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The medical ethics trap behind retinopathy of prematurity and much cerebral palsy:

A detailed documentation of an ongoing medical malpractice and its continued cover-up that severely harms many premature babies   
by H. Peter Aleff

Introduction

The material in this book confirms - again - the ancient Greek belief that the god of medicine holds two vials, one that gives life and one that dispenses death, and that at times he omits to check for the poison label and so confuses the two.

It documents such a double confusion which is clearly visible to any outsider who reads the directions and checks the facts, but which seems difficult to discern for some modern imitators of that god. True to the tradition, these ignore clear and abundant safety warnings; they pour poisonous doses of radiation into the eyes of their patients, and they withhold life-saving oxygen from them.

The difference is that the ancient medical god was quickly chastised when he did wrong, whereas said moderns seem to think they can simply deny the poison is poison and continue to pour, without having to switch the vials and thereby admit their harmful error. The comments I included from some of these modern poison promoters will show you that they surpass the most proverbially over- confident ancients in hybris.

I am an engineer and independent researcher. Earlier in my career, I managed some factories that cure glues and inks with visible and ultraviolet radiation and so require certain workers to be protected from light damage to their eyes. That is how I learned about the blue-light hazard to the retina and about the precautions which the concerned manufacturing operations are mandated to take against it.

I also learned that the youngest and most vulnerable hospital patients do not rate the same safety precautions against this well-known hazard as healthy adult workers. 

My son David is blind from retinopathy of prematurity (ROP), a retina disease that is epidemic among premature babies and accounts each year in the US for more cases of childhood blindness than all other causes combined.

When I studied the medical literature about his and similar forms of eye damage, my knowledge of the industrial safety guidelines for protecting eyes from harmful light helped me to recognize that the bright fluorescent lighting in typical intensive care nurseries exposes the preemies there to gross overdoses of the most retina- damaging irradiation.

The lamps which the American Academy of Pediatrics recommends for the sensitive eyes of preemies concentrate much of their radiation energy in precisely the narrow wavelength window where the retina is most vulnerable to damage from light. The specified lamp type and light level routinely expose the still developing and thus most vulnerable retinae of premature babies within fifteen minutes or less to the amount of damage-weighted retinal irradiance which the US Occupational Safety Guidelines consider as the maximum permissible cumulative dose for the eyes of healthy adult industrial workers, not to be exceeded in any 8-hour workday.

Preemies are typically left exposed to this steadily accumulating irradiation for 16 or even 24 hours a day.  If intensive care nurseries had to obey safety regulations like those that apply to factories, they would all have been shut down long ago for this blatantly unsafe condition.

The damage-weighted retinal irradiance overdose is easily verified: take the dimensions and transparency factors of preemie eyes from clinical articles and textbooks, get the lamp manufacturer's data sheet for the energy distribution over the output spectrum of the specified nursery lamps, then plug both into the relevant equations from the industrial safety booklet "Threshold Limit Values for Chemical Substances and Physical Agents and Biological Exposure Indices" which the American Conference of Governmental Industrial Hygienists in Cincinnati issues each year, now also on CD-ROM.

You will find those data and simple calculations in  my paper "Baby-blinding retinopathy of prematurity and intensive care nursery lighting".

I document there in addition that the beginning and spread of the epidemic paralleled precisely the introduction and spread of fluorescent lamps, and that the blue-light hazard from the intense blue-violet energy spike of these lamps is more dangerous to the eyes of preemies than of adults.

I also show that the cell changes caused by blue-light damage look under the electron microscope like those seen in early ROP, and that all the medical study authors who found ROP also in allegedly light-protected babies had applied the protection much too late to do any good.

The chapter on oxygen withholding explains the background that makes neonatologists deny and continue their blinding irradiation of preemie eyes. They were taught a wrong dogma about the cause of ROP, and although they know by now it was wrong, its mental imprint lingers on.

Long before non-medical laser researchers discovered in the 1960s the retina- damaging blue-light hazard, medical opinion leaders in the 1950s had hastened to blame another agent for ROP and had greatly touted their alleged success.

Ignoring the discoverer of the disease who had from early on argued that excess light was its most logical cause, his eugenics-minded peers set out to prove that excess oxygen was the culprit instead. They rigged their study to find oxygen guilty, and they knowingly asphyxiated many "weakling" babies in their desire to declare a victory over the epidemic.

No outsider questioned at that time their  fraud, and they succeeded. So started the highly injurious and scientifically indefensible, but still dominant policy of withholding oxygen from the preemies who need it most, and the habitually repeated Article of Faith that the blinding could not have some other simple or even obvious cause, such as the glaringly blinding light.

