Saving medical practice from the tyranny of health

From Spiked:

Dr Michael Fitzpatrick talks to James Le Fanu, the one-time scourge of those medical practitioners who blamed lifestyle or pollution for ill health, to find out if he really has made peace with the medical establishment.

Turning to the fall of modern medicine, Le Fanu diagnoses the onset of the current malaise of the world of medicine in the 1970s, when ‘the revolution faltered’ and ‘the age of optimism’ came to an end. Clinical science went into decline, the flow of new drugs slowed and technological innovation stalled. The resulting ‘intellectual vacuum’ has been filled by what Le Fanu regards as the specious notions of the ‘New Genetics’ and the ‘Social Theory’ (blaming lifestyle, pollution and poverty for much current ill health). He blames the twin influences of genetics and epidemiology for leading modern doctors (and their patients) down ‘blind alleys’.

Le Fanu’s exposure of the pretensions of the ‘genetic revolution’ and the hype surrounding the human genome project and all the claims for imminent dramatic developments in genetic engineering and gene therapy will strike a chord with many doctors. As he observes, we have witnessed ‘a relentless catalogue of failed aspirations’; despite a vast investment of energy, resources and hopes, the practical benefits of the ‘New Genetics’ in our surgeries are ‘scarcely detectable’. In his new edition Le Fanu brings the critique of the New Genetics up to date with an appraisal of the ‘wishful thinking’ of ‘personalised genomics’ and a discussion of the ways in which ‘genome-wide association studies’ have thrown up more new problems than potential solutions, particularly in relation to chronic diseases. Though he acknowledges the emergence of new cancer drugs such as Herceptin and Avastin, he neglects wider developments in cancer genetics where advances in molecular biology have led directly to therapeutic innovations. For example, the introduction of Imatinib (Gleevec) for the treatment of chronic myeloid leukaemia in 1998 has been followed by the development of more than 20 new drugs for the treatment of cancer, including myeloma (which until recently had a grim prognosis). ‘I accept that these drugs mark a major conceptual advance’, says Le Fanu, ‘but the problem here is that we have a handful of very expensive drugs which provide modest benefits to small numbers of people with relatively rare conditions. We were promised personalised treatments for common chronic conditions and these are still over the horizon.’

More here.