This comment is asking for trouble, but I'm making it in the hope of getting some good discussion going, and hopefully not a flamewar. I've been thinking about this a lot lately since my own family is struggling with this issue.
I very strongly feel, like many people probably do, that I would not want to live with dementia. I would not want to live that non-life, I would not want my family to have to experience it, and I would not want to burden them with my care. In the not-unlikely event that I'm diagnosed with Alzheimer's or some other form of dementia, I would want to end my life while I'm able to competently choose to do so. I would want to do so with quick and painless drugs instead of a gun. However, assisted suicide is only legal in a handful of US states, and then only in cases of terminal illness with less than six months to live. There is nowhere in the US for an early-state dementia patient to commit assisted suicide.
It is currently legal in Switzerland to do so, and people have traveled there for that very purpose. [1] Other people have committed suicide without assistance to avoid the ravages of dementia. [2]
I'm aware of the counter-arguments to assisted suicide: that it can cross the line into euthenasia, that it makes the most vulnerable in our society even more so... but still, there has to be some way for this to be legalized.
What to do? What are some concrete proposals for how to alter existing legislation to allow assisted suicide in cases of dementia? Does anyone have personal stories that make the argument against it?
At least with Alzheimer's, there is no bright line between competence and incompetence. It's a relatively slow slide into incompetence. And not an even progression, since in fuzzy area there may be periods of competence mixed with periods of incompetence. I think big part of problem for person with Alzheimer's to make decision of suicide is to have the resolve to do it early enough, while they're still clearly competent and would have much more time as a competent person, instead of waiting to try and milk out as much time as they can. Cause if you wait you're likely to forget your strong desire (I'm not joking here) or simply lack the resolve to do the deed.
>> I would want to do so with quick and painless drugs
>> instead of a gun. However, assisted suicide is only
>> legal in a handful of US states, and then only in
>> cases of terminal illness with less than six
>> months to live.
I'm not sure why, but you seem to think use of "quick and painless drugs" requires use of assisted suicide. Maybe one solution would be for someone to publish some "How To" information on how to assemble and use a quick and painless drug solution, all on your own. Then at least anyone worried enough about developing Alzheimer's would have a length of time measuring in years to get their solo-suicide plan in place.
I say this as a person who hopes he'd be able to take his own life before incompetence comes. My father and several members of my extended family had Alzheimer's. I think that people who lack experience with it are sometimes unaware of how Alzheimer's robs a person of their personhood. It's not pretty and nobody should ever have to go through it.
If there was a legal framework for assisted suicide, you could state your wishes unequivocally today -- while you're still competent -- and have help carrying them out later when you're vulnerable and no longer competent.
You won't find a legal framework anywhere that assumes your wishes years ago still are your wishes today.
The best you probably can do is to repeatedly state something along the lines of "if I haven't repeated this statement for a month, ask me about it. If I am competent, I will repeat the statement; If I cannot, and don't answer the question, try again a few times in the next month. If I never answer the question, I would want to die."
That would give those who would have to decide about your wishes at a time where you cannot communicate them anymore a track record of what your past self thought the wishes of your current self would be. It still would be a tough decision for them, but you cannot give them more.
someone to publish some "How To" information on how to assemble and use a quick and painless drug solution, all on your own
There are a lot of sites and organizations dedicated to that exact thing. An interesting one, in my opinion, is "Max Dog Brewing"[1] which uses nitrogen as an alternative to the helium asphyxiation technique. No drugs required.
I regret that this comment is so brief, as I don't want it to appear curt. I just have a lot of opinions that I don't feel like putting in this thread.
I've considered starting a tradition in my family wherein every year you put on a pack and head out, on foot, in the wilderness for one week. Every year, for the rest of your life.
If your family adopted this tradition, many problems would be solved. Many complications become greatly simplified. It's much more dignified than drug-assisted suicide and certainly more dignified than going through Alzheimer's.
In fact, I think it's more dignified than simply dying of old age.
I'm assuming you're replying in good faith, but that's pretty silly. I'd prefer that every person gets to choose how to live (and end) their own life the way they damn well please, not starve to death in the woods because of a family tradition. There are a lot of glib solutions would greatly "simplify" things.
Except most people love their families more than health or life. Missing out on the childhoods of your grandchildren or great-grandchildren is a nonstarter for them.
This doesn't address your questions, but does address your comments.
I know someone who managed to obtain a lethal dose of the drug they prescribe in Oregon. He believes in the right-to-die movement but lives in a state that will probably never allow it. Before anyone asks, I don't know how he got his hands on it.
"How to Die in Oregon" is a heartbreaking documentary on the right-to-die issue that brought me to tears (I don't cry easily). The assisted deaths that occur at the start and end of the film are punctuated by the patients reassuring their family members that they are in no pain as they say goodbye. Both had low quality of living due to their respective illnesses, but they got to say goodbye on their own terms and with dignity. Very touching.
I agree with you. I just don't get why the distinction between physician assisted suicide and voluntary euthanasia is such a big deal. And there seems to be evidence that assisted suicide reduces involuntary euthanasia, which is what we should care about:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1377611/
Legislation is very hard to change, although it seems to be going in the right direction. Washington and Oregon allow assisted suicide for the terminally ill.
I'm no maritime law expert, but I wonder if it's possible to offer assisted suicide in international waters, similar to abortion ships. It'd be much more accessible than traveling to Switzerland.
