On Liberty and Mammograms
Interesting article from, of all places, the New York Times today regarding the “double-edged sword” of regular screening for breast and cervical cancer in women. Basically, the argument is that sometimes increased or too frequent testing can have harmful effects on women while too infrequent screenings may lead to missed indications of the onset of malignancy.
This is the point dear readers. Information is good. Ordinarily, the more information at our disposal the better. The more data we have on the pros and cons of any medical procedure or test the better.
That’s not the issue though and, not surprisingly, the NYT misses or simply ignores the point as they so often do. The relevant question is, who is the proper decision maker concerning whether women should or should not undergo a given test? The answer tothat question is, quite frankly, more important in the long run than whether more tests or less tests are the better option:
The challenge of persuading patients and doctors to accept such standards requires a transformational shift in thinking, particularly when the disease involved is as prevalent, as deadly, and as potentially curable as cancer. How do you convince them that it is in their best interest to play the odds when they have been conditioned for so long to not gamble on health? After all, for the one in 1,904 women in their 40s whose life would be saved by early detection of breast cancer, taking the risk would in retrospect seem a bad choice.
“This represents a broader understanding that the efforts to detect cancer early can be a two-edged sword,” said Dr. H. Gilbert Welch, a professor of medicine at Dartmouth who is among the pioneers of research into the negative effects of early detection. “Yes, it helps some people, but it harms others.”
Dr. Welch said this week’s recommendations could mark a turning point in public acceptance of that notion. “Now we’re trying to negotiate that balance,” he said. “There’s no right answer, but I can tell you that the right answer is not always to start earlier, look harder and look more frequently.”
That concept is proving easier to swallow in the halls of Dartmouth Medical School than in the halls of Congress. Coming as they did at the height of debate over a sweeping health care overhaul, the recommendations have provided fresh ammunition for those who warn that greater government involvement in medical decision-making would lead to rationing of health care. It has not mattered that the breast cancer screening recommendation is only advisory, and that the federal government, the American Cancer Society, and numerous private insurers have said they will not adopt it.
Of course it doesn’t matter. Just because the NYT is confident that the Government won’t ration care doesn’t mean they won’t. In fact, based on the NYT track record in predicting what Government will or will not do, you’ve got pretty damn good odds betting against them on any given issue.
Why does anyone need the Government to advise on this issue anyway? Rapid dissemination of information isn’t an issue anymore and hasn’t been for half a century. If Dartmouth Medical School, the American College of Obstetricians and Gynecologists or anyone else has data or research they think is important let them publish it and subject to review. This is the way it’s been done since time immemorial.
The problem arises when Government, who always has an agenda, gets involved and starts issuing “advisories” from on high. Who cares if the task force’s recommendations aren’t binding now? The fact that a Government agency took a position on this issue is enough to make any rational person stop and ask why. And when no less an authority than the American Cancer Society comes back and says the Government is backing the wrong horse, it makes it even less likely that the Government made the right decision.
For a decade now we’ve gone through this charade with the “global warming” idiots who have been proven unequivocally wrong after several phony IPCC studies were debunked in their entirety. The Obama administration, through the Preventive Services Task Force, has now picked a side in a debate over when women should have mammograms performed before anyone has had a chance to put one sides analysis through the proper peer review ringer. Couple that with the fact that Government run health care will lead to rationing and Kay Bailey Hutchinson is right:
One life out of 1,904 to be saved,” Ms. Hutchison said, “but the choice is not going to be yours. It’s going to be someone else that has never met you, that does not know family history.” She added, “This is not the American way of looking at our health care coverage.”
If the Obama administration was ever serious about returning science to its rightful place, they should immediately retract the task force’s recommendations and let science, real science, hammer this out the way it was meant to be. Put your findings out there for the world and let science have at it.
Otherwise we may just find out that, like there’s no such thing as anthropogenic global warming, Dartmouth and the Federal Government were wrong.