Friday, August 15, 2008

Amazing: Patients 'should not expect NHS to save their life if it costs too much'

The NHS should not always attempt to save someone's life if the cost is too much, the medical regulator has ruled. The National Institute for Health and Clinical Guidelines (Nice) has ruled for the first time that saving a life cannot be justified at any cost, in a review of its ethical guidelines.

The ruling - made by the board of the controversial organisation - contradicts advice it received from its own 'Citizens Council' which offers advice from a representative sample of the general public. Nice is facing growing criticism over the number of drugs it is now rejecting which are available throughout Europe and in America. Last week, it refused to sanction four kidney cancer drugs which can double life expectancy.

It has now rejected the so-called "rule of rescue" which stipulates that people facing death should be treated regardless of the costs. The rule is based on the natural impulse to aid individuals in trouble.

In a report on "social values judgement" the regulator says: "There is a powerful human impulse, known as the 'rule of rescue', to attempt to help an identifiable person whose life is in danger, no matter how much it costs. When there are limited resources for healthcare, applying the 'rule of rescue' may mean that other people will not be able to have the care or treatment they need.

"Nice recognises that when it is making its decisions it should consider the needs of present and future patients of the NHS who are anonymous and who do not necessarily have people to argue their case on their behalf.The Institute has not therefore adopted an additional 'rule of rescue'."

The ruling contradicts the advice of Nice's Citizens Council, which said that a rule of rescue was an essential mark of a humane society. The report said that where individuals are in "desperate and exceptional circumstances" they should sometimes receive greater help than can be justified by a "purely utilitarian approach".

Doctors have also criticised the ruling. Tony Calland, chairman of the ethics committee of the British Medical Association, said: "We would be opposed to ignoring a rule of rescue when it introduces a degree of flexibility around extreme cases. So what if you waste a few pounds if you are doing your best for humanity?"

Nice defended its ruling last night saying that the Citizens Council provided useful input to its decisions but that the organisation's role was to determine how best to allocate the health service's limited resources.

Nice is facing increasing accusations that it is giving undue weight to financial considerations - rather than medical benefits - when making decisions on whether to allow drugs or other treatments on the NHS. Doctors and patients have alleged that they are treated with contempt by the organisation and that life-saving drugs are being unfairly denied.

The Daily Telegraph disclosed yesterday that Nice is preparing to offer patients advice on the medical benefits of drugs that are not available on the NHS. The disclosure is likely to anger patients who face paying tens of thousands of pounds for expensive drugs which may prolong their lives.


Reading standards drop in Britain

Reading standards among 14-year-olds have fallen in the past year, national curriculum test results revealed yesterday. The Schools minister, Jim Knight, called on parents to encourage their children to read after results showed a drop of two percentage points in the number of students who had attained the required reading standard. The results of the tests, taken by 14-year-olds, showed 73 per cent of students were up to par in English (down one percentage point), 77 per cent in maths (up one point) and 71 per cent in science (down two). The drop in English was based on the reading tests, where the number of up-to-standard students fell from 71 per cent to 69 per cent. Writing, however, went up from 74 to 77 per cent.

The results were published despite calls from education professionals to delay their issue, because so many papers were missing or unmarked. Only 84 per cent of English scripts and 94 per cent of maths and science ones had been marked when the figures were compiled. Leaders of the National Association of Head Teachers said the results should not have been published. Mary Bousted, the general secretary of the Association of Teachers and Lecturers, claimed the tests were an "irrelevance" and should be scrapped.

Nearly 250,000 students failed to reach standards in writing, reading and maths. Only 60 per cent were up to par, the same as last year and well short of a target of 85 per cent set by ministers. Boys lagged behind girls in reading and writing. Only 62 per cent of boys reached the reading standard, compared with 76 per cent of girls, and 70 per cent attained the writing standard, compared with 83 per cent of girls. Mr Knight said boys should read more fiction instead of stories about football teams and asked parents to read the same books as their children, so they could discuss them.