I have upvoted your comment but I don't think it is as simple as you seem to think it is.
My father had Alzheimer's. He was given six months to live but my mother was too good at taking care of him. It took him about three more years to actually die. At some point, I got a copy of the death certificate. One of his diagnoses* is a form of "anorexia." The picture of him in his casket was unrecognizably thin. In other words, he basically took three years to slowly starve to death, in spite of being given excellent care.
While he slowly starved to death, he still drew two retirement checks. I am currently homeless and was homeless for a good portion of the three years it took him to die. Part of the money he still drew for still drawing breathe helped keep me and my sons fed. When he died, I was glad his suffering was over but I also worried that it would mean more suffering for me and my sons.
I have a different condition. It is medical and incurable and comes with a death sentence. About 13 years ago, I spent about a year at death's door. I was told "people like you don't get well." I have figured out how to get well. I sometimes wish I had died 13 years ago. Getting well has involved a lot of suffering, plus a lot of people think I made the story up or something, and because I am destitute I struggle to get enough to eat every month.
On the other hand, I have solved a hard problem: Getting well when that is not supposed to be possible. If I ever solve another hard problem -- getting the world to believe me and finding a way to effectively share the information -- it may help a lot of people. Or it may not. I might yet die on the street, in obscurity, just some "crazy" homeless person suffering what other people think are delusions.
Some people with my condition hold on and do not commit suicide, in spite of how miserable it is, because they are hoping for a cure, for a medical miracle. Things have gotten better. Average life expectancy has roughly doubled in recent decades. I once saw an email from a mom saying "My child is now 18. Life expectancy is currently 36. When he was born, it was 18."
I don't have any answers for you. Thirteen years ago, I was not looking to get well. I was just looking to hurt less. I would have welcomed death. Had assisted suicide been an option, I might have taken it. I often think about that when such discussions come up. My oldest son has the same thing. He was 14 when he was diagnosed. He is now 27. He, at least, has a brighter future than he should have had because of what I have been through. He, also, has gotten healthy, but without first spending a year at death's door. It does matter to me that I have at least done something for my children.
I am sorry for what you are facing. I am sorry there seem to be no easy answers for some things.
* edit: By "diagnoses" I mean the listed causes of death, I think. I don't have the death certificate in front of me.
Maybe they should consider using medical marijuana for such patients, it might have some unexpected benefits which seem to be the pattern we see with marijuana as more studies are done on it. Give it chance rather than having them kill themselves in a foreign country where it's better to die than smoke weed.
what I meant was use marijuana as a way to control depression. How the hell can killing yourself be better? Obviously they have not smoked good weed.
The article does point this out which I think is also relevant.
“ .. if you do anything, such as smoke a bunch of
marijuana in your 20s and 30s, you may wipe out all of
the inflammation in your brain and then things start
over again. And you simply die of old age before
inflammation becomes an issue for you,” Wenk states.
Nixon's ever lasting war on drugs to distract the world from the ongoing humiliation in Vietnam conflict is the greatest trick the devil has ever pulled.
I understand your position however I am ultimately against assisted suicide and euthanasia. Suffering and hardship are not bad things. They are means to a greater end, a crucial part of the human journey. Anyone who tries to eliminate suffering by killing "sufferers" is establishing a horrific trend.
Would you also deny others pain-relieving medication?
See, your philosophical stance is admirable. In my mind, thinking of pain as a positive thing is a healthy approach to life. What I find deplorable is forcing your personal view on others. That is pure righteousness.
Indeed, righteousness is the underlying problem here. Taking one's personal views on life ('... a crucial part of the human journey ...') and believing they are a universal truth. Once this belief is formed, the natural conclusion is to force others to live by it, because it is the Truth.
How about we let everyone decide what to do with their own lives, as long as they do not inflict harm on others?
Why does your definition of suffering hold more weight and authority than the one suffering? Why do you have more right to claim agency over those whom suffer? I am serious here. Please watch How to Die in Oregon (on Netflix) and get back to me, this is a very serious issue.
Only I don't. But how does it felt? Do you really stoop to being so low a human being as to wish BS upon other people because you disagree with in a discussion?
Do you think that makes you better than whatever you think he is?
I don't care about this guy's family. Why did you bring mine into it?
I do not merely disagree with his position. I consider it vile and a threat to me and everyone I know. It is one of those positions where compromise is immoral. Some disagreements are not matters for civilised discussion if you actually believe in it, slavery, religion, gay rights, morality in other words.
I feel just fine about wanting an end to Alzheimer's, to aging and senescence in general and I feel equally fine about wanting him to live out his beliefs about how suffering brings meaning to life.
One thing we can do is stop the false accusations of suicide. Suicide - which is indeed almost always wrong - is choosing death when you could have had life. What we're talking about here is a scenario where you are going to die either way, and your options are torture or no torture. Given that, 'no torture' is the sane and reasonable option. Let's not put up with lies about it being suicide.
Alzheimer's is terrible, but the way our current medical system handles old age makes it even worse. A doctor friend of mine wrote an essay on this, titled Who By Very Slow Decay (http://slatestarcodex.com/2013/07/17/who-by-very-slow-decay/):
"Somewhere in the process your mind very quietly and without fanfare gives up the ghost. It starts with forgetting a couple of little things, and progresses until you have no idea what’s going on ever. In medical jargon, healthy people are “alert and oriented x 3″, which means oriented to person (you know your name), oriented to time (you know what day/month/year it is), and oriented to place (you know you’re in a hospital). My patients who have the sorts of issues I mentioned in the last paragraph are generally alert and oriented x0. They don’t remember their own names, they don’t know where they are or what they’re doing there, and they think it’s the 1930s or the 1950s or don’t even have a concept of years at all. When you’re alert and oriented x0, the world becomes this terrifying place where you are stuck in some kind of bed and can’t move and people are sticking you with very large needles and forcing tubes down your throat and you have no idea why or what’s going on.
