Why I believe in informed consent and medical choice

Posted on Thursday, February 10, 2022 by Rebecca

Doesn’t everyone? Not really, it seems. Some people seem to think that there are any number of valid reasons that should override an individual’s right to consent or decline medical treatments. I’m neither a legal scholar nor an expert in ethics (to understate things to the extreme!) but I would like to explain why this issue is important to me personally. Here are my main reasons:

I was raised by a survivor of Nazi Germany. In addition, one of our dear family friends was a concentration camp survivor. I grew up hearing about the horrors of the medical experiments carried out by Nazi doctors. Unless you or one of your parents suffered under totalitarianism, you probably have no idea how that shaped my thinking about freedom, the role of government, the rights of citizens, etc.
When I was in high school, the horrifying Tuskogee medical experiments were in the news. I was both frightened and ashamed of my country.
In the 1980’s, I became active in an organization that was seeking to stop the alarming high rate of medically unnecessary cesarean sections. What was troubling was how poorly mothers and babies in the U.S. fared compared to other countries with lower c-section rates and different obstetric practices. I became appalled at what I learned of the history of obstetric care in this country, the misinformation being given to mothers, and how mothers of not just my generation but pervious ones had to fight for better care and better hospital practices. We had science on our side, but it seemed like we were fighting a losing battle. We were no match for the medical industry.
During that time, I also discovered that most doctors learned almost nothing about breastfeeding or nutrition, and were often the source of misinformation that many of my peers began jokingly referring to as “old doctors’ tales”. Again, we had science on our side… but that wasn’t enough. We couldn’t reach every mother, and we couldn’t fight the medical system. (Although, years later, I was excited about the strides made in changing many hospital policies that undermined breastfeeding.)
I also learned, through bitter experience, that our medical system often withholds information from patients. It may not always be deliberate — medical professionals cannot inform us of something they themselves do not know — but our system does not always welcome questions, provide information regarding other treatment options, or disclose all of the potential side effects of treatments and medications. (Think of all the things we’ve been assured were “safe and effective” that turned out to be neither for far too many people.)

In short, I simply don’t like the idea of allowing either my government or medical professionals to make medical decisions for me. Ultimately, it’s not just a matter of wanting the freedom to make my own decisions; it’s also a matter of being the one who has to live with the consequences of those decisions.

Not all “advancements” in commercialized medicine are improvements

Posted on Saturday, February 5, 2022 by Rebecca

A discussion on Facebook reminded me of how easy it is to smugly view previous generations as “ignorant” or even “stupid”, without realizing how little of their practical knowledge and skills we possess. We are often far more reliant on others to do for us what previous generations did for themselves.

The field of medicine has made enormous strides. But it has also become commercialized, and too many people have become overly reliant on pharmaceutical remedies.

I grew up before medical insurance in a family that had to consider every expenditure carefully. I was blessed with a Daddy who had been a medic in the Korean war, and I was thankful he was able to “fix” my broken nose, help me avoid stitches several times (except for one dramatic injury) and, along with my mother, nurse me through various illnesses and injuries. He also knew his limits and knew when a call to the doctor or an ER visit was necessary.

At age 18, I was diagnosed with a mild case of a serious, usually progressive, neuromuscular disease. (God later healed me during pregnancy, but that’s a story for another time.) While at UCLA, I read everything in the BioMed library related to my disease and watched/listened to every lecture, symposium, and presentation available in the library. I was so up on the latest research that, moments before I had my wisdom teeth extracted at the dental school, one of the professors asked me to explain my condition and its implications to a group of dental students.

It never dawned on me to consider investigating “alternative” treatments.

Then an interesting thing began happening. I’d get sick with something and go to a clinic or doctor — including the top specialists at UCLA — and we would end up having conversation after conversation along these lines:

Doctor: Normally I would prescribe x or y, but those are contra-indicated for you, and there is no safe or effective alternative.

Me: [alarmed, frightened face]

Doctor: Don’t worry. [recommends some home remedy or describes how this sickness was treated before current pharmaceuticals were developed]

Me: Seriously? Just go home and do that? Does it even work??!!