This absurd patient-harming policy contradicted all previous experience as well as all common sense, but it became instantly, without discussion or replication or follow-up evaluation, a major task of intensive care nurseries around the world.

All later studies that tried to confirm a connection between O2 and ROP remained inconclusive, but the imagined need for oxygen rationing still forms the intellectual fundament for much of today's intensive care nursery theory and practice, and it accounts for up to a third of the latter's direct cost -- that is, without counting its much higher cost to the many killed or maimed patients and their families.

Meanwhile, the practitioners of this rationing know and admit in their literature that their withholding of breathing help from gasping babies is futile because no one can measure or control the oxygen concentrations at the retina where alone they would influence the growth of retinal vessels. But oxygen rationing is at the core of their doctrine, so they continue this futile practice anyway, even though they are aware it harms the babies.

You will also find here a sampling of reactions from physicians and medical officials to my safety alert about the irradiation overdose, and my answers to their defenses of the status quo.  Section 3 of the Contents Table gives you an annotated description of this correspondence, with links to those letters that are already on-line.

The lessons these reactions teach about the conscious mis-shaping and mis-use of the medical doctrine should deeply disturb anyone who would have preferred to think of medicine as a science, and of doctors and medical officials as concerned about hazards to patients.

None of those physicians who sent replies admitted or even addressed the literally glaring safety violation and evidence that the excess irradiation severely harms many preemies. Most answers displayed the vial-confusing official attitude that as long as the connection between the glaring and test-animal-blinding light and the eye damage epidemic among human babies is not "proven", then there is no reason to worry. 

By "proven", these sovereign setters of arbitrary standards mean with statistical odds to overwhelm the pickiest  quibbler,  with one or preferably more large-scale, double-blind controlled trials fine-tuned to find out how severe the eye damage gets at different lighting intensities.  If there are less than 19 chances in 20 that the blinding is connected with the light they declare the light safe, in a total inversion of any rational approach to evaluating risks.

This cookbook recipe for evaluating the positive effectiveness of treatments is clearly the wrong choice for detecting their negative side effects -- no informed patients would willingly gamble their eyes against such poor odds.

No one has been able to dispute the facts about the gross blue-light hazard overdose, or to substantiate any of the trumped-up charges against oxygen. But many doctors wrote outright lies to deny and conceal these medical blunders.

Some of the respondents freely misrepresented and contradicted the clinical literature, including their own published writings; some invented data from scratch, even entire studies, to support their denials of all danger.

These disdainers of logic and documented facts are not isolated charlatans, as the public image of medicine as a supposedly honest science might lead you to think, but they represent the current mainstream medical thinking.

For instance, a "medical ethics" committee at the University of Wisconsin saw nothing wrong with a fellow faculty member's having made up such an ad hoc phantom study.  He tried to dissimulate the danger which he could not refute, so he said in print a study had shown that bright light may actually be good for the preemies.  The dictionary calls this quackery, but it meets the standards of "medical ethics".

Meanwhile, the medical baby-blinding and oxygen-starving continues. The self-evident reaction of caring and responsible people would be to protect vulnerable preemies from the well-known hazard of blinding blue light.

Various ancient civilizations considered destroying a convict's eyes with light as one of the most cruel punishments. In our days, the United Nations Convention on Certain Conventional Weapons is proposing to ban blinding laser rifles as too inhumane to be used in armed conflicts against enemies.

Yet, trusted neonatologists, all while pretending to heroically battle against an epidemic of retinal damage among much publicized "miracle babies", routinely inflict this same unspeakably cruel and inhumane retina-searing on the preemies in their careless "care".

Some of these physicians may destroy the babies' eyes out of ignorance, with the fundamentalist faith in their doctrine often found among medical doctors -- the same blind faith which made many doctors believe until not long ago, for instance, that babies feel no pain and can be vivisected.

But other physicians continue the blinding knowingly, as their reactions to my safety alert show. They are aware of the evidence against the light and that they can not contradict it, but they arrogantly deny that the undeniable overdose they prescribe of the undeniably most retina-damaging radiation could have anything to do with the equally undeniable damage to the retinae of the babies.

Like Humpty-Dumpty, these doctors try to make words mean whatever they want them to mean - in this case that light strong enough to blind test animals is perfectly safe for human eyes at their most critical stage of development.

Some of these doctors leave Humpty- Dumpty far behind and even try to make clinical studies say what they want them to say. To back up the denials and to make the cover-up more convincing, officials at the National Eye Institute tried to deliberately falsify the allegedly scientific medical doctrine: they paid for planning an intentionally misleading trial that was knowingly designed to wrongly exonerate light.

The trial plan of the LIGHT-ROP study proposed to again protect the babies too late; the ROP cases in the allegedly protected group would thus falsely appear to rule out light as the cause and thereby justify and perpetuate the current overexposure.