So of course you start screaming and trying to attack people and trying to pull the tubes and IV lines out. Every morning when I come in to work I have to check the nurses’ notes for what happened the previous night, and every morning a couple of my patients have tried to pull all of their tubes and lines out. If it’s especially bad they try to attack the staff, and although the extremely elderly are really bad at attacking people this is nevertheless Unacceptable Behavior and they have to be restrained ie tied down to the bed. A presumably more humane alternative sometimes used instead or in addition is to just drug you up on all of those old-timey psychiatric medications that actual psychiatrists don’t use anymore because of their bad reputation."
emts get to deal with this all the time too. People get sick in nursing homes -- they are cesspools -- and have to be transported to a hospital. Unfortunately, they have no idea what's going on, and they're being strapped down in a van and manhandled by strangers. You can imagine how they react. After a while they get notes in their medical records saying they have to be physically restrained during transport, which terrifies them even more.
Part of the problem is that it affects much older people so it's out of our daily thoughts, and we might not know them as well. Also, when people get the disease, they often go into hiding. Ronald Reagan, Margret Thatcher, and Charlton Heston come to mind.
I noticed that there's a Glenn Campbell documentary that covers his Alzheimer's. He was a little before my time and a superstar in his time.
Figures from the article may help us think about this issue more clearly. "Alzheimer’s disease is practically unheard of in adults younger than 40, and very rare (one in 2,500) for those under 60. It affects 1 percent of 65-year-olds, 2 percent of 68-year-olds, 3 percent of 70-year-olds. After that, the odds start multiplying. The likelihood of your developing Alzheimer’s more or less doubles every five years past 65. Should you make it to 85, you will have, roughly, a fifty-fifty shot at remaining sane."
When we are talking about a disease with base incidence of only 3 percent even for seventy-year-olds, we are so far talking about a disease that has been a low-priority disease. It's only in recent decades, as life expectancy has increase at all ages from 40 on up to 80,[1] that a lot of people have outlived heart disease, cancer, and the infectious diseases that used to cut life short at younger ages. As more people who are otherwise healthy age into ages at which their risk for Alzheimer disease increases, there will be increasing research and study of treatments related to Alzheimer disease. The fact that there are still people who can live past age 100 without getting severe signs of any kind of senile dementia suggests that we have something to discover about individual differences to find out what protects some people from Alzheimer disease decade after decade after decade. There is no need to give up hope. Incremental improvement--a little change in treatment here, a little change in lifestyle there, and a better understanding of prevention overall--is most of what has improved healthy lifespan in relation to other diseases, and there is no reason to think that Alzheimer disease is any different.
My own maternal grandmother, born in the 1800s, lived to the age of ninety-nine. Near the end of her life, she plainly had some kind of dementia, and presumably that was Alzheimer disease, and I think that was her cause of death. But she had a lot of interaction with her eleven children and thirty-eight grandchildren and various great-grandchildren for a long time after she was widowed, and I don't think anyone in the family looks back on her life and thinks that her death needed to be hastened. Some people retain memories of childhood in extreme old age even after they no longer form new memories of current events. For my grandmother, this was shown by one visit I had with her in her mid-nineties, when she no longer was sure who I was, but still remembered and was able to sing along me a song she had learned in childhood. (The song was in German, her native language, so I know she had not heard it for many years by the time I sang it with her. I had learned the song only when I studied German in university studies.) So don't give up on communicating with your aged relatives. Try to reach back in time to the best memories they have of their childhoods. They may surprise you with their understanding for a long time. And by a long time from now, when all of us reading this are old, Alzheimer disease may be largely a thing of the past.
The lengthy second-person-viewpoint account of caring for an aged parent with Alzheimer disease in the article is disturbing and moving. It reminded me deeply of caring for my late dad during the last six years of his life, when his thinking was completely intact but his mobility was destroyed by a spinal cord injury. There are a lot of devastating forms of disability that human beings can face, and, no, Medicare in the United States does not take care of patients with long-term disability of any kind. I did feel a lot of futility when talking to my dad (who had difficulty talking not because his brain wasn't working, but because he was paralyzed from his second spinal vertebra down, and couldn't even clear his throat or swallow on his own). He wanted to walk again--or at least to be able to scratch his own nose again--but he never did after his injury. Taking care of a helpless relative is rough--any time, for any reason--but we didn't give in to the idea that he should die early just to make our lives more convenient. He died only when a lot of other health problems (many of them aggravated, surely, by six years of immobility) piled up just after his seventy-eighth birthday. There a lot of memories I have of my dad (and my children have almost ALL of their memories of their grandfather) after the day on which his spinal cord was injured. I was willing to interrupt a career transition and diminish my "free" time to almost nothing to be with him in his old age. That wasn't easy, but that's what we did.
Wonder if the advance of virtual reality could improve these peoples lives in some way -- kind of what they're doing in the Hogewey complex -- simulate a life that is somewhat "normal" to these people to reduce stress and anxiety.