Doctor: The old remedies and treatments don’t lose their effectiveness simply because we have discovered new ones.

Me: Oh.

One doctor, offended at my youthful arrogance: Doctors knew what they were doing long before you were even born, and what I’m recommending has worked for centuries.

———————-

“Yeah, but we know better now!” people protest. They act as if everyone used to die of every childhood disease pre-vaccine. They can’t imagine a world before pharmacies in supermarkets and on multiple street corners, before medical insurance, before medical imaging and lab tests…

I’m thankful for many of the advancements in medicine. I have benefited greatly. But I’m not thankful for big corporate medicine, or for how many of us have been turned into helpless consumers of medical services. I’m not thankful for the opioid epidemic, the over-reliance on pharmaceuticals, the obesity epidemic, etc., etc.

Oh, and the “home remedies” those doctors suggested to me back in the day? They worked wonderfully… and without side effects.

[Previously posted on Facebook]

Should I take the COVID vaccine?

Posted on Tuesday, January 19, 2021 by Rebecca

Back when I was making vaccine decisions for my children, people kept urging me, “Do the research!” Ironically, the people who tended to say this the most emphatically were usually those who did not follow their own advice, but I digress… Often these same people would also recite various pro-science slogans. While I didn’t agree with their passive approach (“I’ll just assume my doctor or the woman at CVS has already done my research for me.”) I did find their advice and slogans compelling.

And I found this video a helpful resource. It pointed me in the right direction for how to follow some of the science — and how to access information about the clinical trials and studies conducted on the COVID vaccines.

What we know and don’t know about the vaccines

Spoiler alert: thus far, I haven’t been able to find any studies that indicate the vaccine has been tested on people my age, with my co-morbidities. (In fact, it seems to have only been tested on a carefully selected group of healthy individuals between the ages of 18-55.) I prefer not to take vaccines without evidence of their safety and effectiveness. It’s that whole “follow the science” thing.

Navigating health care and “clinics” in the time of pandemic

Posted on Monday, March 23, 2020 by Rebecca

Note: since I live in the United States, this post is more applicable to our health care system.

During this difficult time, a lot of businesses are being asked or ordered to shut down, and some — understandably fearing financial ruin — are coming up with creative ways to claim they are “essential businesses”. One especially egregious tactic I recently discovered is businesses claiming to be “health clinics”.

What can we do to keep ourselves safe and avoid “health clinics” that might put us and others at risk? Even more importantly, how do we make difficult health care decisions during this time?

Here’s what I’m asking before I venture into any hospital, doctor’s office, or “health clinic”:

1. Are they a legit health care facility? If so, they will be following CDC guidelines as briefly summed up here:

Public Health Reminder
Healthcare facilities and clinicians should prioritize urgent and emergency visits and procedures now and for the coming several weeks. The following actions can preserve staff, personal protective equipment, and patient care supplies; ensure staff and patient safety; and expand available hospital capacity during the COVID-19 pandemic:
Delay all elective ambulatory provider visits
Reschedule elective and non-urgent admissions
Delay inpatient and outpatient elective surgical and procedural cases
Postpone routine dental and eyecare visits

2. Is this a life or death emergency? Would it be dangerous for me to move the injured or critically ill person? If so, I’m going to call 911.

3. Is time not of the essence? Am I unsure whether or not this warrants an ER visit? Then I’m calling the primary care physician for advice.

4. Is this ongoing treatment truly necessary? Unless told otherwise by their physician, no one should stop chemo, kidney dialysis, etc. Thankfully, neither my loved ones nor I need life-sustaining treatments at this point, nor are we fighting acute, life-threatening diseases. And the latter is exactly what we are trying to avoid.

5. If my health condition needs attention but is not an emergency or crisis, and I don’t require life-sustaining treatment, do I really need to risk myself and others by being seen in person? More and more doctors’ offices and legit health clinics are doing phone consultations or practicing telemedicine.

