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Footnotes :

 

1 That doctrine reversal was just on paper: a recent study of physicians' beliefs about pain in circumcision said some believed the babies felt minimal pain and did not remember it anyway, as reported in the Philadelphia Inquirer of 12-25-97.

 

2 Lawson JR. Letter to the editor on "Pain in neonate and fetus. New Engl J Med, May 26, 1988, 318: 21: page 1398 top right.

 


 


 

  

 

  

  Congress can make laws galore

 

but can't get medical officials to respect them

 
 

DavidNurs03.jpg (22659 bytes)

The non-response of the alleged bioethics guarantors to an inquiry by a member of US Congress
by H. Peter Aleff

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The medical suppression
of revealing comparative outcome data

Dr. Reynolds attached to his letter also a "Cochrane literature review" co-ordinated by Dr. Dale Phelps, one of the medical opinion leaders in the baby- blinding issue. Dr. Phelps is well aware of my documentation about the speed of the eye damage to be expected from excess light -- some of her colleagues at Strong Memorial Hospital in Rochester, New York, told me ten years ago they had discussed it with her.

However, the review she directed again ignores the critical fact that the eyes of all the babies in all those studies were protected much too late to do any good.

The review itself is thus of no value despite its learned airs, but items 8 and 9 on its page 8 (copy enclosed) are interesting. In item 9, Dr. Reynolds is cited as saying about his own pilot study of goggle wear tolerance that "ROP outcome was stated to be lower than in previous periods of time, but no comparison group was described." He had no plans to publish this information.

Item 8 mentions another unpublished study by Repka MX, cited in the LIGHT-ROP Manual of Procedures. Repka et al. had compared two nurseries, one with high light levels in Baltimore and one with low lighting in Boston. They found a higher incidence of blinding in the brighter nursery, but the reviewer dismissed and excluded this embarrassing data because different nurseries should not be compared:

"However, the nurseries have very different populations (race, illness, insurance, etc.) and different physicians and policies involved in their care. Therefore, it is not appropriate to compare these outcomes directly, and the investigators have decided not to submit the outcomes for publication."

This looks like a replay of the medical reluctance to release outcome statistics for cardiac surgery by hospital. When consumer pressure made that information finally available, at least in some states, the comparisons were duly adjusted for many kinds of patient differences and exposed dangerous inadequacies in the worst cardiac programs. Some of the worst cardiac programs had to shut down, and many others were obliged to improve their procedures and performance.

Clearly, an open comparison between the light levels and blinding outcomes in different nurseries would similarly expose the worst-blinding units and oblige others to acknowledge the light as a danger to preemie eyes. If the leading nursery doctors were at all concerned with ending the ROP epidemic, they would have begun to collect and publish such comparative data long ago.

Unfortunately, unsupervised nursery doctors cannot be trusted to behave in such a responsible and professional manner. In over 50 years of baby-blinding epidemic, they have yet to perform an outcome comparison between nurseries and investigation of the differences in lighting.  They still have not done this although light had been the first suspected and most logical cause.

Such an investigation would have been the first logical step towards understanding, and thus ending, the causes of the epidemic; however, it would also have ended the steady stream of expensive retinal patch-up operations which the epidemic generates.

The scientific method calls for the open discussion of all data and the analysis of possible differences, not for their suppression.  The decision to not publish such comparisons is therefore a rather unscientific way of dealing with potentially embarrassing data, a part of the patient-harming medical stonewall against all information about the dangers to helpless preemies from nursery light.

Dr. Reynolds' pretensions to be scientific

Dr. Reynolds claims in his letter that dozens of scientific experts felt "there was insufficient credible data" for suspecting the light. He omits to mention that their not being aware of said data was simply due to their own ostrich policy. They refuse to address the documentation of dangers to preemie eyes that I had repeatedly submitted to the National Eye Institute, to Dr. Reynolds' co-author in the LIGHT-ROP study, Dr. Spencer, and also to many other nursery doctors and medical officials.

None of these doctors or officials ever refuted my warnings about the nursery lighting. Also, none ever explained why medical doctors responsible for the safety of their patients could simply ignore the government-prescribed Laser Safety Guidelines and the Threshold Limit Values for Physical Agents from the American Conference of Governmental Industrial Hygienists.  They simply call these official safety thresholds "insufficient credible data". They display thereby their own reckless disregard for the scientific method, and their own pathetic lack of credibility.

