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IatrogenesisIatrogenesis Bad F/L.................................................................................................................................2Alternatives to Hospitals – Individual Treatment......................................................................................6Alternatives to Hospitals – Internet...........................................................................................................7Alternatives to Hospitals – Telecommunications.....................................................................................10Alternatives to Hospitals – Health Buddy................................................................................................11Alternatives to Hospitals – Environment.................................................................................................12Communications Link.............................................................................................................................13AT: People Don’t Use Alternatives..........................................................................................................14AT: Alternatives Fail................................................................................................................................15Hospitals Don’t Solve Psychological Problems........................................................................................16Superbug Turn........................................................................................................................................17Ext. Iatrogenesis Superbugs...............................................................................................................19Staph Turn..............................................................................................................................................23

Illich Link.................................................................................................................................................24Illich Impacts...........................................................................................................................................25Illich Impact Defense..............................................................................................................................28Capitalism Links......................................................................................................................................29Western Medicine Bad............................................................................................................................31

2AC Iatrogenesis.....................................................................................................................................33Ext. 3: Tech Advances............................................................................................................................34Economy Solves Your Impacts................................................................................................................35Bioterrorism Turn....................................................................................................................................36Disease Turn...........................................................................................................................................37Hegemony Turn......................................................................................................................................38Economy Turn.........................................................................................................................................39

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Iatrogenesis Bad F/LTurn – Iatrogenesis is America’s 3rd largest cause of death in America- our studies are backed by the most esteemed medical journal in the world.Kulak, 2006 (Daryl Kulak, Author of Health Insurance Off the Grid, a book that explains how to save thousands on health insurance using the new Health Savings Account (HSA), “The Number 3 Killer In America is Iastrogenesis”, http://ezinearticles.com/?id=124398, January 6)

The number 1 killer in America? Heart disease. Number 2? Cancer. Number 3? Iatrogenesis.Have you ever heard of iatrogenesis? The word doesn't even sound that harmful. It comes from two

Greek words – iatros – meaning physician, and genesis – meaning created. Yes, the number 3 killer in America is death by doctor.Did you know this? Wasn't it plastered all over the newspapers? Unbelievably, it was not broadcast on cable news channels, daily newspapers or on the radio.This might make you suspect the origin of my claim. Did it come from some crazy tabloid? Some off-the-wall Website?Well, that depends. It depends on whether you consider the Journal of the American Medical

Association as a crazy tabloid. I really don't think it is. These statistics were published clearly and convincingly in the most esteemed medical journal in the world.I'd like to venture into how and why doctors kill, and give you some alternatives to consider.First, let me qualify my statements. I do not consider doctors to be bad people. As we'll examine in the next few minutes, it is the system that the doctors are forced to operate within that causes all these deaths.

How many deaths are we talking about? Death by doctor kills over 200,000 people each year. Cancer takes over 500,000 lives, and heart disease takes 600,000.

Death by doctor includes several types of problems:* unnecessary surgery, resulting in death* medication errors and other types of errors* fatal drug reactions* infections from hospitals Essentially, each of these causes was separated from the cases where the patient would have died anyway. For instance, if someone was dying of a heart attack and a medication was applied that quickened the patient's death, it's not fair to say the medication was the killer. That would be like saying someone who fell off a cliff died of a heart attack that they suffered mid-way down.

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IatrogenesisLee Quinn7WJ - HPSWPage 3 of 72Turn- Hospitals are deadly- patient reactions and human errors.Kulak, 2006 (Daryl Kulak, Author of Health Insurance Off the Grid, a book that explains how to save thousands on health insurance using the new Health Savings Account (HSA), “The Number 3 Killer In America is Iastrogenesis”, http://ezinearticles.com/?id=124398, January 6)

But hospitals are dangerous places. The primary reason for people dying unnecessarily in a hospital is the pharmaceutical drug. This is a strange thing to

hear. We know that drugs have saved many lives, and we tend to hold the drugs in

great esteem. But there is a flipside. Many of the most commonly prescribed drugs are also terrible killers, due to bad patient reactions and the possibility of human error in administering the drugs.Pharmaceutical drugs are immensely powerful, in a good way and a bad way. Take the right drug at

the right time and it will help your illness in a dramatic way. Take the wrong drug at the wrong time and it will kill you on the spot.I've said we have great respect for pharmaceutical drugs. Maybe our problem is that we don't respect

them enough! These powerful, dangerous pills should really be something we handle gingerly, almost like a bomb. How many bombs killed 80,000 people since 1999? Vioxx did. It seems to me that our best solution is to find health practitioners who treat drugs with as much respect as they deserve. A practitioner who uses pharmaceutical drugs as a last, best resort, who tries everything else possible before they prescribe these powerful, dangerous substances.Some people think that doctors like this don't exist. I used to think so too. But once I looked a little harder, I found lots of them. In fact, I believe there is a revolution going on. Doctors are switching to a better, safer path for their patients, and they are tired of being “the number 3 killer.” Wouldn't that grate on your nerves too?

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Iatrogenesis Bad F/L

Turn- Iatrogenesis is one of the leading killers in America- prefer our evidence its based on the most conclusive studies.Gristani, 2006 (Ronald Gristani, Practicing Doctor with degree’s from New York University and Pennsylvania University, “Iatrogenic Disease: The 3rd Most Fatal Disease in the USA”, http://www.yourmedicaldetective.com/public/335.cfm, 2006)

Iatrogenic Disease is defined as a disease that is caused by medical treatment. Read major headlines around the globe on this serious disease. How Prepared are You to Not Become a National Statistic? If a Jumbo Jet crashed and killed 280 people everyday... 365 days a year... year after year... would you be concerned about flying?? Would you question the Federal Aviation Administration? Would you demand answers?? Think about it! Close to 100,000 people dying every year from plane crashes? Sounds Ridiculous??!!

Well think again. What if you were told that over 100,000 people are killed and over 2 million people maimed and disabled every year...year after year from modern medicine...would you believe it?? Well these may be my words...but read the following articles from the most respected medical journals and institutions (Journal of the American Medical Association, Harvard University, Centers for Disease Control, British medical journal The Lancet, New England Journal of Medicine and national news (New York Times, Washington Post, CNN, US World Report) and you be the judge.Writing in the Journal of the American Medical Association (JAMA), Dr. Starfield has documented the tragedy of the traditional medical paradigm in the following statistics:* The term iatrogenic is defined as "induced in a patient by a physician's activity, manner, or therapy. Used especially to pertain to a complication of treatment." Furthermore, these estimates of death due to error are lower than those in a recent Institutes of Medicine report.

If the higher estimates are used, the deaths due to iatrogenic causes would range from 230,000 to 284,000.Even at the lower estimate of 225,000 deaths per year, this constitutes the third leading cause of death in the U.S.Dr. Starfield offers several caveats in the interpretations of these numbers:First, most of the data are derived from studies in hospitalized patients.Second, these estimates are for deaths only and do not include the many negative effects that are associated with disability or discomfort.Third, the estimates of death due to error are lower than those in the IOM report. If the higher estimates are used, the deaths due to iatrogenic causes would range from 230,000 to 284,000.In any case, 225,000 deaths per year constitutes the third leading cause of death in the United States, after deaths from heart disease and cancer.

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IatrogenesisLee Quinn7WJ - HPSWPage 5 of 72Even if these figures are overestimated, there is a wide margin between these numbers of deaths and the next leading cause of death (cerebro-vascular disease).Another analysis concluded that between 4% and 18% of consecutive patients experience negative effects in outpatient settings, with:# 116 million extra physician visits# 77 million extra prescriptions# 17 million emergency department visits# 8 million hospitalizations# 3 million long-term admissions# 199,000 additional deaths# $77 billion in extra costsThe high cost of the health care system is considered to be a deficit, but it seems to be tolerated under the assumption that better health results from more expensive care.

However, evidence from a few studies indicates that as many as 20% to 30% of patients receive inappropriate care.An estimated 44,000 to 98,000 among these patients die each year as a result of medical errors.This might be tolerable if it resulted in better health, but does it?Out of 13 countries in a recent comparison, the United States ranks an average of 12th (second from the bottom) for 16 available health indicators.More specifically, the ranking of the U.S. on several indicators was:# 13th (last) for low-birth-weight percentages# 13th for neonatal mortality and infant mortality overall# 11th for post-neonatal mortality# 13th for years of potential life lost (excluding external causes)# 11th for life expectancy, at 1 year for females, 12th for males# 10th for life expectancy, at 15 years for females, 12th for males# 10th for life expectancy, at 40 years for females, 9th for males# 7th for life expectancy, at 65 years for females, 7th for males# 3rd for life expectancy, at 80 years for females, 3rd for malesThe poor performance of the U.S. was recently confirmed by a World Health Organization study which used different data and ranked the United States as 15th among 25 industrialized countries.It has been known that drugs are the fourth leading cause of death in the U.S.

This makes it clear that the more frightening number is that doctors are the third leading cause of death in this country, killing nearly a quarter million people a year.These statistics are further confused because most medical coding only describes the cause of organ failure and does not identify iatrogenic causes at all.

Lucian Leape, a Harvard University professor who conducted the most comprehensive study of medical errors in the United States, has estimated that one million patients nationwide are injured by errors during hospital treatment each year and that 120,000 die as a result. In their study, Leape and his colleagues examined patient records at hospitals throughout the state of New York. Their 1991 report found that one of every 200 patients admitted to a hospital died as a result of a hospital error.

That number of deaths is the equivalent of what would occur if a jumbo jet crashed every day; it is three times the 43,000 people killed each year in U.S. automobile accidents."It's by far the number one problem" in health care, said Leape, an adjunct professor of health policy at the Harvard School of Public Health.Researchers such as Leape say that not only are medical errors not reported to the public, but those reported to hospital authorities represent roughly 5 to 10 percent of the number of actual medical

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IatrogenesisLee Quinn7WJ - HPSWPage 6 of 72mistakes at a typical hospital. "The bottom line is we have a system that is terribly out of control," said Robert Brook, a professor of medicine at the University of California at Los Angeles. "It's really a joke to worry about the occasional plane that goes down when we have thousands of people who are killed in hospitals every year." Brook's recognition of the extent of hospital errors is shared by many of medicine's leaders.

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Iatrogenesis Bad F/L

Turn- Iatrogenic infections kill 90,000 people a yearGristani, 2006 (Ronald Gristani, Practicing Doctor with degree’s from New York University and Pennsylvania University, “Iatrogenic Disease: The 3rd Most Fatal Disease in the USA”, http://www.yourmedicaldetective.com/public/335.cfm, 2006)

The NEW YORK TIMES reported that 5% of people admitted to hospitals, or about 1.8 million people per year, in the U.S. pick up an infection while there. Such infections are called "iatrogenic" -- meaning "induced by a physician," or, more loosely, "caused by medical care."

Iatrogenic infections are directly responsible for 20,000 deaths among hospital patients in the U.S. each year, and they contribute to an additional 70,000 deaths, according to the federal Centers for Disease Control CDC). The dollar cost of iatrogenic infections is $4.5 billion, according to the CDC.

Medical deaths outweigh small arms and car accidents.Gristani, 2006 (Ronald Gristani, Practicing Doctor with degree’s from New York University and Pennsylvania University, “Iatrogenic Disease: The 3rd Most Fatal Disease in the USA”, http://www.yourmedicaldetective.com/public/335.cfm, 2006)

For years, the American Medical Association, hospitals, medical magazines and various other health care groups have been beating the drums for more gun laws.

And some of us have pointed out their chutzpah, since -- according to the official figures, the National Center for Health Statistics, more than twice as many are killed every year in medical accidents than in gun accidents.Yesterday, an independent report from the Institute of Medicine, an arm of the National Academy of Sciences, said the number of deaths from medical mistakes every year may total 98,000 -- about three times the number of deaths due to accidents, homicides and suicides with firearms.The study says medical mistakes may cost the nation as much as $29 billion a year and may be the fifth highest cause of death -- behind heart disease, cancer, stroke and lung obstructive lung diseases.That 98,000 total is over twice as many as die in auto crashes each year.

