Monday, 28 June 2010

Religiousness and teen pregnancy rate linked

This paper finds that US states with greater levels of conservative religious beliefs have a higher teen birth rate. The statistical significance of this relationship survives controlling for mean income (more religious states tend to have lower mean income), and, of course controlling for abortion rates (if states with higher religiosity have lower abortion rates then higher teen birth birth rates would not necessarily be a surprise). Here is the graph (Mississippi is on the top right!)

The authors state "One possible explanation for this relationship is that teens in more religious communities may be less likely to use contraception". For example:
Rosenbaum compared adolescents who reported taking a virginity pledge with a matched sample of nonpledgers [12]. Among the matching variables was pre-pledge religiosity and attitudes toward sex and birth control. Pledgers did not differ from nonpledgers in lifetime sexual partners and age of first sex, but pledgers were less likely to have used birth control and condoms in the past year and at last sex.
So much for sex education which promotes abstinence as a viable form of contraception. And how astonishing that international aid organisations like Catholic Relief Services still see abstinence education as a key weapon in their fight against HIV/AIDS.

Another case of illogical beliefs resulting in very logical (and tragic) outcomes.

Friday, 25 June 2010

The foetus cannot feel pain before 24 weeks

The peer-reviewed working party report by the Royal College of Obstetrics and Gynaecologists is here. The findings of the committee hinge on the following evidence:

1) That the foetus is not conscious by that time, being kept in a state of "a continuous sleep-like unconsciousness or sedation".

2) That the neural connections allowing the experience of pain (by relay of neural signals to the cortex) are not sufficiently developed.

Recently, UK parliamentarians (including the Prime Minister, David Cameron) have begun making noises about possible downwards review of the 24 week limit. This follows bills introduced by various US states to limit late term abortions on the basis of the putative ability of foetuses to feel pain, most notably that of Nebraska which has decreased the upper limit to 20 weeks. Another 29 states have bills scheduled for the 2010-2011 legislative seasons. Of course, none of those bills will now pass if the lawmakers are interested in scientific evidence (and, of course, the separation between church and state means that the lawmakers will most certainly not be considering any religious views!).

Sunday, 20 June 2010

I had calling from God to be a doctor, says GP who admits to shortening patients' lives

Dr. Howard Martin, age 75, has admitted he shortened the lives of "scores" of patients by administering large doses of opiate drugs (morphine/diamorphine), to enable them to die at home. He did this out of "Christian compassion":
"I don't believe I've killed any patients. I believe I've made them comfortable in their hour of need. But I am deemed to be arrogant because I used my discretion. They want to extrapolate that to say I'm choosing to kill people. It's not like that. The patients are about to die and I want to make sure they are comfortable. How can a so-called caring society not understand that? How can I be reckless with someone who is about to die?"
Dr. Martin is no doubt correct that there are serious problems with end of life care in the UK and that there is frequently a dissonance between public opinion and criminal law regarding voluntary euthanasia. However, he has also admitted that in two cases he hastened patients deaths without their permission. Professor Steve Field, chairman of the Royal College of General Practitioners, said:
"I'm horrified that the doctor seemed to indicate in the interview that he actually hastened the death of two patients without their consent - I'm speechless."
It is perhaps unsurprising that the GMC panel found that he had an "autocratic attitude" and believed he was always right.
“On Judgment Day I will have to answer to God, and my answer will be this: that I did my best for my patients.”
Dr. Martin's frequent religious references seem to indicate that there is a link between his faith and his medical care (or lack thereof, depending on viewpoint). As considered in a previous post, to make decisions using texts that exalt the stories of a group of iron-age shepherds (instead of using a process of rational and exhaustive ethical decision-making) is a recipe for poor decisions in which the patient comes second to the decision-maker's desire for supernatural approval.

For these reasons, and in spite of the importance of the topic and need for its careful reform, I find it difficult to imagine a worse medically-trained ambassador for end of life care issues than Dr. Martin.

OK, maybe one.

Thursday, 17 June 2010

Justice John Paul Stevens — The Practice of Medicine and the Rule of Law

New England Journal of Medicine (free full text article) marks the retirement of Supreme Court Justice John Paul Stephens and his record of defending medicine against interference by government and other groups, including matters of abortion and assisted suicide:
Although it’s not a thought that has leapt to the minds of commentators, U.S. Supreme Court Justice John Paul Stevens will be missed by physicians and patients. Stevens believes that the Constitution prohibits government from interfering in personal decision making, including medical decisions that belong in the hands of physicians and their patients, not politicians and regulators; it was for this reason that he was Justice Harry Blackmun’s staunchest ally in upholding the Roe v. Wade abortion-rights decision.
What can be expected of his successor, Elena Kagan, here: Kagan Memos On Abortion Limits, Religious Rights