Death by Modern Medicine

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"Death by Medicine" is a paper on medical iatrogenesis--44 pages in length. The definition of iatrogenic is "a symptom or illness brought on unintentionally by something that a doctor does or says." Much like conventional medicine itself, my dictionary is in denial about iatrogenic deaths. Iatrogenesis is not just about symptoms or illness--incredibly, I found that in the U.S. there are 783,936 deaths annually due to medicine's effects.

I WROTE "DEATH BY MEDICINE" IN LATE FALL 2003 WHILE MY mother was dying of acute leukemia. She was 82 and sharp as a tack and lively to boot, just a few months before she was diagnosed. It's a rare disease in the elderly but while I was reading hundreds of studies on drug side effects, I was confronted with the fact that the two medications she was taking--one for high blood pressure and one for cholesterol--were both found to cause acute leukemia.

In 1998 a Canadian team of researchers, led by a friend, Dr. Bruce Pomeranz, found that 106,000 people die annually in the U.S. from properly prescribed medications. No "mistakes" were made here--these drugs were the right amounts, given to the right people, at the right time--and still ended up killing 106,000.

In "Death by Medicine" I went beyond "adverse drug reactions," adding up the death toll for medical errors, surgical errors, outpatient adverse drug reactions, drug-resistant hospital infections, unnecessary medical and surgical procedures, malnutrition and bedsores in hospitals and nursing homes.

The statistics that I did not add include deaths due to:

• X-ray exposures: mammography, fluoroscopy, CT scans

• Overuse of antibiotics in all conditions Drugs that are carcinogenic: hormone replacement therapy, immunosuppressive drugs and prescription drugs

• Cancer chemotherapy

• Unnecessary surgery: Caesarean section, radical mastectomy, preventive mastectomy, radical hysterectomy, prostatectomy, cholecystectomies, cosmetic surgery, arthroscopy, etc.

• Medical procedures and therapies

• Discredited, unnecessary and unproven medical procedures and therapies

• Missed diagnoses.

Another important area not included in "Death by Medicine" are deaths due to "something a doctor says." Because I am a naturopath as well as a medical doctor, I realize that many deaths are caused by doctors giving their patients bad advice. Every patient I have ever seen has told me s/he was given some combination of the following advice by a "trusted" doctor:

• Vitamins are not necessary and you get all you need from your diet

• Chinese medicine won't help you

• Acupuncture is worthless

• Don't waste your money on vitamins

• It's perfectly OK to eat sugar, aspartame, fast food, coffee

• Doctors who tell you to take high doses of vitamin C are quacks.

By not keeping up with the current knowledge of therapeutic nutrients, doctors are ensuring that their patients do not get proper care and they are treating nutrient-deficient conditions with harmful drugs. A PubMed search of 50 known nutrients finds almost half a million studies on these nutrients. A very brief overview of the existing literature on nutrient therapy finds the following:

• Homocysteine disease can be treated with B6, B12, folic acid and magnesium

• Niacin treats high cholesterol

• Vitamin E treats heart disease

• Vitamin C treats infectious diseases and prevents cancer

• Niacinamide treats some forms of arthritis

• Antioxidants, in general, delay the onset and severity of Alzheimer's disease

• Antioxidants, in general, prevent some forms of cancer

• Magnesium prevents heart disease and 22 other conditions

• St.-John's-wort is a treatment for mild to moderate depression

• Red clover and black cohosh treat menopausal symptoms

• Echinacea, garlic and astragalus are used to boost the immune system.

Because they are not keeping up with nutrient research, many conventional doctors are rapidly losing the trust that they once had. Since they have become entrenched in drug-based medicine, bonded with their pharmaceutical reps, and are receiving consideration From drug companies to prescribe their products, many doctors are losing an adoring public. A 2004 survey of complementary alternative medicine found that 25 percent of people who use CAM do so because they no longer trust conventional medicine.

I was shocked by many things while researching and writing this paper. Shocked that no one had ever done this compilation of statistics before; shocked at the incredible number of lives cut short; shocked that nothing was being done to stop this insanity; shocked that only 5-20 percent of iatrogenic incidents ever see the light of day. That's right! I couldn't believe my eyes when I first found that statistic. However, another four journal articles confirmed it, making the 750,000 death rate pale when you think it could be doubled or tripled!

In 1994, Dr. Lucien Leape produced a major report, focusing on medical error alone. He equated his findings of 180,000 deaths annually to three jumbo jet crashes every two days. "Death by Medicine" shows that six jumbo jets are falling out of the sky each and every day--and no one seems to notice. What contributes to this denial? Unlike a jumbo jet crash, which gets instant media coverage, hospital errors are spread out over the country in thousands of different locations. This makes it more likely that they are perceived as isolated and unusual events. However, the most important reason that medical error is unrecognized and growing, according to Leape, is that doctors and nurses are unequipped to deal with human error due to the culture of medical training and practice.