Dr. Reynolds further asserts that if the dangers from light were such a foregone conclusion as I "so rigidly and foolishly" maintain,

"... then the entire world scientific community including the NIH study panels, the data and safety monitoring committee, and investigators would be operating outside the parameters of acceptable scientific method. That is clearly not the case."

To identify a relatively small group of like-minded and fact-suppressing nursery doctors with "the entire world scientific community" seems an unwarranted generalization, and it might be interesting to find out if, say, the American Association for the Advancement of Science or any of its counterparts around the world would agree to be so hijacked.

Furthermore, Dr. Reynolds' invoking of that alleged consensus displays his lack of acquaintance with the scientific method which frowns upon proofs by mere assertion: scientific arguments are not resolved by consensus of opinion, however sweeping, but by the observation of facts and patterns and their interpretation through logical reasoning.

Otherwise, the official consensus would still hold that the sun turns around the earth in one of seven crystal spheres. Neither Dr. Reynolds nor any of the study panels or reviewers he mentions have done such scientific reasoning about the facts of the baby-blinding; they only keep telling each other that the earth is flat and speculating that it might be hollow, too.

A recent grim precedent
for the nursery doctors' dangerous delusions

It is clearly the case that these brightness-accepting nursery doctors operate outside any acceptable scientific method, Dr. Reynolds' unsupported assertion to the contrary notwithstanding. He claims a quasi-papal infallibility for the nursery doctors who reviewed his trial, but medicine offers plenty of precedents, old and new, for widely believed and horribly wrong and patient-endangering nonsense.

For instance, just recently these same nursery "experts" believed also in routinely vivisecting babies without anesthesia, even for major operations. In that case, the nursery doctors' inane "science" told them that babies don't feel pain before about two years.

They uncritically continued this unspeakably barbarian vivisection of human babies until Mrs. Jill R. Lawson, a mother of a preemie, exposed their inhuman torturing and forced the perpetrators to admit in 1988 that the consistent consensus of all these pompously titled alleged scientists had been all along dead wrong on this basic issue.

See the attached article on "Standards of Practice and the Pain of Premature Infants" by Mrs. Lawson (posted here on the Preemie Pain pages).  She encountered much stubborn and uncomprehending medical resistance before her press campaign finally obliged the American Academy of Pediatrics and the American Society of Anesthesiologists to officially reverse this unbelievably absurd part of their frighteningly unscientific medical doctrine1.

After Mrs. Lawson had at long last obtained that long overdue reversal of an idea so horribly deluded that it should never have been taken seriously to begin with, she wrote in the New England Journal of Medicine:

"The forward strides of physicians in recognizing and ameliorating infants' pain are commendable. (...) I am glad that there now seems to be theoretical agreement about pain in infants and its physical ravages if untreated, as demonstrated by the official statements of the American Academy of Pediatrics and the American Society of Anesthesiologists. I cannot help but wonder, however, how such a situation came to develop.

As an academic exercise, one could use pure logic to prove that pigs can sing. However, one's audience would not be convinced. If I had been told by a physician, no matter how senior, that infants don't feel pain, I would never have believed it. What constitutes the difference between my reaction and that of the thousands of physicians who did believe it?"2

None among the thousands of nursery doctors who had so eagerly lined up to buy pig opera season tickets dared to answer her fundamental question.  

Dr. Reynolds clearly never gave it a thought. Despite this recent example of how shudderingly wrong the consensus of all the top medical "experts" under the spell of the same prejudice and of the same preposterously wrong doctrine can be, Dr. Reynolds' tries to defend the just as cruel baby-blinding in the standard intensive care nurseries with an alleged consensus of "the entire world scientific community", meaning his clique of a few thousand equally credulous nursery doctor colleagues who are so imbued with their danger-disregarding doctrine that they learned nothing from the so recent and so stomach-turning medical vivisection scandal.

This lack of physicians' progress in understanding the shortcomings and limitations of the medical doctrine demonstrates again that the ethical aspects of medical research cannot be left up to medical doctors. Their chronic recidivism shows that they need outside supervision since the medical doctors themselves keep demonstrating that they cannot detect and expose their own or their colleagues' errors.

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