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Healthy Skepticism Library item: 11156

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

Mangin D, Sweeney K, Heath I.
Preventive health care in elderly people needs rethinking
BMJ 2007 Aug 11; 335:(7614):285
http://www.bmj.com/cgi/content/full/335/7614/285


Abstract:

Dee Mangin, Kieran Sweeney, and Iona Heath argue that, rather than prolonging life, preventive treatments in elderly people simply change the cause of death-the manner of our dying

Summary points

- Single disease models should not be applied to preventive treatments in elderly people

- Preventive treatments in elderly people may select cause of death without the patient’s informed consent

- Preventive use of statins shows no overall benefit in elderly people as cardiovascular mortality and morbidity are replaced by cancer

- A more sophisticated model is needed to assess the benefits and harms of preventive treatment in elderly people

Preventive health care aims to delay the onset of illness and disease and to prevent untimely and premature deaths. But the theory and rhetoric of prevention do not deal with the problem of how such health care applies to people who have already exceeded an average lifespan. In recent years, concerns about equity of access to treatments have focused on ageism. As a result, preventive interventions are encouraged regardless of age, and this can be harmful to the patient and expensive for the health . . .

The epidemic of cardiovascular disease

Evidence for lipid lowering treatments in elderly people

Are we further blighting old age?


Notes:

Free full text

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909