I was fortunate enough to have studied at Leeds University Dental Institute. For me, the most important lessons were in the ethics and principles of clinical practice. These foundations exist to protect the public and ensure that they can trust us to provide any necessary care.
So what in particular did I learn and what would have prevented me from being allowed to qualify and have a licence to practice?
I had to study physiology, anatomy and pathology in great detail and be continually tested on these subjects before moving on to practical surgical and technical skills. One of the key considerations I had to have in mind when making the transition from theory and applying this to practice was to understand that not all specifically diagnosed cases are the same and that the health status of a patient is never fixed. It can be ever-changing and dynamic, so a clinician needs to be reactive to this.
We were also taught about perspective when assessing a patient. I was once pulled up by the Professor in Radiology for dwelling too long on one particular area of a radiograph in my determination to reach a diagnosis. The valuable lesson was that by doing this, I risked finding artefacts and missing the bigger picture. When it comes to safety, airline pilots, sea vessel captains and motorists should know the perils of focusing too much in one area, especially in an emergency. For Covid the bigger picture includes the latest data that shows 99.9987% of the under 20s and 97.1% of the elderly survive Covid.
Examination questions were very often designed to see how well we could accommodate these variables in order to tailor-make individual treatment plans. The complete antithesis of providing safe, effective healthcare would have been to rush in and provide a blanket ‘one-size-fits-all’ treatment plan for every patient.
Not understanding and applying these principles would likely prevent you from qualifying as a dentist or a doctor.
Apart from individualising treatment and monitoring for beneficial and adverse effects, further prescribing principles focused on the following: patient safety, identifying the most vulnerable, informed consent and prescribing within the limitations of your knowledge, skill and experience.
So, in the context of Covid, how well – how correctly and ethically – have we applied these basic principles in tackling the disease?
Individualised, tailor made treatment plans – Recommended treatment (e.g. vaccination) does not appear to have accounted for the huge difference in Covid risk profile with respect to each person’s age and general health status.
Monitoring effects – Patients have not been provided with simple, recordable post-treatment assessment forms. For instance, surely it would have been simple enough to provide patient questionnaires to return on second or further booster visits to help monitor and evaluate the effectiveness and safety of an embryonic vaccination programme.
Informed consent – Patients have been denied a full range of possible treatment options through closing down any debate on focused protection as per the Great Barrington Declaration, improving lifestyle choices to fortify our immune systems naturally and blocking alternative drugs or pharmaceutical regimes that, evidence suggests, have proved so successful in India. Patients have been coerced into acceptance of a single treatment plan (i.e., vaccination) and have no choice but to be vaccinated when their freedom to access services or even employment is threatened without compliance.
Prescribing within the limitations of knowledge, skill and experience – Many issues are now coming to light with regard to the lockdown/vaccination strategy. For instance, the latest studies on how Covid vaccines affect blood clotting, heart muscle, the menstrual cycle and other sites or organ systems remote from the injection site which were, on roll-out, initially discounted.
In terms of safety, where has there been a consideration to pause or stop prescribing for the young, the fit and healthy, including athletes with extremely low Covid risk? There is no clear evidence that these asymptomatic subjects spread symptomatic disease to the vulnerable; the vaccinated elderly and vulnerable are protected from severe illness and it is virtually impossible to stop a virus from spreading in any case.
I’ll keep firing principles at you. The following are the five ‘rights’ that clinicians should aspire to achieving – the right patient, medication, dose, route and time. Lockdown and vaccination protocol has not reached out for these ‘rights’. In particular vaccination has been delivered indiscriminately and regardless of antibody status and evidence of pre-existing immunity and the dose and timing have been experimentally adjusted by mixing vaccines and shortening the booster intervals.
Finally, the pillars of medical ethics in the simplest terms:
- Autonomy – respecting the patient’s right to self determination;
- Duty to do good;
- Duty to not do bad;
- To treat all people equally and fairly.
I’ll let you consider whether those ethical pillars have been adhered to in the context of the backlog of non-Covid care (including cancer diagnosis, mental health, impact on education); the blanket medical treatment of low or near zero risk patients; the economic consequences that are eventually bound to impact mostly on the poorer in society; the blatant coercion and stigmatising of non-conforming or sceptical individuals; and the gross lack of a determination to record medically or publicise in the media adverse consequences of an experimental lockdown-and-vaccination strategy. It seems that all the above rules have been tramped on by a hypocritical political elite that parties-on whilst tired-out healthcare professionals wearily acquiesce.
It is only with Covid, it seems, that we have allowed the demolition of safe, ethical clinical practice.
Dr. Mark Shaw is a retired dentist.
