Vital Choices:
Life, Death & the Health Care Crisis

by William Molloy,
ISBN: 0140173730

Magic or Medicine?

by Sabbagh, R. Buckman, Buckman,
ISBN: 1550132954

Safety Last

by Regush,
ISBN: 1550134620

Post Your Opinion
Keeping Our Health
by Ellen Roseman

FOR ANYONE who still thinks that modern medicine can cure all ills, these books help provide an antidote. Attacking the shortcomings of the medical model from different angles, they explain why people are flocking to alternative therapies.

Magic or Medicine? looks at heating as an art as well as a science. Every interaction between a patient and a healer involves a treatment (a Pitt, herb, operation, or manipulation) and an element of magic (hope, empathy, acceptance). While going to the doctor can make you get well, it doesn't always succeed in making you feel well.

Conventional doctors neglect the magic in their dealings with patients, while alternative practitioners often offer nothing but magic. Magic or Medicine?, which grew out of a four-hour TV documentary, tries to reconcile the two philosophies. The partnership between Dr. Robert Buckman, a Toronto cancer specialist, and Karl Sabbagh, a television producer, works well as they combine a fast-moving narrative with cutting-edge scientific research and interesting case studies woven into the story.

Doctors take well-deserved knocks for being remote know-it-alls, insensitive to patients' feelings and emotional needs. But holistic healers are criticized for taking the notion that body and mind are interconnected and

expanding it way beyond its natural limits.

While encouraging people to exercise more and give up smoking is good, the authors argue that some diseases are not within the individual's control. If your illness has not been caused by anything you've done, or if you're losing the battle against it, the constant reminder that you are in some way to blame for Your poor state of health can be damaging, demoralizing, and punitive: "Personal responsibility for health is a two-edged sword - one edge is a catchy slogan for the healthy, the other edge cruelly transforms the patient into a scapegoat."

Vital Choices is another book by a doctor whose views veer from the mainstream. William Molloy, a geriatric specialist in Hamilton, Ontario, is worried about a technologically advanced medical system whose guiding principle is quantity of life keeping people alive longer - rather than quality of life.

In North America, an estimated 10,000 people are suspended in chronic vegetative states or comas, unable to breathe for themselves and fed through tubes, at a cost of $200 million a year. For the vast majority, there is no possibility of recovery. But as long as these patients do not meet the clinical criteria for brain death, the health professional's primary duty is to keep them alive.

Many of us, if allowed to choose for ourselves, Would never consent to having our lives painfully and needlessly prolonged in this way. As the controversy about assisted suicide shows, we want to control our own lives and, finally, our deaths. With a fast-growing elderly population and zooming health-care costs, society is being forced to confront these difficult issues.

Dr. Molloy echoes Dr. Buckman in slamming doctors who, blinded by the awesome power of the technology they use, lose touch with the emotional needs of their patients. The person is reduced to nothing more than the subject of a series of tests and procedures.

Besides the horror stories, he discusses the importance of preparing an "advance health care directive" - a way to tell physicians how to treat you when you are unable to state your own wishes. This is similar to a living will, but more specific and drafted with input from the family and the family doctor (Dr. Molloy's previous book, Let Me Decide, gives detailed tips on how to draft an advance directive.)

To show the need for such an action plan, he mentions a survey he did in 1989, asking 900 people what level of care they would want for an irreversible condition. Fewer than 20 per cent asked for surgical or aggressive treatment, yet failing instructions, to) the contrary, rnedical staff are more likely to treat irreversible condition,, aggressively rather than palliatively. As a rule, he says,,doctors and nurses give more treatment to their patients than they would want for themselves

Safety Last is an indictment of the consumer health protection system that approves new drugs and medical devices sold in Canada. Nicholas Regush, an investigative reporter with the Montreal Gazette, helped unearth the scandal around the Meme breast implant. (The implant, later drawn from the market had a polyurethane cover that released a potential carcinogen into the body.) His insistent badgering of the government about this dubious device, often used for cosmetic reasons, led to his being banned from interviewing federal health officials.

The Meme saga forms the core of the book, but Regush also throws in chapters about lax regulation of pills for menopause (Premarin), migraine (Imitrex), insomnia (Halcion), and pain relief (Toradol). And there's a truly horrifying chapter about benzoyl peroxide, an ingredient in overthe-counter acne medications that may promote skin cancer. Teenagers are using a potential carcinogen on their skin twice daily.

Regush calls Health and Welfare Canada "negligent and near-criminal" in its handling of drugs and medical devices. New treatments are rushed onto the market because of industry pressure, without proper testing and review. Health-protection officials, picked through cronyism, are not schooled for the job. Submissions for new drugs and devices are sent to outside reviewers, many of whom have worked for or maintain ties with industry. Committees meet privately and whistle-blowers are stifled.

Like a small but potent pill, this book packs a lot of punch in its 200 pages. Regush writes in a personal and breezy style, with a journalist's outrage and at times overly casual approach to the issues, but he's bound to get you thinking about the drugs you ingest and the treatments you take. He closes with some sensible political and personal prescriptions for making the health-care system work better for us.


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