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What about the victims of medical error?

Letter to the British Medical Journal
Gurli Bagnall
Patients' Rights Campaigner
New Zealand
August 6, 2001

Much has been said in the last year or so about the handling of medical error and the consensus seems to be that each incident should be used as a learning experience (with which most would agree), and that blame should not be apportioned (with which most outside of the profession would disagree). If iatrogenesis occurred in 1% of all cases the latter might be a reasonable proposition, but since reported medical error is in the vicinity of 33.3%, accountability is long overdue. Taking into account the unreported cases which are frequently misdiagnosed, we have a situation where the medical profession is creating its own business.

Embarking upon "learned" dissertations about the "etiology" of iatrogenesis as the BMJ did some months ago, suggests that this is an infectious disease beyond the control of the physician. In using such language, the profession distances itself yet again, from responsibility.

As a patients' rights campaigner, my concern is that the victims in these cases, are hardly, if ever, considered. The message they receive, is that responsible physicians must be protected at all costs, while the lives, health, careers and financial security of their victims, are not even worthy of a mention. Worse, once the damage has been done, patients typically find that rather than being offered the help that they need through no fault of their own, the profession turns its back leaving them to struggle alone with enforced poverty and lack of medical help and equipment.

Medical "error" goes hand in hand with incentives from drug manufacturers to prescribe specific drugs, just as it goes hand in hand with political lobbying and contributions to party funds. In the United States, "Drug company lobbying for the first half of 2000 reached $US42.9million" and it was "predicted that the prescription drug industry would spend $US230 million during the election". Certainly the current most influential man on earth, George W. Bush, had no qualms about allowing the industry to contribute $US1.7 million towards his inauguration celebrations. (British Medical Journal 27.01.01). Sums such as these, are not contributed without the promise of a pay-back.

Roche had a cunning plan about thirty years ago, where the payback was to corner the market in addictive benzodiazepine drugs. They"....had been supplying hospitals with Valium and Librium free of charge. This not only blocked the competition, it also contributed to dependence.... in response to the Monopolies Commission enquiry, Roche ceased this practice in 1972. In the same year, Dr. Anthony Clift published his seminal report on hypnotic drug dependence, in which he estimated that about one in five of his patients had started their hypnotic habit in hospital." ("Power and Dependence - social audit on the safety of medicines" by Charles Medawar)

Benzodiazepines have to date, been one of the greatest medical scourges of all time. How many of those who suffered the effects of addiction, and long-term or permanent neuronal damage, appear in the medical "error" statistics? Where are the statistics regarding the floppy baby syndrome? Where in the records, does it specify how many of those babies were later subdued with Ritalin? And where in the statistics are the iatrogenic birth defects such as cleft palates, recorded?

In her article "The big tranquillizer cover-up" published in "What doctors don't tell you", June 2001, Margaret Bell described how her friend and benzodiazepine victim, died. "My friend Simon died last year at the age of 36 after 15 years of painful [post] withdrawals. Over six feet tall, he weighed only six stone. His post mortem showed swelling and marked pallor of the entire brain... he also suffered from an atrophied heart, artherosclerosis, oedema, congestion of the lungs, liver damage, stomach bleeding and multiple gastric erosions. The pathologist diagnosed death due to multiorgan failure..." In life, Simon's GP had diagnosed anxiety. A cover-up, indeed.

"Mistakes" such as these and the denial of them, have eroded the public's confidence. The profession is itself the author of the public's cry for accountability. It would be a mistake indeed, to continue to ignore it.

Gurli Bagnall,
New Zealand

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