Monday, January 24, 2011

A Health Paradigm

 In his book The Structure of Scientific Revolutions, Thomas Kuhn defines a scientific paradigm as:
  • what is to be observed and scrutinized
  • the kind of questions that are supposed to be asked and probed for answers in relation to this subject
  • how these questions are to be structured
  • how the results of scientific investigations should be interpreted

Our current 'health systems' use an illness paradigm.  That we
  • observe and scrutinize illness and progression of illness. 
  • that we ask questions about the causes of illness and their prevention and cures.  
  • that these questions are structured around the science of clinical studies 
  • and that these scientific investigations give us the 'gold standard' of treatments.
This may be true in the doctor's office, but it is not true on the frontiers of medicine. The frontiers of medicine operate on a patented product paradigm, where most of the products are patent medicines.
  • chemicals and techniques are scrutinized with an aim to create patent medicines and patented technologies. 
  • questions are asked about the sales potential of the proposed patented product. 
  • questions are structured around products and sales. Effects on illness are measured.  Effects on healthiness are not measured. Negative effects on health are reported as side effects. Positive effects on health are ignored, except where specifically targeted by the medicine.
  • new products are tested against placebos.  They are never tested against the 'best treatment currently available' - in fact no-one tracks the 'best treatment currently available'.  
Our medical system produces 'new treatments and medicines' based on their sales potential, not their health potential This is not a useful way to examine or improve health and healthiness. It is not even be the best way to look at illness. However, the patent medicine model is so pervasive that it totally infiltrates modern medical practice.

The patent medicine paradigm has goals so strongly linked to sales and profit - that clinical studies do not dare measure health and healthiness.  It is completely acceptable, with the current paradigm, to sell products that decrease the overall health of patients - while improving specific conditions or symptoms. Not just acceptable - it can be very profitable, and no risk.  No one measures the health results of a patent medicine. No one will know unless the effects are so serious that they cause significant illness.

Our current medical systems have recently - in the past ten years - developed a tendency towards banning products. Products may be banned for a variety or reasons, or for no apparent reason at all. In a previous blog we saw that a teddy bear was banned in Canada, even if it makes people feel better - because it contained white rice, so that it could be warmed in a microwave. Clearly a case of the medical system running amuk. Not only was the teddy bear banned, all of them were confiscated by 'Health Canada' and the manufacturer was put out of business.

When we have a system based on health, we will understand that products should not be banned if they improve health. And that when a product ban is considered, both sides - the potential for good as well as the potential for bad need to be considered.

Our medical systems are currently on a 'banning blitz', removing potential health products by the thousands in Canada, the USA and Europe. How can we expect to learn about health if our medical system creates banned products everywhere?

To quote from the Canadian Health Products regulations, for example: "All natural health products must have a product licence before they can be sold in Canada ...Once Health Canada has assessed a product and decided it is safe, effective and of high quality, it issues a product licence".

Stated most simply: All health products are banned unless they are deemed safe, effective and high quality by Health Canada. Health Canada does not need to justify their decisions, they can simply not issue a licence.  Note, this regulation places a blanket ban on all natural health products.  However, patented products normally have a very large, well established company working towards acquisition of a product license.  There is generally no problem getting a licence for a patent medicine - it's simply part of the normal process.

Our freedom to buy and to sell, but also to propose, design, and evaluate all health products is drastically limited by this current paradigm.

No-one measures health. So how can a 'health product' be determined to be effective?  How can we know it should be banned? Or licensed? 

How might our health systems look if we shift our paradigms from illness and patent medicines to health and healthiness? 
  • What if our goals were to observe and measure health and healthiness? 
  • What if our questions asked were how to improve health and healthiness at all levels (nutritional, cellular, etc. as defined)
  • What if these questions were structured around the measurement of health and healthiness, not around the measurement of sales and profit? 
  • What might we learn if we make rigorous studies of health and healthiness separated from illness, prevention and cures?

Our current medical systems can be very effective. Sometimes, however, they get 'stuck' because of an isolated point of view or medical paradigm. And sometimes our medical systems get things very, very wrong due to the narrowness of our medical paradigm. And our medical systems are ignorant of health.

When we start to use a health paradigm, to more clearly understand the hierarchy of healthiness - we will be able to see things that were not visible from inside our current medical paradigm.

We need a health paradigm, not an illness paradigm. 
We need a health paradigm, not a product paradigm. 
We need a health paradigm and a health system for a more effective medical system. 

Until we have a health paradigm - we will continue to lose more and more of our health freedoms. 

Everyone has a right to life, liberty and the pursuit of healthiness.

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Tracy is the author of two book about healthicine: