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Access to Medical Treatment Act

William T. Jarvis, Ph.D.

Congress has bought into organized quackery's main ploy, which is to disguise its promotions in a cloak of consumer freedom of choice. A proposed bill is:

To permit an individual to be treated by a health care practitioner with any method of medical treatment such individual requests...

The law would require the individual to be warned that:

This food, drug, or device has not been declared to be safe and effective by the Federal Government, and any individual who uses such food, drug, or device, does so at his or her own risk.

It is obvious that the only freedom that this act would confer is freedom from accountability to health care providers who traffic in dubious alternative / complementary medicine. People do not want to be cheated by ineffective treatments, nor do they want to be harmed. The only reason peoplewould want to be treated by an unapproved procedure is that someone has convinced them that the method IS safe and effective. Desperate patients are willing to try most anything that a health care provider suggests might help. Alienation also plays a powerful role in misguided patient behavior. Deviant providers often convince their patients that an oppressive and corrupted bureaucracy is keeping the treatment off the market. Even the language "declared...by the Federal Government" rather than "determined on the basis of evidence" is prejudicial. This bill is a charlatan's dream because it entices patients to sign away their rights. By fulfilling the duty to warn, quacks will be getting the same kind of protection the tobacco industry got with warning labels. After a consumer realizes he has been harmed, he has little chance of redress because of having been warned.

Are Our Legislators Up To Their Jobs? NCAHF finds it incredible that our Senators and Representatives are willing to sell out to quackery by introducing and promoting such legislation. Americans are disgusted with Congress for selling itself to special interest groups, but the Congress sinks to a new low when it jeopardizes the health of the public by putting quacks on a par with responsible medicine. If these legislators plead ignorance, they are incompetent to serve. If they deny that their legislation indemnifies quackery, let them show how their law protects the public from delusional crank health care providers who truly believe that their nostrums have value, ideological types who base their practices upon the sectarian teachings of gurus, or psychopaths described by Dr. Robert Hare:

Psychopaths are "social predators who charm, manipulate, and ruthlessly plow their way through life, leaving a broad trail of broken hearts, shattered expectations, and empty wallets. Completely lacking in conscience and in feelings for others, they selfishly take what they want and do what they please, violating social norms and expectations without the slightest sense of guilt or regret. Their bewildered victims desperately ask, 'Who are these people?' 'What makes them the way they are?' 'How can we protect ourselves? [1]

Most of the characters that Hare describes in his book are criminals. Some are infamous serial murderers. This is because a great deal of his research was done in prisons. But Hare has stated that not all prisoners are psychopaths, and not all psychopaths are in prison. He says, "You find psychopaths in all professions. He's the shyster lawyer, the physician always on the verge of losing his license, the businessman with a string of deals where his partners always lose out." [2] The new research indicates the slippery ease with which psychopaths lie, twist language, and manipulate and destroy people in pursuit of their own ends is associated with brain function that differs from that of normal people. The psychopath shows a facile use of language, but the defect leaves him oblivious to the emotional meaning of the words he speaks and hears. "The con man understands what he is saying at the intellectual level, but when he uses words they don't carry the same emotional baggage for him as they do for other people."

South Dakota Senator Tom Daschle, and Oregon Congressman Peter DeFazio are the prime movers behind the ill-conceived "Access to Medical Treatment Act." DeFazio states in a letter to The Wall Street Journal (6/23/97) that:

The case of Dr. Stanislaw Burzynski is a prominent example of why we need FDA reform. During Dr. Burzynski's trial, his critically ill patients were faced with the loss of access to his experimental drug, antineoplastons. Many of us in Congress found the government's conduct and handling of this case to be heavy-handed and costly. In fact, it is the subject of an ongoing congressional investigation. Americans should not have to fear that the government will take away their access to alternative therapies.

DeFazio goes on to say that this is one reason why he introduced the Access to Medical Treatment Act. A letter from William London appeared in the same column rightly pointing out that "people don't choose an unapproved treatment unless marketing efforts lead them to believe that it can make them well." And that "The utility of freedom of choice depends upon reliable information."

Accompanying DeFazio's letter was a testimonial from Ted Wadman of Corvallis, Oregon, who states that his "12-year-old son has a brain tumor that has shrunk by 70% in volume over the past two years while on Dr. Burzynski's treatment." What Mr. Wadman doesn't acknowledge is that his son's brain tumor may have shrunk whether or not he had been on antineoplastons. Some of the problems involved in evaluating the effectiveness of any remedy on brain tumors are that (1) their irregular shapes can cause their apparent size to vary considerably even from day to day on CT scans depending upon the "cut" and contrast load; (2) cystic tumors may nearly disappear if they happen to drain; (3) patients with lower grade tumors tend to survive for long periods of time in any case. Since the survival curve for any population of cancer patients is skewed (ie, resembles a toboggan run that is steep at first, lessens in gradient, and then trails way out), any clinic that treats a large number of cancer patients is bound to have a number of long term survivors. Understanding this, cancer specialists know that the presence of a few long term survivors cannot prove the value of any remedy--only randomized, controlled clinical trials can provide the evidence that is needed. This is what the case against Burzynski is about. He has failed to test his antineoplastons choosing instead to market them based upon testimonials. Anyone intelligent enough to serve in the U.S. Congress should be smart enough to understand why testimonials are unreliable, and why randomized, double-blind clinical trials are needed to establish the value of a treatment. Previous congresses recognized this fact and wrote these requirements into law. Is DeFazio's inability to grasp these fundamental realities an indication of the "dumbing down" of congress?

NCAHF wonders if Daschle or DeFazio have communicated with the medical scientists among their constituencies for their input on the wisdom of this kind of legislation. Or, whether they believe that evidence-based medicine is the proper standard for the nation? Are they willing to admit that they are representing the antiscience, anticonsumer protection factions in their constituencies? Do they not realize that true believers do not need such legislation? People who are alienated from standard medicine will attend the quacks with or without such a law. The people in need of protection are the unsuspecting patients who seek nonscientific health care for themselves and their children who will seek redress when things go badly. They will then discover that the law protects the provider, not the consumer; that they were operating at their own risk. Most are surprised to learn that nonscientific health care provider is not held to the same standards as are physicians, but only to those of others of their guild. For instance, when an Oregon woman, who at the time resided in what is now DeFazio's district, fractured a vertebra, she went to a chiropractor for the back pain. He failed to diagnose the fracture and manipulated her spine. The failure to put her in a cast resulted in severe bone-spurring that became the source of perpetual pain and dysfunction. When she sued the chiro, she lost. The reason: other chiros testified that their colleague had delivered care appropriate for a chiro. The court ruled that she had chosen to seek chiro care, and had gotten what she bargained for. Chiros are held to chiro standards, not medical standards of care [3]. Sick people deserve better than to have to sort through a maze of alternatives that include both legitimate medicine and quackery.

Incredibly, in little more than a decade, Congress has gone from indignation over quackery to tacit endorsement. In 1983, following a national survey of over 1,300 consumer affairs and law enforcement offices, U.S. Senate Committee on Aging reported that "quackery and medical related frauds" was first among the ten most harmful frauds directed against the elderly. In 1984, a U.S. House of Representatives subcommittee chaired by Claude Pepper (D-Fla) which had independently arrived at the same finding, culminated an intensive four-year study of quackery and its impact upon the elderly [4]. The Pepper Committee estimated that the elderly were spending at least $10 billion per year, and that the nation as a whole was probably wasting $25 billion, on quackery. Most shocking, was the estimate that the amount expended exceeded by several magnitudes the $3.8 billion spent annually for all health research at the National Institutes of Health [5]. In 1987, Louis Harris and Associates reported on a national sample telephone survey of American adults to determine the use of questionable health care products for fifteen treatment areas (figure 2). The study found that 26.6% of the American public (est. 46 million) used one or more questionable health care treatments, and 21% (est. 38 million) had used a questionable health care product during the past year [6].

The events that changed the picture appear to be the emphasis President Clinton put on developing a national health care financing program early in his administration. The likelihood that third-party payers would write the checks under government guidelines mobilized nonmedical providers to become organized and to lobby for inclusion. At the same time, political insiders such as Senators Tom Harkin and Orrin Hatch were working on behalf of off-beat health care. Harkin managed to have established the NIH Office of Alternative Medicine, and Hatch managed to pass the 1994 Dietary Supplements Health and Education Act. In 1993, the New England Journal of Medicine reported that the use of unconventional medicine was far higher than previously thought. This time the numbers were deemed as something worth cashing in on. Why did people react this way? Because managed care entrepreneurers had taken over medicine and were imposing commercial rather than professional values on the situation (see: "Professionalism versus Commercialism" NCAHF Newsletter, July-August, 1997). The public has been confused by all of this, but people know that they are unhappy with the new health care. Ironically, they may interpret the language of "access to medical treatment" as making more available the health care being denied by tight-fisted HMOs, when what is really happening is a substitution of questionable alternative and complementary health care for the real thing.

References

  1. Hare RD. Without Conscience. Pocket Books, 1993, p.xi)
  2. Goleman D. "Brain defect tied to psychopathic detachment," The New York Times, July 7, 1987, p.C2; a review of Reid WH, Dorr D, Walker JI, Bonner JW. Unmasking the Psychopath. New York: W.W. Norton & Co., 1986.
  3. Sutton v. Cook. Oregon Supreme Court, 458 P2d 402, Sept, 1969.
  4. Heinz J. Consumer frauds and elderly persons: a growing problem. Special Committee on Aging, United States Senate, Washington, D.C., April, 1983.
  5. Pepper C. Quackery: A $10 Billion Scandal. Subcommittee on Health and Long-Term care of the Select Committee on Aging, United States House of Representatives, No.98-435, 1984.
  6. Louis Harris and Associates. Health, Information and the use of Questionable Treatments; A Study of the American Public. September, 1987, Washington, D.C., U.S. Department of Health and Human Services.

Copyright Notice

© 1997 National Council Against Health Fraud. With proper citation, this article may be reproduced for noncommercial purposes

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This article was posted on December 1, 2000.