Tuesday, November 18, 2008

Failed by Complementary Medicine - The Tragic Case of Russell Jenkins

From time to time, I get asked why I bother putting the screw on various complementary therapies - my usual first response is as someone who finds science interesting, overwhelming, incredible and at times barely believable (but always based on rigorous experiment), I get frustrated at people inventing non-sensical waffle that is often demonstrably wrong, and passing it off as science (usually to make money).

Further on in the conversation, the phrase "well, it's fine as long as you don't take it too seriously" rears its fence-sitting little head. If that's the case, why no just ditch it now and be done?

Also from time to time, something happens that demonstrates clearly, tragically and painfully that you ignore conventional medicine at your peril and there are occasions where no placebo, no therapy, no energy, no matter how theatric will affect your situation. These have been collated at What's The Harm? and the story that follows will no doubt be added to that list in the near future. The Lay Scientist has written up the story here.

The inquest of Russell Jenkins took place this week, following his death in April 2007. The Coroner recorded a Narrative Verdict, meaning the cause of death is not attributable to anyone.

Mr Jenkins was a spiritual chanting artist who set up the Quiet Mind Centre at his home in Southsea in 1992, offering Reiki Massage, reflexology and the like.

After standing on an electrical plug, Mr Jenkins ended up getting an infection in his foot, which given his condition as a diabetic, was quite serious. Unfortunately, his 'inner being' told him not to go to hospital and his partner, Cherie Cameron who lived with him and joined the Quiet Mind Centre in 2002 also did not seek medical help. Ms Cameron still works at the Quiet Mind Centre, and despite previously being a theatre nurse did not see the danger in what was happening.

Mr Jenkins called on the advice of a homeopath, Susan Finn. (There is no mention of a Susan Finn in the records of either the Society of Homeopaths or the Alliance of Registered Homeopaths). By this time the foot had become gangrenous and it appears Ms Finn did not offer a homeopathic solution, instead suggesting he cover it in manuka honey.

This for me is the gut-wrenching part of the story. Susan Finn, regardless of her training or background, had a terrible situation on her hands. Here was a patient who was quite clear that he did not want to go to a Doctor or hospital and wanted alternative treatment, yet I'm sure she must have pleaded with him to get medical attention, despite her alternative beliefs.
His condition deteriorated and on April 13 he was forced to take to his bed. When Ms Finn visited the following day, she saw blood on the bed sheets and described a foul smell in Mr Jenkins's bedroom. His foot was swollen and one of his toes was discoloured. Two days later Mr Jenkins's condition had rapidly worsened and his toes had turned black.
- The News, Portsmouth.co.uk

Even at this stage, Mr Jenkins refused to seek medical help with the tragic consequences that about a day later, he died from a 'mixed bacterial infection'. Mark Pemberton, consultant vascular surgeon reckoned that even 2 hours before he died, he had a 30% chance of survival.

This is quite a disturbing story and in fairness, I'm not sure how I feel about it. Where does the point of allowing someone the choice to make their own decisions stop and the point of overriding their belief system for their overall good start? I guess parallels can be drawn with religious beliefs where a medical practice viewed as 'illegal' within the community will result in an unnecessary death - blood transfusions for Jehovah Witnesses are one such example.

One thing is clear, anything that can be done to solve the problem and counteract the pseudoscientific claims of well-meaning but misguided believers long before it gets to this stage has to be a Good Thing.


BPSDB

17 comments:

  1. It is tragic and disturbing that Mr Jenkins paid the ultimate price for his misguided beliefs and, apparently, could not be persuaded away from this fatal course. But I find it disturbing also that, in the link to website of his healing centre, he is said to have 'died suddenly' in 2007. This is not quite the impression one gets on reading the press accounts of the inquest and I'm afraid I find it disingenuous.

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  2. I'm always torn between two things when I hear cases like this.

    One part of me says that if he wants to die from overwhelming stupidity that's his own choice and we have no right to force anything on him, also thanks to him for raising the our planet's IQ.

    Another part of me says that idiots like this should be protected from themselves and we should just do what's best for them. Lacking that, they at least deserve our pity for not understanding that gangreen = bad.

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  3. Well, the question is whether the patient is making a fully informed decision to forgo treatment. If he knew that his options were to go to hospital or die of gangrene, and he chose to die, well, there's nothing anyone can do about it. If, however, someone falsely gave him the impression that there was a third option, then it's a somewhat different matter... It's not that the idiots need protecting from themselves, it's that they need protecting from liars and charlatans.

    Tempting as it is, I'm not prepared to take the leap to asserting that belief in woo alone is enough to render someone unfit to make their own treatment decisions.

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  4. Hi Dunc,

    I think that's a valid viewpoint. The fact that the coroner reported a narrative verdict I guess suggested that he himself was unable to decide whether the deceased had made a fully informed decision to die of gangrene, as opposed to being advised by a charlatan. Otherwise, I guess (no idea) that he would have pointed the finger at someone?

    Also, belief in woo is certainly not enough to render someone unable to make decisions about their health. However, it is a belief you choose to believe and there are consequences with that. Similarly if you are surrounded by like-minded people, it is very difficult to get *fully* informed decision making.

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  5. If a medical practitioner was giving him treatment advice with such a negative outcome, surely the Homeopath should have some case to answer. Honey as a dressing is being researched (see bandolier for details if you are interested) but gangrenous toes- tragic

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  6. As a diabetic myself I would like to know whether this poor individual had been taking medication, treatment etc for the condition, or was he relying on alternative ideas to keep him healthy? If he was, as I am, taking regular meds to control diabetes, getting checkups at 6 monthly intervals etc, what was he doing refusing other, scientific, advice?

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  7. Hi Roger,

    It is an intriguing part of the story, but those details didn't come out.

    It does seem odd that he would take(if indeed he was taking) insulin products but refused to get other medical help.

    T

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  8. ....I guess parallels can be drawn with religious beliefs where a medical practice viewed as 'illegal' within the community will result in an unnecessary death - blood transfusions for Jehovah Witnesses are one such example.....

    On the other hand, the same Witness thinking that disallows blood transfusions also disallows smoking, overdrinking, drug abuse, even participating in war. Thus for every JW who dies as a result of transfusion beliefs, there are thousands who don’t die (compared to the general population) for their other lifestyle beliefs. I’m not sure how you can condemn one without at least acknowledging the other. If one tallies up the consequences of all beliefs regarding lifestyle, not just the one you disagree with, then few groups have philosophies as conducive to long living as do Jehovah's Witnesses.

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  9. Thanks for the comment Tom, but it's a logical fallacy.

    There's no point in putting people in groups or looking at belief systems as an overall balance.

    By your reasoning, it's OK to kill a few non-believers here (in the name of your deity), providing a few believers somewhere else do something morally good. Doesn't stack up.

    No part of any group/religion should be exempt from skeptical thinking or fenced off from criticism. It doesn't matter a dickens what JWs do for the rest of society, while they have such 'dark ages' approach to healthcare, they will be up for castigation.

    T

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  10. No, I don't think the logic is that flawed, though I guess you can look at it in more than one way.

    Moreover, even the essential nature of blood transfusions is being re-thought today, largely because of Jehovah's Witnesses.

    http://tinyurl.com/6n9lvx

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  11. Hi Tom,

    It's clear to me your logic is flawed, but there we go.

    I'm trying not to be patronising, but it's amazingly common how often people (esp. religious & alt med religions) will pick up small changes in culture and parade them as if it is the general consensus because they happen to coincide with their worldview.

    If I was in a car accident (or similar) and ruptured (e.g.) my femoral artery hence losing lots of blood, I would want a blood transfusion in order to live. End of story (or actually, hopefully not :)

    Now, there is a lot of effort going in to create 'bloodless' blood - it is innovative, scientific, interesting, potential useful for a myriad of reasons.

    Somewhere way down the list of reasons is JW. Not because of JW, although to be fair not in spite of either. JW money is as good as anyone else's money when it comes to selling a product, and many of the problems associated with blood transfusions will hopefully be superceded.

    I have a very good friend who is alive largely because he had a blood transfusion. You've no idea how glad we are that he had wasn't a JW.