6. Will I be using time and resources better spent on those whose need for care is more crucial? I don’t want to be the cause of one less patient being seen or one less set of available protective gear unless I really, really need medical attention.

If the “health clinic” is legit, they won’t even want to see me for anything that is routine, elective, or non-urgent. But what if they aren’t following the CDC guidelines? I can only draw one of three conclusions:

The people running that “health clinic” are woefully ignorant and have not even bothered to educate themselves about how to best protect their patients during this crisis. In that case, I have zero confidence in their ability to meet any of my health care needs, let alone protect me from disease or harm, and will not seek out their services now or in the future.
The people running the “health clinic” are familiar with the guidelines and educated enough to comprehend why they are necessary, but are callously choosing to ignore them, not caring who their actions put at risk. Frankly I cannot imagine anyone in the health care field being so despicable.
They are actually another business entity only pretending to be a “health clinic” in order to stay open. Anyone willing to risk my community in such a deceptive way — and potentially not only my life and health but that of my loved ones — is someone I will avoid and encourage others to do the same.

Addendum, from the California Coronavirus (COVID-19) Response website:

Health care and helping sick relatives
What if I need to visit a health care provider?
If you are feeling sick with flu-like symptoms, please first call your doctor, a nurse hotline, or an urgent care center.
If you need to go to the hospital, call ahead so they can prepare for your arrival. If you need to call 911, tell the 911 operator the exact symptoms you are experiencing so the ambulance provider can prepare to treat you safely.
What about routine, elective or non-urgent medical appointments?
Non-essential medical care like eye exams, teeth cleaning, and elective procedures must/should be cancelled or rescheduled. If possible, health care visits should be done remotely.
Contact your health care provider to see what services they are providing.
May I still go out to get my prescriptions?
Yes. You may leave their homes to obtain prescriptions or get cannabis from a licensed cannabis retailer.
Can I leave home to care for my elderly parents or friends who require assistance to care for themselves? Or a friend or family member who has disabilities?
Yes. Be sure that you protect them and yourself by following social distancing guidelines such as washing hands before and after, using hand sanitizer, maintaining at least six feet of distance when possible, and coughing or sneezing into your elbow or a tissue and then washing your hands. If you have early signs of a cold, please stay away from your older loved ones.
Can I visit loved ones in the hospital, nursing home, skilled nursing facility, or other residential care facility?
Generally no. There are limited exceptions, such as if you are going to the hospital with a minor who is under 18 or someone who is developmentally disabled and needs assistance. For most other situations, the order prohibits non-necessary visitation to these kinds of facilities except at the end-of-life. This is difficult, but necessary to protect hospital staff and other patients.

Too much weekend! | Move it Monday

Posted on Monday, July 7, 2014 by Rebecca

The holiday weekend was wonderful — so wonderful, and so full of celebratory feasting, that I was reluctant to step on the scale this morning. Sure enough, some of those pesky pounds I’d worked off had returned to haunt me…or taunt me…I’m not sure which. Of course, it’s not like this came as a complete surprise; I hadn’t even made an effort to eat sensible portion sizes, nor had I bothered logging my food intake.

Back when I’d lost what was for me a substantial amount of weight, I had worked with a fitness trainer who insisted I kept track of everything that I ate. There were things I was tempted to eat, but didn’t just because I didn’t want her to tease me about them, or point out how many empty calories they contained and what it would take to work them off.

I no longer have my fitness trainer, but I do have this great app:

MyNetDiary app — the editorial comment about my weight is mine.

For more info, you can visit their website at mynetdiary.com

What I like about the app and website, besides its ease of use and the detailed and useful info it generates for me, is that it links to my Fitbit account. All in all, it’s very customizable and as comprehensive as I could ever want. Even though I don’t have diabetes, I would recommend it to those who do, because it has a special module that looks excellent.

It’s very easy to log my meals because the food database is HUGE. I can scan bar codes, search the database, or enter my own foods and recipes. I’ve tried various other food-logging apps in the past, and this is the only one I want to keep using. It also gives me the most detailed summaries of whatever nutritional data I care to track.

This was today’s lunch: