Reviewing the Evidence

A great part of our life is governed by evidence – we look and listen for evidence of danger when starting to cross the road. In particular areas such as health care, evidence tells us what has benefited patients and what has not.

Can we take an evidence-based approach when we consider religion? Many people would say that the evidence for God is in the Bible. But is the Bible really evidence? It is after all a lot of anecdotes quite often without any cross-references which might help confirm what is put forward as fact. For some this may be enough but the decline of church attendance suggests that for many it is not. The standards which one would apply to assessing the Bible as evidence would be completely inapplicable if we were looking at healthcare. In healthcare there need to be undeniable facts supported by measurable data. So is there a better way to go about looking for evidence which supports the exercise of faith?

Those with a strong faith may be horrified by taking a modern approach allied to science to this question. Is such an approach appropriate? I think it is. It is perhaps surprising to find that there are many scientists who have a faith. It isn’t rooted in their science. It is rooted more than anything in their understanding of life, and their awareness that there is something deep in humanity which cannot be readily explained.

It is not about language, family or society. It is not measurable. It is a different kind of evidence. Some would identify it as the core of our humanity. It is about the spiritual love of human kind which we all know about. Something taught by Jesus and all the great prophets of religion. It is something which takes you into the deeper connections of humanity.

This brings science and faith together in love. It is personally spiritual and intellectually mysterious. It is also quite exciting. Acceptance of this is a process which is both emotional and scientific. The evidence is personal, unique to each of us. Once understood like this it is with us everyday in everything we do; the eternal mystery of unconstrained love, striking the chords which are the music of faith.

First published in Stretton Focus, November 2014

Drug approvals and age discrimination

Cancerworld recently published a debate between Professor Karol Sikora and Dr Ulrich Wedding on using age as a criterion of regulatory decisions on funding new drugs.

The push to use age as a determining factor in drug funding permissions is blatantly discriminatory. There are better methods and measures for discerning eligibility, if only someone researched them properly. The pharma industry is not interested in this research. Its business model (which determines its approach to pricing) is encouraged by the current inadequacy of HTA and political decisions such as England’s Cancer Drugs Fund. Indeed the latter encourages higher prices.

When the current UK government came to power in 2010 they vowed that by 2014 we would have a value-based approach to funding decisions. Its nearly 2015 and there is no sign of it but as there was no research into how value could be defined let alone measured, its no wonder we are back to simplistic thinking about age.

The core issues here are about the holistic treatment of a patient. Just looking at the disease (albeit hosted by a person) does not take into account the needs of the whole person. This debate should be about integrating supportive care into oncology practice, about losing the barriers between palliative care and oncology, about educating patients on the balance between cure and end-of-life care so that when disease is truly incurable patients make rational decisions themselves. Another cycle of chemo given to a dying patient is immoral.

Living and dying have to become palatable points for discussion. This will deliver benefits for individuals and society and could well cut drug costs. While politicians, healthcare administrators, academics and doctors are the main voices on this issue simplistic inward-looking solutions will result. Get patients involved, introduce some earthy common sense.