Hi Keith
(KH)
> > > Intuitively, ordinary people are well able to judge the sincerity and
> > > expertise of specialists -- so long as their debate is fully accessible.
> > (CR)
> > Their debate is never nearly "fully accessible" -- neither by medium
> > (scientific journals) nor by participation (forums) -- and even if it
> > was, how should "ordinary people" be "well able to judge the sincerity
> > and expertise of specialists" ? Can you name a single issue where this
> > would be the case ?
> (KH)
> Yes, I can. This is the issue of drug efficacy. The National Institute of
> Clinical Excellence (NICE) in the UK is composed of pharmaceutical
> chemists, biologists and doctors who investigate the cost-effectiveness of
> drugs on behalf of the National Health Service (NHS).
Well, I wouldn't be so sure that NICE's agenda is in the best interest of
patients (or that it is impartial). Their agenda is to cut short-/mid-term
costs in health care, and this is rarely in the interest of the patients.
Their criterion of "cost-effective" is pretty problematic. For example,
among all dental materials, Amalgam has been found to be the *most* "cost-
effective", although it is the *worst* material for general public health.
Also, the fact that NICE only approves treatments whose "cost-effectiveness"
is already "proven", will exclude many alternative and new treatments whose
effectiveness can only be assessed in the long run and which perhaps won't
fit NICE's orthodox criteria. A recent German survey found that due to
harsh economic bounds for doctors, 25% of patients are being denied the
treatment they would want, so many patients turn to "self-treatment" which
can have very bad consequences.
NICE's decision on beta-feron has led a Multiple Sclerosis patients group
to spell out NICE as "Now I Can Expire"...
> I may proved to be wrong in this instance and at this point in time, but
> this is but one example of democratic pressures being mounted against
> confidential deliberations on important matters, the pressures increasing
> from year to year.
It rather seems (esp. in the EU context) that the public PR spin gets ever
more professional... Organizations like NICE make people *think* they can
participate in and even influence the debate.
Chris
___________________________________________________
"An infallible method of conciliating a tiger is to
allow oneself to be devoured." -- Konrad Adenauer