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IatrogenesisLee Quinn7WJ - HPSWPage 8 of 72Iatrogenesis risks outweigh the positives of the medical system- killing more than any war related event ever.Laura, 1991 (Dr. Ronald S. Laura, Professor in Education, University of Newcastle & P.E.R.C. Fellow in Health Education, Harvard University, “Medical Intervention Hit or Myth?”, http://www.whale.to/v/laura.html, 1991)

Iatrogenic illness refers to those illnesses which result from professional medical treatment, and which could presumably have been avoided had such treatment not been administered. Ivan Illich has done much to consolidate and bring into bold relief studies concerning this category of physician or hospital-caused injuries. He writes

that "the pain, dysfunction, disability, and anguish resulting from technical medial intervention now rival the morbidity due to traffic and industrial accidents and even war-related activities, and make the impact of medicine one of the most rapidly spreading epidemics of our time.’ Illich claims that one out of every five persons entering a typical research hospital will acquire an iatrogenic disease. Given that every twenty-four to thirty six hours, from 50 to 80% of all Americans will swallow a medically prescribed drug, it is perhaps unsurprising to find that one half of iatrogenic episodes arise

from complications of drug therapy.’ Some patients are given the wrong drugs, others are given drugs which are contaminated. Some patients receive injections with improperly sterilised syringes, while others are given combinations of drugs which in their chemical reactions to each other prove to be harmful. The main problem here, however, is not simply one of negligence. Although the well considered and circumspect use of drugs may have a role to play in

health care, chemotherapy is an interventionist technique whose importance and use has been greatly exaggerated. As Mendelsohn has put it: "Unfortunately doctors have seeded the entire population with these powerful drugs. Every year from 8 to 10 million Americans go to the doctor when they have a cold. About 95% of them come away with a prescription - half of which are for antibiotics ... The doctor, once the agent of cure, has become the agent of disease. By going too far and diffusing the power of the extreme on the mean,

Modern Medicine has weakened and corrupted even the management of extreme cases. The miracle I and other doctors were once proud to take port in has become a miracle of mayhem" While there has during the past decade been a growing awareness of the limitations of drug therapy, the extent of the use and abuse of drugs in conventional medicine is still

staggering. As a consequence of negative reactions to drugs, more than a million people every year, or 3-5% of hospital admissions, are treated for drug complications. It is also reported that 30% of these patients will experience a second drug reaction during the course of their hospital stay. The cost of health care associated with drug toxicity in the United States is estimated at US$3 billion yearly, and reflects the fact that 1/7th of all hospital days are required to attend to patients suffering drug reactions (3).

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Iatrogenesis Bad F/LMedical Drug misuses kills more than illegal drugsLaura, 1991 (Dr. Ronald S. Laura, Professor in Education, University of Newcastle & P.E.R.C. Fellow in Health Education, Harvard University, “Medical Intervention Hit or Myth?”, http://www.whale.to/v/laura.html, 1991)

Despite the growing use of street drugs, deaths attributable to medically prescribed drugs still exceed the number of deaths caused by the use of illegal drugs. It has been estimated that approximately 30,000 deaths per year are the consequence of adverse reactions to drugs prescribed by doctors. Serious reactions to drugs as common as penicillin, for example, occur in 5% of those individuals who are administered the drug. The anaphylactic shock which results from severe penicillin allergy is often more debilitating than the medical condition that the penicillin was used to treat. Clammy skin, profuse sweating, fallen blood pressure, cardiovascular collapse, and even unconsciousness are just a few of the side-effects of acute reaction to penicillin. During the 1960’s the drug tetracycline was administered so frequently that it came to be called the "housecall" antibiotic, and a generation of children in America and elsewhere have suffered its adverse effects. In 1970 the U.S. Food and Drug Administration finally required that a warning be affixed to all packages of the drug, admonishing of the tendency of tetracycline to accumulate in bones and teeth.’ One of the more visible side effects of this chemical deposition has been to cause the permanent discoloration of developing teeth (ie stages of tooth development ranging from the last half of pregnancy to approximately 8 years of age). Countless adults now bear their "tetracycline scars" on their teeth in shades of discolored enamel ranging from yellow to yellow-green to gray brown. Illich’s study showed

that one in every thirty cases of iatrogenic illness leads to death, and that the frequency of reported accidents in hospitals exceeds the accident rates of all industries with the exceptions of mining and high-rise construction (10). Of all children admitted to hospitals, one in fifty will suffer an accident for which specific treatment will be required (11). In a study of medical malpractice conduced by the United States Department of Health, Education, and Welfare, it is reported that 7% of all patients suffer compensable injuries while hospitalised, though few of them take legal action. Nonetheless, it is estimated that in 1971 from 12,000 to 15,000 medical malpractice suits were lodged in Courts throughout the United States. In a study by Berman and Stamm on misdiagnosis, it was calculated that the number of children who suffer disability as a consequence of medical treatment for what turned out to be cardiac nondisease exceeds the number of children under effective treatment for genuine cardiac disease (12).

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Alternatives to Hospitals – Individual Treatment

Less medical care is better - individual treatments solve your impactsKulak, 2006 (Daryl Kulak, Author of Health Insurance Off the Grid, a book that explains how to save thousands on health insurance using the new Health Savings Account (HSA), “The Number 3 Killer In America is Iastrogenesis”, http://ezinearticles.com/?id=124398, January 6)

I think you should seek out "alternative-tolerant" doctors who will use the safest, cheapest, effective remedies first, and only then move you on to the expensive, dangerous pharmaceutical drugs.Safe, cheap solutions might be exercises, herbs, vitamins, acupuncture, bodywork, dietary changes or other types of healing.I know this may sound a bit odd to some of you, but please consider the alternative. Using pharmaceutical drugs as a “first resort” got us where we are today. With so many problems in the existing system, aren't we obligated to search for a better way for our own health and the health of our families?I'd like to ask you to consider switching to one of these doctors as your primary physician. I realize it might be a longer drive or perhaps cost a little more per visit. But can you afford to be a statistic? Can you afford to die at the hands of the number 3 killer in America?

The only way we'll reduce the number of deaths by doctor is to change the way we use doctors. Send the medical system a signal that you want better, less dangerous care, and that you want to live!Daryl Kulak is the author of Doctors of the Future, a book containing eleven profiles of Central Ohio doctors who use alternative medicine in their daily life with patients.He is also the author of Health Insurance Off the Grid, a guide to help you afford the holistic lifestyle.

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IatrogenesisLee Quinn7WJ - HPSWPage 11 of 72Individual treatment solves better than medicalization. Gristani, 2006 (Ronald Gristani, Practicing Doctor with degree’s from New York University and Pennsylvania University, “Iatrogenic Disease: The 3rd Most Fatal Disease in the USA”, http://www.yourmedicaldetective.com/public/335.cfm, 2006)

Care -- not treatment -- is the answer. Drugs, surgery and hospitals become increasingly dangerous for chronic disease cases. Facilitating the God-given healing capacity by improving the diet, exercise, and lifestyle is the key.Effective interventions for the underlying emotional and spiritual wounding behind most chronic disease is critical for the reinvention of our medical paradigm. These numbers suggest that reinvention of our medical paradigm is called for.

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Alternatives to Hospitals – Internet

Current websites exist and provides extensive information to treat ailments Reisinger, 2009 (Don Reisinger, Writer for CNet News, “Find answers to your medical questions with these five sites”, http://news.cnet.com/webware/?keyword=WebMD, February 18, 2009)

I am, sadly, well-acquainted with medical research sites. (I broke my back years ago, and am still dealing with the recovery.) But while everyone knows WebMD and probably uses the site to find out about medical conditions, you might be surprised to know there are a slew of sites that offer similar service, providing outstanding medical information. I've found these sites to be good resources.

While some sites deliver articles of medical information, HealthiNation uses videos to inform you about what a condition is all about.Overall, HealthiNation is designed quite well and its easy to search for videos. The site doesn't boast articles like those you'll find on sites like WebMD, but its videos are extremely informative and I found that when I searched for simple issues like "back pain," the clips were just as useful as when I searched for more complex topics like diabetes. HealthiNation's videos are split into general health, men's health, women's health, and "true life stories," which detail how one person faced medical conditions in their lives. Each section features information that's worth perusing through, regardless of the topic.

The videos on HealthiNation were outstanding. Each is clearly defined and once you fire them up, you'll be presented with a wealth of knowledge by health care professionals. But because HealthiNation relies on videos, the scope of its medical coverage isn't nearly as great as I would have liked and it only covers general topics. A specific condition, such as spondylolysis, isn't included on the site, though it is on competing services, like WebMD. Realizing that, it's best to use HealthiNation when you want information on general health topics.

Although Livestrong, which is co-founded by bicyclist Lance Armstrong, is touted as a "lifestyle" site that helps you achieve greater health and fitness, it's also a great resource for health research. The first thing that will strike you about Livestrong is its almost unbearable design. It's yellow, black, and cluttered. It's a mess.

That said, the site is rich in features and its search tool is outstanding. Instead of trying to find information on the home page, immediately enter your query into the search box and

you'll be brought to a results page featuring information on a wide array of topics. From back pain to diabetes, the site not only features videos like HealthNation, which are narrated by health care professionals, but it also boasts informative articles on all the topics. I was impressed by how much information the site actually has on any given topic.But much like HealthiNation, Livestrong doesn't support obscure ailments and I was a little disappointed that in the entire discussion on back pain, the site failed to address individual issues that might affect different areas of the spine. Regardless, Livestrong is a unique destination that makes using it every day worthwhile if you want to be healthier.

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IatrogenesisLee Quinn7WJ - HPSWPage 13 of 72The Medpedia Project is a joint effort on the part of Harvard Medical School, Stanford School of Medicine, Berkeley School of Public Health, and other global health organizations that hope the site will change "how the world will assemble, maintain, critique and access medical knowledge." It delivers.The site features a repository of up-to-date medical information, contributed and maintained by health professionals from around the world. The site also boasts a professional network and directory for visitors to find health professionals and organizations, a communities of interest section where medical experts and patients can share conditions and treatments, and a growing knowledge base featuring information on health issues ranging from back pain to diabetes.I was generally impressed by the level of detail Medpedia offered. The site's knowledge base is a wiki that allows you to search for specific ailments or ask general questions that might already have been answered by the community of doctors. At first glance, the idea that a health site is a Wiki may turn some off, but to ensure all the information on the site is accurate, Medpedia only allows physicians and those with a Ph.D. to edit the articles, and only once their credentials are certified. That cuts down on the number of erroneous bits of information that crop up on the site and, in my opinion, makes the site more reliable than a resource like Wikipedia, which anyone can modify. When I entered "back pain" into the site's search field, I was brought to a results page that not only featured a Wiki containing general information about the ailment and links to other, related Medpedia Wikis, but also a series of answers provided by doctors to questions asked by the site's users. And although some weren't directly targeted at my query, I could have easily asked my own set of questions, which would have been answered directly by a medical professional. I should note, though, that Medpedia is still in beta and was launched Tuesday. Because of that, the site doesn't offer every conceivable health topic and a few obscure conditions are still missing. But more Wiki pages are being added each day and the community of doctors and patients is growing. It might not be WebMD yet, but it's off to a good start. Read more on Medpedia.

WebMD is the leader in the health research space and it boasts more features and options than any other site in this roundup. WebMD is simply the best health research tool on the market.My biggest complaint with WebMD has nothing to do with its information and everything to do with its design: it's ugly. I was happy to see that the site features a prominent search box at the top of the page, but its home page is cluttered with blogs, articles, and other information that I ignore because there's simply too much information packed into a small page. The real value of WebMD is seen in its search. From something simple like "back pain" to something complex like "spondylolysis," the site has it all. I was impressed by the wealth of information WebMD provides and its simple articles actually provided me with more information that the videos on HealthiNation or the articles on Livestrong. It

was outstanding. Beyond its information service, WebMD's drug finder is an outstanding tool that helps you learn all about a particular prescription medicine you're using. It comes in handy when you need to find out if you're experiencing sickness or a side effect from a medication and it's an ideal tool when you want to determine if a generic brand of a particular drug is suitable in place of the name brand. It's easily one of my favorite tools and one that shouldn't be

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IatrogenesisLee Quinn7WJ - HPSWPage 14 of 72overlooked when you're using WebMD. WebMD is a great service that will provide you with all the health information you're looking for in as little time as possible. And although its design is downright awful and it should be addressed, its articles make up for that lackluster design and make it the best health research service in this roundup.

