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Follow-up: Medical Damage

Posted Sep 25 2013 12:09pm

crossedAnother fascinating – if disconcerting – study on “preventive” double mastectomy came out recently.

That procedure made big news earlier this year, you may recall, when Angelina Jolie announced that she had gone this route. And as we noted then , she’s hardly the only one. One study we mentioned found that nearly 20% of women diagnosed with early stage breast cancer who opted for mastectomy instead of lumpectomy chose to have their healthy breast removed, as well. In 3/4 of those cases, there was no medical justification.

The new study looks to the whys of this trend, which is most pronounced among women under 40. Surveying women who have taken this radical step, its author found that

90 percent of them said their most important reason for removing the healthy breast was to decrease their chances of getting cancer again, while 95 percent listed peace of mind as a key reason and 94 percent listed improving survival as a top reason.

* * *

The top reasons…were given despite the fact that women are directly informed by their doctors and surgeons that there’s no evidence in the scientific record that removing a healthy breast improves health outcomes. [emphasis added]

* * *

“I inform [patients] very plainly that this isn’t likely to improve survival, and women still want to have the breast removed,” said Dr. Marissa Howard-McNatt, a surgical oncologist at Wake Forest University Baptist Medical Center in North Carolina.

Fear. It’s that powerful.

And the actual, intentional mutilation may not be the only damage to contend with. There are also the risks of medical treatment itself, which may be far greater than some may wish to believe, as another recent study shows.

Published in BMJ Quality & Safety, this analysis of thousands of published articles on “adverse events” in hospitals found “that millions of people around the world are hurt, disabled, and sometimes even die as a result of medical errors.”

In high income countries like the US – countries in which medical care is readily available (if not exactly affordable) – there were about 14.2 adverse events per 100 hospitalizations. This amounts to 15.5 million “disability-adjusted life years” lost – more than double the number in low-income countries.

If you read this blog regularly, you probably won’t be surprised to hear that drug related injuries are the most common of the 7 types of adverse events tracked.

However, [the authors] added, there are many other types of adverse events not examined in this study—such as the use of infected needles, tainted blood products, or counterfeit drugs—that would likely raise the estimates of DALYs lost substantially.

Just the 7 kinds of events they did track make iatrogenic (medicine-caused) health problems “the 20th leading cause of morbidity and mortality for the world’s population.”

We’ll say it again: More medicine is not necessarily better medicine .

Also

Image by korafotomorgana , via Flickr


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