Wednesday 4 August 2021

Any medical intervention that has an effect but does not work - is harmful

Any medical intervention that has an effect but does not work - is harmful. 

This is something I understood many years ago, during my medical training, I don't don't think it has ever failed to be correct. 

Some medical interventions (aka. 'treatments')  don't seem to have any effect at all - and these are not necessarily harmful. 

But when a treatment does have an effect: that is, when a treatment affects the body's functioning - its physiology or biochemistry, for example; then it will be doing harm, unless that harm is outweighed by good. 

With any effective treatment, the question should always be about the balance of overall harm versus overall good in a particular person - or in a population.  

There are an 'infinite' number of ways of harming and killing the human body - but only a few ways of helping it. (Just as there are an 'infinite' number of ways of breaking an engine; but only some, few, specific ways of repairing it.) 

Therefore, most effective medical interventions that are intended to be treatments will actually harm. 

So, if an effective treatment does not work, does not provide overall benefit; then it will be harmful. It will merely disrupt physiology/ biochemistry - and thus body functioning. 

It is on these grounds that we can know that masking and pecking (which cannot be shown to provide significant objective benefit) are actually physically net-harmful. 

The legitimate question should not be 'whether these are harmful?' but how harmful are they? A little harmful, a lot harmful - or something in-between. 

Thus it is not appropriate to continue using medical interventions that have an effect but do no good, while supposedly gathering 'evidence' to discover 'if' they are harmful - because we already know they are harmful. 

The same in terms of psychology. Masking and social-distancing have an obvious effect on people's feelings and behaviours; but they do not work at preventing the spread of viral pneumonias. Therefore, they are harmful - overall, necessarily. 

We did not need (should not wait-upon) 'research' to 'prove' this harm; which means that 'research' itself is harmful - merely an excuse for continuing interventions, and an opportunity to mislead.

But there is a considerable difference between benefit-harm balance in populations and in individuals - and it is not necessarily or usually legitimate to generalize between individuals or between populations. 

These are deep waters; but the difference between personal and public is the basis for the old principle that treatment requires at least consent of the patient - since he is the one best able to appreciate harms to him-self. 

And also, it is behind the principle that medicine works best when it is the patient who initiates the consultation - who brings a 'complaint' to the doctor in hope that it can be alleviated. For example, a patient has a pain and seeks relief. 

Now of course, the situation can be and is manipulated by propaganda, advertising and other forms of psychological influence - patients can be made to want and ask for intervention when their complaint does not warrant it and they would not otherwise have sought help. 

And there is the potential confusion of the placebo effect that may occur with some kinds of complaint (although not all) - whereby a patient attributes improvement to an ineffective treatment. 

But when the 'public health' or 'preventive' imperatives become dominant - then the potential for harming individuals becomes almost unlimited

An intervention may be implemented for public/ social/ political reasons that (sooner or later) will harm every patient (or a large majority) - may be enforced. The patient then suffers all 'side-effects' and no benefit at all. 

Because, unwanted 'side effects' and harms from the individual patient's perspective may actually be wanted, core-effects from the point of view of those who are imposing the interventions - especially when those who speak for 'public health' have evil motivations or serve those with evil motivations - as now. 

When 'public health' trumps' personal well-being'; when mass interventions are initiated on healthy/ non-complaining patients for their supposed population benefit or for preventive reasons; then there is no limit to how much the health of individuals can be harmed.  


Side effects

The term 'side effects' is nearly always misleading. Drugs and other interventions just have effects - some are wanted, others unwanted. Some 'treatment' effects are wanted by the patient; but other drug effects are wanted by the world government, Big Pharma, or health service managers - and these are usually un-wanted by the patients. This is why they get termed 'side effect's and minimized or denied.

Personal or population benefit

Some drugs have near zero benefit at the population level - depending on the population being studied; but a considerable effect on individuals - some of whom benefit and others of whom are harmed. This is due to the individual differences in the physiology of individuals (physiological variation) and by the fact that large and/or poorly controlled therapeutic trials (eg randomized trials) recruit subjects with a range of pathologies - some of which are helped by, and others worsened-by, the intervention. 

An example is the SSRI/ Prozac group of so-called 'antidepressant' drugs. These do not help - therefore they harm - in-patient hospitalized depressed patients (approximately 'endogenous' depression or melancholia) - which means they do overall harm in this group. 

They have approximately zero average effect on out-patient depressives; who have a range of 'neurotic' disorders with nervous symptoms of mood swings, anxiety, depression, phobia, obsessive symptoms etc - which means that they do net-harm in this group. 

However, the average effect includes a wide range of responses - some strongly positive, and others strongly negative (including the increased rate of suicides). Therefore, SSRIs do have significant beneficial effects overall on the target symptoms in some individuals within the 'out-patient depressive' group - and these individuals will experience net-benefit. Yet, the benefits in some patients with some problems are equaled (or, nowadays strongly outweighed due to gross over-prescription) in sub-groups with other core problems, or who do not respond to the wanted effect.  

Thus the same drug may do overall good, overall harm, or on average nothing - according to the make-up of the group being studied. This is an artefact of averaging a variety of individually different responses. 

And, as always, the actual individual receiving an intervention ought to take priority over the averaged effect in group studies - when the group is usually very heterogeneous (because researchers strive for large numbers of subjects - for statistical reasons; rather than maximal-control - for scientific reasons), and may be irrelevant to that individual.

Plus - and over-riding all the above - medical research has been for two or three decades almost wholly dishonest; and cannot be trusted for that reason! In the end - medicine ought to be about the individual except where public health considerations are so clear as to be obvious to common sense, or knowledge from research done in less-corrupt places and eras than here and now.

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