The results show that writing weaknesses identified in 11-year-olds appear to have been addressed by the time children reach the age of 14, but reading and science standards fall away.


Is there a cold future just lying in wait for us?

Comment from Ulster

Our own observatory at Armagh is one of the oldest in the world and has been observing solar cycles for more than 200 years. What this work has shown is that, over all of this time, short and intense cycles coincide with global warmth and long and weak cycles coincide with cooling. Most recently, this pattern continued in the 1980s and 1990s when cycles 21 and 22 were short (less than 10 years) and intense and it was notably hot. But all this now looks set to change.

Cycle 23, which hasn't finished yet, looks like it will be long (at least 12 to 13 years) and cycle 24, which has still to start, looks like it will be exceptionally weak. Based on the past Armagh measurements, this suggests that over the next two decades, global temperatures may fall by about 2 degrees C - that is, to a level lower than any we have seen in the last 100 years. Of course, nothing in science is certain. Perhaps (though I doubt it) Armagh's old measurements are wrong or perhaps there are now other factors, such as CO2 emissions, which may change things somewhat.

However, temperatures have already fallen by about 0.5 degrees C over the past 12 months and, if this is only the start of it, it would be a serious concern. Northern Ireland is not noted for extreme warmth at the best of times and has much more to fear from cold weather than it does from hot. We really need to be sure what is going to happen before spending too much money on combating global warming. We may need all the money we can save just to help us keep warm.


Official spying expands in Left-run Britain

A big disincentive to free speech:
"Councils [municipalities] and health authorities are to be given the right to access e-mail and internet records under surveillance powers to be introduced next year, the Home Office said yesterday. Although first proposed to tackle terrorism and serious crime, powers have been extended to cover other criminal activity, public health, threats to public safety and even prevention of self-harm.

The Home Office said that the move would involve internet service providers storing one billion incidents of data each day and storing them for a minimum of 12 months. Under the plans the taxpayer would pay $92 million to internet service providers for holding information, even though some already keep similar records for marketing purposes.

Opposition MPs criticised the plans as a "snoopers' charter".


Leftists used to say they supported privacy -- but I guess that applies to homosexuals only.

The Pill may put you off smell of your man and ruin your relationship. An update

To millions of women it has been the great liberator over the past four decades, allowing them the freedom to control their fertility and their relationships. But the contraceptive Pill could also be responsible for skewing their hormones and attracting them to the "wrong" partner. A study by British scientists suggests that taking the Pill can change a woman's taste in men - to those who are genetically less compatible.

The research found that the Pill can alter the type of male scent that women find most attractive, which may in turn affect the kind of men they choose as partners. It suggests that the popular form of contraception - used by a quarter of British women aged between 16 and 50 - could have implications for fertility and relationship breakdowns.

The findings, from a team at the University of Liverpool, add to growing evidence that the hormones in the Pill influence the way that women assess male sexual attractiveness. The Pill is thought to disrupt an instinctive mechanism that brings together people with complementary genes and immune systems. Such a couple, by passing on a wide-ranging set of immune system genes, increase their chances of having a healthy child that is not vulnerable to infection. Couples with different genes are also less likely to experience fertility problems or miscarriages. Experts believe that women are naturally attracted to men with immune system genes different to their own because of their smell.

Commenting on the latest study, the researchers said that it could indicate that the Pill disrupts women's ability to judge the genetic compatibility of men by means of their smell. They said that this might not only impact on fertility and miscarriage risk, but could even contribute to the end of relationships as women who stop or start taking the Pill no longer find their boyfriend or husband so attractive.

Several previous studies have suggested that women tend to prefer the smell of men who are different from them in a cluster of genes called the major histocompatibility complex (MHC), which governs the immune system. Some of these studies have also found that this effect is not seen among Pill users.

