, and what do we choose: the dark side of ourselves and society.

There is more than a little personal aggravation in this subject. I work with more than 40 other physicians (residents and faculty). I don't know of any that practice differently from what I have described above. I have been repeatedly "called down" for my unwillingness to prescribe antibiotics when at the same time I am already prescribing 10x more of these drugs than I would without peer review.

A Rudderless Ship

The ship of modern medicine is rudderless. But, then, so is any person or group without Biblical standards. Modern medicine stands condemned by its own science, without even resorting to ethical standards. 

Biblical medical ethics extends beyond specific Biblical texts and dogma. It extends to the best understanding available to human minds (even though fallen) and a rigorous, disciplined approach based upon medical science. Modern physicians do not even practice the latter, much less the former. For the most part, Christian physicians are no better.

I speak of my profession, but the problem is culture-wide. In virtually every area (education, welfare, psychology, sociology, economics, etc.), empirical studies point to a better way. Indeed, to any observer with some objectivity or Biblical understanding, these conclusions are obvious. "Broad is the way that leads to destruction." Dear readers, what can explain such foolishness except willful, obstinate blindness?

Back to Our Patient

The hope of the patient presented at the beginning is beyond the ability of any physician. To attempt to fulfill his hope is to portray a great lie. First, antibiotics don't help "colds." Second, most colds don't "move into the chest." And, even if they do, they usually clear on their own. What the patient wants is God-like response: instant cure and reassurance that it will not get worse. I can't provide that. Only God can. To pretend that antibiotics are effective in this situation is to continue a great deception, an unscientific medicine, and ultimate victory for bacteria and viruses.


Tape Review: "The Expansion of Medicine"

"The Expansion of Medicine" is an audio tape by Otto Scott, an historian with Biblical premises who has written numerous books, such as The Secret Six: John Brown and the Abolitionist Movement and The Other End of the Lifeboat. I recently purchased this tape, which describes how medicine (as psychiatry) from the time of Freud has contributed to (caused?) the demise of justice and the place of priests in society. 

Sigmund Freud's explanation of human behavior was a direct challenge to the role of priests. Until that time, confessions were made to priests and pastors and sins were dealt with on a religious basis. The result was causal explanation for abnormal behavior somewhere outside the person (parents, society, etc.) rather than inherent evil. 

Today, we have more police and judges (and psychiatrists) than ever before, but we have less justice and more crime. Why? The concept of evil that needs to be punished is gone.

Interestingly, even psychiatry cannot avoid "federal" (representative) responsibility in mankind's first parents. If parents are responsible for the behavior of their children, then the grandparents are responsible for their children's behavior, all the way back to the first parents. 

Psychiatry opened the door of the bedroom. Biblical influence made sodomy and other public sexual acts illegal and punishable crimes. The privacy of the home was sacrosanct to any legitimate investigatory powers of the state. Indeed, we see the horror stories of children giving false testimony against their parents because of overzealous inquisitors and sometimes fabricated accounts in the children's own minds.

Scott finds it strange (and I agree) that our culture looks to a profession obsessed with sex to provide sexual mores. And, the results of their advice are obvious to anyone with any rational point of view. 

There is more on this 45 minute tape, but these are some general themes. If you want the tape, send $6.50 (includes shipping and handling) to Uncommon Media, P. O. Box 69006, Seattle, WA 98168 or call 1 (800) 994-2323. They will also send you a list of his other works. You will find historical accuracy and honesty that is rare today.

Duck, Duck! Who's the Quack?

Hilton P. Terrell, Ph.D, M.D.

Americans make hundreds of millions of visits annually to providers of unorthodox medical care. They are voting with their feet, clambering over the razor wire of federal regulations. Dissatisfied with its already prodigious powers, the Food and Drug Administration (FDA) has a new law requiring herbal remedies and dietary supplements to have some kind of evidence that they accomplish what they claim. Though far from the onerous regulations superintending the drugs of orthodox medicine, such items as extract of valerian root will now require FDA approval before marketing. The FDA reportedly is not satisfied with the law. The agency is afraid some Americans might come to harm from herbs taken without its oversight. No American, of course, ever came to harm from government-approved medicines and surgical procedures!