    I know it's another conversation, but taking stuff from Leviticus literally is going to end in problems - unless you are still living as a patriarchal feral tribe living in the middle east?

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  12. If, say, my camp feels free to cultivate habits & lifestyle choices (smoking, alcohol, drug abuse, even going to war) which routinely causes premature death, and the other camp does none of those things, thus protecting themselves, but does make one choice which, on very rare occasion, causes them problems, can I really ignore my own hangups and throw stones at the other camp? Really?? You don't think there is something a little "flawed" with that logic?

    Regarding the hypothetical car accident and your saved friend, I didn't dispute those things, did I? The article I linked to acknowledges transfusion is still the treatment of choice for catastrophic blood loss. And I take no issue with your friend saying a transfusion saved his life. It likely did. But that's not to say that another treatment, even one out of favor with most medical personnel, might also have succeeded, is it?

    Look, I'm not saying you have to believe it, just acknowledge that some people will choose differently than you. If your concern is to save people at all costs, then why not direct your main firepower toward the other habits I mentioned, since they claim far, far more lives? Why not lobby to outlaw auto racing or extreme sports, since even they claim more lives than anything transfusion-related?

    ...."Somewhere way down the list of reasons is JW. Not because of JW, although to be fair not in spite of either. JW money is as good as anyone else's money when it comes to selling a product".....

    The implication with your statement is that doctors look at patient care primarily as a business transaction, and that their main motivation is money. Surely you don't believe this. Though I am aware a minority of medical people likely do feel this way, it the failure to treat the "whole" person that accounts for the disgust some have (among the general population, not especially Jehovah's Witnesses) toward conventional medicine. But most doctors do consider their patients to be more than just a wallet, and it is those doctors we seek out.

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  13. Althougha sad case - I'm inclined to the view that if a mature adult chooses to do stupid things that end up killing them then aside from trying to ensure they don't take others down with them it's ok.

    The disturbing thing here to me is his girlfriend or partner. It appears she was a proper qualified nurse. Bad enough that she let him suffer and die but I get concerned about what sort of things she (or others like her) do when they are in the scientific (normal) health system.

    Are they secretly undermining treatment regimes in hospitals and health services?

    At the very least it seems to me they must be unconsciously subverting proven treatment regimes they are implementing.

    I mistrust any nurse or doctor who talks woo such as reiki as I cannot see how they can have a cohesive treatment theory or practice.

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  14. Hi Tom - it's quite simple. It doesn't matter about anything else you believe in or do as a group. That is irrelevant. The topic under the microscope is blood transfusion.
    The JW increasingly bizarre malleability of their beliefs that "It's ok in certain circumstances, or with special bits" etc is the like the Pope saying condoms are fine, providing you don't enjoy the sex. It makes a laughing stock of the whole point of view.

    "If your concern is to save people at all costs, then why not direct your main firepower toward the other habits I mentioned, since they claim far, far more lives? Why not lobby to outlaw auto racing or extreme sports, since even they claim more lives than anything transfusion-related?"

    Pointless strawman argument.

    "The implication with your statement is that doctors look at patient care primarily as a business transaction, and that their main motivation is money."

    Again, a strawman. I said nothing even close to that.

    If I want to be an entrepreneur and somehow invent a fantastic bloodless blood. Despite my thinking towards JW religious beliefs, I'd still be quite happy to take their money for it - that's basic economics.

    Doctors do what is evidence-based to be shown to be the best thing to do. They are not automatons, nor are they perfect. They are good ones and not so good ones.

    The evidence-base will demonstrate over time what the best practices are, which will hone the skills of the DR and hopefully prolong the life of the patient.

    T

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  15. ...."The topic under the microscope is blood transfusion."....

    Why is it under the microscope? Since there are so many much more lethal habits that most people cultivate but Jehovah's Witnesses do not? Isn't the sole reason so as to provide a vehicle for anti-religious critics to drive?

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  16. Ahm....because that was the discussion that was produced from the blog post?

    I'm sure you can go and have an anti-war rant somewhere else, but it's hard to shoe-horn into a story about complementary 'medicine'.

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