Wellsphere is a nice health research site that aims at making you healthier through education. It works--the site's articles deliver basic information like symptoms and treatment, and its prevention information is the best on the market.

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Alternatives to Hospitals – Internet Internet access is removing the need for health care- cost, accessibility, and easeHerrick, 2009 (Devon Herrick, Journalist for Health Care News, “Web Replaces Doctors as Patients’ Top Health Information Source”, http://healthcare.ncpa.org/commentaries/web-replaces-doctors-as-patients-top-health-information-source, January 1 2009)

A study by New York-based Manhattan Research has found people more frequently turn to the Internet for health information than seek information from their doctor. An estimated 145 million U.S. adults now turn to the Internet for information about diseases and other medical conditions.According to Meredith Abreu Ressi, vice president of research at Manhattan Research, the Internet is a convenient way for patients to manage their health conditions independently. “With health care costs skyrocketing, many consumers are replacing visits to their physician with information found online in health sites, communities, patient testimonials, and blogs,” said Ressi.Surveys Agree

The Pew Internet & American Life Project estimates more than three-quarters of Internet users have searched for health information online. That is consistent with surveys from Harris Interactive, which found 81 percent of Internet users have done so.Of patients recently diagnosed with a disease who seek health information online, nearly six in 10 (59 percent) report finding information there that led them to get a second opinion or raised new questions to ask their doctors, according to Manhattan Research.

Pew speculates the relative convenience of the Internet may not be the only factor making it a preferred source for medical information. Accounts from numerous surveys point to the positive experiences patients have with online searches for health-related information. Nearly one-third (31 percent) of people who have sought health information online claim they themselves or people they know have been helped significantly by health information found online, the Pew survey found.That figure is 10 times the percentage who claimed they or someone they know have been seriously harmed by following information obtained online.Cost Savings

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IatrogenesisLee Quinn7WJ - HPSWPage 16 of 72People often search for information about prescription drugs, according to the surveys, seeking more information about prescription therapies or ways to save money on drugs. Rxaminer.com, a Web-based tool developed by Joseph Rogers and operated by DestinationRx, helps patients identify lower-cost drugs that might serve as good substitutes for the ones they currently take. “Comparing and shopping for prescription drugs is one of the easiest and most-effective actions consumers can take to save on their health care costs,” said Toby Rogers, vice president for DestinationRx. The Web site also creates a report of lower-cost alternatives, making it easy to discuss them with one’s physician.Always Available

Another possible reason Americans are surfing the Web for health content may be because they have a hard time getting their doctors on the phone. To answer the simplest questions, patients often must schedule an office visit well in advance, take time off from work, and queue in a crowded waiting room. That may be changing, the surveys show.Gregory Couto, founder of the telemedicine firm AmeriDoc, says the future of medical consultations will increasingly involve combining information technology with the ability to interact with a physician.

“Providing tools for patients to quickly connect with doctors reduces unnecessary trips to the doctor’s office; improves access to health care services for uninsured, underinsured, and rural Americans; and fundamentally changes health care services from reactive care to more proactive, preventive care,” Couto said.AmeriDoc members can consult with a physician by way of telephone, but they also can follow up with a physician online through a secure, Web-based interface, Couto notes. In addition, “We feel that follow up email is critical,” Couto said.

The surveys confirm the Internet has already changed the way most patients get information on diseases and conditions, and Couto says it may soon change the way patients routinely interact with physicians.

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Alternatives to Hospitals – Internet The internet is stopping the need to visit hospitalsPerth, 2009 (The West Australian (Perth), Australian Newspaper, “www medicine;Experts predict the internet and digital technology are set to stretch the reach of medical care and could help fill the gap left as fewer GPs pay home visits”, lexis, April 29, 2009)

In future your doctor might be able to advise you by text message to change your medicine after detecting changes in your blood pressure, pulse and blood glucose levels from information delivered to their computer from a wireless sensor on your body.You might then be able to get a prescription for your new medication by consulting your doctor online. This could be by email or by a virtual "face-to-face" appointment using a webcam, a camera attached to the computer systems at both ends. Using this technology, your doctor could also look into your eyes, or inspect a wound, without either of you having to move further than the nearest internet connection.The technology for this type of doctor-patient digital interaction exists,

according to WA-based e-health expert Yogesan Kanagasingam and is only a few years away from becoming a reality.He predicts sitting in a crowded waiting room to see a doctor may be required less often as technology enables the replacement of some face-to-face consultations with the online variety.In Perth this year, Bill Crounse, US-based Microsoft Corporation senior director of worldwide health and also a doctor, said if the 30 per cent of primary consultations that were sought because patients were anxious or needed information, rather than sick, were replaced by online services, it would help clear waiting times and save some patients the inconvenience of attending medical appointments.But he stressed the technology was not intended to replace the relationship a patient had with their personal doctor.

"These kinds of services are used when your own physician isn't available for a variety of reasons and you have a need for simple information or a medical service that is appropriate for this kind of environment," Dr Crounse said.Professor Kanagasingam, director of the Centre for e-Health at the Lions Eye Institute in Perth, who has pioneered remote eye-screening technology for use in remote areas of WA, said internet-based medical technology held most promise initially to help monitor elderly patients living alone.

Computer attachments and wireless monitors with the capacity to transmit body temperature, blood pressure and ECG readings had already been produced, he said.

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IatrogenesisLee Quinn7WJ - HPSWPage 18 of 72Already trials using this technology combined with video-telephone, computers and call centres were under way in Australia, checking older patients' welfare in their homes and whether they were taking their medication correctly."They are trying to make the technology so easy that with just one touch to the computer screen they will connect to the nurse," Professor Kanagasingam said.Patients with chronic diseases subject to fluctuations, such as diabetes, also stood to benefit significantly from future digital monitoring, he added.Online follow-up had proved successful in a group of patients, who returned home to Carnarvon after eye surgery in Perth and had eye scans relayed to specialists to monitor their progress. "For GPs, someone could be seen for a fever and then send their vital signs over the internet so the doctor could assess their progress," he said. But before we forget our GP's phone number and address in favour of their login details, Professor Kanagasingam said government-set standards and checks, possibly in the form of iris or fingerprint scanning, had to be embedded into any digital medical system to ensure the identity of patients and doctors and the security of information. Doctors also needed assurances of the accuracy of medical data collected. "There is the potential for the wrong diagnosis if, for example, the visual quality is not good," he said. "Then there are personal security issues and doctors are worried about giving advice over the internet."

But he said digital technology now enjoyed much wider acceptance in medical applications than a decade ago."Ten years ago when I started telemedicine at the institute, a lot of doctors were very sceptical and so even were patients," he said.

"Recently, it has completely changed. It is now integrated into mainstream healthcare and patients just come in and sit, photos are taken and sent and it is just part of healthcare delivery."In a wider application of video-conferencing that had already proved beneficial for patients living in remote areas, "doctor-robots" could now do virtual ward rounds and bedside visits. Patients could talk to a doctor many kilometres away, who, in turn, could check clinical details and view wounds, dressings or movements."It is video-conferencing with movement - doctors can rotate the camera and see the patient," Professor Kanagasingam said."Here in Perth we can monitor patients who have undergone surgery in Carnarvon."Doctor-robots were used in parts of the US and had proved a big hit when tested on children in hospital in Queensland. Telemergency technology under development could in future transmit patient information and images from an ambulance or disaster zone so hospital emergency doctors could advise on the best first-aid management and prepare for the arrival of the patient or casualties.It would be possible to send pictures of burn injuries from a fire or disaster zone to a hospital in another country that was awaiting their arrival."They would know who was coming, what their condition was, to better prepare X-rays, tests and operating theatres," Professor Kanagasingam said.

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IatrogenesisLee Quinn7WJ - HPSWPage 19 of 72Dr Crounse said the internet had enabled public health authorities in the US to get a jump-start on potential disease outbreaks by monitoring the number and types of patients presenting to hospital emergency departments."We can get real-time 'dashboards' of flu outbreaks and acute epidemics," he said.Also, analysis of data from online patient and doctor networks about rare conditions was uncovering less well-known treatments or side-effects of treatments that had helped to save lives. `For GPs, someone could be seen for a fever and then send their vital signs over the internet so the doctor could assess progress.'

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Alternatives to Hospitals – Telecommunications

Email and telephone communications stop the necessity of health care visits. Greenfield Health, 2001 (Greenfield Health, Medical Information Website, “E-Mail and Telephone Contact Replaces Most Patient Visits in Primary Care Practice, Leads to More Engaged Patients and Time Savings for Physicians”, http://www.innovations.ahrq.gov/content.aspx?id=1785, 2001)

Based on the belief that more than one-half of primary care office visits are unnecessary, GreenField Health relies heavily on e-mail and telephone communications for the majority of patient contacts, which in turn frees up staff to see patients who need in-person care on a timely basis. Anecdotal reports indicate that this approach more fully engages patients in their care and decision making, enables better care management, and saves physician and staff time.Problem Addressed

Although the environment for medical care has changed dramatically in recent years with the development of new clinical knowledge and information technologies, the structure of primary care has remained largely the same, with face-to-face office visits serving as the primary method of delivering services and little patient-clinician contact taking place outside of that visit. The net result is a large number of unnecessary visits, long waits for those who truly need in-person care, and missed opportunities for providing effective care and education between visits.* Many unnecessary visits: An estimated 50 percent of ambulatory care visits are unnecessary due to a mindset that equates physician visits with medical care.1 * Few available appointments for those who need them: Patients who need care are not always able to get an appointment, because physicians are so busy conducting visits that may not be necessary. * Little time for ongoing management: The typical time-limited office visits provides only episodic care designed to treat specific symptoms or problems of the moment; this is especially true for patients with chronic diseases. The net result is that physicians are often unable to provide ongoing care management (e.g., preventive and screening services, education on self-management) that can help to prevent problems from occurring in the future.GreenField Health has fundamentally redefined the relationship between patient and provider by setting up a system that provides ongoing, continuous (rather than episodic) care, with heavy reliance on e-mail and telephone communications as a replacement for in-office visits when practical. Freed-up office time has been used to enhance access to in-person visits for those who truly need it. Among the features that make this medical practice design unusual are the following:

* As-needed contact by e-mail, online, or telephone: Patients can contact their providers at any time by e-mail, telephone, or through an online system. Approximately 80 percent of care is done by e-mail or telephone. Laboratory results are also sent to patients in a timely manner via e-mail and/or telephone.

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IatrogenesisLee Quinn7WJ - HPSWPage 21 of 72 * Enhanced access to in-person care: The time freed up through electronic and telephone contact enables the clinic to provide walk-in and same-day appointments to any patient who needs them. Any patient can see a physician within 24 hours of requesting an appointment. * Personal medical assistant: Each patient is matched with a health coordinator who serves as an advocate and care coordinator for that patient, including interacting with consulting physicians, hospitals, laboratories, and other ancillary services. Health coordinators are trained as medical assistants and serve as the point of contact for referrals, ordering tests, and other services.

* Indepth patient education: Online educational materials and group visits for patients with the same diagnosis or risk factor (e.g., weight management) provide an opportunity for indepth education that more fully engages patients in their own care and decisionmaking processes. Many educational documents are sent electronically to patients, and GreenField Health has educational videos on their Web site. Patients also receive a monthly electronic newsletter with large amounts of information about prevention and chronic disease management. * Clinical information system as support: GreenField Health's clinical information system connects and integrates information from both within and outside the practice. All members of the care team, including the patient, have access to the same medical information and participate in making care decisions. The system includes the following components: an electronic health record that integrates knowledge management through automated clinical guidelines; a practice management system; customized encounter forms; disease registries; secure messaging (e-mail) and connectivity; secure Internet portal for patients; online clinical information; practice decision support; patient decision support; electronic diagnostic technology; scanning; network faxing; interfaces with laboratory, radiology, and hospital systems; medical group intranet; patient e-newsletter; and telecommunication systems.

