The New Leviathan Blog

  Hospitals deadlier than the road

1) Victim of a serious infection, Mariana Bridi da Costa, a 20-year-old Brazilian model who was a candidate to represent her country in the Miss World competition, had to undergo amputations of her feet and hands and is still in a critical state. Treated at the end of December for kidney stones, Mariana Bridi saw her condition worsen, forcing her to return to hospital two days later. It turned out that the girl was actually suffering from a very serious infection, which led to the amputation of her feet and hands. Following these operations, the model had to undergo a third operation due to internal bleeding. Mariana Bridi was among the Brazilian contestants who reached the national finals for the Miss World competition in 2006 and 2007. She won a prize at the Miss Bikini International competition held in 2007 in China, where she finished 6th out of 50 participants (7 out of 7, 23/ 01/09).
2) In Belgium, more than 1,500 people die each year following hospitalization, the French-speaking press wrote on Monday, based on data from the Federal Center of Health Care Expertise (KCF) coming from a KUL researcher. These people die following an “adverse event” that occurred in a healthcare center. It is, according to the KCF, “an unintentional injury or complication, leading to disability, death or an extension of the patient’s hospital stay and attributable to the management of hospital care rather than to the pathology of the patient”. According to Baudouin Byl, medical officer of health at the Erasme hospital in Brussels, “adverse events range between 6 and 10% of hospital admissions”. The mutual company Medical Services reports 20,000 medical errors each year, 2,000 of which result in the death of patients (Belga 01/19/2009).

3) Cultural factors influence the amount of antibiotics used by people in a country. Belgians consume a lot of it, indicates a comparative study which has just been published carried out by Dr. Reginald Deschepper of the Vrije Universiteit Brussel in collaboration with other European universities. Two cultural dimensions appear to be significant in relation to the consumption of antibiotics: the difficulty in coping with uncertainty and distrust of authority. Difficulty coping with uncertainty aims to analyze the extent to which people are willing to accept uncertainty and lack of clarity in medical situations. In countries where this score is low, such as in the Netherlands, doctors and patients accept relatively easily to live with this uncertainty and wait to see how it develops. In this way, they generally avoid the use of antibiotics. The second dimension linked to antibiotic consumption is distrust of authority. In countries where trust is high, such as Belgium, patients follow the judgment of those in authority, the doctors. So they don’t feel the need to discuss the need to use antibiotics. According to Dr Deschepper, studying the role of the cultural dimension can help us understand why in certain countries like Belgium it is difficult to reduce the use of antibiotics (La Libre 07/18/2008).

This beauty queen died less from the effects of illness than from the brutal barbarity of the medical profession. What would have been the life of this young girl who had had her hands and feet amputated, both kidneys and part of her stomach, if by chance these mutilations – very probably carried out without the slightest authorization from the person concerned or her family – had allowed him to stay alive, which as we quickly saw was not the case? The fact is that the “medical divide” allows the men in white to play the authorities without receiving the slightest counterweight. This is one of the most glaring illustrations of the truth stated by Thomas Jefferson, according to which there can be no democracy without educated citizens. In this area, the credulity of the public, the physical but also psychological dependence of worried or depressed patients, and the helplessness of distraught families, know no bounds.

Naturally, governments have reinforced the weakness of public control by making the medical world an administered and controlled economy. Prices are set by the state, a large proportion of hospitals are “public” (meaning: state). The sacrosanct “reimbursement”, the terms of which are set by the State and no longer by solidarity, boosts the turnover of doctors and selects in its own way “good” practices, becoming the cornerstone of a protected business. The State intervenes directly in the infantilization of the public: medicines not issued without a prescription (the doctor provides services on an obligatory basis… but is paid) nor without proof of identity on the basis of State documents, hospitals which refuse to provision without a prescription, individual control of the quantities taken of certain medications, customs controls, etc. We will also refer to the strange notion, introduced by governments, of “medical authority”. We must remember in all circumstances that the doctor is a technician, qualified certainly, but a technician serving his client, and not the opposite.

The result of this mafia system is described by the KUL report: uncontrolled therapeutic decisions, opaque and poorly managed hospital bureaucracies, insufficient service, propitiatory illnesses, medical blunders, “undesirable events”, etc. Again, the figures cited, of 10% deaths – already staggering – are probably underestimated. Because to be able to identify a diagnosis or care management problem, a lucid and active counter-power must intervene in a contradictory manner. Implausible, because determining the causes of a death by mistake or the existence of complications caused is the responsibility… of the medical profession. The latter would have to be gifted with a famous capacity to question himself for him to act like this.

Obviously, the principle of democratic control of medicine by the public will be all the more difficult to enforce if the population is kept in total ignorance about their own body. The solution would be to massively teach medicine, psychology and personal development from secondary education. Rather than knocking out young people with high doses of Ronsard and Du Bellay, or even algebra, this would ultimately allow the population to self-diagnose more easily, prevent the development of certain pathologies and participate in conducting your own therapy. In a deregulated society plagued by serious public health problems, this would be very useful.

We must of course count neither on the medical profession nor on the State to instigate such a reform, nor even to have the idea. Soviet-style medicine would be too shaken in its power and prestige, the regulatory ministries would be too emptied of all meaning. As for Dr. Deschepper’s study, it uses Hofstede’s uncertainty avoidance and power distance scales. It shows that in this case, securing oneself within a hierarchical system leads to not being able to control the use of a medication whose abuse has known harmful effects.

A rediscovered community requires the abolition of prebends and protected areas allocated to certain particular groups – these nourish state power, which in turn works to consolidate them.