"1 percent of 65-year-olds, 2 percent of 68-year-olds, 3 percent of 70-year-olds. After that, the odds start multiplying. The likelihood of your developing Alzheimer’s more or less doubles every five years past 65. Should you make it to 85, you will have, roughly, a fifty-fifty shot at remaining sane."
1% at 65 doubling every 5 years for 20 years = 16%
3% at 70 doubling every 5 years for 15 years = 24%
The "likelihood of developing" vs incidence (what proportion of population suffers from it)
1% at 65, 3% at 70 means that, in the 65-70 year range, about .4% of that cohort develops Alzheimer's per year. Double that to .8% per year in the 70-75 year range and you get 7% incidence at age 75 (3% had it at age 70, 4% got it between ages 70 and 75). Continuing, you get:
- 1.6%/year in the 70-75 range gives you 15% incidence
- 3.2%/year in the 75-80 range gives you 31% incidence
- 6.4%/year in the 80-85 range gives you 63% incidence
Didn't you use 70-75% twice? Once in the text body and once in the list?
Wouldn't your method leave you with 31% at the end if you just used this age bracket once and didn't have the extra double cycle?
But for the record, I'm sure you are right. The ODDS of developing start doubling. Not the amount of people afflicted (No doubt a somewhat complicated figure as death, not insignificant at those ages, starts changing the equation. Do people with Alzheimer die at the same rate as those without?). Thanks for the explanation.
>In 1900, about 4 percent of the U.S. population was older than 65. Today, 90 percent of all babies born in the developed world will live past that age.
This comparison is a bit fishy, isn't it? The 4 and 90 don't have much to do with each other, since the age at which people die isn't taken into account. Even if everybody lives past 65, if they all die at 66, only 1/66th (or 1.5 percent) of the population is older than 65.
Someone PLEASE make a startup that somehow enables people to stop suppressing thoughts of death related to heart disease, cancer, alzheimers,etc., and instead helps up mobilize a response. 3000 people die every 30 minutes. And yet we spent trillions on 9/11. A complete waste of money. We could do so much better.
Governments will pay you if the cost of your preventative treatment is less than the cost of providing state welfare. Don't assume that the public has to pay from their own pocket, they can pay you through other means. Government grants are often sizeable and under appreciated.
>Everyone knows that obesity is a bad thing, and that it can be avoided by not eating too many calories. Why are there so many obese people?
Because unhealthy food is delicious, cheap AND addictive.
>Since everything else we've tried to get overweight people to stop eating so much has failed it might be worth looking at different approaches.
Well, a ban on refined starches and corn sugar work quite well. People were much healthier (from an obesity perspective) when such products were not available.
> Well, a ban on refined starches and corn sugar work quite well. People were much healthier (from an obesity perspective) when such products were not available.
Do Scotland, New Zealand, Hungary use "corn sugar"? We don't use it much in England and we (along with those other countries) also have problems with obesity.
I'll happily accept that calories from sugar are a problem.
>Do Scotland, New Zealand, Hungary use "corn sugar"? We don't use it much in England and we (along with those other countries) also have problems with obesity.
How much of a problem, though, compared to say, the US? I've travelled quite a bit in Europe, Asia, etc, and I've seen nothing compared to the US level of obesity. Heck, the kind of people you'll see in a Walmart (and not isolated -- tons of them, and all over the states)...
I guess it's also other stuff: deep fried anything, Sneaker and Mars bars, chips (crisps), BS "sports" drinks, sodas, etc etc.
I'd rather be obese than give up my ability to eat products made with refined starches or corn sugar. Wouldn't this have a big impact on the food industry, too?
>I'd rather be obese than give up my ability to eat products made with refined starches or corn sugar.
That's a really bad choice, though, that a lot of people make. Perhaps it will be good if that choice was eliminated, or made more difficult with a large tax. At least then people would think twice before ordering a $10 corn-syrup soda vs a $2 no-sugar one.
>Wouldn't this have a big impact on the food industry, too?
Well, the smoking bans also hurt the tobacco industry too. If an industry relies in causing people harm by using cheap substitutes (e.g corn sugar for sugar etc), or selling addictive shit, let them be impacted.
> At least then people would think twice before ordering a $10 corn-syrup soda vs a $2 no-sugar one.
That's just it, I don't like the idea of bullying people into healthy eating. I don't want to end up in a future where it's illegal to consume more than 2000 calories in a day. Fortunately people don't seem to like this idea given the reception of the large soda ban in NYC.
Would you support it if "bullying" was shown to work?
Leaving people to freely chose their food is obviously not working. We could pay people to eat more healthily - would you support that? So why is it different to add costs to unhealthy food?
Of course it would "work" in the sense that taking away people's freedom to eat unhealthy food would generally make them healthier. That doesn't make it right to do. It would also "work" to chase fat people around with sticks all day. I don't like the idea of restricting people's personal choice to force them to be more healthy. If I, fully informed of the consequences, want to buy soda and twinkies, I should have the full right to do so and not have it made economically unviable due to ridiculous fees and taxes.
Some people whose comfortable level of eating happens to be above what they burn in their average day would rather eat what they want instead of counting calories, going hungry, and exercising all day.