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Alternatives to Hospitals – Health Buddy Hospital requirements decreasing now- health buddyWLKY, 2009 (WLKY, Newspaper Website, “Health Buddy Could Reduce Hospital Visits Computer Could Keep Patients At Home, Costs Down”, http://www.wlky.com/health/19211475/detail.html, 2009)

New medical technology is helping families save thousands of dollars by allowing patients, normally needing hospitalization, to stay at home and be treated.A medical device called the Health Buddy is like having a doctor right by your bedside while at home.Floyd Purdue struggled with various complications of heart disease and then a heart attack and COPD made things even worse. Purdue's health problems caused him to be hospitalized at least twice a month, and those stays were costly."Well, it's a big stress 'cause we're on a set income. I'm on disability; my wife is too. When you're on a set income, you've only got so much you can pass around," said Purdue.Purdue said it got to the point where buying food and paying for his prescriptions became difficult. That's when Purdue's doctor gave him a Health Buddy. The Health Buddy is a small push-button computer that hooks up to a patient's home telephone.

"Patients every day can take their blood pressure, their weight, or their pulse, or their blood sugar and they answer some questions. It takes less than five minutes," said Michelle Wyatt with Floyd Memorial Home Health.

With the Health Buddy, they can even take their oxygen levels. If anything is too high or too low, a nurse is alerted and will call the patients. The nurse can determine whether a patient is properly treating himself or herself at home, needs a nurse to visit, or needs to be hospitalized.Purdue uses his Health Buddy to take his levels twice a day. He said it has been a lifesaver."It just helps all the way around. I'd recommend it to anybody," he said.

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Alternatives to Hospitals – Environment Improving human environment problems solves diseases spread – there is only a risk of a drug resistant disease from medical service- malaria and syphillis prove.Laura, 1991 (Dr. Ronald S. Laura, Professor in Education, University of Newcastle & P.E.R.C. Fellow in Health Education, Harvard University, “Medical Intervention Hit or Myth?”, http://www.whale.to/v/laura.html, 1991)

The first major challenge to the integrity of conventional medicine came in 1959 when Rene Dubos

urged in his book Mirage of Health that the technological innovations of modem medicine, including the development of antibiotics, had far less to do with the improved health of the community than it might at first appear (1).

Amassing an impressive array of statistics in support of his claim, Dubos argued that the most significant changes in the health of the population derived from social, economic, and nutritional advances. Environmental factors not clinical factors, were applauded as the determinants of the improved state of general public health. Better housing, for example, meant less overcrowding, thereby reducing the facility with which infectious disease was previously spread. Similarly, the provision of safe drinking water in conjunction with the treatment of sewerage dealt a forceful blow to infectious disease. Other environmental factors such as improved sanitary conditions and the effective disposal of garbage also had a beneficial impact upon the virulence and incidence of infectious disease. Heralded by some writers as the single

most important factor in the decline of infectious disease, better nutrition has been acclaimed to assist host-resistance, as well as host recovery (3). Indeed, by the time the etiology of infectious disease was sufficiently understood to develop and to administer vaccines, diseases such as cholera, typhoid fever, and dysentery had already been robbed of their virulence. In his presidential address in 1971 to the British Association for the Advancement of Science, R.R. Porter confirmed that between 1860 and 1965 almost 90% of the total decline in mortality among children up to fifteen suffering from diptheria, scarlet fever, measles and whooping cough had occurred prior to the introduction of antibiotics and immunisation on a systematic basis (3). The virulence of tuberculosis had also declined markedly prior to the introduction of antibiotics. In 1812 the death rate from tuberculosis in New York was estimated to be higher than 700 per 10,000. When Koch first isolated and succeeded in culturing the bacillus in 1882, the death rate had dropped to 370 per 10,000. By the time the first sanatorium was opened in 1910 the rate had further declined to 180 per 10,000, until shortly

after World War it had slipped from second to eleventh place with a rate of 48 per 10,000. Still before antibiotics were used routinely, tuberculosis had flourished and dwindled outside the control of medical science (4). This is not to say that drug

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IatrogenesisLee Quinn7WJ - HPSWPage 24 of 72treatment has been entirely incidental in the decline of certain infectious disease. Syphilis and malaria

were both quickly cured by chemotherapy. On the other hand, malaria has reappeared despite the continued use of antimalarial drugs, largely because the use of pesticides was eventually superseded by the evolution of pesticide-resistant mosquitoes. Syphilis strains resistant to penicillin have also returned to remind medical science that the inter-link between mores and medicine are of fundamental importance in understanding disease patterns.

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Communications LinkCommunication barriers create accidents.Gristani, 2006 (Ronald Gristani, Practicing Doctor with degree’s from New York University and Pennsylvania University, “Iatrogenic Disease: The 3rd Most Fatal Disease in the USA”, http://www.yourmedicaldetective.com/public/335.cfm, 2006)

When asked what may have caused their doctors to make such errors, patients cited carelessness, stress, faulty training and bad communication.Three out of four believe the best solution to the problem would be to bar health care workers with bad track records.

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AT: People Don’t Use Alternatives

61% of Americans use the internet to research healthPew, 2008 (Pew Internet, “61% of adults in the U.S. gather health information online.”, http://www.pewinternet.org/Reports/2009/8-The-Social-Life-of-Health-Information/02-A-Shifting-Landscape/2-61-of-adults-in-the-US-gather-health-information-online.aspx?r=1, 2008)

Three-quarters of American adults, age 18 and older, have access to the internet, a percentage which held steady throughout 2008.83% of internet users, or 61% of U.S. adults, have looked online for information about any of the health topics we ask about, ranging from information about a specific disease, a certain treatment, alternative medicine, health insurance, doctors, hospitals, and ways to stay healthy.Internet users with home broadband or wireless access are more likely than dial-up and tethered internet users to look online for health information.

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AT: Alternatives Fail

Their indictment of natural medicine is misguided- both allopathic and traditional medicine contain anecdotes of failuresWilkonson et al, 1999 (D. Wilkinson, South Australian Center for Rural and Remote Health, L. Gcabashe, South African Medical Research Council, and M. Lurie, South African Medical Research Counsil, “Traditional healers as tuberculosis treatment supervisors: precedent and potential”, Lexis, 1999)

Another common theme in the literature is that traditional healers are (obviously) indigenous, and that ‘western’ healers are ‘imposed’. This distinction is often used to imply that traditional healers are therefore inherently ‘better’ than doctors, but there is little— If any—data to support this contention.8,9 However, at times this view is used as a counterbalance to the belief that because doctors have formal and recognised training they are inevitably ‘better’ than traditional healers. A more critical perspective notes that doctors are frequently unable to cure their patients, and often

fail to care for them adequately.8 This theme of accusation and counter-accusation around the relative safety and effectiveness of the two models of care is common, especially in older literature. Linked to this are frequent reports of apparently highly toxic effects of traditional remedies;10 this is a particularly difficult area of study, with substantial anecdote, and it is difficult to disentangle symptoms of primary illness from symptoms of toxicity of traditional therapy. More recently, and particularly well documented in South Africa, a more constructive view has emerged, with detailed analysis concluding with several positive recommendations about how to bridge the gap between healers and conventional medicine.8 A report from the Centre for Health Policy in South Africa11 also recommended formal recognition by the government for traditional healers along the lines used for other health professionals, and parliament is currently considering how this can be achieved. In South Africa, some medical insurance schemes reimburse their members’ use of healers, and the National AIDS Programme is engaged with traditional healer organisations to train members in HIV/AIDS prevention and care strategies.12

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Hospitals Don’t Solve Psychological Problems

Western Medicine only attempts to treat physical discomfort, ignoring the effects of psychological distressHewson, 1998 (Michael Hewson, “Traditional Healers in Southern Africa”.

Annals of Internal Medicine, 128 (12), 1029–1034.

In contrast, medical science (and, hence, western medicine) rests on the axiom of Cartesian dualism, or the separation of mind and body, which holds that healing is correcting disease by using appropriate medical and surgical procedures; the primary concern is healing the body and eliminating physical suffering [3]. A recent neurologic treatise suggests that the Cartesian split has resulted in the modern medical view of the "disembodied mind" and has led to the diminished role of the concept of humanity and neglect of the physical effects of psychological distress [4].

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Superbug Turn

Iatrogenesis increases infection of disease and risk super bugsHealthcare Management, 2004 (Express Healthcare Management, Indian Newspaper, “Nosocomial Infections”, http://www.expresshealthcaremgmt.com/20040630/infectionctrl01.shtml, June 30, 2004)

The Problem About one patient in ten of those who come in contact with hospital and health care settings acquires nosocomial infection. In United States, the nosocomial infection rate is about 5 to 6 hospital-acquired infections for every 100 admissions. As of 1995, the health care cost of nosocomial infections was huge ($4.5 billion) and has contributed to more than 88,000 deaths (one death every 6 minutes) and these numbers have grown with each passing year. No statistical data is available about India; due to lack of health care data

notification and linkage system. It is believed that the majority, perhaps as much as 80% of nosocomial infections are caused by the microbial flora that patients bring with them upon admission to the hospital. This "stay-at-home" flora appears to be opportunistic to the new environment and is able to take advantage of new routes of transmission that medical procedures offer. Other nosocomial infections (perhaps 10% to 20%), develop following contamination with microbial organisms found within the hospital environment, often via the hands, instruments of Health Care Workers (HCWs) or contact with contaminated hospital materials. Examples of this include transfer of Staphylococcus aureus or Streptococcus pneumoniae from one patient to another via the hands of HCWs. Handwashing with antiseptics, use of disinfectants on inanimate objects and environmental surfaces have been shown to decrease the spread of potential pathogens to patients. Finally, person-to-person spread of infections in the health care setting can occur via direct contact, droplet, airborne, fecal-oral, and

blood-borne routes. Risk Factors A number of risk factors have been linked with the development of nosocomial infections, especially the antibiotic-resistant micro-organisms. Perhaps the most important is prior treatment with broad-spectrum antibiotics, which has been shown to suppress symbiotic intestinal normal microbial flora. The presence of a

persistent focus of infection (i.e. abscess, or large wound) is another important risk factor. An extended stay in hospital is also a risk factor for acquisition of antibiotic-resistant pathogenic infection. Individuals may also have multiple risk factors and are accordingly at very high risk for nosocomial infection. These risk factors overlap, but may be considered broadly as underlying host defects (i.e. immunosuppression, old age), and mechanical predispositions (being bedridden, invasive medical devices like intravascular catheters). The most important contributing factor for increase in occurrence of nosocomial infection rates is that many HCWs fail to follow basic infection control procedures such as hand washing between patient contacts and in ICUs, emergency rooms and pre-& postoperative asepsis is often overlooked in the rush of crisis care. During daily activity, HCWs progressively accumulate micro-organisms on their hands from direct patient contact or contact with contaminated environmental surfaces and devices. The commensal resident flora colonises skin layers and resident flora generally has lower pathogenic potential than transient flora and is considered important for colonisation resistance, preventing colonisation with other, potentially more pathogenic, micro-organisms. Transient flora colonises the superficial skin layers for short periods and is usually acquired by contact with a patient or contaminated environmental surfaces and devices. These micro-organisms are easily removed by mechanical means such as hand washing. Hand washing refers to the application of a plain (non-antimicrobial) or antiseptic (antimicrobial) soap, mechanical friction generated by rubbing the hands together for 1 minute (covering all surfaces of the hands and fingers), rinsing with water, and drying thoroughly with a disposable towel (which is then used to turn off the faucet). The cleaning activity is attributed to detergent properties, which result in mechanical removal of dirt (soil and organic substances) and loosely adherent flora (most transient flora and a small portion of the resident flora) from the hands. The term "hand antisepsis" indicates hand hygiene with an antiseptic agent, either washing the hands with an antimicrobial soap or using an alcohol-based hand rub. In contrast to hand washing, the objective of this procedure is a more effective and rapid reduction of skin flora by killing, not mechanically removing micro-organisms (all transient flora and most resident flora). Therefore, the alcohol hand-rub procedure should not be confused with hand washing and vigorous friction, rinsing with water, and drying with a towel are unnecessary. Instead, the technique consists of rubbing alcohol onto both hands until it completely evaporates, usually requiring 15 to 30 seconds. Most dispensers deliver 1.5 to 2.0 mL of alcohol per application; therefore, 2 applications are usually

necessary to completely cover both hands. A second contributing factor is the overuse of antimicrobials. Increased concern about infections in the 1970's to 1980's led to the increased use of antibiotics. For example, widespread use of cephalosporin antibiotics is often cited as a cause for the emergence of Enterococci as nosocomial pathogens. At the same time, methicillin resistant Staphylococcus aureus

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IatrogenesisLee Quinn7WJ - HPSWPage 30 of 72(MRSA), also in response to extensive use of cephalosporin antibiotics, became a major nosocomial threat. This led to the overuse of vancomycin, partly in response to concerns about MRSA and for treatment of vascular catheter associated infections by organisms such as the resistant coagulase-

negative Staphylococci. Now medical institutions are faced with a resident flora of "super-bugs", resistant to the most potent antimicrobials. A third contributing factor is the hospital environmental dust and suspended particulate matter, which contain many pathogenic fungal spores, toxic molds leading to severe nosocomial fungal infections and illness due to other pathogens, such as Legionella pneumophilia.

