So we are currently in the middle of our Brain and Behaviour course. Last week, we had a PBL session focussing on multiple sclerosis. Our discussions of the disease naturally included a consideration of the Liberation Treatment which was developed by Dr. Paolo Zamboni in Italy. Dr. Zamboni believes that many cases of multiple sclerosis are due to a condition called ‘Chronic Cerebrospinal Venous Insufficiency’ that can be treated with endovascular therapy. Dr. Zamboni’s work was featured in a segment by W5 on CTV on November 21, 2009 (See http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20091120/W5_liberation_091121/20091121?s_name=W5). After this news segment aired, there was a media frenzy surrounding the Liberation Treatment and patients all over the world started to demand the treatment from their doctors. The problem was that many physicians felt that the evidence supporting the treatment was anecdotal, at best, and refused to endorse the treatment. The fact remains that endovascular therapy has risks associated with it like any surgical procedure and should not be prescribed unless proper evidence has been assembled. In the era of evidence-based medicine, it is important to conduct more studies to meet the same scientific standards to which we hold other medical procedures accountable. What really surprised me was how a simple news program was able to spark what has been dubbed a “Liberation War” pitting patients against their doctors. What do you think about the role of media in the medical world? What are your thoughts on this situation? Has CTV overstepped? Let me know your thoughts on the subject.
For more information, check out the W5 website.
Nadia
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... I guess you can't really blame the patients - being in the state that they are in, they are just so desperate for any shread of hope. When a program appeals to their emotional side to get them dreaming of being able to live a normal healthy life, they begin to undervalue the very real risks involved. As third party observers, we'd be tempted to see it as a "Liberation War", but it's really a lot deeper than that. Both parties are afterall on the same side - the side of the patient. It's kind of like the relationship between the young teen (ie. the patient) and the wise parent (ie. the doctor) - we don't blame the media for the teen's irrational perspective, since youth are inherently prone to be irrational. It's the parents' role to use their wisdom guide the youth to see the bigger picture. |
Michael C
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... I agree with you that the issue is much more complex than I've presented. I guess, however, we are moving towards patient-centered care and away from the paternalistic style of medicine. I wonder if patient's have been assessed to be competent and exhibit a complete understanding of the risks involved with the procedure, then should they be offered the procedure? Its a very difficult situation. |
JoshNS
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... It is not paternalistic care to refuse to provide an unproven, unvalidated, and risky procedure to treat a heretofore unrecognized condition which may not have anything to do with the underlying disease process. There is no plausible pathophysiology for this "iron overload" hypothesis, nor are there animal experiments offering any evidence in its support. |