You are the younger version of your parents; this is how we have beat death for billions of years (you are just a branch of a much bigger genetic program). It's really easy to activate this feature, I bet you won't even need the documentation. It does require two-factor authentication although... but there are lots of startups (ie. okcupid) working to solve that problem for you. :P
This shows how flawed the whole medical science is today. The issue is not Alzheimer, the issue is autoimmune diseases, specifically, leaky gut, constant low-grade inflammation, and others. If you try to fix just Alzheimer's alone, you've accomplished little! Fix the leaky gut issue, you've solve tens of chronic diseases at once. But, I guess, it's more profitable to sell 10 different "targeted" therapies instead of fixing one thing with lifestyle and proper nutrition! Another thing to add is the Hygiene Hypothesis - we're not adapted to live in a sterile environment, so, either get a bit more filthy (and resilient) or adjust your nutrition to more anti-inflammatory state. Anyway, I'm happy that there are conscious physicians who are revolting against the status quo and practicing Functional Medicine like Dr. Mark Hyman and others.
Your pet issue has little or nothing to do with Alzheimer's. Alzheimer's results from a combination of three things:
1. Amyloid plaques forming between brain cells.
2. Neurofibrillary tangles forming in brain cells.
3. Loss of brain cells, likely from the build-up of 1 & 2.
All three of these things happen to everyone as we age. This is true no matter how good your immune system or diet is. Many of us just get killed by something else before it becomes pathological.
A good example is the Sardinians whose lifestyle is in the base of the Mediterranean Diet. They are actually getting pretty sick recently from autoimmune diseases and one of the leading hypotheses is the eradication of malaria, which has kept their immune response overactive before that.
They've had remarkable life expectancy with the malaria as well. I'm sure everybody would prefer dying from malaria than MS, getting blind or an amputee from diabetes, and so on. Improvements in life expectancy today is not an improvement of overall health, just the medicine found ways to keep sicker people alive for longer (i.e. countering natural selection). If infectious diseases like tuberculosis and others were eradicated just a couple of centuries earlier, modern medicine today wouldn't be so proud of the accomplishments in life expectancy! Unfortunately, due to widespread abuse, antibiotics are no longer the panacea that they used to be!
Again, you're going symptomatic about the disease... The premise that we live longer than ever before and that's why we get these diseases is a statistical error. Child mortality and poor record-keeping was driving life expectancy down. My own homeland had a lot more centenarians in the past than in the past decades, for example. My own predecessors lived longer than my relatives who died recently of various chronic diseases.
It's not a statistical error. Overall, the maximum age that anyone gets to is not much higher than before, but:
1. Many more people reach old age than previously (due to reduced infant mortality), so old age diseases are a larger problem for society since a larger portion of society is getting old. (not citing a source for this because it's extremely well established)
> Overall, the maximum age that anyone gets to is not much higher than before
Not-so-fun fact: ever since Jeanne Calment died in 1997, the maximum age (as recorded by the GRG) has kept falling: while Calment hit 122, we're now down to 116 or so, which is much more impressive than it looks because the annual mortality rate for supercentenarians is like 50%+.
I've wondered more than once if she was some kind of unique freak of nature - she was even a smoker!
As you can tell by your own sample, above 50, the improvements are more like a rounding error than anything. Considering that most of these "improved" lives are actually suffering from various chronic diseases, I don't think there's any improvement. It doesn't really matter if one lived 80 or 82 years, the quality of life of those 80 years is what matters and given how much time is invested now in healthcare compared to zero to nothing in the past, that is really non-productive, no fun, i.e. wasted time, so, subtract that from the overall lifespan and there's no improvement at all and on the contrary!
Why? You can't help your downvoting urges? I think a lot of you should learn to respect and tolerate other people's opinions! Definitely your overreactive aggressive mentality is not gonna help you with your lifespan!
I agree that novel approaches should be welcomed, but I doubt that pseudoscientific fads perpetrated by Hyman et al are going to bring us a cure for Alzheimer's Disease.
Isabel, a cute 10-year-old girl from Texas who loved riding horses, walked into my office a year and a half ago with one of the most severe cases of autoimmune disease I had ever seen. Her face was swollen, her skin was inflamed, her joints were swollen, her immune system was attacking her entire body–her muscles, her skin, her joints, her blood vessels, her liver, and her white and red blood cells. Isabel couldn’t squeeze her hand or make a fist. The tips of her fingers and toes were always cold from Raynaud’s disease that inflammed her blood vessels. She was tired and miserable and was losing her hair. Isabel was on elephant doses of intravenous steroids every three weeks just to keep her alive, and she was taking prednisone, aspirin, acid blockers, and methotrexate, a chemotherapy drug used to shut down the immune system daily.
Two months after I first saw Isabel and discovered and treated the underlying causes of her inflammation–after, as she says she, “stopped eating gluten, dairy, and sugar and took some supplements” she was symptom free. In less than a year, she was completely healthy, her blood tests were normal, and she was off all her medication.
I can't tell you what u/conception means specifically, but I can point out that the story cites exactly one individual and has no control group. If you don't have a statistically significant sample size and a control group, you are conducting bad science.
I'm afraid science is more complex than that. It's true that you don't have a proven theory, verified to the point that it can be considered settled, until you have a statistically significant sample, a control group, and several replications. But a lot happens before you get to that point. You can't test every hypothesis you come up with; there's no time. The hypotheses that are worth testing have to be sorted from those that aren't.
In fact, the medical literature is full of case studies. Do they prove anything? No. But they suggest things to try in subsequent cases that seem similar -- and if a technique finds enough success in practice, maybe it's worth doing a study on.