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Superbug TurnSuperbugs risk extinctionBuisness Day, 2008 (Graeme Addison, Writer for Buisiness Day (South Africa), “Scientist Struggle in war Against Superbugs”, Health News Edition, Lexus, June 04, 2008)

Scientists struggle in war against superbugsBacteria are fighting back against our best drugs, with some mutating into killer s. reports on how scientists are unmasking the secrets of the superbugsSO THIS is the way the world ends: not with the sudden bang of thermonuclear warfare, nor even the mounting disasters of global warming, but with the miserable whimper of millions of human beings whose immune systems cannot fight off drug-resistant bacteria.In hospitals, the very havens to which we go for treatment of illness, many patients now carry deadly drug-resistant bacteria like MRSA (methicillin-resistant staphylococcus aureus). Most antibiotics fail against this superbug.Now it has escaped from the wards and cases of community-acquired infection (known as CA-MRSA) have been detected in major cities and some rural settings across the world.Medical researchers in California recently identified CA-MRSA as the cause of necrotising fasciitis ("flesh-eating disease") and necrotising pneumonia (an aggressive tissue-destroying lung infection).The original "staph" bacterium is common and found on the skin and in the noses of an estimated 30% of people where it may cause infections such as pimples or boils. The mutated bug is a horror, and it is not the only one.An extensively drug-resistant strain of the tuberculosis bacterium, known as XDR-TB, has caused scores of deaths in KwaZulu-Natal and is alarming local and world medical authorities seriously by its rapid and unstoppable spread.

The worldwide trend of drug resistance indicates that bacteria - among the oldest and simplest forms of life on earth - are capable of reinventing themselves to fight off our best medications. This is hardly surprising considering that bacteria have flourished despite every kind of planetary disaster over billions of years, and may inherit the earth when we are gone.Also, bacteria formed the primitive building blocks of our own complex cells and have inside knowledge, so to speak, of our make-up and defences.But medical science is not about to give up the fight against killer infiltrators. Research programmes are using humanity's recently acquired knowledge of genes and DNA to analyse how microorganisms can change their spots to threaten lives.Dr Matthew Avison and colleagues at the University of Bristol and the Wellcome Trust Sanger Institute near Cambridge recently sequenced the genome of a newly emerging superbug, commonly known as steno. This is another hospital marauder that thrives in moist environments, such as around taps and shower heads, and is responsible for thousands of cases of blood poisoning annually, with about 30% proving fatal.

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IatrogenesisLee Quinn7WJ - HPSWPage 32 of 72Announcing the findings, Avison said no new drugs capable of combating "pan-resistant" strains were currently in development, implying that a new tack had to be taken. The search for genes that either help or hinder bacteria may show the way to combat drug resistance."Through complete genome analysis we can pinpoint which genes carry the information required for a bacterium to do something - for example resist antibiotics or cause a disease symptom," Avison says.From the gene's DNA sequence , biochemists can work out the structure and properties of the protein that the genes encode."Since this protein is ultimately the reason for resistance or disease, you can design drugs that bind to the protein and stop it working, thereby stopping resistance or disease."An example is the mechanism of antibiotic resistance in steno and other similar bacteria. Avison refers to proteins that work as "pumps" within the cell mechanism, suggesting that creating drugs to stop the pumps would be like throwing a spanner in the gene's works."Our research has shown two genes to be important for resistance in steno. Both genes encode proteins that act as pumps, which remove antibiotics from the cell before they have time to kill it. We want to learn about how these pumps work, so we can design inhibitors that stop them working, reducing antibiotic resistance."Unfortunately the slow pace of drug development (due to painstaking research, clinical trials and funding availability) means that drugs to treat steno remain beyond the horizon.It will be at least five years, says Avison, before his group can consider clinical trials on current lead compounds that inhibit bacterial antibiotic efflux pumps.On a practical level, the researchers are trying to find how steno manages to stick to sterile tubes or catheters inserted into patients' bodies. The bacteria apparently grows into a kind of biofilm and when the catheter is flushed, the biofilm can infect the patient - especially when immune systems are weak.Throughout evolution, bacteria have shown to be supremely adaptable to environmental conditions. We are now learning that some have managed to pick up genes, allowing them to evade most drugs used to combat them.Drawing attention to this amazing flexibility, Dr Shiranee Sriskandan, professor of infectious diseases at the Imperial College in London, says in MRSA , bacterium had picked up genes in the community in the relatively recent past. These genes confer methicillin resistance, but are different to those in so-called "hospital" MRSA strains, says Sriskandan.The research is called molecular epidemiology. Sriskandan cautions it will not lead directly to new drugs, though it will allow clinicians to map the spread and transport of organisms and predict whether they pose a threat of invasive disease to populations.Medical science and sociobiology are converging on problems posed by drug-resistant diseases globally. Armageddon - the final battle that ends all - has come to science with works like biologist Jared Diamond's book, Collapse, in which he analyses several ancient civilisations that suddenly imploded.Diamond finds causes for the collapse of the Polynesians on Easter Island, or the Mayan cities in central America, in the plunder of the environment and the trashing of trading relationships upon which civilised life depended. They didn't all die. Some societies just faded away into barbaric limbo.With us, though, doom may have been written into the script of our scientific achievements from the start. For a brief period in the second half of the 20th century it looked as if antibiotic wonder-drugs like penicillin would "conquer" disease, but it was too early to declare victory.

The worldwide trend of drug resistance indicates that bacteria - among the oldest and simplest forms of life on earth - are capable of reinventing themselves to fight off our best medicationsScientists are working on designer inhibitors to combat superbugs, or drug-resistant bacteria, some of which are so flexible they can even pick up genes, allowing them to evade most drugs used to fight them. Picture: STOCKXPERT

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Ext. Iatrogenesis Superbugs

The Health Care system kills more people than it saves- iatrogenesis creates the risk for superbugs and kills 784,000 people a year in the US. This outweighs all wars.Tylee, 2009 (Jenny Tylee, Doctor and writer for Disabled World- an information center, “Problems with the Health Care System”, http://www.disabled-world.com/medical/healthcare/health-care-system.php, March 21, 2009)

Given the enormous amount of money that is spent on our health care system and the research that has gone into the various diseases we would be excused if we think that there should be able to trust

our health care system to deliver quality health care. Sadly, our Western health care system falls well short of what is desired. Instead of healing and health it largely delivers suffering and further disease. Mendelssohn as far back as 1979 (and he wasn't the first to suggest it) considers that the public has been 'conned' about the benefits delivered by 'scientific

medicine'. There is a great deal of myth that surrounds our current system. A part of the myth is that medical practice has produced an overall increase in health in the past one hundred years. However,

historical analysis has found that general improvements in social and environmental conditions provide a more adequate explanation of the changes than the rise of 'scientific medicine'. Factors such as the improvement in diet and nutrition, sanitation and improved general living conditions have made the greatest difference.

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IatrogenesisLee Quinn7WJ - HPSWPage 34 of 72Hospitals are deadly. Mistakes/errors, accidents, infections, medical drug disasters, diagnostic equipment including; X-rays, ultrasounds and mammograms make hospitals very dangerous. Hard technology has taken over the central role in modern medicine as it is considered effective and efficient. This has however been questioned. It is considered uneconomic and it also causes an unnecessary amount of pain and suffering.Accidents in hospitals now occur more frequently than in any other industry except mining and high rise construction. In addition to this are the medical doctor caused diseases. They are so common that they have their own name - iatrogenesis. Again the general public is unaware of how common this disease is. All told, iatrogenesis accounts for 784,000 deaths each year in the United States - more American deaths than all the wars of the 20th century combined. 98,000 deaths a year are caused by medical errors alone, and surgical errors account for another 32,000 deaths. These figures include only deaths. Officials admit that medical errors are reported in official data only 5 percent of the time, so the problem is much greater - exactly how much greater, no one really knows.Research carried out in Australia showed that the equivalent of a jumbo jet load of people died unnecessarily died each week in Australia because of medical interventions - this information was contained in an official Health Department report. It was substantially hushed up - because of the potential impact of the information on the general public! We talk about and work to reduce road accidents and we 'ground' airplanes that are shown to have faults - but the general public is generally unaware of the risks that they take when they come under the care of the medical health care system. Apart from accidents and medical mistakes adverse drug reactions and infections account for many of the incidences of iatrogenesis. Adverse drug reactions are very common. Some of these reactions can be minor but they can also be deadly. There are five main groups into which these adverse reactions can be placed. Those that: adversely affect the blood cells, cause toxicity in the liver, damage the kidneys, affect the skin, affect the unborn baby. The hazardous side effects listed here do not include allergic reactions or medication errors, but rather the effects of the drugs themselves. Out of the 2.2 million cases of serious adverse reactions to drugs each year, authorities have listed four types of drugs as being the worst offenders for adverse reactions. These are antibiotics (17%), cardiovascular drugs (17%), chemotherapy drugs (15%), analgesics/anti-inflammatory drugs (15%). 198 drugs were approved by the FDA from1976 through 1985 and over 50 percent had serious post-approval reactions. Many adverse reactions were discovered during clinical trials and were covered up by pharmaceutical manufacturers in order to get FDA approval. The FDA is also far from blame free when it comes to giving approval for drugs that have serious reactions. The whole drug approval process has many problems and cannot be relied upon to protect the public from dangerous drugs.

Antibiotics are no longer working on many extremely dangerous bacteria or they only work in doses that that cause serious side effects. The development of these antibiotic resistant 'superbugs' is in the order of a crisis. In the years following the introduction of antibiotics they were (and still are) used for the treatment of common colds and flu and other complaints. Antibiotics, such as tetracycline were used (and still are) over long periods of time for the treatment of acne. Ampicillin and bactrim were used for the wrong reasons and there has been a reliance on antibiotics to treat recurrent bladder infections, chronic ear infections, chronic sinusitis, chronic bronchitis and non-bacterial sore throats. The UK office of health Economics in 1997 (cited in Chaitow) reported the following statistics:

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IatrogenesisLee Quinn7WJ - HPSWPage 35 of 725,000 people are being killed every year (in UK hospitals alone) by infections that they caught in hospital.A further 15,000 deaths are being contributed to by the infections that they caught in hospital.One in 16 patients who goes to hospital for anything will develop a 'hospital acquired infection'.Many of the infections acquired involve the difficult to treat 'superbugs'.USA figures published more than a decade ago show that 1 in 10 patients develops an infection that they caught in hospital - this involves around 2.5 million people every year.

