[Marxism] Death from Iatrogenic causes

[sabocat59@xxxxxxx]

http://www.alternative-doctor.com/specials/Dr_%20Barbara_Starfield.htm

Biogenic Medicine

Death from Iatrogenic Causes

Dr. Barbara Starfield    

Journal of the American Medical Association (JAMA) 

Dr. Barbara Starfield of the Johns Hopkins School of Hygiene and Public Health 
describes how the US health care system may contribute to poor health.   ALL 
THESE ARE DEATHS PER YEAR: 12,000 -----unnecessary surgery (8) 7,000 
-----medication errors in hospitals (9) 20,000 -----other errors in hospitals 
(10) 80,000 -----infections in hospitals (10) 106,000 ----non-error, negative 
effects of drugs (2) 

These total to 250,000 deaths per year from iatrogenic causes!! What does the 
word "iatrogenic" mean? This term is defined as induced in a patient by a 
physician's activity, manner, or therapy. Used especially of a complication of 
treatment. Dr. Starfield offers several warnings in interpreting these numbers: 
First, most of the data are derived from studies in hospitalized patients. 
Second, these estimates are for deaths only and do not include negative effects 
that are associated with disability or discomfort. Third, the estimates of 
death due to error are lower than those in the IOM report.   [Remember, only 
60,000 Americans lost their life in the entire Vietnam war!- KSM](1) If the 
higher estimates are used, the deaths due to iatrogenic causes would range from 
230,000 to 284,000. In any case, 225,000 deaths per year constitutes the third 
leading cause of death in the United States, after deaths from heart disease 
and cancer. 

Even if these figures are overestimated, there is a wide margin between these 
numbers of deaths and the next leading cause of death (cerebrovascular 
disease). Another analysis (11) concluded that between 4% and 18% of 
consecutive patients experience negative effects in outpatient settings, with: 
116 million extra physician visits 77 million extra prescriptions 17 million 
emergency department visits 8 million hospitalizations 3 million long-term 
admissions 199,000 additional deaths $77 billion in extra costs The high cost 
of the health care system is considered to be a deficit, but seems to be 
tolerated under the assumption that better health results from more expensive 
care. However, evidence from a few studies indicates that as many as 20% to 30% 
of patients receive inappropriate care. An estimated 44,000 to 98,000 among 
them die each year as a result of medical errors. (2) This might be tolerated 
if it resulted in better health, but does it? Of 13 countries in a recent 
comparison, the United States ranks an average of 12th (second from the bottom) 
for 16 available health indicators. More specifically, the ranking of the US on 
several indicators was: 13th (last) for low-birth-weight percentages 13th for 
neonatal mortality and infant mortality overall 14 11th for post neonatal 
mortality 13th for years of potential life lost (excluding external causes) 
11th for life expectancy at 1 year for females, 12th for males 10th for life 
expectancy at 15 years for females, 12th for males 10th for life expectancy at 
40 years for females, 9th for males 7th for life expectancy at 65 years for 
females, 7th for males 3rd for life expectancy at 80 years for females, 3rd for 
males 10th for age-adjusted mortality The poor performance of the US was 
recently confirmed by a World Health Organization study, which used different 
data and ranked the United States as 15th among 25 industrialized countries. 
There is a perception that the American public "behaves badly" by smoking, 
drinking, and perpetrating violence." However the data does not support this 
assertion. The proportion of females who smoke ranges from 14% in Japan to 41% 
in Denmark; in the United States, it is 24% (fifth best). For males, the range 
is from 26% in Sweden to 61% in Japan; it is 28% in the United States (third 
best). The US ranks fifth best for alcoholic beverage consumption. The US has 
relatively low consumption of animal fats (fifth lowest in men aged 55-64 years 
in 20 industrialized countries) and the third lowest mean cholesterol 
concentrations among men aged 50 to 70 years among 13 industrialized countries. 
These estimates of death due to error are lower than those in a recent 
Institutes of Medicine report (and as said if higher estimates are used, deaths 
due to iatrogenic causes would range from 230,000 to 284,000). Even at the 
lower estimate of 225,000 deaths per year, this constitutes the third leading 
cause of death in the US, following heart disease and cancer. Lack of 
technology is certainly not a contributing factor to the US's low ranking. 
Among 29 countries, the United States is second only to Japan in the 
availability of magnetic resonance imaging units and computed tomography 
scanners per million population. Japan, however, ranks highest on health, 
whereas the US ranks among the lowest. It is possible that the high use of 
technology in Japan is limited to diagnostic technology not matched by high 
rates of treatment, whereas in the US, high use of diagnostic technology may be 
linked to more treatment. Supporting this possibility are data showing that the 
number of employees per bed (full-time equivalents) in the United States is 
highest among the countries ranked, whereas they are very low in Japan, far 
lower than can be accounted for by the common practice of having family members 
rather than hospital staff provide the amenities of hospital care. Journal 
American Medical Association, (Vol. 284), July 26, 2000 COMMENT: Folks, this is 
what they call a "Landmark Article". Only several ones like this are published 
every year. One of the major reasons it is so huge is that it is published in 
JAMA which is the largest and one of the most respected medical journals in the 
entire world. I did find it most curious that the best wire service in the 
world, Reuter's, did not pick up this article. I have no idea why they let it 
slip by. I would encourage you to bookmark this article and review it several 
times so you can use the statistics to counter the arguments of your friends 
and relatives who are so enthralled with the traditional medical paradigm. 
These statistics prove very clearly that the system is just not working. It is 
broken and is in desperate need of repair. I was previously fond of saying that 
drugs are the fourth leading cause of death in this country. However, this 
article makes it quite clear that the more powerful number is that doctors are 
the third leading cause of death in this country killing nearly a quarter 
million people a year. The only more common causes are cancer and heart 
disease. This statistic is likely to be seriously underestimated as much of the 
coding only describes the cause of organ failure and does not address 
iatrogenic causes at all. Japan seems to have benefited from recognizing that 
technology is wonderful, but just because you diagnose something with it, one 
should not be committed to undergoing treatment in the traditional paradigm. 
Their health statistics reflect this aspect of their philosophy as much of 
their treatment is not treatment at all, but loving care rendered in the home. 
Care, not treatment, is the answer. Drugs, surgery and hospitals are rarely the 
answer to chronic health problems. Facilitating the God-given healing capacity 
that all of us have is the key. Improving the diet, exercise, and lifestyle are 
basic. Effective interventions for the underlying emotional and spiritual 
wounding behind most chronic illness are also important clues to aximizing 
health and reducing disease.  Related Articles:  Medical Mistakes Kill 100,000 
per yearUS Health Care System Most Expensive in the WorldAuthor/Article 
Information Author Affiliation: Department of Health Policy and Management, 
Johns Hopkins School of Hygiene and Public Health, Baltimore, Md. Corresponding 
Author and Reprints: Barbara Starfield, MD, MPH, Department of Health Policy 
and Management, Johns Hopkins School of Hygiene and Public Health, 624 N 
Broadway, Room 452, Baltimore, MD 21205-1996 (e-mail: bstarfie@xxxxxxxxx). 
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