Okay, but the passage 'conception quoted said nothing about proving anything.
I don't know what source that was quoted from or what other claims that document might make. (The quoted passage doesn't even tell us what theory its anecdote is being presented in support of.) But to claim that this passage in itself establishes that the source is "pseudoscience" or "bad science" is, frankly, ridiculous.
You know, the scientific method has no special dispensations for orthodoxies -- if anything, the very notion of an orthodoxy should be repellent to a scientist. But scientists are human, and many people are attracted to orthodoxies.
Yet if there's anything we know, it's that all theories, orthodox or not, have their limitations. Given that, isn't it a good thing that there are people willing to explore unorthodox possibilities even if most of them are wrong?
I'm not suggesting credulity. I'm suggesting humility: a keen awareness of how much we still don't know.
Dr. Mark Hyman is a practicing physician, not a disconnected from patients (i.e. the real world) researcher. He's identified an intolerance and he's treating it, and he got positive results. What's unscientific in his centuries-old approach?
So, if I'm a physician, and if somebody comes to me with signs of a peanut allergy, I need to first do a control group before I treat by asking them to eliminate peanuts from their diet and see if they will get the symptoms? You're not being serious! Gluten intolerance is often asymptomatic and does harm that's not so obvious and directly correlated. In fact, it's probably better to have Celiac's and completely eliminate gluten with no doubts than have the asymptomatic form and keep living in denial!
Okay, I agree with you on the proof, but, again, he's a doctor and his focus and moral goal is healing patients, not doing research by the book. If he was purely a researcher, I'd agree with you, but, again, he's very actively practicing medicine, and his conclusions are not based solely on the cases he references, I'm sure.
According to Wikipedia (http://en.wikipedia.org/wiki/Coeliac_disease), there's a growing asymptomatic Celic disease in the United States - about 1% of the population. So, is this rare or not, I don't know, but all this is about a pathological level of sensitivity. There many more who are sensitive yet not to the level of pathology and that's what's causing low-grade inflammation that's slowly and silently ruining your thyroid and other organs.
Well, in America, the placebo effect is more effective than many pharmaceuticals, so, yes, I'd recommended homeopathy as well, knowing that it can do well and for sure do no harm compared to drugs that just address symptoms, don't cure anything, and do certain damage especially in the long run. I'm not saying that plecebo could help anyone with PMS, I honestly doubt that, but he lists that as the last resort in that particular article and being a doctor who's seen a lot of patients, why would I doubt his recommendation? Maybe it really works for some, how can I know?
"in America, the placebo effect is more effective than many pharmaceuticals" - There's nothing particularly unique about Americans that would require different treatment than humans in the rest of the world (except for perhaps the incredible obesity problem).
"I'd recommended homeopathy as well, knowing that it can do well and for sure do no harm compared to drugs that just address symptoms" - Actually, there is harm is encouraging people to spend money and time on things that are demonstrably false, because it prevents that time and money from being applied towards worthwhile causes (like finding effective treatments for Alzheimer's).
"being a doctor who's seen a lot of patients, why would I doubt his recommendation?" - An MD degree does not bestow infallibility or scientific inscrutability on the people who have them. MDs disagree with each other pretty routinely, so if you're curious about a doctor's recommendation, 1. find another doctor who disagrees, and try to understand why they disagree, and 2. read some summaries of the actual scientific studies behind whatever the recommended treatment is. If you can't find any scientific studies supporting the treatment, that should be a warning sign.
1. Regarding the placebo/nocebo effect, cultural and other differences matter. I can't find where I read about Americans being generally more affected by it, but I won't be surprised if it's related to powerful marketing of pharmaceuticals on media. Trying to find this, I just read that Americans are the most hypochondriac - maybe it's related.
2. I agree with what you said on second opinions and doing your own due diligence, but my point was different - I'm not a doctor, so, I'd take his advice on PMS with a grain of salt although I personally doubt that the placebo can help with that. Hyman's main theme is reducing sugar intake and I honestly haven't found a doctor so far who argues with that. I've only found people living in denial, because they are so hooked up to that substance.
3. As I said, I personally don't believe that the placebo effect of homeopathy can help with PMS and many other conditions, but maybe it does work better for women who look alternative therapies.
That really depends on who prepared your homeopathic treatments. They aren't regulated or subject to reasonable quality control. A few years ago a couple of manufacturers had to pull a number of products - the FDA had discovered that they contained medicinal quantities of actual medicine (no wonder they worked for some people!) Worse, because of the lack of quality control, the dosage was wildly inconsistent from batch to batch, and of course with the active ingredients not listed anywhere people were having allergic reactions to medicines they didn't think they were taking.
The homeopathic medicine market is not in anyway trustworthy.
I think Boiron and Hyland are pretty trustworthy, but I agree that maybe there are questionable manufacturers out there. The same applies to supplement manufacturers, but that's a whole another chapter of this discussion! I recently found (thanks to my ConsumerLab subscription) that one of the leading vendors of organic raw cacao actually had pretty high levels of cadmium (way above the norm) and I've read in the news feeds that even strictly controlled pharmaceuticals have recalls, so, it's all a matter of luck.
Well, I asked for those as that's what I've been accused of not doing myself earlier. So, if I'm the one not providing any, do better! I'm sure you all can use Google, but, I guess, there are way many here who are too lazy to do their own search and research and just come here to click arrows, hyperlinks, and scroll!
