Archive for category health
One of the more remarkable gifts our technological world is the increase in our life expectancy. Even but a century ago the average life expectancy of a British man was half of that of today, even in the last two decades it’s gone up by five years. This increase has a myriad of reasons; an abundance of food, water, law and order, an increase in hygiene and sanitation and finally massive advances in medical science.
Extending one’s life and capability through innovative means is part of what makes us human. This trend of increasing life expectancy is one that doesn’t seem to be slowing down, indeed as we develop our biosciences we are gaining a deeper understanding as to the mechanisms of ageing. This occurred to me as a topic to talk about when I saw an article on the BBC news website reporting on the state of anti-ageing science. The report highlighted a few issues that were vehemently discussed in the comments, to get to the issues I’ll go over a bit of the science behind ageing.
We don’t fully understand every mechanism that goes on whilst we age. There are many contributing factors that we have discovered though; the most often touted cause of ageing is the shortening of telomeres. These are stretches of DNA found at the end of chromosomes, every time a cell replicates a bit of these telomeres are cut off. Over time this leads to shortened telomeres and a more likely chance of DNA damage. Other contributing factors include protein build up inside and outside of cells, DNA mutation and cellular replacement (many cell types die faster than they can be replaced, this is more apparent in the elderly). Designing therapies to counter all of these (and any undiscovered causes) would lead to a stabilisation and even reversal of the ageing process.
This is all interesting science but it has far reaching consequences for our society and people have a lot of different ideas about the ethics of life extension. Let’s imagine that effective treatments for all the causes of ageing are produced, in this scenario a regime of drugs is introduced to the public that when taken every day reverse your age to a physically fit, healthy 25 year old body and keep it that way. I’ve heard many arguments for why this is apparently a bad thing. A common argument is that we should not “play god” or “mess with the natural order”. The argument states that death is natural and any attempt to prevent death from old age is morally wrong. Whenever I am faced with this argument I simply ask the person if they take medicine, drive cars or use the internet. If the answer is yes then the argument for being unnatural seems pretty thin. Furthermore nobody has ever died from old age; people die from age related disease. Getting old is simply a slow wearing out until finally something vital fails. In curing old age diseases we ramp up the life expectancy. Are these people really going to advocate not researching medicines for these diseases? Are they going to tell elderly patients “we don’t have medicine for your kind. It’s natural! Accept it”?
Another popular argument is that of overpopulation. Proponents state that if we do not allow people to die the world will be overfull. I’m always sceptical of this claim; firstly it assumes that we cannot support this amount of people. In the year 1800 we could not have supported the 6 billion people we have today because it took over 200 years of technological development for us to be able to support us. The claim that there will be too many people assumes that this progression will not continue. Secondly the claim assumes that we will still give birth to as many people as we do today. Add to that the fascinating discovery made over the last century that if you give women rights, education and prospects they (shock horror) don’t want to spend their lives spitting out children like high-throughput human factories! The birth rate in countries with equal rights for women shrinks enormously. Couple this with the decreasing need to have so many children (you don’t need to have 12 in the hope 6 will survive to adulthood to take care of you) and we get a scenario of 1 or less children per adult.
For me life extension always makes me wonder; I am 21 years old; once I’ve lived that many years again I hope to have had kids, be married and have a good career. At that age I can expect that once I’ve lived that many years again I will probably be dead or close to it. But that is on the basis that near 80 is the age I will kick the bucket. If the regime of drugs we have supposed comes to pass and my life expectancy jumps from 80 to several hundred years I doubt my principles will stay the same. Why have kids at any age before 100? Why not spend a few centuries learning, travelling and establishing a good life before tying myself down with other humans to raise?
Personally I would work for decades then take a sabbatical (instead of retirement) and spend a few decades travelling, studying and generally being on holiday. I’m interested to know what you all think. Do you think age-stabilising drugs would be a good thing? What would you do if your life expectancy jumped by orders of magnitude? How do you think society would change? Ultimately these issues are nothing new, but as science marches on our life expectancy is shrinking over the horizon. So who knows? Perhaps one of you will be mulling over this blog on your 200th birthday…
I’ve stated it before on this blog but these days we are surrounded by people peddling “alternative medicines” and the like in an attempt to gain funding for what ultimately, has either not been proved to work or proved not to work. One of the biggest perpetrators of this is homeopathy also called homeopathic medicine. Homeopathy was concocted by Samuel Hahnmann a little over two hundred years ago. He disliked the philosophies of the then current medicine and instead attempted to develop a field of medicine based on the principle of “like-cures-like”. Hahnmann believed that if something was to cause a set of symptoms in one amount then in a much lower amount it would surely cure the same symptoms, specifically if that substance was massively diluted in water and repeatedly shook it would release its ‘healing energy’ into the mixture which is then called a remedy. He went on to test many different substances by getting people to take them and record every symptom they then suffered. This practice is called “homeopathic proving” and the records of the symptoms from each substance are then stored in books known as “repertoires”. Using all of this the practice of homeopathy goes a little like this…
Patient: I have aches in my feet, a swollen neck and am feeling nauseous.