The law is only one more strand of barbed wire on the concentration camp fence which seeks to keep Americans from obtaining treatments they desire. It won't work. It already doesn't work. Americans make nearly a half billion yearly contacts with herbalists, acupuncturists, iridologists, reflexologists, those who wear quartz crystals around their neck, those who sit beneath cardboard pyramids that focus mystical emanations in the universe, and hosts of other strange practices.

Based on the apparent invalidity of such practices as those listed above, some argue that the public is ill-equipped to make good decisions regarding the technical issues that medicine holds. Thus, government is doing us all a favor, at the cost of some freedom. But, necessity is the plea of every tyrant and misses a more basic matter: By what standard is it decided who shall determine medical treatment? God has not left us adrift to guess or put it to a democratic vote. He has outlined the purposes of civil rulers. Deuteronomy 17:14-20 outlines the proper constitution for a civil ruler. First Samuel 8:11-18 is sometimes cited as the authority for civil rule. That passage is, rather a warning as to how rulers may be expected to misbehave. In the New Testament, Romans 13:1-7 describes the civil ruler as one who executes wrath on evil doers, not as one who makes health care purchasing decisions for everyone in the realm. Analogous to our Constitutions's Tenth Amendment, what is not given by God to the civil ruler is reserved to other loci of authority instituted by God. Except for isolation of those with contagious diseases and perhaps the disposal of human waste as listed in the Pentateuch, the civil ruler is by no stretch of biblical revelation the appropriate authority to determine medical care.

It is useless to cite the alleged tremendous strides made by medicine since government became involved, beginning with the licensure of physicians a bit over a century ago, proceeding through the establishment of the FDA, Medicare, Medicaid, "required request" laws on organ donation, and the like. The very mandatory, exclusive nature of government-approved medicine means that the possibilities of a free-market medical system cannot be well known. Further, an historical view of standard, state-approved medicine reveals that people have received grossly wrong, even stupid, therapy at our orthodox hands. How could we be so sure that similar errors are not taking place now? Why should the fact that a state-privileged (read, "monopolistic") physician corps believes a treatment to be right mandate that everyone submit to our judgment?

Medical quackery, as we orthodox practitioners usually refer to it, can actually serve medicine, even if 100% of its treatments are worthless, which proportion isn't likely. Quackery can preserve the idea that the proper person to determine medical care is the patient, with the advice of his family, his church, and his chosen practitioner. Quack remedies, being (in my estimate) generally less powerful for anything, could be expected to be less dangerous. "Real" drugs work because they exert a biological effect, often discovered from a poisonous effect of a plant, such as digitalis, periwinkle, or ergot. Diluted, the toxic effect can be used therapeutically. The difference, as the maxim has it, between a medicine and a poison is only the dose. Some estimate that as many as 15% of the visits for new problems to orthodox practitioners of medicine can be traced to an adverse reaction to a medication. One doubts that the frequency is as high for ginkgo leaves or the fruit of the saw palmetto.

That resorting to quackery deters patients from more efficacious orthodoxy is a little more difficult, but careful study of the efficacy of medical orthodoxy raises doubts also. I recently saw a patient who fell while visiting back home in England. Weeks later, on return to the U.S., she had an x-ray of her injured ankle, with the discovery that the fibula was fractured. The ankle mortise was intact, her symptoms were gone, and sufficient healing had already occurred that she did not require a cast. Had it happened in the U.S., she would doubtlessly have had an early x-ray and a cast applied. Retrospectively viewed, it was not necessary. Given our interventionist bent in American medicine, we retain little appreciation for the natural history of disease. It is possible that quack remedies serve to let "nature take its course," getting credit for what they did not produce, but at least being cheaper, the choice of the patient, and perhaps with fewer dangers.

Let freedom roll! Or, put another way, let responsibility lie where God has placed it.

Ed's Note

Want to know a little more about what the FDA is up to? Check these excerpts from the FDA Medical Bulletin (January 1996).