The point of asking you to provide references is to give you the benefit of the doubt. Maybe you're reading well-conducted scientific research but making errors. Or maybe you have nothing at all to support what you say.
You've said a bunch of stuff in this thread that makes me think your cites are goig to be low quality, but may e I'm wrong and you have links to randomised controlled studies.
All I said is based on many years of following various carefully selected sources of information. I cannot provide exact studies as I don't really keep tract of things outside of the conclusions I accumulate in my mind and based on my own self-experimentation. I really can provide them, I need to invest a lot of time digging them out and, honestly, I won't do this for people who're being aggressive and not appreciative to me - I won't sugarcoat it, you're not worth the effort and my time given the attitude. I do a lot of legwork only to people who respect my effort. Anyway, health and nutrition is not my job, but I have a great interest in it, and a very good track record of being able to memorize facts, aggregate, and distill knowledge. Studies, when it comes to nutrition, are more often flawed than not, but the people who I follow are pretty trustworthy, have the credentials, and they weed out things for me and explain them in a accessible way to a person who's not a biochemist or any health professional. I will list some of my sources though: Robb Wolf, Chris Kresser, Mark Hyman, William Davis, David Perlmutter, Mercola (I know, I know), Andrew Weil (I know, again), Jack Kruse, Doug McGuff, Chris Masterjohn, Paul Jaminet, and some others. I listen and follow many others, but I don't trust them - it's only to find references and seeds for new knowledge, but even those who I trust - I still try to dig deeper, cross-reference, and so on. I also do my own research over at the Hacker News of biohacking and self-experimentation (Longecity), but, again, that's only to see what others are doing and find new seeds, I'm not trusting most of the people over there as they have no face. I follow a long number of blogs, listen to many podcasts, so, I see many angles, and I pick for myself the lifestyle that makes the most sense based on my accumulated knowledge and, so far, and, thank god, things are working outstandingly for me. Also, I do find a meaningful explanation of things - something that's very essential, yet, a luxury nowadays. So, low quality or not - it's really your problem, not mine. I have no goal to prove anything to anybody, I spare the seeds of knowledge I've acquired so dearly to those who could appreciate the gift, to the others - they don't deserve it anyway. I'm really not the humanist type. I'm more of the egoist, so, the less people know the truth as long I know it, the better it is for me and my family! This planet is getting too overcrowded anyway! Munch grains, slurp kale, binge on pizza, abstain from wine - I can only feel sorry for you! I am sorry for being cynical, but that's life.
Regarding which specific points I made all over this thread do you want me to back with a study? The whole modern CVD prevention is based on a hypothesis (Lipid hypothesis), which itself is based on scientific fraud committed by Ansel Keys (he ignored evidence that didn't suit him well), and most of America and the world today eats the semi-dwarf wheat, which was created with prehistoric genetic engineering means, has never been studied on humans, and is not even wheat as it's a mix of wheat and a weed, and has twice the chromosomes of the other wheat cultivars. In science, the simplest hypothesis wins and there are competing ones, and the winner should be the explanation that we're eating foods that we're not adapted to and due to the oversanitization and many infection diseases of the past being eradicated, our immune response needs time (generations) to tame itself down. So, our hypothesis should be the winning one, not the one made with fraud for political and geopolitical reasons!
"The simplest hypothesis" does not "win". The hypothesis that fits the evidence best is accepted until a better one is discovered.
Your spittle-flecked diatribes don't put forth anything remotely resembling the scientific process.
Cite your sources and their studies, not their blogs. But frankly, you're well through the rabbit hole and I don't think you realize how out to lunch your insistence on avoiding those in favor of crackpot pseudoscience is.
"Outright quackery", really? It seems that you haven't been following recent developments. All the quackery is proven to be coming from FDA - vilifying salt, alcohol, saturated fats, animal protein for decades with no scientific proof.
Abuse of alcohol (or anything) is harmful. Two glasses of red wine a day have proven benefits. Drink a few gallons of water and you'll die. I hope you get my point. Toxicity and harmfulness is all about the dose. Eating a small piece of bread cannot harm you, getting way too much fast carbs in your diet is without any doubt harmful.
I think that if you truly believe in the narrative that you're espousing, and you actually want to do some good, you should start qualifying your statements with facts and changing the tone that you present them with.
Spewing vitriol because someone disagreed with you and down-voted only serves to illegitimatize the statement you're trying to make.
Which is a shame because behind that facade of angst and unqualified opinion is a kernel of relevant truth.
Not really the case. My karma here doesn't pay my bills or has any practical benefit to me or anyone. I don't really care about it as I never downvote, which is the only practical use of karma. So, I read something and because I've been following the new movements in health and nutrition in the past 10 years and investing a couple of hours a day to keep up, then I invest time in giving some seeds of thought for others and then downvotes start to pile up. I made clarifications and then I get even more downvotes on each of them usually having the same negative score on each post, which means that it's the same people downvoting every single one! This is not a dialog, this is a sort of punishment for thinking differently. Some people just can't help their aggressiveness, I guess. It's not the karma I care about, it's the lack of any appreciation of other people's efforts and their good intentions; it's the downhill movement of this community. It's just turning into a much less popular version of Reddit, unfortunately. Honestly, if there was no YCombinator brand behind it, it would have self-destructed itself long ago, but thanks to Paul Graham's halo and YCombinator brand, the agony will be forever. Recently, most of the top posts are copied from ProductHunt, which is very indicative of the decline. Learn from the biggest - Facebook and Twitter don't have downvote, dislike, distweet, and similar means of social punishment! The negative vibe would always destroy a community or, at least, make it unhealthy.
