"Try not to kill anyone"
I love this story in Burt Prelutsky's Townhall column today of the above title. We can all agree that our public health authorities, as well as our personal doctors, should avoid harming us with their interventions "on our behalf." But that really is setting the bar too low, isn't it?
I'm reminded of the furor a decade ago when the first studies began appearing examining whether reduced-salt diets actually delivered the improved health outcomes long forecast based on blood pressure models. They didn't. The first study, in fact, in 1995, found in a New York City medical practice, that diagnosed hypertensive patients who consumed low-salt diets actually had a 430% greater incidence of a heart attack than those on regular levels of salt intake. Of course the study had flaws, but it was what it was; and what it was was a wake-up call for The Establishment to re-examine its advocacy of reducing dietary sodium/salt. The National Heart, Lung and Blood Institute leaped into action, commissioning both internal and external research on the subject and produced consistent results: their research, they proclaimed, demonstrated that there was no elevated risk of reducing dietary sodium. Unstated, their research also clearly showed that there was no benefit of the reduced-salt diets. No matter. Their advocacy persisted, despite subsequent studies showing risk in the U.S. and Scottish populations. Still, today, one hears low-salt advocates claiming that while not everyone could conceivably benefit by reducing dietary salt, "at least no one could be harmed." We are unpersuaded and have called for a controlled trial of the health outcomes of low-salt diets, but, in the meantime, shouldn't we be a bit more concerned about the lack of efficacy? As Prelutsky says:
The first principle of the Hippocratic Oath, which all physicians are sworn to abide by, is: Do no harm. I don't want to be regarded as a nitpicker, but, as standards go, I'd say that's a pretty measly one.
Do no harm?! For crying out loud, Boy Scouts at least have to be prepared. Soldiers are expected to be all they can be, and while I think we'd all agree that's pretty vague as to specifics, the basic tone suggests that courage and self-sacrifice could well be part of the job description.
And although I don't know it for a fact, logic would dictate that being a member of the 4-H Club would at the very least require feeding the chickens, slopping the pigs, and washing one's hands before sitting down at the breakfast table.
I mean, what if something that inconsequential was the first principle of other occupations? What if accountants had to be admonished not to round off numbers to the nearest zero, and bus drivers were told to really knuckle down and not run into any lampposts? How would you like it if chefs graduating from culinary academies were handed their diplomas, their puffy white caps, and a friendly piece of advice from the dean along the lines of "Remember, arsenic is not a condiment"?
How about barbers? Would it put your mind to rest if you discovered that the first principle in their handbook was a reminder that they're not matadors, and it's not recommended that they take home a bagful of ears at the end of the day?
This is not to say that we should all stand around and ridicule physicians simply because the Mafia apparently has slightly higher expectations of its members than the AMA has. While we can all agree that the doctors' motto leaves something to be desired, things could be a lot worse. Take criminal defense attorneys. Please, as Henny Youngman used to say.
