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Ten commandments for the rational use of vaccines. November 2015

1 Nov

Vaccines are a treasure that is not defended and it is improved by simply repeating that mantra. The vaccine treasure requires good use and a continuous critical evaluation, in relation to developing and maintaining the vaccination schedules. Vaccination policies have been very poor in the recent decades, in the scientific, professional and political areas. This has arose “vaccine hesitancy” in the population and in some extreme cases, rejection as a whole. The medical students integrated into Farmacríticx and IFMSA-Spain and healthcare providers members of NoGracias are developing a project that promotes the best use of vaccines, and they have develop the decalogue commandments to promote the rational use of vaccines

Social egg freezing (oocyte banking for anticipated gamete exhaustion). Ethical, practical and social problems

18 Sep

This text has two objectives: 1/to draw attention to an important issue in women’s health; and 2/to help train health professionals by providing evidence-based information about and criteria for what is called “social egg freezing.” Why don’t we extract eggs or ovarian tissue from women who are still young and then freeze and store them until they are needed at a later age? At first glance, this may seem to be a kind of preventive measure, one that could achieve “better health of the embryo”, that “buys time” and allows “breathing”, since freezing offers a de facto stopping of the clock. Regression and atresia of eggs are avoided, since frozen eggs remain as they were when initially removed many years earlier.

Unfortunately, however, only the eggs or ovarian tissue fragments remain the same: real time passes for the woman herself, her own body ages, so that if she becomes pregnant at a much later time, more complications are expected in pregnancy, childbirth and the postpartum period. Freezing eggs and ovarian tissue fragments for use in reproduction for social causes raises serious ethical, practical and social issues that require reflection to prevent “normalization” and trivialization and to ensure there is no medical violence against women.

  • Social egg freezing (oocyte banking for anticipated gamete exhaustion). Ethical, practical and social problems. Juan Gérvas and Mercedes Perez-Fernandez. Madrid (Spain) September 2015. Download whole document here.

Overdiagnosis as an extreme form of length-time bias. Breast cancer screening as an example

14 Oct

Overdiagnosis is an error of prognosis. Overdiagnosis is not an error of diagnosis. Overdiagnosis is a “true positive” diagnosis. We cannot distinguish between overdiagnosis cancer and non-overdiagnosis cancer. In this presentation the focus is on the vision of overdiagnosis as extreme form of length-time bias, and the research lines which might help in the future to resolve the problem. Please, download the presentation because it is a dynamic one.

  • Overdiagnosis as an extreme form of length-time bias. Breast cancer screening as an example.  Gérvas J. Madrid (Spain). October 2014. Download presentation here.

See more in:
The overdiagnosis of cancer: when the diagnosis undermines the quality of life. http://pharmawatchcanada.wordpress.com/2014/01/10/the-overdiagnosis-of-cancer/

“Dr Cholesterol” against the “British Medical Journal”. Do not measure your cholesterol, be happy

26 May

The British Medical Journal has had problems with two papers about primary prevention of coronary artery disease (heart disease). Both papers have data that demonstrate statins have no use in primary prevention for most patients. The British Medical Journal problems relate to power, money and censorship. In this text a teacher explain the situation to her students.

  • “Dr Cholesterol” against the “British Medical Journal”. Do not measure your cholesterol, be happy. Gérvas J. August, 2014. Download document here. Download whole document here.

Organization of Spanish Consumers against “medicalization of daily life”

8 May

Last 25th March, OCU joined and signed “Action on Selling Sickness” during a public action in a press conference. The Organization of Spanish Consumers is a private and independent one.

OCU has translated into Spanish the document, and have started a campaign againts “medicalization of daily life” http://www.ocu.org/salud/medicamentos/informe/demasiados-medicamentos/stampa

Notice the Spanish impact in the call for action” after the OCU action http://sellingsickness.com/final-statement/

The OCU organization was created in 1975; is a non-profit organizationto defend the rights of consumers.

The OCU is not subsidized, but is financed by contributions from its members, currently over 315,000 members. -OCU belongs to “Consumer International” http://www.consumersinternational.org/our-members/member-directory/OCU%20-%20Organisation%20of%20Consumers%20and%20Users%20-%20Organizaci%C3%B3n%20de%20Consumidores%20y%20Usuarios

It is important that consumers associations joint health professionals and health intitutions. See its 3 recommendations for being aware about medicalization and selling sickness. Summary, be aware when:

  1. Speak only of great benefit without mention the risks or alternatives, where they exist (although they have nothing to do with taking pills).
  2. Exaggerate the dangers of a health problem or even a risk factor to the point of generating large dose of insecurity and alarm.
  3. Behind campaign, web, advertisement or any other form of communication that seeks to “inform” about a disease or health problem, is a company that can thereby obtain a direct economic benefit.

Sacred secrets broken. Threats to the confidentiality of medical records. The case of Osabide, the centralized data base of Osakidetza (Basque Health Service) in Spain

25 Mar

The Basque Health Service, Osakidetza, established in 2003 a centralized data base, Osabide, with two millions medical records in full without asking permission or even notifying patients or the public (in some cases against the written opposition of a few patients who knew about the initiative). Two general practitioners who rejected Osabide and prepared a piece of paper to inform patients in the waiting room were punished with a penalty of two years without work and salary (later on a jury order to repair all rights). This is a letter about the case.

  • Sacred secrets broken. Threats to the confidentiality of medical records. The case of Osabide, the centralized data base of Osakidetza (Basque Health Service) in Spain. Gérvas J. 2003. Download whole article here.

Link to first publication http://docpatient.net/ethics/pdf/Sacredsecretsbroken2003.pdf

Too much medicine. Less is more

13 Feb

Too much of a good thing is bad. Too much of good thing may not be wonderful. You can have too much of a good thing as food and alcohol and the excess of either can make you fat or drunk. In medicine, in general, the motto should be “maximum quality, minimum quantity”. Because more medical interventions, different patients-population expectations and the technology advances, medical activities are becoming dangerous. In this presentation we give a few examples and suggest some solutions.

  • Too much medicine. Less is more. Gérvas, J., Pérez Fernández, M. Vasco da Gama Movement Forum. Barcelona 7-8 Feb 2014. Download presentation or simple text.