Is medicine 'messing with nature'?

[XmasCrap]

Prompted by something I read earlier and a discussion at the dinner table this evening.

Do you consider medicine to be 'messing with nature'? Keeping people alive, albeit not 'well', so poor quality of life. IVF - if not allowed, people would unfortunately be childless and that would be that. Transplants, etc.

Is medicine to blame for some of the problems the NHS experiences?

Yes, but given that nature is cruel and doesn't care about the individual, that's fine.

"Keeping people alive, albeit not 'well', so poor quality of life. " well the best person to judge QOL is the individual contemplating or undergoing treatment. You can refuse treatment altogether or throw in the towel whenever you want.

I mean pretty well all medicine is "messing with nature" - even things like spectacles. But so what? Most of modern life is messing with nature.

It's true that medical care has become much more complex in recent decades. Conditions that are now not curable but treatable would have previously led to people being sent home to die. A consequence of that is a lot more healthcare required, at great expense, to maintain life. In most cases I don't see that as a bad thing, e.g. insulin for diabetes turned it from a death sentence.

For some of the more extreme cases I think there are a great deal of ethical questions - where treatment is prolonging suffering with no hope of a cure or relief. Or where medical intervention requires the use of the body of another person (e.g. surrogacy, organ transplant).

But what would the NHS be for if not medication? Just verbal counselling for the dying? Where do you draw the line?

Well I guess it is messing with nature.

Without it many of us would be dead, from a dozen or illnesses we are vaccinated against or infections or get fixed up with antibiotics. Polio and leprosy would still be common.

People would probably have more children in the hope some would survive childhood.

People would died leaving more children orphaned who in turn would be glad of the childless to take care of them.

What are you actually suggesting we should do?

Well only if you believe being “natural” means doing fuck all to steer your life. Is eating or drinking “unnatural”? If you didn’t you’d die. What about washing?

[quote XmasCrap]@Lockdownbear, I'm not suggesting we 'do' anything, although I really don't see the point of keeping people alive who aren't going to get better, blocking beds, etc.[/quote]
OK so we aren't talking about medicine we are talking about care for those who are terminally ill.
What do you suggest bump them off?

I'm talking about medicine, nothing else, @5zeds.

This is a question I have seriously contemplated. I would be dead without modern medicine. So would my DH. We would have no child. Our genetics would not continue. He and I are clearly physically inferior members of the species in that respect. What does it mean for the direction of human evolution that our dna is allowed to continue? He and I also happen to have other attributes that are possibly very positive. Those positive attributes would not have had an opportunity to merge and potentially evolve if we had not been saved. Perhaps our genetic contribution will play an overall positive role?

Medical intervention has allowed our species to possibly play a huge role in directing the next stages of human development without even intending to intervene.

Yes it is but IVF and end of life care is the least of your worries. Female hormones are going into the water system which is having an impact on nature. As are badly disposed of antibiotics and medical waste that leech into water and soil.

Really good points Blossom64265.

@Blossom64265 I suspect many of us would be dead if it wasn't for medicine.

The NHS has saved my backside on 3 separate occasions. And that doesn't include minor infections that could have become serious.

Not to mention the immunisations we all have.

I'm still not sure what medicine the Op wants to scrap but be careful what you wish for. I'm sure most of us would opt for treatment if necessary.

@Lockdownbear I'm not wishing for anything, I am genuinely interested in people's thoughts on the topic though.

well the best person to judge QOL is the individual contemplating or undergoing treatment. You can refuse treatment altogether or throw in the towel whenever you want.

Speaking as someone who worked for several years in elderly care :

1 the patient isn't always capable of deciding

2 when patients aren't capable of deciding those deciding for them don't always follow their wishes!

I've seen patients kept alive, in considerable pain (we know this from monitoring certain things as well as knowledge of the conditions etc) for YEARS simply because the person with the legal right to decide what happens to them is making decisions based on what THEY want THEIR inability to let go - shouldn't be allowed!

Death isn't always the worst that can happen!