The latest study, published in the journal Proceedings of the Royal Society, has now assessed the impact of Pill use in the same women, both before and after they began using oral contraception. A group of 97 women was tested, some of whom started taking the Pill during the course of the research. All had their MHC genes tested and were asked to sniff T-shirts worn in bed by men with different patterns of MHC genes.

Unlike some previous studies, the research did not find any preference for dissimilar MHC genes. However, when the women started taking the Pill their preferences shifted towards the scent of men with more similar genes to their own. This suggests that Pill use has an effect on perceptions of scent attractiveness, even if there is no underlying female preference for similar or dissimilar MHC genes.

Craig Roberts, who led the study, said: "The results showed that the preferences of women who began using the Pill shifted towards men with genetically similar odours. Not only could MHC-similarity in couples lead to fertility problems, but it could ultimately lead to the breakdown of relationships when women stop using the Pill, as odour perception plays a significant role in maintaining attraction to partners."

The research also found differences between women in relationships, who tended to prefer odours of men with different MHC genes, and single women, who tended to prefer the smell of MHC-similar men. This could potentially indicate that if women are tempted to have an affair, they are more likely to choose a man with very different genes, to maximise the diversity of any offspring that they might have.

The scientists said that more work was needed to explain the way various studies have obtained different results on whether women naturally prefer men with different or similar MHC genes. They also cautioned that the importance of scent in human mating preferences remains uncertain.

The research backs up an earlier study of how women's perceptions of partners can alter when taking the Pill. Psychologists from St Andrews and Stirling universities found that women on the Pill tend to prefer macho types with strong jaw lines and prominent cheekbones. However, women who are not taking that form of contraception seem to be more likely to go for more sensitive types of men without traditionally masculine features.


Improved IVF process

A couple have become the first in Britain to have a baby using a new fertility technique, after seven years of trying to become parents. Evie Bloomer was conceived using vitrification - a method of embryo storage that has a higher success rate than the standard slow-freezing process. Her parents, Ian and Rebecca, from Cwmbran, South Wales, have been trying for a baby since marrying in 2001. Mrs Bloomer, 28, suffers endometriosis, a condition in which womb tissue grows elsewhere in the abdomen.

Evie's birth is a landmark because vitrification could deliver substantial improvements in fertility treatment. Embryo freezing allows parents to store surplus embryos should the first cycle fail, or to try for further children later on. The first such baby was born in the United States in 1984 and thousands have since been born in Britain.

But only 50-80 per cent of frozen embryos survive the thawing process because of ice crystals, which can cause fatal damage. Vitrification is an improved method by which embryos are flash-frozen in liquid nitrogen, together with an antifreeze. Around 98 per cent of embryos frozen this way survive thawing. Lyndon Miles, head of embryology and andrology at IVF Wales, who treated the Bloomers, said that a vitrification programme started in August last year was already delivering very promising results. Of 39 couples treated so far, 17 have had a pregnancy and the success rate of 43.5 per cent is more than double the 21 per cent that the clinic has achieved with slow-frozen embryos.

Dr Miles said wider use of vitrification could help the Human Fertilisation and Embryology Authority to persuade more couples to use just one embryo in IVF treatment, potentially cutting the multiple birthrate from one in four to one in ten. "If you are going to have single embryo transfer, your embryo freezing programme has to be very good so you have embryos available as a back-up," he said.

"Though this is a new technique for the UK, early results and publications in Japan and the USA have been extremely encouraging. The first published study on babies born from vitrification shows no adverse effects and there are no implications to Evie's health as a result of the process."


Britain's newest epidemic: "The knife violence in Britain has reached epidemic proportions according to an article at, an online news agency in England. . Americans recognize the sensational headlines and use of the term epidemic to describe the actions of common criminals because of articles by the U.S. media that use the same format but vilify guns instead of knives. The nature of this type of news reporting makes it obvious they are used to sway public opinion against guns, or knives or the use of self-defense by the average citizen. When Britain outlawed guns (and self-defense), their elected officials claimed that the impending domestic tranquility would make them the envy of the world."

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