"FDA has been reviewing the safety and effectiveness of marked Over-the-Counter (OTC) drugs for many years. The OTC Drug Review has been a massive project evaluating nearly 1,000 active ingredients used in the estimated 300,000 marketed OTC drug products. Most of these drugs have been used for decades and have never been reviewed under the criteria set forth in the law.... The vast majority of OTC ingredients that have to be removed are found to be ineffective and pose little safety risk."

Hmmmm. Let's see. "The vast majority ... pose little safety risk." So, we have this gigantic government investigative program to find the needle in the haystack that might be a danger to you. And, for all its "safety" concerns, the FDA has still marketed some dangerous drugs that later had to be recalled. I believe that the private sector can do better and am willing to take my chances with them.

Bob's Banter

I Used to Be a Doctor

I used to be a Doctor,
now I am a Health Care Provider.

I used to practice medicine,
now I function under a managed care system.

I used to have patients,
now I have a consumer list.

I used to diagnose,
now I am approved for one consultation.

I used to treat,
now I wait for authorization to provide care.

I used to cure patients,
now I am dared not to cure them by insurance carriers, I use up the authorization, I lose
the patient.

I used to see patients on referral from doctors, patients, and friends,
now I must be listed in their Provider Manual.

I used to see patients who traveled to see me,
now I am considered out of their approved geographic area.

I used to be paid a Usual, Customary & Reasonable (UCR) fee,
now I don't have a usual fee;
now there is nothing customary, only managed competition;
now who is reasonable?

I used to get paid,
now I accept the allowed charges as payment in full for covered services.

I used to be paid for professional services,
now I am not paid either for time, materials, or nonallowed services.

I used to be an independent specialist,
now I am a dependent ancillary care provider.

I used to provide charity care,
now since I am not an authorized provider, I am not permitted to provide charity, to barter, or to offer advice.

I used to consider insurance as a third-party carrier,
now insurance is a intermediary between the provider and the consumer.

I used to care for my patients by appointment,
now the patient requires authorization to make an appointment.

I used to provide hands-on care,
now I provide hands-off, gloves-on procedures.

I used to use words to describe my care,
now I must fill in all boxes with appropriate code numbers.

I used to provide necessary services,
now I am unnecessary.

I used to have a front office coordinator,
now triage is performed at the front line.

I used to have a clean office,
now I am certified by OSHA.

I used to have a practice,
now I am employed to provide services.

I used to have a successful "people" practice,
now I have a paper failure.

I used to spend time listening to my patients,
now I spend time justifying myself to the authorities.

I used to have feelings,
now I have an attitude.

Now I don't know what I am.

Harry F. Hlavac, D.P.M.
Mill Valley, CA
Used with author's permission.

Brief Reports with Commentary

A Matter of Whose Ox (Life) Is Being Gored (Taken)

"As everybody knows, the progressive position is in support of assisted suicide. Thus a recent national poll shows that voters aged eighteen to thirty-four are in favor (56 percent to 40 percent). People sixty-five and over are against (55 percent to 37 percent, with 48 percent strongly opposed). Older folks are the supposed beneficiaries of a legal "right to die." Funny they don't see it as being in their interest. Young people, of course, are not at all sure that they are going to die, or even grow old. On this question, as on almost everything else, religion is a powerful variable. A majority of mainline Protestants support assisted suicide, while Baptists and Catholics are generally opposed. 

"Far more important than denomination is regular church attendance: 65 percent of weekly churchgoers oppose legalization (with 56 percent strongly opposed), while 70 percent of those who rarely or never attend church think it is a good idea (with 47 percent in strong support). The Hemlock Society people are right in saying that the question is, Whose life is it anyway? They just have difficulty in grasping the fact that there's another answer to the question." (First Things, February 1996, p. 83. Original source: Life at Risk, June-July 1995)

Simple Biblical Answers to Modern Questions!