It's a tricky balancing act. I've even seen patients kept alive simply due to Drs not wanting to admit failure! Rare thankfully but it sadly does happen.

IVF - treating infertility that has come about through disease/problem with development is something I support, I don't think it should be provided free to those who have simply chosen to wait until their 40's to have dc. It's well known that female fertility declines with age and sharply so after 35 I don't think we should be funding choice based issues

I also don't agree with purely cosmetic surgery - by which I mean literally just about "improving" looks. Plastic surgery post mastectomy or for scarring etc of course but not boob enhancements cos someone lacks confidence in their body and sexuality - which again I HAVE known to happen (Mh issues faked/exaggerated to push it through)

@TooBigForMyBoots I agree the chemical changes due to medicine dumping is very worrying!

When people raise this topic, there is often the assumption that asking the question implies that intervention in nature is bad. I don’t think we should make that assumption. We don’t know the impact of intervention. We actually won’t live to see it. It’s largely a philosophical discussion that can be guided by some historical observation and scientific theory.

Yes and no!

Yes because if we were wild animals we would not be able to do anything except take what happens.

No because we're humans and humans have always messed with nature.
Weapons
Farming
Healing of any type
I mean loads. It's how we are so successful.
And when it comes to medicines, that goes back so far. Using certain plants which have various properties had gone on for millennia.
In the end loads of medicines are still made from plants one way or another.

Eg
Digitalis heart drugs = foxglove
Opiates pain relief = opium poppy
Loads antibiotics originally (still?) Moulds, bark etc
We are a part of nature. A maybe too clever too destructive one. But this planet is where we evolved, species animal we call human. So from that perspective everything we do is natural, for us to do. Iyswim.

'Is medicine to blame for some of the problems the NHS experiences?'

The question about messing with nature.

Is a totally different question to the end NHS one.

If there were no medicines ever then who knows what the human species would be doing etc now.

I mean we could have all been wiped out by now! Or still living in smaller communities etc.

I'm not at all sure there would BE an NHS! Likelihood I think not. Disease etc would have kept the population lower probably.

Just dunno.

Anyway.

First question and second question not related. Second makes zero sense given the first part, in fact.

Why did you randomly pick 35 for IVF cutoff? There's a bit of a sliding scale I think, and it gets reviewed as advances in fertility change over time. Current guidelines say you can have one cycle if aged 40-42 but you have to meet various criteria including having been TTC for 2 years. So you can't just "choose to wait to your 40s" then swan in and get it.

Re cosmetic surgery- yes a few undeserving cases are going to slip through the net, like there are some dole bludgers and disability benefit cheats. It's the price of trying to have some sort of a humane system. The selection process is never going to be 100% sensitive and specific.

My experience with elder care is limited to parents and GPs so of course you will have seen more in one day's work than I have in my lifetime so far. My dad got dementia, cared for at home to start then a nursing home for about a year and a half. I think in that time he got antibiotics twice for UTIs. I guess they could have just left him with a UTI boiling along in the "hope" that he would get pyelonephritis, then sepsis and die a bit quicker? As it turned out he lost weight, then got ill quite quickly, was in hospital for 3 days and died of suspected pancreatitis. The last day of that he just received morphine I think.

My mum got cancer twice. The first time in hospital for months and eventually left somewhat debilitated longer term though she could still walk a couple of miles, spend hours gardening and running her business employing 50 people. The second time hopeful of cure chemo that then turned into palliative care chemo that then stopped. When she got close to the end all other treatment (eg potassium supplementation) except analgesia and oxygen supplementation was stopped, with her understanding and being a major part of the decision making process. It was handled beautifully. Once the body really starts to die like mum and dad's did, you can't really "keep it alive" anyway. Using medicines to rage against the dying of the light doesn't usually work, even if we / they had wanted to.

Well modern medical care is great, but our approach to end of life care sucks

Most people don't contemplate their deaths and how they would like that to be until it's far far too late and many people feel very uncomfortable discussing it. It is very distasteful to think people should be denied care because they're an inconvenience. But it's also cruel to keep people alive who clearly don't or didn't want to be forced to live an undignified and painful end.

