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Symbols and snakesSymbols are the signatures of human
endeavour. They are soundings of the past, statements of the present and
signposts to the future. Medicine has its share of symbols. These once included
the stethoscope, the white coat and the black bag; but the white coat has been
shed, the black bag abandoned and technology stalks the stethoscope.
One symbol persisted – the snake-entwined staff of
Asklepios, hero physician and mortal son of the Greek god Apollo, from whom he
inherited his mythical healing powers. Not so long ago, this familiar emblem
graced the cars of doctors. But with persistent raiding of their cars for drugs
and other booty, the badge of Asklepios has also been abandoned.
Disappointed as these symbolic losses are, of further
concern is the usurper in the New World – the ‘medical
caduceus’, the double-serpent staff with its surmounting wings. The
‘medical caduceus’ is based on the ancient staff of Hermes,
messenger of Zeus. Among other things, Hermes was the god of thieves, merchants
and commerce. Mercury, Hermes’ Roman counterpart, ‘was even more
closely identified with commercial pursuits and was commonly depicted carrying a
purse bulging with coins’. In truth, Apollo judged Hermes to be ‘a
schemer, subtle beyond belief’.
Some may argue that Hermes’ staff is an inappropriate
symbol for modern medicine. But, given medicine’s current climate of
corporatisation, commercialism and advertising, it may well be entirely
apposite.
MJA 2003;178:529
The media and medicineAlan Cassels and colleagues recently
analysed Canadian daily-newspaper stories from the year 2000 about five new
drugs – atorvastatin, celecoxib, donepezil, oseltamivir, and raloxifene
– all selected for their high profile in the media. Their most startling
findings are that only 32% of the articles mentioned potentially harmful
effects, while benefits were discussed almost five times more often than harms.
Only 32% of stories mentioned drug costs, and only 26% of stories citing a
scientific study included information on the funding source for the study. After
excluding industry and government spokespeople, in only 3% of cases did stories
mention the potential conflicts of interest of those quoted.
For celecoxib, only 16% of Canadian newspaper articles
mentioned potential harmful effects – yet the drug may be associated with
an ‘increased incidence of serious adverse events’ compared with
older cheaper alternatives. Similarly, when paying for celecoxib was about to
cause major financial burdens for public and private health-insurers worldwide,
only 13% of stories covered the drug’s cost. Cassels and colleagues
conclude that their results ‘raise concerns about the completeness and
quality of media reporting about new medications’.
Lancet
2003;361:2097–8
A hot potato?A genetically modified potato
developed in India to contain extra protein is under attack, with opponents
claiming that it will result in the neglect of traditional sources of protein
and thus exacerbate protein deficiency.
A senior Indian biotechnology official said last week that
the potato, which has undergone nearly three years of field trials, could be
approved for commercial cultivation before the end of this year.
The potato expresses 40% more protein than wild or
cultivated potatoes. The potato has been engineered with a gene, AmA1, from the
amaranth plant, a grain that has been consumed for centuries in central America
and Asia.
But opponents say the potato will have little impact on
human health because the absolute increase in protein is not significant. The
protein content of wild potatoes is less than 2% of their weight. An increase of
even 40% would raise it to a maximum of 2.8%. Pulses are the most important
source of protein in the Indian diet.
BMJ
2003;326:1351
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