"The story is so unthinkably bizarre, it might have sprung from the macabre mind of Robin Cook. But even though the author of popular medical thrillers hasn't hatched this plot yet, it's already giving bioethicists nightmares.... 'The case is beyond our imagination. Something like that would never even cross our minds. And, here it is,' said Dr. Evelyne Schuster, a member of the ethics committee of the American Society for Reproductive Medicine." (Chicago Tribune, January 26, 1996, Section 1, p. 4)

What is this case? A woman, 29, has been comatose since 1985 when she was involved in an automobile accident. She is now five months pregnant which could have occurred only as a result of rape. (The assailant is unknown and not yet identified.) There does not seem to be any physical threat of the pregnancy to the woman.

Commentary: The simple Biblical solution is the best medical care for the mother and child until she delivers. The child's custody belongs to the mother's parents. Case closed.

Today, however, there are so many supposed "rights" and devaluation of life that medical ethicists have no foundations (absolutes) on which to begin ethical constructions. God gives the unborn child every right to life. Biblically, the parents have the right to keep the baby or place it for adoption. 

So many ethicists, including deluded and deceived Christian ethicists, who state that the Bible is either antiquated or unclear on modern medical dilemmas. The Bible is never antiquated. Sometimes it is unclear. However, in this instance, the answers are simple and clear.

Preparing for All Contingencies: Playing God

"Upon the birth of their third child in December, Jeanne and Everett Simons spent $1500 (and $95 a month) on a new and controversial medical procedure.... The Palatine (Illinois) couple asked an obstetrician to painlessly harvest several ounces of blood from the newborn's umbilical cord for long-term storage so that if the child ever contracted leukemia or any other disease requiring a bone-marrow transplant, the baby's own blood would be available." (Chicago Tribune, January 9, 1996, Section 1, pp. 1, 10)

Commentary: I do not like the term, "playing God," usually applied to physicians. God is God, and however much we would like to have His power and wisdom, we are fools. Further, "playing God" muddies the water about the real issue, what is and is not ethical by Biblical standards. 

The situation here is a little different. It is another in a long line of "just-in-case(s)" (e.g., freezing sperm and embryos). It is another in misplaced priorities. For Christians, it is another case of worshiping medicine.

As I grow older and face more clearly the aspect of mortality, I also reflect on the real tragedy of our human existence: the killing fields of Cambodia, the millions dead under Stalin and Hitler, the savage brutality in Rwanda before our very eyes, the dead children in mangled cars from a drunken driver, and on ad infinitum, and if you can really grasp its reality, quite sobering.

"In the day that you eat of it (the fruit of the forbidden tree), you shall surely die." I doubt that even Adam's uncluttered and uninhibited presin intellect could have grasped the depth and breadth of that curse.

We play at trifles when we attempt to prepare for such things as childhood leukemia. The number one killer of children is accidents. The Simons' money would be better spent on accident prevention (perhaps a more sturdy car with air bags everywhere).

I don't want to make light of preparation for the future. As Christians, we are called to think and plan long-term. However, trying to prepare for every eventuality is "playing God." It is denying God. It is the unnamed idolatry of modern Christians worshiping medicine, instead of resting in God's Providence and Provision. It contributes to the misplaced and deluded faith in medicine to which we more than tithe our incomes in the United States.

Medicaid Pays for Transsexual Operation

A "Mr. Smith" underwent a transsexual operation to change his physical sex from that of a man to a woman. In New York, Medicaid pays for transsexual operations and the related costs of drugs and psychotherapy when such a change is considered "medically necessary." (The Augusta Chronicle, February 6, 1996, p. 4A)

Commentary: Read the article herein on the poor that has a lot to say about Medicaid. Also, I wrote in a previous Reflections that providing birth control via Norplant can be paid for by Medicaid in Georgia if it is considered an "emergency." And on and on. There is not enough money in the world to pay for all the whims, fancies, and ambitions with such re-definition of "medical care."

More Good (Immoral) Use of Taxpayer Money"

Scientists have developed an experimental vaccine that blocks cocaine's powerfully seductive 'high' by spawning antibodies that mop up drug particles in the blood stream before they reach the brain." (Associated Press, date unknown)

Commentary: My audience can decipher this immoral research without my help!