Every year 20,000 of these people die from their infections and the deaths of a further 60,000 are contributed to by the hospital acquired infection - a large number of these involve antibiotic resistant 'superbugs'.The current approach of our health care system is ineffective and can potentially cause more harm and damage than the original condition. Although undoubtedly many lives have been saved by timely medical intervention much medical intervention is unnecessary and alternatives, which don't cause the same devastation, are available. Everyone needs to consider the way they interact with the medical system. Try to avoid the health care system if you can and certainly question your medical practitioner very carefully about any intervention they wish to make. Many will not like this questioning and just want to be seen as the 'all knowing, all wise doctor' - but this they are not! Do not be conned and do not buy into myths about the medical profession and health care.Having said this it is important that if you are currently taking medication that you don't suddenly stop. Seek information, discover alternatives and discuss changing you approach to health care with a health professional. If your current medical practitioner is uninformed about alternatives (as many are) or unwilling to discuss these with you (as many are) then you may need to seek a different health professional who is prepared to help you improve your health rather than just use medical drug prescriptions or surgery!

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Ext. Iatrogenesis Superbugs Iastrogenesis causes death and disease- risking superbugs Baker, 2000 (John Raymond Baker, Jounralist for Chiropractic Community, “Allopathic Medicine and Adverse Outcomes; The Iatrogenic Problems Continue”, http://www.chiroweb.com/mpacms/dc/article.php?id=31900, October 1, 2000)

Death, disease, mutilations, and more: It is a world war or international terrorism? No, we are talking about the outcome of medical procedures being carried out every day by MDs practicing allopathic medicine.Dynamic ChiropracticIn fact, a study of the malpractice situation in the United States1 came to an astounding conclusion.

"Studies such as the Harvard medical practice study, which was designed to develop more current and reliable estimates of the incidence of adverse events and negligence in hospitalized patients, have shown that there is a significant amount of injury to patients caused by the delivery of medical care. For example, the Harvard study found that almost four percent of the 30,195 sampled hospital admissions in New York State in 1984, reflected an injury that increased the length of hospital stay. Fourteen percent of these injuries were fatal."

The hideous fact is that all across this country, MDs are practicing a system of health care that results in a panoply of horrors, and the word iatrogenic associated with a disease or injury says it all. Iatrogenic (Greek, iatric = doctor, genic = arising from or developing from) literally means "disease or illness caused by doctors."If one starts doing research on the web, one soon discovers that there is a wealth of information published out there (ironically, most by MDs themselves in their own journals). This demonstrates that

the American public is being seriously and negatively impacted by a whole host of conditions, either caused by medical intervention directly, or are caused as a result of the medical interventions using the allopathic protocol of treatment.The Adhesive Arachnoiditis SyndromeOne such problem doctors of chiropractic may encounter is the adhesive arachnoiditis syndrome. This is closely associated with "failed back surgery." Adhesive arachnoiditis is thought by many to result from chemical or physical insult to the arachnoid layer, including the insults involving introduction of foreign substances into the subarachnoid space. One such possible cause may be iatrogenic, such as use of oil-based contrast media used in myelography, or the adverse effects of epidural steroids such as depo-medrol (depo-medrone). The strong association between so called "failed back surgery" and the adhesive arachnoiditis is significant; the possibility that many failed back surgeries may be the result of the insult done by previous medical procedures cannot go unnoticed.Hospitals Are Like War ZonesIn the Berkeley Medical Journal, spring 1996, Mai Ngo makes the following statement: "Hospitals can be dangerous zones to unsuspecting guests. Nosocomial infections are hospital-acquired infections. Dr.

Robert N. Butler expressed, in a Geriatrics editorial, that nosocomial infections victimize one out of every 20 patients with a new infection in the hospital. Viruses,

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IatrogenesisLee Quinn7WJ - HPSWPage 37 of 72bacteria, protozoa, or fungi are usually the culprits. These infections kill 20,000 patients annually and add an estimated $5-10 billion to health care costs." She also talks about how use of radiation to treat cancer and increase ones chances of getting radiation-induced cancer later on in life. In

fact, after reading her short article, it is almost impossible to see a hospital as a hospitable and healing place."And the problems are not confined to the United States. Iatrogenic injuries and diseases and nosocomially-acquired infections are now a very serious worldwide problem of epidemic proportion. A 1995 study, "Quality in Australian Healthcare," indicated as many as 50,000 patients were injured and 18,000 died each year due to errors in hospitals. Another problem, iatrogenic and nosomially related, is MRSA, or methicillin-resistant Staphylococcus aureus, some strains of which may be resistant to several antibiotics. Overuse of "broad spectrum" antibiotics has taken the Staph aureus and turned it into a pathogen with resistance to multiple antibiotics. To use an analogy from nature, if regular Staph aureus is like the European honeybee, MRSA is the killer bee version, and there are indications that this "superbug" is expanding its attacks into the community at large. MRSA is an emerging community-acquired pathogen among patients without established risk factors for MRSA infection (e.g., recent hospitalization, recent surgery, residence in a long-term-care facility [LTCF], or injecting-drug use [IDU]).Since 1996, the Minnesota Department of Health (MDH) and the Indian Health Service (IHS) have investigated cases of community-acquired MRSA infection in patients without established risk factors. This report describes four fatal cases among children with community-acquired MRSA; the MRSA strains isolated from these patients appear to be different from typical nosocomial MRSA strains in antimicrobial susceptibility patterns and pulsed-field gel electrophoresis (PFGE) characteristics.

The scary thing is that modern hospitals, due to the overuse of various broad-spectrum antibiotics, are becoming incubators and breeding grounds for what may be a whole spectrum of resistant pathogens. What is the treatment for MRSA? The MRSA strand is usually combated with a series of different antibiotics, starting with vancomycin (the drug of choice), imipenem, cilastatin and quinolones. If eradication of the disease is not successful by vancomycin or the first line of defense, then second-line antibiotics, such

as rifampicin, fusidic acid or minocycline, are employed. Most of these antibiotics have proven to

be effective; however, some are expensive and can produce adverse side effects. The main trust and challenge that faces the medical community is to find an effective, affordable and tolerable way to control and prevent the spread of MRSA.

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Ext. Iatrogenesis Superbugs Medical Treatment actually exacerbates diseases.Laura, 1991 (Dr. Ronald S. Laura, Professor in Education, University of Newcastle & P.E.R.C. Fellow in Health Education, Harvard University, “Medical Intervention Hit or Myth?”, http://www.whale.to/v/laura.html, 1991)

In other cases it has been shown that specific forms of treatment actually exacerbate the specific condition they are intended to alleviate. The epidemic of asthma deaths in the mid-1960s provides a useful illustration. In England and Wales between 1959 and 1966 mortality due to asthma trebled in the age group 5-24 and increased seven-fold in the 10-14 age group (13). Up to this time mortality rates from this cause had remained relatively constant for more than half a century. Although the epidemic was shared by Scotland, Ireland, Australia, and New Zealand, asthma mortality in Europe, Japan and North America remained virtually stable. Once it was ascertained that the

prevalence of asthma was not on the increase, investigators hypothesised that the epidemic of asthma deaths could be associated with the new forms of treatment whose introduction roughly coincided with the steady increase in mortality rates. Evidence of the excessive use of pressurised aerosols containing bronchiodilator drugs correlated with asthma patient deaths. Other investigations confirmed that the increase in asthma mortality correlated with the increased sales of aerosol bronchiodilators, particularly those containing the drug isoprenaline. Additional evidence in favour of the causal connection between the epidemic in asthma mortality and the excessive use of bronchiodilator drugs came in 1968 when the sales of these aerosols were regulated in the United Kingdom by prescription. Within a year asthma mortality rates declined and levelled off to almost pre-epidemic rates. Isoprenaline came under immediate suspicion since it was in any case the drug mainly used as a bronchiodilator in the 1960s, though considerable debate ensured as to whether the fluorocarbon propellant could be cast as the true culprit. Although both isoprenaline and the fluorocarbon propellants were demonstrated to produce heart irregularities, it has more recently been shown that asthma mortality correlates particularly well with the sale of bronchiodilators capable of

delivering up to five times the concentration of the normal spray of isoprenaline. It is estimated that in England and Wales the asthma epidemic claimed a total of 3,500 lives in excess of the expected rate over the same period calculated on the basis of the pre-epidemic rate in 1959-1960. It has been remarked by

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IatrogenesisLee Quinn7WJ - HPSWPage 39 of 72Taylor that, even if some asthmatics were saved by medical treatment, more were lost" (14).

Medical Drugs create a worse form of diseasesLaura, 1991 (Dr. Ronald S. Laura, Professor in Education, University of Newcastle & P.E.R.C. Fellow in Health Education, Harvard University, “Medical Intervention Hit or Myth?”, http://www.whale.to/v/laura.html, 1991)

The use of other medically prescribed drugs has led to the increased risk of other diseases worse than the ones that they are designed to treat. Reserpine, for example, is one of the drugs which has been used to control high blood pressure.

Despite the fact that studies undertaken in the mid-70s have established that reserpine triples the risk of breast cancer, already ranked as the number-one cause of death in women, it is still prescribed. There are now indications that insulin, heralded as one of the miracles of modern medicine, is implicated as one of the causes of diabetic blindness (15). Investigations undertaken in the 1970s have

revealed that daughters of women treated with a synthetic oestrogen, Diethyistilbestrol (DES), during the early stages of pregnancy for the purported prevention of miscarriage are developing vaginal cancer at an alarming rate. It has also been confirmed more recently that an alarmingly high incidence of genital malformations can be correlated with the male offspring of women treated with DES, not to mention that the cancer mortality rate of the women themselves is also statistically significant. Studies of DES have since established that it does not prevent miscarriage; indeed, it is in fact currently used as a "morning-after" contraceptive pill and in some cases to dry up milk. In the case of DES it is particularly ironic that here we have a drug that not only caused vaginal cancer and other abnormalities, but did not even work for the purpose for which it was originally administered (16). DES is not the only hormone which--despite detrimental side-effects--doctors prescribe for women. While it is to be

admitted that there has in recent years been a greater awareness of the drug-associated victimisation of patients to which we have been alluding, the fact that some 20 million women in the United States alone are under prescription for the birth control pill or menopausal estrogens gives cause for reflection. Concern about the side-effects of the pill led the U.S. Food and Drug Administration to issue a warning bulletin to doctors in 1975 exhorting that women beyond the age of forty be taken off the Pill and provided other means of contraception. This first admonition was followed by a second from the FDA in 1977 requiring the provision of a warning brochure stressing ‘he inordinately high risk of cardiovascular

disease among women over forty taking the Pill (17). The mortality risk from cardiovascular disease for women over forty taking the Pill is increased by a factor of five; for women between the ages of thirty to forty the risk of dying from a heart attack is multiplied by a factor of three. Increased risk of cardiovascular disease is not the only health hazard associated with the Pill. The risk of high blood pressure is six times greater for women taking the Pill than for those who are not. Women taking the Pill run a risk of thromboembolism which is more than five times that for women not taking it and the risk of stroke is four times greater. Other risks associated with the Pill are liver tumours, headaches, depression, and cancer. Similarly, antihypertension drugs have in recent

years soared in popularity as an easy way to lower blood pressure. Although medical journals 39

IatrogenesisLee Quinn7WJ - HPSWPage 40 of 72carry advertisements for drugs intended to counteract the adverse effects of antihypertension drugs, sufficient awareness of their dangers seems decidedly not to be reflected by the astronomical number of medical prescriptions still written for them. Among the multitude of side effects associated with high blood pressure drugs are rash, hives, sensitivity to light, vertigo, muscle cramps, weakness, inflammation of the blood vessels, joint aches, muscle spasms, nausea, psychological disorientation, reduced libido, and impotency (affecting women as well as men) (19).

