We all become judges in our daily lives because we need to take decisions related to our own lives especially when the question is of life and death. Decisions pertaining to our health. We decide to undergo bypass surgery because the doctor has said; you need to take supplement because it is shown on TV; children are to be vaccinated because it is ordered by the government; these are decisions based on mass opinion. But think for a while. Do our judges when sitting in the courtroom take decisions considering mass opinion/public perception and not based on evidence?
Imagine a situation of the courtroom – the judge is sitting and Sanjay Dutt is standing in the dock. When the judge took a decision that Sanjay Dutt is a criminal, what was the basis? Just one basis- the evidence. Just imagine if the judge too was influenced by the media which says Sanjay Dutt is a superstar. Common perception is that Sanjay Dutt is a hero; mass opinion is that Sanjay Dutt is Munnabhai. If this was the basis of decision, we cannot call it a justice.
Now it’s your turn. Become a judge and do justice; take a decision but not based on mass opinion. What do the doctors say? What is the common practice? What is the general trend but based on evidence? What does the evidence say?
For example, imagine your friend gets a heart attack. Right in front are two emergency rooms. Emergency Room A has facility of oxygen and Emergency Room B has no facility of oxygen. In which room will his chances of survival be more? According to the opinion of doctors, his survival chances will increase if the patient is taken to the room where there is facility of oxygen. But what does evidence say? According to Cochrane review 2010, whenever the patient with heart attack has been given oxygen mask, his chances of death increase three times. So in 2010, the protocol of heart attack changed. That is, patients with heart attack or brain stroke should never be given oxygen mask. Today, even in 2019, in corporate hospitals of India, whenever a patient with heart attack appears, he is given oxygen mask. His chances of death are increased. So mass opinion, doctor’s opinion, common belief can be lethal and killing.
Let us take one more example. Suppose, a person has to get a heart attack. Where will his chances of revival increase?
A- If he gets a heart attack in the hospital
B- If he gets a heart attack far away from the hospital
According to the common belief, if he gets a heart attack in the hospital, his chances of survival will increase. But what does evidence say? According to the report published by Journal of American Medical Association 2013, whenever a person gets a heart attack in the hospital, his chances of death increase three times. That means if a patient gets a heart attack, the more he is away from the hospital, his chances of survival will increase as much as three times.
Let us take one more example. Suppose somebody’s fasting blood sugar is 250. What should he do?
A – He should take medicine of diabetes and reduce the blood sugar and increase his life span
B – He should not take any medicine
According to a doctor’s opinion, medicine should be taken so that blood sugar gets reduced and life span is increased. But what does evidence say? ACCORD Trial, UKPDS Trial and other big trials of the world on diabetes patients arrive at one conclusion that whenever blood sugar is reduced by taking medicines, their life span is reduced and the complications increase. That’s why on 6 March 2018, the guidelines of diabetes changed and what is known as new ACP guidelines were introduced. And if you read statement number 1 of this guideline, you will see that doctors have been discouraged that giving medicine to patients with high blood sugar to reduce blood sugar, it is something that will kill more patients. So medicine should be rarely , temporarily taken to reduce blood sugar.
One last question. Suppose doctors from all the hospitals in the world suddenly vanish, or go on strike. What happens then?
A – Patient’s condition will worsen, chances of patient’s death will increase and they will die early
B – Patient’s condition will improve, less patients will die.
According to the common opinion or logic, patient’s condition will worsen, their chances of death will increase, their mortality rate will be high. But what does evidence say? According to the British Medical Journal 2000, it has been noticed that whenever the doctors in the world go on strike, the mortality rate of the patients is reduced, their health improves. Actually doctors do not contribute towards your health, they just make you more sick. And this is what the evidence says.
Actually what I am trying to say is that in the last 10 years, medical science has witnessed several changes; doctors’ current knowledge has become totally obsolete. . It’s time to, once again, take admission in a medical college and learn about the inside story of modern medicine.
(DISCLAIMER: The ideas and opinions expressed in this article are solely of the author and do not reflect those of the publication)