New Under the Sun:
Volume 5, Issue 2
The weather in February can be particularly dismal. Perhaps this is why the month is interrupted with Valentine’s Day: a cheerful break in the gloom and/or cold. Yes, it has been commercially co-opted. But if we ignore that and go to the core of the day, it is about bringing some happiness, a warm, cheerful feeling, to someone we care about. And, as we know, that is good for our health.
Right of Refusal or Refusal of Rights?: We expect our health professionals to have our best interests at heart; to be well-informed on current practices; and to give us the best treatment possible. We also expect them to behave ethically and without bias. Since these individuals are humans with foibles and flaws, sometimes optimal standards are not met. However, because the health of the patient may be at stake, health professionals are required to meet higher standards. What happens when a health professional refuses to offer a patient a legal and medically appropriate treatment? How should the professional be treated?
In the current issue of the British Medical Journal, a medical ethicist examines the issue of conscientious objection on religious grounds by some health professionals. Do they have a right to refuse to offer certain treatments to patients that they themselves find objectionable, but which are legal and medically-appropriate? Does such conscientious objection amount to refusing to give patients treatments they rightly deserve? Whose rights should triumph? Medical ethics comes down squarely on the side of the patient.
Physicians who object to abortions should not specialize in fields where abortion is a possibility. Pharmacists who refuse to dispense emergency contraception are violating the patient’s rights. As the author points out, if a medical student really objects to some legal forms of medical treatment, that individual should find another profession. If a health professional has conscientious objections to some types of care, they are ethically required to find another professional to treat that patient. If a health professional refuses to provide a legal, medically-appropriate treatment for a patient, and/or to give the patient complete, unbiased information on treatment options, that professional should be disciplined and should lose his/her license to practice. The author concludes by stating that, “The door to ‘value-driven medicine’ is a door to a Pandora’s box of idiosyncratic, bigoted, discriminatory medicine. Public servants must act in the public interest, not their own.” [p. 297] Savulescu, J. Conscientious objection in medicine. BMJ 2006. 332: 294-297.
Walgreen’s policy dealing with their store pharmacists seems in line with Savulescu’s prescription. Four pharmacists who worked the night shift in their stores, and thus worked alone, were fired when they refused to dispense the morning after pill as required by law. The pharmacists are suing, but we will hope that public interest prevails over private beliefs. http://www.medscape.com/viewarticle/522604?sssdmh=dm1.179755&src=nldne
Comment: Religious values should not be permitted to trump secular values. Religious values tend to be sectarian, while secular values tend to be non-sectarian. That is, secular values should be for the common good, and set at a distance from religious beliefs. This is the meaning of “separation of church and state”, and is necessary because religious sects frequently express extreme differences in values from each other, and may be opposed to the secular values adopted by their own society. We cannot rely on religion to set our moral compass because whose religion should we choose? The founders of the United States understood this. We risk opening that Pandora’s box bigotry and discrimination if allow the wall separating church and state to be breached.
Not Soy Good for You: Soy has been touted far and wide as practically a miracle food: eat lots, be healthy. There have been rumblings of discontent [see this article for more complete detail: http://www.westonaprice.org/soy/tragedy.html ]. However, a major organization, The American Heart Association, now has countered one of the soy group’s major claims: they found that a diet high in soy and soy isoflavones does not provide special protection for the heart. Any heart health benefits of a soy diet are negligible and require ingesting quite large amounts of soy (50 grams). The lipid and LDL cholesterol profiles show no benefit; symptoms of menopause were not relieved; and there was no reduction in perimenopausal bone loss associated with soy intake. Given these lack of benefits, and given that the AHA also mentions that other research indicates that soy isoflavones might actually increase cancer risk, one would think that the AHA would recommend avoiding soy foods. But, no, they just recommend against using soy isoflavone supplements. They still think soy protein would be fine to substitute for other protein sources. Erdman, J. AHA Science Advisory: Soy Protein and Cardiovascular Disease, A Statement for Healthcare Professionals From the Nutrition Committee of the AHA. Circulation. 2006. 102: 2555.
Comment: I have long argued against relying on soy for the protein content of one’s diet. My reasoning is, of course, from the AnthroHealth perspective. Soy would have played little, if any, role in the diet of our Paleolithic ancestors. We are adapted to obtain the majority of our protein from animal sources such as fish, shellfish, eggs, and small amounts of meat. The primary source of vegetation-based protein should be from tree nuts such as almonds, walnuts, etc. Legumes such as soy would have made in-roads into our diets only after agriculture became wide-spread. The dramatic population increases made possible by agriculture are directly associated with reduced dietary quality for the masses leading to an unhealthy reliance on legume- and grain-based foods instead of the more diverse and appropriate foods of our ancestors. A little soy here and there is fine. Heavy reliance on it is extremely problematic.
Chinks in Their Armor: Adolescents frequently feel they are invincible. Bad things might happen to others, but not to them. They have some justification for believing this since, on average, adolescents are at the peak of their health. Researchers in North Carolina have been tracking a group of 14,000 adolescents of diverse ethnic backgrounds as they move into their young adult years and have found some disturbing trends. The participants first entered the study when they were aged 12 – 19. When they were aged 19 – 26, they were interviewed again, responding to questions related to their health and any behaviors that could adversely affect their health such as tobacco and other substance use/abuse, binge drinking, diet, activity levels, access to health care, STDs and other factors related to reproductive health, exposure to violence, and mental health. Of the 20 specific measures surveyed, researchers found that the young adults had declining outcomes for 15 of the measures. A major factor in their declining health was reduced access to healthcare due to no or inadequate insurance coverage leading to fewer medical and dental exams. Other significant factors were poorer quality diets which, with decreased activity levels, led to increasing rates of obesity. Young adults were also more likely to experience binge drinking, substance abuse, and STDs than were adolescents. All ethnic groups showed declines in health. Harris KM, Gordon-Larsen P, Chantala K, Udry JR. Longitudinal trends in race/ethnic disparities in leading health indicators from adolescence to young adulthood. Arch Pediatr Adolesc Med. 2006 Jan;160(1):74-81.
Comment: It would appear that parents and being carried on the parents’ insurance, or receiving insurance under government programs for children, are critical for providing a foundation of good health for adolescents. Once they wing away from home and need to make all their own health decisions and provide for their own medical care, significant declines in health occur. Although some of this can be chalked up to testing one’s limits, in large part, the decline is the result of how our society is structured. Entry-level positions are generally low-paid and frequently without health insurance. With competing needs for their limited funds, health insurance is discarded. After all, they are young and invincible. In addition, if one wants to get ahead on the job, it is frequently necessary for the entry-level worker to put in longer, more stressful hours on the job, none of which benefits their health. With little time to exercise or prepare healthy meals, weight creeps upward and physical fitness declines. This study was carried out in the United States which, of all the industrialized nations, does not provide universal healthcare coverage. It would be interesting to see if the same declines in health occur elsewhere to the same degree.
AnthroHealth Tip of the Month: Eat lots of fruits and vegetables. Avoid vegetarianism. While this may seem contradictory to some, regular readers know that it is not. Too frequently, vegetarians or vegans lean heavily on grains and legumes and are really pretty light on the richly-colored fruits and vegetables that provide necessary nutrients. There are vegetarians whose diet seems to consist almost entirely of cheese, yogurt, soy, and grain-based products. These are all foods associated with the development of agriculture and, therefore, post-date the period for which our bodies adapted. Keep them in your diet if you must, but make them the minor, not the major element. Think of the color wheel when you plan your meals.
© 2001-2009 Kathleen E. Fuller, PhD. All rights reserved.