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Ext. Iatrogenesis Superbugs New technology doesn’t solve and just creates new and more dangerous diseasesLaura, 1991 (Dr. Ronald S. Laura, Professor in Education, University of Newcastle & P.E.R.C. Fellow in Health Education, Harvard University, “Medical Intervention Hit or Myth?”, http://www.whale.to/v/laura.html, 1991)

Medical intervention utilising the tools of high technology has also given rise to its own peculiar forms of iatrogenic diseases. Between the years 1942 and 1954 the problem of retrolental fibroplasia, disease of the eye leading to blindness, came to figure

prominently in the management of premature infants in the United States. Despite being possessed of some of the most advanced medical technology available, hospital nurseries especially equipped to accommodate premature babies were finding that around 90% of all low-weight infants suffered either partial or total blindness. Indeed by 1954 retrolental fibroplasia ranked first in the United States among the causes of blindness in children (20). Investigations eventually showed that the increasing incidence of the disease paralleled the introduction of plastic incubators into which high concentrations of oxygen were pumped to the premature infants on the assumption that oxygen therapy was beneficial, an assumption which, during the time high-concentration oxygen therapy was used, was in fact untested. Oxygen therapy did make the babies look pink, but definitive evidence was provided in 1954 by Lanman et al. that it also made

them go blind (21). Another example of the extent to which high-technology medicine can be debilitating is amply demonstrated by the controversy surrounding coronary arteriography, a test technique whereby a dye is injected into the coronary arteries by way of a small catheter threaded from one of the blood vessels in the limbs and back towards the heart. The technique is designed to assist in the diagnosis and evaluation of coronary heart disease by providing an outline of the interior of the coronary arteries through the medium of the passage of the dye which is visible on X-ray film. In support of the procedure, mortality rates of 0.1% or one per thousand are cited to indicate the technique to be relatively innocuous. Taylor has commented, however, that the statistics belie the true state of affairs. The mortality rate of one per thousand is accurate, he says, if the statistical analysis is restricted to results of the procedure deriving from only "very competent" and "experienced" units which perform it. Surveys of the technique which reflect a regional and more comprehensive base reveal practice of coronary arteriography was carried out, it showed that the mortality rate was not one per thousand, but virtually one in every hundred, ten times the rate

regarded as innocuous. The death rate for patients undergoing the procedure in some institutions was as high as 8%. The incidence of cardiac arrest during the procedure, is in respect of which defibrillation was required to resuscitate the heart, ranged from 1-10%. Some studies report that in addition to the threat of mortality, serious complications

resulting for coronary arteriography are of the order of 1.5% (22). X-rays represent another

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IatrogenesisLee Quinn7WJ - HPSWPage 42 of 72dimension of high-technology medicine whose unbridled use has led to untold iatrogenic illness and disease. Mendelsohn reports that thyroid lesions, a considerable number of which are proving to be cancerous, "are turning up by the thousands in people who were exposed to head, neck, and upper chest radiation twenty to thirty years ago" (23). The amount of radiation required to cause thyroid cancer, he asserts, is "less than that produced by ten lite-wing dental X-rays" (24). It is sobering to hear that every year some 4,000 people die from radioactive dental and medical interventionist techniques, and there are those who urge that the estimate is conservative (25). The use of X-rays to diagnose and assess the female breast--despite the iatrogenic problems associated with them—widely recommended as an effective mean of detecting breast cancer in its stages. Setting aside the fact that studies have shown that disagreament among radiologists is considerable in respect of their interpretation of the same film, it is even more distressing to find other studies reporting mammography will in fact cause more breast cancer than it will detect and that the number of deaths from breast cancer caused by mammography may in fact "balance the number of patients who may be cured by early diagnosis and treatment of the naturally occurring disease" (26). Putting aside the cancer-causing effects of mammography, the efficacy of the procedure in correctly diagnosing cancer can be questioned. At on Australian teaching hospital between 1979 and 1988, 218 women attended for mammography, in 95 of which cases the mammogram failed to detect breast cancer. For 47 of these delayed treatment had tragic results (27).

Specific iatrogenic diseases resulting from surgical intervention are astronomical in number and kind. Complications arise from lack of surgical expertise, the degree of difficulty involved in performing the surgery, the unique constitution of the patient, anaesthetic accidents, laceration of large blood vessels, and misplace ligatures disrupting nerve

responses, blood flow, etc. Taylor reports that an untold variety of surgical instruments have been left and sutured to cause serious infection. Even the talc commonly used by surgeons to lubricate their hands so that their surgical gloves can be more easily fitted is now known to cause inflammatory reactions in patients on whom they operate. Uncontrollable internal bleeding, shock, coma, and death are not uncommon side effects of surgical intervention (26).

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Staph Turn

Hospitalization increases staph infectionsMartin, 2007 (Nicolas M. Martin, http://www.deathreference.com/Ho-Ka/Iatrogenic-Illness.html, 2007)

The Centers for Disease Control and Prevention (CDC) estimate that each year nearly 2 million people acquire infections while hospitalized and about 90,000 die from those infections. More than 70 percent of hospital-acquired bacterial infections have become resistant to at least one of the drugs commonly used to treat them.

Staphylococcus aureus (staph), the leading cause of hospital-acquired infections, is resistant to 95 percent of first-choice antibiotics, and about 30 percent of second-choice antibiotics. In New York City alone, treatment of people with hospital-acquired staph infections exceeds $400 million, according to a study published in 1999. Researchers found that staph infections doubled the length of hospitalization, and more than doubled the patient death rate and per patient costs.

Staph infections are caused primarily by hospital infectionsHastings, 2009 (Richard Hastings, Attorney Hastings is the Founder and CEO of SELECTCOUNSEL, “Iatrogenic Disease and Medical Malpractice”, http://ezinearticles.com/?Iatrogenic-Diseases-and-Medical-Malpractice&id=2202645, April 9, 2009)

More people die each year from medical errors than from motor vehicle accidents, breast cancer and AIDs. Of the 2,000,000 people each year who contract infections in hospitals, 90,000 will die. To compound the situation, the overuse of antibiotics to treat infections has lead to bacterial infections becoming resistant to medications.Seventy percent of hospital infections are resistant to a minimum of one of the antibiotic drugs used for treatment. Staphyloccossus aureus, commonly known as staph, is resistant to 95 percent of first-choice antibiotics and 30 percent of second-choice antibiotics. Staph is the primary cause of hospital infections . A research report of 1999 discovered staph doubles the death rate, costs per patient and the duration of the patient's hospitalization.

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Iatrogenesis causes staphylococci superbugsHealthcare Management, 2004 (Express Healthcare Management, Indian Newspaper, “Nosocomial Infections”, http://www.expresshealthcaremgmt.com/20040630/infectionctrl01.shtml, June 30, 2004)

At the same time, methicillin resistant Staphylococcus aureus (MRSA), also in response to extensive use of cephalosporin antibiotics, became a major nosocomial threat. This led to the overuse of vancomycin, partly in response to concerns about MRSA and for treatment of vascular catheter associated infections by organisms such as the resistant coagulase-negative Staphylococci. Now medical institutions are faced with a resident flora of "super-bugs", resistant to the most potent antimicrobials. A third contributing factor is the hospital environmental dust and suspended particulate matter, which contain many pathogenic fungal spores, toxic molds leading to severe nosocomial fungal infections and illness due to other pathogens, such as Legionella pneumophilia.

Iatrogenesis creates a worse form of Staphylococcus- empirically proven Baker, 2000 (John Raymond Baker, Jounralist for Chiropractic Community, “Allopathic Medicine and Adverse Outcomes; The Iatrogenic Problems Continue”, http://www.chiroweb.com/mpacms/dc/article.php?id=31900, October 1, 2000)

Another problem, iatrogenic and nosomially related, is MRSA, or methicillin-resistant Staphylococcus aureus, some strains of which may be resistant to several antibiotics. Overuse of "broad spectrum" antibiotics has

taken the Staph aureus and turned it into a pathogen with resistance to multiple antibiotics. To use an analogy from nature, if regular Staph aureus is like the European honeybee, MRSA is the killer bee version, and there are indications that this "superbug" is expanding its attacks into the community at large. MRSA is an emerging community-acquired pathogen among patients without established risk factors for MRSA infection (e.g., recent hospitalization, recent surgery, residence in a long-term-care facility [LTCF], or injecting-drug use [IDU]).

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Illich Link

Constructions of pathogens as threats just support further health-care dominance.Illich, 75 (Ivan Illich, Austrian Philosopher, “Medical Nemesis”, page 6)

Limits to medicine must be something other than professional self-limitation. I will demonstrate that the insistence of the medical guild on its unique qualifications to cure medicine itself is based on an illusion. Professional power is the result of political delegation of an illusion. Profession to cure medicine itself is based on an illusion. Professional power is the result of a political delegation of autonomous authority to the health occupations which was enacted during our century by other sectors of the university- trained bourgeoisie: it cannot now be revoked by those who concede it; it can only be

delegitimized by popular agreement about the malignancy of this power. The self-medication of the medical system cannot but fail. If a public, panicked by glory revelations, were browbeaten into further support for more expert control over experts in health-care production, this would only intensify sickening care. It must now be understood that what has turned health care into a sick-making enterprise is the very intensity of an engineering endeavor that has translated human survival from the performance of organisms into the result of technically manipulation.

The government uses the threat of tuberculosis as a guise for control of a population- it is used as an excuse to isolate and punish those who are infectedBashford, 2004 (Alison Bashford, Historian at University of Sydney, “Imperial Hygiene: A Critical History of Colonialism, Nationalism and Public Health”, p.66-68, 2004)

'Danger' and 'dangerousness' was the vocabulary of Australian health and hygiene experts when they turned to consider tuberculosis as a problem of public health: 'Every consumptive [is] a source of danger', announced a 1911 Report on Consumption.38 In 1909 one doctor asked what was to be done with the consumptive who 'cannot manage himself, and is a perpetual or intermittent source of danger to his neighbours?'39 And the editor of Sydney's Daily Telegraph warned that consumptives were 'at present a source of danger to

themselves and to all around them'. 40 This language of dangerousness both recommended and justified new institutional isolation among the preventive responses. When the state health ministers met over the issue of consumption in 1911 they recommended five measures to be implemented uniformly, based on the creation of new legal powers: compulsory notification; legal powers to regulate the hour management of consumptives; legal powers to 'remove dangerous or infective consumptives Into segregation; powers to detain them

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IatrogenesisLee Quinn7WJ - HPSWPage 46 of 72in segregation; legal power to medically examine contacts of consumptives.41 In the management of tuberculosis, then, one can see not only the retention of .sovereign powers of removal and detention which had been used in epidemics of various kinds, notably the smallpox epidemics, but their refinement and extrusion to other"-kinds of 'dangerous'. But there were differences between 'dangers', ,unlike the case of smallpox, leprosy or plague, where having the disease or being a contact was enough for the powers of isolation to be enforced, diagnosis with

tuberculosis alone did not warrant similar immediate action. Rather, isolation in the case of tuberculosis was reserved for' people who were proving ungovernable in some other respect as well, usually working-class people without identifiable homes which could be inspected and sanitized by a visiting nurse or a sanitary inspector. Their indigence meant invisibility in a public health system which relied on spatial tracking, their lack of place was understood as dangerous 'roaming', spreading the disease in unknown ways as they moved uncontrolled and unmonitored through the city. This was a longstanding classed understanding of the management of those who could not responsibly

govern themselves.42 The ungovernable consumptive who could not manage himself, needed isolating. His whole being was understood as infective and dangerous, and therefore he needed to be managed totally. The Melbourne psychiatrist and eugenicist].W. Springthorpe wrote in 1912: The danger, the greatest danger of all, is from careless, generally advanced patients, walking about at large, using ordinary handkerchiefs, and spitting here, there, and everywhere ... Such patients should be taught the danger, that it affects themselves, also, and how to cease being a danger ... in many cases, especially among the poor and ignorant, the sufferers must be aggregated into suitable homes or institutions which need not be

dangers to others.43 The new contagiousness of tuberculosis made these ungovernable people dangerous. Once public dangers, the government had a further rationale to regulate their conduct and to secure the safety of others: the medically dangerous could be criminalized in the new discourse of the carrier. 'Such actions should be regarded as a grave crime against the community', wrote Springthorpe. And for Commonwealth Director-General of Health, ].H.L. Cumpston, 'Spitting at all times is a disgusting practice, but when it is a method of dissemination of tuberculosis, then it becomes criminal'.44 There was a sense, then, in which the government sanatorium was in part a carceral space, where penal codes as well as health codes could remove people, where those posing dangers could be prevented from doing so, or even further along the carceral continuum, were punished for doing so.

