The British Medical Journal is patronising and out of touch

The latest BMJ is just dreadful.

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The Knife has long felt that much of its content has bugger all to do with the actual practice of medicine. It is one of the bastions of right-on PC drivel, albeit drivel as written by and for intelligent educated people, although one has to remember that Gordon Brown is also intelligent and educated.

As  economist Thomas Sowell said (and it’s on The Knife’s “About” page):

“There is usually only a limited amount of damage that can be done by dull or stupid people. For creating a truly monumental disaster, you need people with high IQs.”

Which brings us back to the BMJ. For starters there is a wonderfully blinkered editorial, co-written by the dreaded Ian Gilmore, the man who wants to legalise cocaine and restrict alcohol, which states:

….Such statements resonate with those of a 2009 Lancet report, which made it clear that climate change is the biggest global health threat of the 21st century, with the greatest threat coming from effects on water and food security, human shelter and settlements, and resultant population migration. From such soil is conflict born. The United Kingdom’s Ministry of Defence states that “climate change will amplify existing social, political and resource stresses” and will shift “the tipping point at which conflict ignites.” The IISS report concurs: “Climate change will increase the risks of resource shortages, mass migration, and civil conflict. These could lead to failed states, which threaten global stability and security.” In this way, conflict and poor health feed upon one another….

etc etc etc…..I think we’ve heard it all before. As usual there is no attempt to present a balanced view, none at all, which given the weight of conflicting evidence now extant is frankly pathetic, particularly as these individuals would no doubt claim to employ scientific rigour in their day jobs.

Indeed, the phrase:  “climate change is the biggest global health threat of the 21st century” is so ludicrously overblown that it really gives the game away. Have you thought about infectious diseases lads?

However, that’s just the starter. The quite sumptuous main course is a staggeringly patronising effort entitled “Welcome to the century of the patient”. Who?

Well, something called “the Salzburg statement on shared decision making” is invoked – just a touch pompous. Here it is, I was going to edit it to  include  only the self-evident, patronising, smug bits, but that meant printing it all:

Salzburg statement on shared decision making

We call on clinicians to:

• Recognise that they have an ethical imperative to share important decisions with patients

• Stimulate a two way flow of information and encourage patients to ask questions, explain their circumstances, and express their personal preferences

• Provide accurate information about options and the uncertainties, benefits, and harms of treatment in line with best practice for risk communication

• Tailor information to individual patient needs and allow them sufficient time to consider their options

• Acknowledge that most decisions do not have to be taken immediately, and give patients and their families the resources and help to reach decisions

We call on clinicians, researchers, editors, journalists, and others to:

• Ensure that the information they provide is clear, evidence based, and up to date and that conflicts of interest are declared

We call on patients to:

• Speak up about their concerns, questions, and what’s important to them

• Recognise that they have a right to be equal participants in their care

• Seek and use high quality health information

We call on policy makers to:

• Adopt policies that encourage shared decision making, including its measurement, as a stimulus for improvement

• Amend informed consent laws to support the development of skills and tools for shared decision making

Why

• Much of the care patients receive is based on the ability and readiness of individual clinicians to provide it, rather than on widely agreed standards of best practice or patients’ preferences for treatment.

• Clinicians are often slow to recognise the extent to which patients wish to be involved in understanding their health problems, in knowing the options available to them, and in making decisions that take account of their personal preferences.

• Many patients and their families find it difficult to take an active part in healthcare decisions. Some lack the confidence to question health professionals. Many have only a limited understanding about health and its determinants and do not know where to find information that is clear, trustworthy, and easy to understand.

Well Salzburgers, The Knife has news for you:

IT’S A STATEMENT OF THE BLEEDING OBVIOUS THAT ANYONE WITH HALF A BRAIN, ESPECIALLY IF THEY WENT TO MEDICAL SCHOOL FOR FIVE YEARS, COULD TELL YOU. MOST OF US REAL DOCTORS SPEND OUR WORKING DAYS (AND NIGHTS) DOING THIS STUFF WITHOUT ANALYSING OUR EVERY ACTION THEN PATTING OURSELVES ON OUR SMUG LITTLE BACKS.

…and another thing, public statements beginning with “We call on…”  are almost guaranteed to be generated by self regarding individuals who you would cross the street to avoid (see numerous letters to the Guardian).

I feel better now.