Nonsense by Christians

"Apparently, God does not countenance man dying as a result of illness." ("Progress Notes" of the Christian Medical Foundation, International, December 1995)

Commentary: This concept is common among charismatics. They believe that if you confess and pray enough you can live a life of health until you die! Their are deluded and their doctrine is cruel. (It is a doctrine because you won't find any medical science that supports their contention.)

They are deluded because autopsies show that a person always dies of something. It may a subtle, irregular beat of the heart. It may be a stroke in a vital center of the brain. It may be a blood clot that blocks blood supply to a vital organ. The curse of God upon the human race because of Adam did not only include physical death but physical diseases. To say otherwise is a denial of one's reason and of Biblical truth.

Their doctrine is cruel because the converse of their statement is that anyone who dies of sickness had unconfessed sin and a lack of faith. That's cruel. There are many godly people who have suffered and died from acute and chronic diseases. Such a statement is demeaning to their witness.

For sure, God took Enoch and Elijah alive. And, Moses died though "his eyes were not dim nor his natural vigor abated" (Deuteronomy 34:7). However, these incidents were exceptions (miracles). God ordinarily works ordinarily. He has not promised us more. To expect more is to remake God in our own image.

I know that I have been severe with professing brothers in the faith. However, such nonsense is one reason we lack power and influence in the world. And, the cruelness of their position ought to be exposed for what it is. Joni Eareckson-Tada recounts that effect in her life in A Step Further (Zondervan, 1978, p. 122-134).

O, LORD, our Lord, 
How excellent is Your name in all the earth,
You who set your glory above the heavens!
Psalm 8:1


Patient Literacy and Intelligence:

The Poor Will Always Be with Us

More than 2500 predominantly poor and minority patients were studied at "large" public hospitals in Georgia and California. Forty-two percent did not understand directions for taking medi-cine on an empty stomach. Twenty-six percent could not understand data about their next appointment. Sixty percent did not understand informed-consent documents. 

One researcher concluded, "Adults with illiteracy face formidable problems" gaining access to health care. "Clinicians, hospitals, and clinics must become more sensitive" to the problem. (Boston Globe, December 7, 1995. Original report in JAMA, Dec. 6, 1995, pp. 1677-1682)

Commentary: These studies raise larger questions about culture and intelligence relative to medical care. Can the poor or the language-compromised patient receive the best medical care? Can simply providing "access" and payment for services deliver good health/medical care? 

These questions are "cutting-edge" for political and social debate, since the largest portion of many states' budgets are Medicaid payments (a program providing health/medical coverage to generally indigent patients paid for by a combination of federal and state dollars). Could it be that the poor are limited in their ability to help themselves or to be helped? What/who are the poor? 

It is not a simple question. Some are temporarily poor. They lose their job and go bankrupt. These usually do not remain poor. While being blind or having another handicap may contribute to one's being poor, many handicapped people are not poor and are even rich! Immigrants often come with no money and no understanding of English. They often do well. They do not remain poor.

Being "poor" is more permanent, even generation to generation. Why? In the United States, everyone has opportunity. The poor, however, often remain poor, in spite of opportunity, in spite of public education, in spite of public housing, in spite of job-training, etc., etc. Many escape being poor with such opportunities. Others remain.

The poor, then, seem to lack motivation to better themselves generally. Someone has said that they lack a long-term view that causes people to "delay gratification," to save for the "future," and take a long-term view of their health. There is also a more crime among the poor.

I have not worked in places like Calcutta where Mother Theresa is or even the slums of inner cities, but I have seen hundreds of Medicaid patients in urban and rural settings. There are real restrictions on anyone's ability to provide much more than episodic, piecemeal medical care. 

It is a well-known fact today that more than 5 trillion dollars has not changed the proportion of "poor" in the United States in the last 30 years. (I won't deal with the fallacious concept of the "poor" here.) I would contend that the proportion of this money spent on medical care has not changed their health either (except in a small percentage of individual cases). There are several reasons for this. One, mentioned repeatedly on these pages, is the general lack of efficacy of almost every area of modern medicine. 