We all die, it's worth thinking about how we'd like to die...I asked my dad and he said swimming with crocodiles so that'll be awkward but quick.

[quote XmasCrap]@Lockdownbear, I'm not suggesting we 'do' anything, although I really don't see the point of keeping people alive who aren't going to get better, blocking beds, etc.[/quote]
I'm interested in how you came up with your original examples of what's 'messing with nature'.

IVF, is interesting as there's religious aspects - RC church says no.

Transplants? All of them? Corneas, bone, ..? Or just some? Wiki tells me first reasonable recording of transplant (skin) 2nd century BC. Why did you choose transplants?

Keeping ill people alive- but poor quality of life. All people? So if someone with progressive condition, at some point it's sorry have over no more medicine over to nature now? Whether at 15, 30, 50 etc? How do you (you personally)define poor quality of life anyway? In your scenario?

I love the idea of essentially bumping people off because they are 'blocking' beds!

OP you've not taken your thinking far enough.

If NHS stopped treating people full stop, ALL the beds would be empty!

Be bold, think big OP.

@Graphista do you also think we shouldn't fund treatment for alcoholism abs drug addiction as they are also choice based issues?

People don't choose to be infertile. People do choose to drink too much or take drugs.

Or broken limbs from sports.

Or people in car collisions as driving is a choice?

.....

Moral judgement time...

It is far more complicated than we can imagine really. Some genetic traits offer a survival benefit in some situations, but exactly the opposite in other situations.

Natural selection in an organism as complicated as a human being is incredibly complicated. For example, a physical weakness or inherited disease may continue to be passed from one generation to another because a different, highly valued trait provides the population with advantages.

Part of being human is that we invent ways to cure diseases and injuries. We have become a dominant species because of that (partly). Other animals do not have that advantage.

I worry however that once we start trying to change our genetics too much we may indeed be messing with nature in a dangerous way. We may find ourselves living with inadvertent and dangerous consequences.

It is wise not to enthusiastically adopt new technologies too quickly.

"I really don't see the point of keeping people alive who aren't going to get better, blocking beds, etc."

Well my dad, and the second time as it turned out, my mum weren't going to get better. Dad we knew, mum we didn't (the first or second time- I think the doctors were pleasantly surprised she survived the first time) . So there's the first flaw- you often don't know if something is curable or not till you try.

Also, it's often the nursing care that keeps them alive. Dad was offered water frequently, had food carefully prepared and fed to him (and, had not pancreatitis intervened, this would have continued till his swallow reflex was stuffed enough to give him aspiration pneumonia, a good and fatal one if lucky). His personal hygiene was tended to and any hint of bed sores were treated quickly and thoroughly. If the care staff hadn't been do good, he would have died (unpleasantly) of dehydration or sepsis ages beforehand.

My inlaws are spending Christmas with us and my brother's inlaws are with him. Average age 80. Both sets drove themselves to us, from Dublin and Wales respectively. Collectively they are on enough pills to start a pharmacy (without which both FILs prostates would be running the show poor chaps) and it would be a toss up as to which of them would blow their retinas or keel over with a stroke due to hypertension first. They've been on pills for years. The NHS (and the Irish healthcare system) keep screwing back on any bits that fall off and they keep going. Cataract surgery, Dupuytren's contracture surgery, joint injections, crappy teeth or what's left of them...they pull into the pit lane, the docs and dentists and physios patch up the wonky bits and they carry on. You might argue that those things aren't "keeping them alive" but they are. Anything that contributes to better mobility and activity probably does prolong life. If they didn't get any of that stuff they would probably "hurry up and die" faster and suffer perhaps more intensely but briefly, so less overall? But they're still having a good time.

It is yes. I'm on a cocktail of pills and injections that quite frankly, I'd be dead without having. That comes at a cost of feeling like crap for 50% of the time.

There will come a time when I'm beyond exhausted by it and will let nature take its course.