How can it be that the very people we were aiming to protect from COVID-19 became victims of our policies, swapping the risks of a respiratory infection for the realities of a miserable, isolated existence?
by George Santayana The Declaration of Geneva of the World Medical Association binds the physician with the words, “The health of my patient will be my first consideration,” and the International Code of Medical Ethics declares that, “A physician shall act in the patient’s best interest when providing medical care.”From the General Principles in the Declaration of Helsinki. Let me start with a couple of confessions. My first confession is that I work in the pharmaceutical industry and have done so for far more years than I’d like to admit (a Big Pharma Shill as one BTL commentator so kindly put it!). My second confession is that I’m a big fan of vaccination. I believe that clean water, vaccinations, and antibiotics are the three greatest medical innovations and together have probably saved more lives than all other medicines put together. But that said, I’m a supporter of vaccinations in the same way that I’m a proponent of any medical treatment… when it is the right treatment for the right person at the right time. So, with those confessions off my chest, you can see that when I say that I believe that the proposed vaccination of healthy 12-15 year-olds against COVID-19 is morally, clinically and ethically wrong I am doing so from the perspective of a boringly mainstream industrial scientist...
by George Santayana *Spoiler alert*: There is a moment in one of the Mad Max films where Max and his band of tagalongs have successfully escaped from their pursuers and are striking out through the post-apocalyptic Outback in search of The Safe Place, a haven of security where they hope to live out their lives in peace. After much struggle, they crest the top of an enormous dune only to see an endless desert stretching out beyond the horizon. It is as this point that the true nature of their predicament becomes clear; do they continue on alone into the unending sea of sand in what may be the forlorn hope of reaching The Safe Place, or do they stay where they are until their pursuers inevitably catch up with them, or do they turn around and head back into danger but to somewhere where they know there is water and shelter? In many ways, this is an apt metaphor for the situation Australia and New Zealand now find themselves in with respect to Covid. Having apparently successfully escaped from the pandemic, what should they do now? Do they plough on in the hope of reaching some kind of Safe Place, which may or may not exist, or do they instead attempt to re-join the rest of the world? A...
by George Santayana Informed consent is one of the cornerstones of modern medicine and the foundation of the patient/doctor relationship. The principle of informed consent is a core part of the Nuremberg Code on human research ethics and states that consent for any medical treatment must come from the patient themselves who needs to understand both the benefits and risks. Likewise, the opposite, which we might call “informed refusal”, is just as important and a patient can refuse treatment or withdraw consent at any time. The “informed’ part of informed consent can occur in a number of ways such as provision of written materials (the piece of paper you throw away when you open a packet of headache tablets) or a discussion with your doctor. Regardless, the information given to a patient needs to be accurate, balanced and cover both the benefits and risks. Consent must also be given freely and without undue influence or coercion. Of course, a clinician can express their opinion and offer advice as to what course of action a patient might take, but ultimately the decision to proceed (swallow the pill, take the test, have the operation) resides with the patient. Informed consent places the individual patient at the heart of clinical practice and given that they are the person receiving the treatment and taking any associated risks that intrinsically feels like the right thing. And so it used to be for vaccinations, where it was up to the individual whether they wished to have a specific vaccination or not. Yes, there...