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Just to do a ‘Captain Obvious’ here and point out that education, before we even include the disastrous mess that is higher ed, has changed dramatically since the decades mention above. So it seems a no-brainer to me that “education has zero causal effect on fertility” and it’s more to do with the woke ideological crapola kids are being brainwashed with these days. Kids should be attending school to get educated, not indoctrinated.
I would say that western civilisations have much more choice about having children or having a career than most poorer countries, this can be put down to a better education.
Not so much choice in places like Niger so they just do what is nessasary
They will probably never have a career to pay for a pension so children are their insurance policy for old age, the more the merrier as upto 50% of their children may not make it to adulthood.
I certainly agree with your ideological element though, just look at that self important little git Rachel Zegler!
Yes and you raise a good point which is the difference in *motivation* between cultures for having children. Women in some poor country in Africa won’t have any of the opportunities or resources of their counterparts in rich Western countries, therefore their motivation will be based more on necessity, as you say, plus cultural norms/pressure and gender stereotypes will be way more rigid. Over here, women can afford to wait and have kids later in life, have fewer kids or none at all, because they’re no longer deemed an “insurance policy”, unlike generations ago.
Let’s be honest, many in the so-called ‘rich West’ literally can’t ‘afford’ kids anyway because they’re unable to even get on the property ladder, which is the norm before putting down roots and starting a family. And people don’t typically live in multi-generational households, which is normal in other cultures, so childcare is presumably a non-issue compared with here.
Increased wealth.
More live births, lower infant/child mortality, children no longer required as a labour source for the family economy requires reduced birth rates to maintain the “stock”.
Plus sending children to school instead of to work = a cost, not a contributor to parental fortunes.
Parents work fewer hours, have more leisure time and disposable income which they prefer to spend on that rather than children.
Maybe has something to do with it?
Maybe material prosperity has led us to overthink things
I don’t think education is a primary cause of low fertility, though it may be a secondary cause. I think a primary cause of low fertility is little or no religious faith due to increasing wealth. Look at the chart of where high birth rates are found. This cause and effect are summed up by the bible phrase “you can’t worship God and mannon (money)”.
I don’t think it is education per se that makes a person rich. There are many examples that everyone knows of people who left school with few or no exams thar have become rich through hard work.
Increasing wealth includes many factors that would tend to increase birth rates such as improved nutrition and healthcare but the low birth rates in rich countries run counter to this.
Decreasing wealth does seem to encourage higher birth rates. My father’s parents in the 1930s had around 10 children but 3 or 4 died in childhood of diseases that are easily cured today. They were poor but had many children perhaps because unconsciously they knew some would die.
I agree with your point but it’s mammon not ‘mannon’.
Once upon a time, I grew up in an avenue of newly-built 1950’s semis, where at one time up to 30 of us played out in the street, offspring of married couples born before the Second World War.
Then along came “-isms,” “-ists” and “-ism-ist ism-isms,” and the old order changed – for better or for worse, for richer or for poorer, but nowadays up to half the time certainly not until death us do part.
The increased cost of housing is also a practical deterrent. Meanwhile on another forum…
https://www.louiseperry.co.uk/p/immigration-is-not-the-answer-to
“…What’s the solution to Britain’s fertility crisis? There are, broadly, three schools of thought:
One is that you can, through carefully structured incentives and social changes, encourage birth rates to rise to replacement levels.
Another is that the ageing population is, given the potential for automation, robotics and AI, actually not *that* much of an issue.
The final school of thought is that nothing can be done about the Western fertility crisis, and that the only solution is to supplement the working age-population with immigration. This, sadly, is the school which currently governs Great Britain.”
Take your pick – bad luck, the Party has already chosen for you.
No, but abortion does.
See this chart:
https://ourworldindata.org/grapher/children-born-per-woman?facet=entity&uniformYAxis=0&country=~GBR
1950 total fertility rate (TFR) of 2.22
1961 introduction of birth control pills on the NHS, TFR 2.79
1964 late post-war baby boom peak of TFR of 2.93
1967 Abortion Act, TFR 2.68
1974 introduction of birth control clinics, TFR 1.92
1977 a TFR low of 1.69
2001 a TFR low of 1.61
2010 TFR recovered to 1.92
2020 TFR dropped to 1.57 and leveling off through to 2023.
TFR seems to have stopped falling recently – perhaps it will rise again.
If fertility is reducing and climate change adaptation becomes the preferred policy then fewer people will make the social adjustments easier. We might need robot careers for the old, but even that issue will eventually reduce.
Picking one variable which happens to correlate with another from a whole variety of others which interact, is certain to lead to the wrong conclusion except by chance. See: Climageddon (Arctic disappearing, London, New York, submerged, annual droughts and scorching Summers, etc) perpetually being delayed; predicted 1970s world over-population by year 2 000.