FROM VACCINATION TO MASTECTOMY

Billions of dollars have been invested in developing new drugs or even improving existing drugs to improve its efficacy and safety.

Instead of focusing on health and wellbeing, today attention appears to be centered on curing of diseases. Interestingly ancient medical practitioners such a Charaka (Indian Physician, circa 300BC), advocated healthy living rather than disease curing. Therefore it is perplexing to know why there hasn’t been much done in creating a healthy lifestyle. Instead the situation today has degenerated. 

   

Thus the introduction of vaccinations and the many drugs in the market seen more curative than attempting to establish society’s wellbeing. Within the paradigm of a knowledge based society, “fear” owing to overload of information has tuned society to seek out popular trends as a mandate to conform to a prescribed action. The bigger question is who sets motion to this trend? Does an individual’s action in a particular direction eventually snowball into a lifestyle? Or could it be instituted by a more powerful entity with access to the global communication network.

In his book, “Crazy Like Us: The Globalization of the Western Mind”, Ethan Watters said, “Cultures become vulnerable to new beliefs about the mind and madness particularly during times of social anxiety or discord.” 

So in this case the anxiety is in the form of wellbeing of society, which translates to parents’ concerns on  welfare of children’s health,  what more now with the global mobility of diseases. Parents’ concerns are almost homogeneous globally, at least in the socially networked framework. Thus the propaganda towards building a perceived state of mind is inevitable.

This, Watters describes as “psychological imperialism”, a very scary proposition indeed. However one  cannot negate its impact. This predicament in the healthcare is a phenomenon more apparent in the middle income group, a group that is trapped in their own insecurity. For the lower income group, heavy reliance on public healthcare out of sheer circumstances eases them from carrying this psychological burden of guilt. 

So what is the take on the role played by the healthcare industry? I believe it boils down to ethical governance and practices. But who is to monitor these practices? The symbiotic relationship between the healthcare practitioners and the pharmaceutical firms is something that goes back a long way. According to Kalman Applbaum in his literature, “How does the drug industry exert power? An Anthropological Perspective,” says, “pharmaceutical manufacturers like other marketing driven enterprises have realized that it is less in the product, the brand or even the patent where their fortunes lie, but in the stream , the marketing channel, you can insert any product you like into it, no matter how useless or dangerous.” Top on the list of channel members would include the physician, followed by insurance firms, government regulators and hospital managers, not necessarily in that order.

So how do parents than decide whether a particular vaccination is a need or want. I would think they would look up to healthcare professionals who are deemed to have the expertise to advice. Whether ethical advice is given or not, it would be their better judgment and is also the contentious issue that is being highlighted here.

As an example, here in Malaysia, vaccinations are classified under two categories ie. Mandatory vaccination and recommended vaccination. The dilemma for parents would be in the latter category, as such reliance on professional advice plays a crucial role. Interestingly the policy on this matter differs from country to country. This makes it even more difficult for parents to decide, and thus making  parents to become even more susceptible to deceptive advice.

In the name of preventative medicine, the mindset of the society, have been altered over time. So where does this leave us? Today a healthcare personnel has become a businessman, he she is not friend nor a relative. We are treated as a customer. How do we than respond? Well exercise your right as a consumer, the right to choice! Get second or third opinions before deciding on  treatment.

Remember healthcare is a multibillion dollar business, with extensive investments in R&D, as such these investments need to be realized. 

The latest to join this bandwagon is the report that Angelina Jolie went for a preventative mastectomy. The question is does she really need one? According to her health care specialist, Jolie has a mutated BRCA1 genes that increases her chance of developing breast or ovarian cancer. As such she agreed to undergo a double mastectomy and subsequent breast reconstruction with implants. The entire procedure was carried out purely on the basis of statistical probability, and she doesn’t have cancer to begin with to actually undergo a mastectomy. Nobody would know the intentions of her health care specialist to advise Jolie to go through this procedure to mutilate otherwise a perfectly fine part of the body, accept themselves. It looks like health care professionals have become statisticians and even actuarists rather than being  physicians. As for Jolie, I would be inclined to believe, her decision to go through this prophylactic mastectomy was driven by fear.  Fear of contracting the dreaded disease, a fear that could have been induced by her health care advisors. Or maybe it was Jolie's eccentricity that committed her into this action. Either way Jolie's celebrity status would have it's own consequential influence on many women around the world.

So has the noble profession drifted away from the philosophy of the Hippocratic Oath? Maybe not, I believe there are many more practitioners with passion and conscience, doing a great job for the wellbeing of a healthy society.