Homeopath: let me consult my repertoire……Ah I see, a teaspoon of X causes those symptoms. Ill prepare a remedy of diluted X and you will be better before you know it.
There is a wealth of evidence showing that homeopathy does not work as a medicine. Aside from the notion of like-cures-like not having any basis in anything other than wishful thinking the dilutions that homeopaths use ought to demonstrate to anyone that this is at best, an outrageous scam and at worse, a dangerous idea. (As a side note like-cures-like does not apply to vaccination which relies on the exposure of antigens to the immune system. I’m not going to go into immunology right now because it is a huge field but if you are interested wikipedia, contrary to popular belief, is quite a good start). To accurately describe how diluted homeopathic ‘remedies’ are I’m going to have to go over a little bit of chemistry…
All matter is formed of atoms; these atoms can bind together in groups to form molecules. Due to the different masses of different elements (for example; a single oxygen atom masses more than a carbon atom) if we have a gram of one element and a gram of another they will not have the same amount of atoms in them. This is a bit like having a tonne of bowling balls and a tonne of tennis balls; bowling balls are bigger and weigh more so there will be less of them, tennis balls are smaller and weigh less so we need far more than bowling balls to make up a tonne.
If we want to have a sample with one atom of substance A for every one atom of substance B we have to do a bit of working out. There’s a useful unit in chemistry known as a mole (not to be confused with a mole), one mole is roughly 6 billion trillion molecules or atoms (depending if the fundamental unit of the substance is a molecule [e.g. water] or an atom [e.g. iron]). To know how many grams of a substance you need to make one mole you need to find out its atomic weight, simply looking at a periodic table will tell you this (I’m not going to get into how we weigh atoms!). The atomic weight of oxygen and carbon are 16 and 12 respectively, therefore 16 grams of oxygen has the same number of atoms as 12 grams of carbon.
So how does this little chemistry lesson apply to homeopathy? I’m going to go through step by step how to make a homeopathic remedy of salt. The first thing a homeopath does is make a 1 in 10 dilution (homeopaths call this a “1X”); salt is made from the molecule NaCl (a molecule of one sodium and one chloride atom). One mole of NaCl is 58 grams; one mole of water (H2O) is 18 grams. To make a 1 in 10 dilution where we have one NaCl molecule to one H2O molecule we can put 5.8 grams of salt into 18 grams of water. Shake the sample to make sure it’s evenly mixed and voila! Now we have a 1X solution.
The next step is to do the same thing again, diluting one part of this solution into ten parts water. Now for every NaCl molecule there are 100 molecules of H2O and it doesn’t stop there. Homeopaths repeat this shaking and 1 in 10 diluting dozens of times. Remember the number of molecules in a mole? It’s 6 billion trillion (or 6×1023), at the beginning when we had an equal amount of salt to water we had this many NaCl molecules, with every dilution we’ve got 10x less so after twenty-three dilutions there will likely now only be six NaCl molecules in the entire solution. Beyond this limit of only there are only two options; the first is that every time a sample of the solution is taken to dilute in more water some of these six molecules goes with it. This would mean that the 24th dilution was not dilute 10x more than the 23rd. Secondly (and far more likely) these six molecules wont be picked up and all that will be transferred is water, in that case the sample is no longer a dilution but a pure solution of water. From then on any more 1 in 10 mixing is not diluting but merely mixing water on its own. Unfortunately the story gets worse…
Most people could probably see that half a dozen molecules of something is not going to have a great effect on your body but twenty-three dilutions only creates what’s called a 12C remedy. Apparently this isn’t good enough and this solution is then diluted further, the problem with this is that if the solution only has one molecule of a substance in it then diluting it a further ten times in water means that to maintain just one molecule you need ten times more water. After twenty-three dilutions the sample will contain only water but homeopaths advocate remedies to be diluted sixty times! This is called a 60x solution. It’s difficult to understand just how dilute this would be if it still contained just one NaCl molecule;
The Earth is nearly 8000 miles wide. Imagine a globe the size of the Earth but made entirely of water, that’s 1 billion trillion litres of water. Now make that globe a member of a team containing 100 globes. Make that team a member of a group containing 100 teams. Make that group a member of a company containing 100 groups. Make that company a member of a cohort containing 100 companies. Finally make that cohort a member of a system containing 100 cohorts. In one system there are 10 billion globes. Add to that just one molecule of NaCl and that’s how dilute a 60x salt solution is.
At his point it should be obvious that homeopathic remedies are just water and aren’t worth the tap they came out of. But homeopaths in light of this evidence still stick to their guns. When homeopathy was being concocted by Hahnmann it was not known if matter was made of fundamental units or if it could be divided infinitely. Since the discovery of atoms we have known that this is untrue and this leads to preposterous scenarios needed in the dilutions as mentioned above. But homeopaths today try to get round this by arguing that water has memory. Yes they claim that pure water when mixed with a substance and shook repeatedly remembers what was in it and takes on the properties of this substance, purportedly by forming a network of water molecules around the substance to mimic it. But this last attempt at saving their ideology is by far the easiest to prove wrong. To start with if water has memory that doesn’t bode to well for our recycling of toilet water into drinking water (hence the expression “homeopathy is full of shit”), secondly this would mean that the water’s healing properties are due to it replicating the effect of the substance in it. If this were true it would violate the idea that a dilution is stronger because instead of having just the substance in water the entire water now acts as the substance! Lastly the time in which water molecules change places and orientation to form new networks is on the order of picoseconds (meaning it happens nearly a trillion times per second), far too short a time for any memory.