Two glasses of red wine is a harmful amount of alcohol.
This "wine is beneficial" is nonsense. Feel free to provide some cites. You'll find, once you read the papers that i: you don't need the alcohol for some of the benefits, you'd get the same from grape juice and ii: the amount of alcohol needed for benefits is about one glass per week.
By recommending "two glasses" per day (a glass should be 125 ml but most people pour much more than that. Try it yourself and see. And wine varies in strength. Currently wine is getting a bit weaker than it has been, but it's still pretty strong. Most wines are going to be around 12% ABV to 15% ABV. Two glasses of that a day is harmful.)
"In the largest prospective study ever conducted for alcohol, involving nearly a half million subjects, sponsored by the American Cancer Society... The overall death rates were lowest among men and women reporting about one drink daily."
There are other findings from that study which support the health benefits of regular, moderate consumption as well. All levels of alcohol consumption (even 6+ drinks per day!) were found to be associated with lower overall mortality than abstinence.
I'm not advocating anstinence. I'm advocating for knowing how much you're actually drinking, and making sure you drink less than "two glasses of wine a day" - note that two glasses of wine maybe the equivalent of five or six drinks a day.
> The overall death rates were lowest among men and women reporting about one drink daily. Mortality from all causes increased with heavier drinking, particularly among adults under age 60 with lower risk of cardiovascular disease.
The article talks about research but misrepresents that research.
While the death rates for people drinking six drinks per days are lower than for people who abstain the rates are higher than for people who drink one drink a day.
And one drink is probably much smaller than people realise: 125 ml wine at 8% ABV is one drink. 175 ml at 14.5% (much more typical of what people actually drink) is 2.5 units; two glasses is 5 units.
> And one drink is probably much smaller than people realise: 125 ml wine at 8% ABV is one drink.
What is your source for this? The NIH defines a standard drink of wine as 5 oz or about 150ml at 12%. I agree that many people pour more than that since it's less than a cup of wine (about 250ml).
I agree with the general sentiment that you should be aware of how much you're drinking, but as the article points out, mortality rate from "alcohol-augmented conditions" is barely a blip until you hit 4-5 drinks daily. It is a U-shaped curve with the most deadly conditions being abstinence and seriously heavy drinking. Given that, I think just being roughly aware of your intake goes a long way.
I would love to know how the delta in mortality between 1 daily drink (the optimal) and 5 stacks up against mortality from other common behaviors. I'd hazard a guess that an extra 4 drinks a day is actually less dangerous than obesity or lack of exercise. And yet many people seem a lot more afraid of the effects of having two beers a day than they are of skipping the gym!
So, the French are doing it all wrong then - eating too much saturated fat and drinking way too much wine? Maybe they should start measuring exactly the alcohol content and use standard measuring cylinders? Again, this is the oversimplification of human metabolism. Maybe two glasses are too much for your own weak system, but for healthy people it's not much at all and pay attention to the study - people who had more were still fine. Also, pay attention again - drinking wine with a meal (especially something as fatty as cheese) is not the same as drinking it on empty stomach - something you're totally missing in your "guidelines". Also, drinking alone and in a social setting makes a difference, too.
One of the studies even observed pregnant women, but their dose was one glass per day, and still registered health benefits.
Anyway, I personally don't need any studies as something that's been on the table of virtually all ethnicities for thousands of years, I think, is a "study" that surpasses all others!
There is little evidence that the alcohol in the red wine is what gives benefits. It's a possible avenue of study (does moderate consumption of alcohol improve health by relaxing & reducing stress levels?) but the current belief is some of the other chemicals are the key. Otherwise two shots of vodka should render the same health benefit.
Beer has its benefits, too, unless it gets abused, too, or is totally adulterated like most modern beer. Is it the alcohol or the phytochemicals in the alcoholic beverages - I really don't care. Vilifying alcohol in general is what I care about. Tylenol is the leading cause of liver failure in the States, yet, doctors still prescribe it and it's OTC. Why not ban something that's proven to be harmful? I won't even mention Lipitor and similar!
I very strongly feel, like many people probably do, that I would not want to live with dementia. I would not want to live that non-life, I would not want my family to have to experience it, and I would not want to burden them with my care. In the not-unlikely event that I'm diagnosed with Alzheimer's or some other form of dementia, I would want to end my life while I'm able to competently choose to do so. I would want to do so with quick and painless drugs instead of a gun. However, assisted suicide is only legal in a handful of US states, and then only in cases of terminal illness with less than six months to live. There is nowhere in the US for an early-state dementia patient to commit assisted suicide.
It is currently legal in Switzerland to do so, and people have traveled there for that very purpose. [1] Other people have committed suicide without assistance to avoid the ravages of dementia. [2]
I'm aware of the counter-arguments to assisted suicide: that it can cross the line into euthenasia, that it makes the most vulnerable in our society even more so... but still, there has to be some way for this to be legalized.
What to do? What are some concrete proposals for how to alter existing legislation to allow assisted suicide in cases of dementia? Does anyone have personal stories that make the argument against it?
[1] http://www.bbc.com/news/health-22715363 [2] http://news.nationalpost.com/2014/09/01/ethically-this-seems...