Another is the misuse and abuse of the people "served" by the system. They come in for minor complaints. They come in for "check-ups" just in case there might be something wrong. They do end runs around rules and regulations to get free transportation, disability income (and to avoid working), and other freebies. As a physician, I often get caught with a request for signature for what has become a repeated occurrence, but one that is morally wrong. If I don't sign, I become the "bad guy" in a system that rewards "bending" (i.e., breaking) the rules -- which is both immoral and illegal.

The poor have wrong priorities. They have money to buy "things" for the home and for their recreation but not for medications or appliances that would improve their health. They are not oriented to reading and studying how to improve their health. They live in unsanitary conditions that spread disease and lower their resistance to illness. They participate in rampant sexual immorality.

Leonard S. Sagan has written in his book, Health of Nations (Basic Books, 1987), that health is far more a result of character than of medical care and sanitation (187-188). 1) Healthy people are "confident of their ability to make competent decisions." 2) They are not "self-indulgent or pre-occupied" with themselves. 3) They place a high value on health which leads to healthy practices (exercise, attention to nutrition, etc.). However, Sagan believes that the attitude toward health has a far greater impact on health than the practices themselves.

4) Healthy people are "future oriented." 5) They have strong and persisting social networks (marriage, family, community, etc.). 6) They "relish companionship," not being comfortable alone. 7) Healthy people pursue knowledge to find understanding and find meaning about life.

A Conclusion

I have made sweeping generalizations that are unfair to some so-called "poor." I have met some marvelous "poor" people who were not poor by Sagan's criteria. However, as a class, the poor do not possess Sagan's characteristics of a healthy group.

While I am not entirely satisfied with how I have presented this subject, I wanted to introduce it as food for thought or response. To deal fairly with the many nuances of being "poor" would take far more than I have written here. As with welfare in general, medical welfare is a gross mismanagement of taxed income (aside from its being theft morally). 

The poor with their medical problems "will always be with us." There is little that we can do to improve their health until they are no longer "poor" in character. As Christians, we know the usual way that such character comes to be. But, we often fail to know that it rarely comes any other way. Certainly it does not come through government programs.

AIDS: Issues and Answers

Vol. 10, No. 2 (63) March 1996

Update on Peter Duesberg and HIV

Peter Duesberg is the chief spokesman for a growing contingent who believe that HIV (human immunodeficiency virus) is not the cause of AIDS. Despite disagreements with his co-author, Bryan Ellison (Why We Will Never Win the War on AIDS), and publishers' concerns, his book will be published by Regnery Publishing in March 1996 as Inventing the AIDS Virus.

Duesberg's hypothesis that HIV does not cause AIDS grows weaker with new evidence. "Two large clinical studies... indicate" that changes in the number of viral particles present in patients is "superior" to CD4 cell count as a gauge of the severity of disease in AIDS patients (JAMA, February 14, 1996, pp. 421-422). 

At the time that Duesberg first posed his theory, techniques to find and quantitate HIV in patients was limited, difficult, and unreliable. Thus, one argument was that HIV was variably present or not present at all in some AIDS patients. These two studies and many others continue to use polymerase chain reaction (PCR) as a measurement of the presence of HIV. Thus, Duesberg's contention that HIV is not the cause of AIDS is really untenable.

At the same time, do not discount Duesberg entirely. Pretenses, biases, and political games have been exposed on these pages and elsewhere. There is still much about AIDS that needs to be exposed to the light of good science and honest scrutiny. Duesberg is one of the leaders of that charge.

Transfusion Risks and HIV

The primary risk of HIV being present in transfused blood occurs when a donor is in the "window" period. This is the period of time (25-45 days) from infection to his development of antibodies that are detectable by blood screening methods. At the time that I wrote my book, What Every Christian Should Know About the AIDS Epidemic (1991), the risk of a patient's being transfused with a unit of HIV-positive blood was 1 in 50,000 to 1 in 100,000 or 1 in 8,000 to 1 in 12,000 per transfusion. (Each person transfused receives an average of 5.4 units.)