Doctors are taught that mistakes are unacceptable, medical mistakes are therefore viewed as a Failure of character and any error equals negligence. We can see how a great deal of sweeping under the rug takes place since nobody is taught what to do when medical error does occur. Leape said the "infallibility model" of medicine leads to intellectual dishonesty with a need to cover up mistakes rather than admit them. There are no Grand Rounds on medical errors, no sharing of failures among doctors and no one to support them, emotionally, when their error harms a patient.

TO MOST PEOPLE WHO READ "DEAD BY Medicine," these excuses are just that--excuses. What can we do about it? I even tackled this question when I reported on a survey about preventing medical errors (see sidebar).

Whether any of these measures are being implemented is unknown; whether anything will ever be done to decrease the rate of iatrogenesis is also unknown. A recent report From Pennsylvania makes me wonder if there will ever be a change from within the system. On July 8, 2004 the Philadelphia Daily News published a report of a lawsuit filed by a prominent psychiatrist, Dr. Stefan Kruszewski. He had been hired by the state's Department of Public Welfare to "root out Fraud, abuse and waste" within the department. Apparently he found out too much, uncovering several fatalities due to lethal combinations of medications; use of unprescribed, dangerous and unnecessary drugs; use of bizarre combinations of drugs; overmedicating of patients in government Facilities: illegally committing of people and putting them on drugs. Dr. Kruszewski told his supervisor that "These medications are killing people; something's wrong here." That's when Dr. Kruszewski, a 53-year-old Harvard Medical School graduate, was fired.

Fortunately, the good doctor has enough chutzpah to File suit against the state, the only way this information will come to light. You can see how difficult it will be to "root out fraud, abuse and waste" when the very people who hire you to do so--can just as easily fire you. Countless doctors have lost their medical licenses for much less. Doctors who prescribe nutrients and do not follow the "standard practice of medicine," which means they don't prescribe as many drugs or recommend as much surgery, regularly have their licenses revoked. They are usually turned in by jealous or disgruntled conventional doctors or even drug reps who abuse pharmacists' data bases and alert state medical boards if a doctor falls below the "standard" number of drug prescriptions for his or her city. It's a wonder that alternative medicine is practiced at all because an investigation by the state licensing board usually results in loss of license--unless you have a few million tucked away to pay for your defense.

That leaves you, the health consumer, as the only person outside the system who can possibly turn the tide on medical iatrogenesis. You can do that simply by continuing to be a health consumer and by encouraging more people to follow your lead. If medicine has become all about making money, the power of the purse still speaks loud and clear. Keep buying organic food, supplements and health books; keep visiting alternative health practitioners and keep attending natural health seminars.

It all adds up and lets the "bean counters" know that more and more Americans are turning away from drug-based medicine. That's the message conventional medicine and the pharmaceutical industry needs to hear. Once they realize their profits are dropping and they are losing customers, we might see a change in the way medicine is practiced. Of course, we also have to be wary of the takeover of nutrients by pharmaceutical companies that will try to patent synthetic supplements--making them into drugs with side effects. Also, be aware of the Codex Alimentarus, the World Trade Organization's attempt to "harmonize" us out of being able to get nutrients over the counter but available only by prescriptions. But that's another story!

~~~~~~~~

By Carolyn Dean, M.D., N.D.

Carolyn Dean is a medical doctor and a naturopathic doctor, graduating from Dalhousie Medical School in Nova Scotia and the Ontario Naturopathic College. She serves on the board of the Canadian College of Naturopathic Medicine in Toronto. Dr. Dean began practicing integrative medicine almost 25 years ago, long before the term was invented. She's also a writer, researcher and an outspoken advocate of natural healing options and choices. Her widely acclaimed paper, "Death by Medicine," released December 2003, revealed that nearly 784,000 people die annually due to medical interventions. Click "contact" at www.carolyndean.com and find a link to "Death by Medicine."

Untitled.

By telephone, 1,207 adults were asked to indicate how effective they thought the following would be in reducing preventable medical errors that resulted in serious harm:

• Giving doctors more time to spend with patients: very effective 78 percent

• Requiring hospitals to develop systems to avoid medical errors: very effective 74 percent

• Better training of health professionals: very effective 73 percent

• Using only doctors specially trained in intensive care medicine on intensive care units: very effective 73 percent

• Requiring hospitals to report all serious medical errors to a state agency: very effective 71 percent

• Increasing the number of hospital nurses: very effective 69 percent

• Reducing the work hours of doctors-in-training to avoid fatigue: very effective 66 percent

• Encouraging hospitals to voluntarily report serious medical errors to a state agency: very effective 62 percent.

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