In spite of having no evidence for like-cures-like, remedies so far diluted they are just water and no evidence for claims of a memory system in water homeopathy is still a huge and active movement in the western world. The matter is only complicated by figures such as Prince Charles (a man with no scientific or medical credentials) stating that homeopathy should be considered. Homeopathy should be considered as much as any unproven or disproven field in medicine, it is not fair if homeopathy get’s to sidestep the stringent drug testing that any proper medicine must undergo purely on the basis of people’s choice or popular figures ideas. The issue is far worse though, a report by the House of Commons Science and Technology Committee revealed that the NHS is spending money on homeopathic treatments. Worryingly there is no exact data on how much is being spent and on what, however it is estimated that homeopathic remedies cost the NHS over £150,000 a year (outrageous when A, it’s water from a tap and B, in an earlier post I talked about how some people feel £100,000 a year for Paul Mason was not deserved) and the cost of running the four homeopathic NHS hospitals we have in the UK is quoted as being near £12 million.
The only shred of justification modern homeopathy has is that it can act as a placebo. A placebo is a substance administered to a patient that does nothing biochemically relevant to their condition but due to the patient believing they have taken medicine they show improvement. The placebo effect is controversial as it may only work by making the patient less aware of their discomfort whilst their body heals naturally, it cannot heal beyond what the body can heal unassisted anyway and there is an ethical dilemma in lying to a patient about their treatment. But if homeopathic remedies are an effective placebo then there is no reason why they could not just be replaced, very easily, very cheaply by a nice, refreshing bottle of evian.
I hope this post has enlightened you a little on what exactly homeopathy is and how it claims to work. I hope I have stimulated a curiosity to learn about these things and how we can know if something has evidence or not. In the modern world the veracity of any medicine (and indeed any science) is only confirmed through repeated, demonstrable experiments by different parties. The data from these experiments can then be published (providing the research was logically and methodologically sound) for other scientists to examine, repeat and have their results also published. Through this long meticulous process we can ascertain what works and what does not. Now more than ever we can ill afford to allow untested, unproven medicines and sciences to gain funding at the expense of that that has fairly passed the best tests known to man.
At the end of Christmas time I settled down to watch what I thought would be one of those typical Channel 4 documentaries called Britain’s Fattest Man. If you missed it the documentary was about Paul Mason who became the world’s heaviest man weighing in at over 440kg (that’s 70 stone or 980lb for all you imperialists)! Not to go through the whole documentary but in essence it was very sad, Paul became this size after suffering a series of devastating blows in his life before becoming addicted to food. He was bedridden and required carers to wash and feed him. Paul was desperate enough to go for a gastric bypass (a procedure that shrinks the available stomach size) which enabled him to shed 120kg in just a matter of months.
You may ask why I am bothering to blog about this, I had no plans to. It was merely one of those stories we hear about and perhaps relay in a shocked tone to others. The thing that really got me about this documentary was the way people treated Paul. Other than receiving hate mail I was dismayed to see a wealth of articles both online and in newspapers lamenting the cost of Paul’s care and medical treatment. Per year Paul costs slightly over £100,000 to the NHS and over the fifteen or so years Paul has needed this care he has topped over £1,000,000. Reading through some comments online I couldn’t believe the amount of people who were advocating Paul either not receiving this care or not deserving it. This is a bit of a problem for me, I believe in social healthcare. I think medicine should be a right not a privilege. There’s two dangerous mentalities here, one is that if you don’t contribute you don’t deserve (ridiculous, what about students, mentally ill, prisoners and those down on their luck) and the other is that if you did it to yourself you don’t deserve help. To me that’s a pretty slippery slope to start on.
It is possible to go through your whole life without smoking or exposing yourself to any airborne carcinogens and still get lung cancer. The following numbers aren’t real but they illustrate a real point; out of 100 non smokers 20 get lung cancer and out of 100 smokers 60 get lung cancer. Now out of those 60 smokers with cancer 1 in 3 could have contracted the disease independent of their smoking. If we adopt the mentality of “you don’t deserve healthcare if you did it to yourself” we have to deny or charge for care for 40 of them. But it’s impossible to tell! Do we just deny all of them because they took a risk? Even though every third man didn’t cause it themselves? This principle is very damaging and whilst I don’t condone Paul Mason eating himself to that size I certainly don’t think he is any less deserving than a healthy taxpaying member of society. The whole philosophy of social healthcare is that those who can contribute so that all can receive any and every medicine or treatment that they require.
What do you think? Is Paul justified in receiving medical treatment? At the end of the day would you rather live in a society which takes care of those in need or one that dismisses those who can’t help themselves?