A new study estimates this risk at 1 in 450,000 to 1 in 660,000 per unit or 1 in 83,000 or 1 in 122,000 per transfusion. This rate figures to 18-27 infectious donations each year. This reduction in the estimate has occurred because of determination of a narrower "window" than once thought and improvement of the sensitivity of test materials. (The New England Journal of Medicine, December 28, 1995, pp. 1721-1725)

Commentary: I believe these numbers. While transfusion is not without risks (other infections, incompatibility, reactions, etc.) and should be avoided, if possible, it is one of the smaller risks that we face in life-threatening situations (the only place where transfusions should occur). 

From the Top: HIV "Pool" Being Reduced

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, stated that the number of AIDS patients in the United States who die each year (60,000) exceeds those who become infected with HIV (40,000). His conclusion, "the epidemic is starting to wane." (Washington Times, February 1, 1996, p. A3)

Commentary: You have heard it from the top! You don't have to believe me any more. Eventually, barring something unusual (for example, viral mutation -- not likely), the number of deaths and new cases will reach some sort of approximate equilibrium. The "pool" (HIV infections who have not progressed to or been reported as AIDS) will likely number 300,000 to 400,000 or less. For sure, however, HIV/AIDS will be with us for the foreseeable future in considerable numbers, in spite of the decline.

"Hope Fades Fast for AIDS Vaccine Soon"

"The prospects for an AIDS vaccine by the end of this century, already dim, are likely to be dashed by new data showing what had been regarded as the most promising vaccine has failed to protect at least 17 volunteers from infection with the AIDS virus.

"In the mid-1980s, many researchers said an AIDS vaccine was a decade away. Now even the revised goal set by government researchers five years ago -- a workable AIDS vaccine by the year 2000 -- appears to have moved beyond reach." (Chicago Tribune, November 12, 1995, front page)

Commentary: Make no mistake about this vaccine research. It is intended to allow homosexuals (primarily) and IV-drug addicts to continue their immoral and illegal activities without fear of HIV/AIDS. It is tax-subsidized removal of God's legitimate restraints and punishment for violating His law. 

As such, the difficulty of the task for a Bible-believer is apparent. God's laws are not thwarted easily. In fact, I will go out on a limb. A vaccine to prevent HIV infection in homosexuals and IV-drug abusers as effective as most childhood vaccines today will not be found. I base this statement on the spiritual basis above and not research to date. 

Anytime one makes a statement that science will or will not accomplish something, one is on tenuous grounds. However, with the perversity of these two acts, I don't believe the natural laws inherent to allow HIV infection in this perversity can be overcome. Besides, who will remember my statement more than 10 years hence should a vaccine be developed and I be proven wrong?

How We Differ: Simplified

"We" are those committed to a Biblical medical ethic. "We" are those who have produced newsletters, journals, and tapes under the general description "Biblical medical ethics." So far, we have had no challengers under that description. There are all sorts of "Christian medical ethics" and Christians developing medical ethics, but to my knowledge we are the only ones willing to accept and portray this label.

But, who are we? I know that repetition occurs on these pages. It is unavoidable, but I try to present it in a variety of ways. A diamond is a diamond, but as you turn it in the light, you learn more and more about the colors of that diamond that you did not know before.

Here, I want to name four characteristics that distinguish us from other "Christian" ethicists. These are intended for simple identification rather than exploration which is an ongoing project of these pages. 1) The label "Biblical medical ethics" is unchallenged by anyone else.

2) The efficacy of modern medicine is extremely limited. That is, medicine does little to change the course of morbidity and mortality. On balance, it does more harm than good.

3) The government's role in medicine is limited to a few public health measures. Licensure is not the role of the state. Neither are Medicare, Medicaid, and other medical provisions for certain groups of people (other than those injured in direct service to the state: soldiers, police, etc.).

4) The science of medicine mostly does not exist. The large majority of what physicians do has little basis in scientific evidence. There is much condemnation of past medical practices with little acknowledgement that we are likely just as ignorant today as yesterday.


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