This double offense against science and against humanity was not due to the aberrant misconduct of some isolated quack or rogue bureaucrat acting alone. The intended deceit had full official support.

According to the National Eye Institute's internal documents, obtained via the Freedom of Information Act, its Grant Review Council

"... supported and was very enthusiastic about the project. The Council agreed that this is an extremely worthwhile study that should proceed (...) Council stated that the investigators have clearly demonstrated an understanding and sensitivity to the ethical issues posed by the study design."

This enthusiasm about the understanding of the ethical issues in that study plan, absurd to anyone acquainted with the concept of ethics, makes sense in terms of "medical ethics".

Medical anthropologists have noted that all the systems of medical ethics they studied from different periods and places are

"efforts to support professional control by assuring the public that practitioners will use medical resources in morally responsible ways."

These special-purpose medical ethics create now a trap for those myopic physicians who realize how harmful their danger-disdaining doctrine is but who do not dare to openly admit that they and their colleagues have been doing such great harm for so many years.

To change their current practice would mean denouncing their professional doctrine as wrong and having caused severe unnecessary harm to hundreds of thousands of patients.

Admitting the wrong would also oblige the doctors involved to explain how this glaring, gross, and severely harmful cluster of errors and frauds could continue so entirely unchecked for so many decades, despite the alleged self-correcting mechanisms they claim for the scientific mantle of their trade. Such glasnost would contradict the propaganda image of medicine as responsible and scientific which they strive to project.

So, like pre-glasnost party bosses obedient to the official ideology, these short-sighted physicians are obedient to the core principle of medical ethics.  They try to cover up the role of their aberrant doctrine in causing the damage and write letters like those you find in this book.

Apparently these deniers of clear evidence hope they can stonewall forever. Indeed, their position may look safe in the short term since in medical matters, popular opinion and courts of justice usually defer to high-titled medical experts.

The stonewallers can also control much of the information and counter critics with obfuscations they make up as needed. Their intentionally misleading trial plan was a logical next step to support their denials. They seem to think that by such and similar means, they can defend their stonewall for as long as no physician with credentials admits the facts and so breaks from within the cement of medical ethics that holds their wall together.

I still hope that some of their colleagues will see farther and let real ethics guide their judgment instead, as well as the realization that cover-ups never work in the long run but usually make things even worse.

They should also be aware that knowingly continuing or condoning the light overdose and oxygen starving changes the case against the perpetrators and condoners.  Those who have been alerted to the facts about the danger and have no rational arguments against the warning they disregard are not just guilty of ignorance, or of negligence in keeping up with safety issues.  They knowingly cause serious bodily injury to the victims, and that is a criminal charge.

Smart doctors will also recognize that all attempts to suppress such openly accessible evidence are bound to be unmasked sooner or later, and that an actively patient- harming refusal to openly address the facts will ultimately prove all the more devastating to the reputations of "medical ethics" -- and of those who assist with the cover-up.

Although I found none so far, maybe there are somewhere such ethical physicians who will dare to speak out against these cruel baby-harming routines, and who can get their colleagues to stop them.

Or maybe an analytical insurer, or a health plan administrator skeptical about medical motivations, will recognize the baby- blinding epidemic as a relic from the fee-for-service decades when the goal of medical marketing was to maximize the need for expensive medical services, such as the patch-up industry of cryotherapy and laser surgery which sprang up in response to the steady blinding.

Such outsiders, unfettered by "medical ethics", may be able to insist that capitation-based managed-care budgets cannot afford this iatrogenic creation of costly diseases through conscious safety violations.

Or maybe an enlightened judge will remain unimpressed by the defensive and undocumented junk science fabrications of inherently biased medical expert witnesses and will admit into court the written evidence from the scientific literature that the stonewallers try to evade and deny.  The American Medical Association urges courts to allow such written evidence against unscientific practitioners, so why should the physicians among them be exempted from having to address it?

Or maybe you can help the babies. If you want to protect future preemies from the current medical killing, blinding and maiming, then your best bet is to make more people aware of the twin dangers from nursery lights and oxygen withholding, and of the even more dangerous medical deceit that tries to hide them.  You may not be able to change the system or its abuses, but if you alert some expecting parents, they can try to protect their baby from being sacrificed to the medical Moloch.

Preemies make up about seven per cent of all births in the US, and premature birth can happen to anyone, even to people without any of the known risk factors. One of the future babies whose eyes and brain your intervention might save from medical molestation could therefore quite possibly be a preemie who will be born to your family or friends.

I encourage you therefore to download any of my writings in this section and to distribute them to anyone interested.  They are all free.

Continue to the  Table of Contents
 

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