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Illich Impacts

Iatrogenesis is just another part of industrial domination that renders individuals helpless.Illich, 75 (Ivan Illich, Austrian Philosopher, “Medical Nemesis”, page 211)

Iatrogenesis will be controlled only if it is understood as but one aspect of the destructive dominance of industry over society, as but one instance of that paradoxical counterproductively which is now surfacing in all major industrial sectors. Like time- consuming acceleration, stupefying education, self-destructive

military defense, disorienting information, or unsettling housing projects, pathogenic medicine is the result of industrial overproduction that paralyzes autonomous action. In order to focus on this specific counterproductively of contemporary industry, frustrating overproduction must be clearly distinguished from two other categories of economic burdens which it is generally confused, namely, declining marginally

utility and negative externality. Without this distinction of the specific frustration that constitutes counterproductively assessment of any technically enterprise, be it medicine, transportation, the media, or education, will remain limited to an accounting of cost- efficiency and not even approach a radical critique of the instrumental effectiveness of these various sectors.

Medical expansion destroys a patient’s value to life- sentencing them to a dependency on medicine worse than death.Illich, 75 (Ivan Illich, Austrian Philosopher, “Medical Nemesis”, page 220)

The destructive power of medical overexpansion does not, of course, mean

that sanitation, inoculation, and vector control, well-distributed health education, healthy architecture, and safe machinery, general competence in first aid, equally distributed access to dental and primary medical care, as well as judiciously selected complex services, could not all fit into a truly modern culture that fostered self-case and autonomy. As long as engineered intervention in the relationship between individuals and environment remains below certain intensity, relative to the range of the individual’s freedom of action, such intervention could enhance the organism’s competence in coping and creating

its own future. But beyond a certain level, the heteronomous management of life will inevitable first restrict, then cripple, and finally paralyze the organism’s nontrivial responses, and what was meant to constitute health care will turn into a specific form of health denial.

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Health care has changed- dependence on doctors has worsened health problems. Illich, 75 (Ivan Illich, Austrian Philosopher, “Medical Nemesis”, page 225-227)

But by 1975 much of this had changed. A generation ago, children in kindergarden had painted the doctor as a white=coated father-figure. Today, however, they will just as readily paint him as a man from mars or a Frankenstein. Muckraking feeds on medical charts and doctors tax returns, and a new mood of wariness among patients has caused medical and pharmaceutical companies to triple their expenses for public relations. Ralph Nader has made the consumers of health staples money and quality-conscious. The ecological movements has created an awareness that health depends on the environment- on food and working conditions and housing- and Americans have come to accept the idea that they are threatened by pesticides, additives, and mycotoxins and other health risks due to environmental degradation. Women’s liberation has highlighted the key role that the control over one’s

body plays in health care. At few slum control have assumed responsibility for basic health care and have tried to unhook their members from dependence on outsiders. The class-specific nature of body perception, language, concepts, and access to health services, infant mortality, and actual, specifically chronic, morbidity has been widely documented, and the class specific origins and prejudices of physicians are becoming to be understood. The world health organization, meanwhile, is moving to a conclusion that would have shocked most of its founders: in a recent publication WHO advocated

that deprofessionalization of primary care as the most important single step in raising national health levels.

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Illich Impacts

The Health Care institution has ended the individuals’ ability to heal- necessitating dependence upon doctors which in the end makes society less healthy.Illich, 75 (Ivan Illich, Austrian Philosopher, “Medical Nemesis”, page 8)

““Health,” after all, is simply an everyday word that is used to designate the intensity with which individuals cope with their internal states and their environmental conditions. In homo sapiens, “health” is an adjective that qualifies ethical and

politics actions. In part at least, the health of a population depends on the way in which political actions condition the milieu and create those circumstances that favor self-reliance, autonomy, and dignity for all, particularly the weaker. In consequence, health levels will be at their optimum when the environment brings out autonomous personal, responsible coping ability. Health levels can only decline when survival comes to depend beyond a certain point on the heteronomous (other-directed) regulation of the organism’s homeostasis. Beyond a critical level of intensity, institutional health care- no matter what if it takes the form of cure, prevention, or environment engineering, is equivalent to systematic health denial. The threat with current medicine represents to the health of populations is analogous to the threat which the volume and intensity of traffic represents to mobility, the threat which education and the media represents to learning, and the threat which urbanization represents to competence in homemaking. In each case a major institutional endeavor has turned counterproductive, Time-consuming acceleration in traffic, noisy and confusion communications, education that trains ever more people for ever higher levels of technical competence and specialized

forms of generalized incompetence: these are all phenomena parallel to the production by medicine of iatrogenic disease. In each case a major institutional sector has removed society from the specific purpose from which that sector was created and technically instrumented.

The concept of Western Medicine justifies the imperialism of Third World CulturesLynn, 2003 (Lynn Kwiatkowski, Professor in anthropology, “Struggling with Development”, Westview Press, pg. 21, 2003)

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IatrogenesisLee Quinn7WJ - HPSWPage 50 of 72<:. Most poor countries have become dependent to some degree on western nations, in part as a result of former colonial practices; contemporary neocolonial economic practices; foreign lending policies of the International Monetary Fund (IMF), the World Bank, and other lending institutions; the accumulation of massive debt by non-industrialized countries with high interest rates; the transnationalization of labor; transnational corporate investment practices; and increasing global militarization. But the management of poor nations is not attempted

purely through economic means. The global hegemony of western cultural and social forms can be observed in many countries, effected in part through development practices, although these forms are usually reinterpreted, refashioned, and reappropriated the cultural lenses of non-western peoples. Among others, these forms include political systems (often some

semblance of democracy), medical systems (usually a form of biomedicine), formal educational systems, western popular culture (music, dance, performance, fashion), and language

(usually English). One result of the hegemony of western cultural and social forms is the reliance on western products to meet new culturally prescribed needs. For example, exported western biomedicine creates dependency by non-western countries on western pharmaceutical companies to purchase drugs and other medical technologies introduced to their countries. To reiterate, this analysis follows the emerging view of the development model as an historically specific form of knowledge, a form of power that constructs a particular reality of the world, imposed on peoples of non-western countries through a variety of strategies, technologies, and discourses. Development is a view of the world that seeks to erode non-western knowledge, practices, and cultures. It is a force perpetuated by western, industrialized countries seeking to manage and gain from the human and material resources of non-industrialized

countries (Escobar 1995, 1988). For example, western biomedicine's focus on individual, . technical, and bodily aspects of illness and healing diverts attention away from social causes of illness and problems such as hunger, malnutrition, and poverty. Biomedicine also allows for the penetration of the state into local communities through medical surveillance and monitoring. such as the weighing surveillance programs of governments, usually viewed as objective, non-politicized technology(Foucault 1994).

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Illich ImpactsVaccines create dependence- subjugating individuals to tools of the stateBashford, 2004 (Alison Bashford, Historian at University of Sydney, “Imperial Hygiene: A Critical History of Colonialism, Nationalism and Public Health”, p. 38, 2004)

The histories of transmissible diseases and their containment have long invited attention to geographical and historical, spatial and temporal axes of transmission, attention to the history of

movement and contact, and to the history of imperial and colonial connections. But the preventive vaccine for smallpox also produced a transmissible disease. And its 'epidemic' spread through imperial and global individuals and communities was not incidental to buf necessary for its success. The spread over time and space of the technologies of vaccination, of

infected/immune individuals and populations, and of both the vaccinia and the variola viruses, implicates smallpox and vaccination in a modern history of travel and colonisation. The movement of the vaccinia virus in stored vials or cloth, or in the pustules of

children's arms traced the global lines of Empire in the Victorian period. These were also the lines of knowledge, as the technique was disseminated with the matter and the disease itself. This is the colonial history of vaccination. But the procedure of vaccination crossed lines as well as travelling lines of communication. Alongside the question of compulsion, this crossing accounts for the extraordinary noise about the practice in the

period - expert, religious, political, and popular. Vaccination crossed the membrane-line, introducing a foreign body into the otherwise healthy self. It crossed species lines. It enabled the crossing of governmental lines of hygiene - quarantine and segregation borders, and later national borders. Most importantly, it crossed the line between the pure and the impure.

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Illich Impact Defense

Medicine doesn’t help individualsIllich, 75 (Ivan Illich, Austrian Philosopher, “Medical Nemesis”, page 14)

After a century if pursuit of medical utopia, and contrary to current conventional wisdom, medical services have no been important in producing the changes in life expectancy that have occurred. A vast amount of contemporary clinical care is incidental to the curing of disease, but the damage done by medicine to the health of individuals and populations is very significant. These facts are obvious, well documented, and well repressed.

Health care systems mandate a disconnect between individuals and their labor – preventing self sufficiency.Illich, 75 (Ivan Illich, Austrian Philosopher, “Medical Nemesis”, page 215-216)

The achievement of a concrete social goal cannot be measured in terms of industrial outputs, neither in

their amount nor in the curve that represents their distribution and their social costs. The effectiveness of each industrial sector is determined by the correlation between the production of commodities by society and the autonomous production of corresponding use-values. How effective a society is in producing high levels of mobility, housing, or nutrition depends on the meshing of marketed staples with inalienable, spontaneous action. When most needs of most people are satisfied in a domestic or community mode of production, the gap between expectation and satisfaction tends to be narrow and stable. Learning, locomotion, or sick-care are the results of highly decentralized initiatives, of autonomous inputs and self-limiting total outputs. Under the conditions of a substinance economy, the tools used in production determine the needs that the application of these same tools can fulfill. For instance, people know what they can expect when they get sick. Somebody in the village or the nearby town will know all the remedies that have worked in the past, and beyond this lies the unpredictable realm of the miracle. Until late in the nineteenth centrury, most families, even in western countries, provided most of the

therapy that was known. Most learning, locomotion, or healing was performed by each man on his own, and the tools needed were produced in his family or village setting. Autonomous production can, of course, be supplemented by industrial outputs that will have to be designed and often manufactured beyond direct community control. Autonomous activity can be rendered both more effective and more decentralized by using such industrial made tools as bicycles, printing presses, recorders, or

X-ray equipment. But it can also be hampered, devalued, and blocked by an arrangement of society that is totally in favor of industry. The synergys between the autonomous and the heteronormous of production then takes

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IatrogenesisLee Quinn7WJ - HPSWPage 53 of 72on a negative cast. The arrangement of society in favor of managed commodity production has two ultimately destructive aspects: people are trained for consumption rather than for action, and at the same time their range of action is narrowed. The tool separates the workman from his labor. Habitual bicycle commuters are pushed off the road by intolerable levels of traffic, and patients accustomed to taking care of their own ailments find yesterday’s remedies available only on prescription and hence largely unobtainable. Wage labor and client relations expand while autonomous production and gift relationships wither.

The health care system has made individuals reliant upon doctors- healing should be an individual task for it to truly be effective.Illich, 75 (Ivan Illich, Austrian Philosopher, “Medical Nemesis”, page 213)

The industrial distortion of our shared perception of reality has rendered us blind to the counter positive level of our enterprise. We live in an epoch in which learning is planned, residence standardized, traffic motorized, and communication programmed, and in which, for the first time, a large part of all foodstuffs consumed by humanity passes through

interregional markets. In such an intensely industrialized society, people are conditioned to get things rather than to do them; they are trained to value what can be purchased rather than what they themselves can create. They want to be taught, moved, treated, or guided rather than to learn, to heal, and to find their own way. Impersonal institutions are assigned personal functions. Healing ceases to be considered a task for the sick. It first becomes the duty of the individual body repairmen, and then soon changes from a personal service into the output of an anonymous agency. In the process, society is rearranged for the sake of the health-care system, and it becomes increasingly difficult to care for one’s own health. Goods and services litter the domains of freedom.

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Capitalism Links

Western Health Care promotes profit maximization over individual health.Biehl, 07- National Institute of Mental Health postdoctoral fellow at Harvard University (João, Anthropological Quarterly, “Pharmaceuticalization: AIDS Treatment and Global Health Politics, p. 1099-1100, Project Muse)

Global ARV rollouts rightly open the door to drug access, but they also exemplify the inadequacies of a magic bullet approach to health care. The methodological designs of AIDS treatment programs (pilot and otherwise), as well

as the models they employ, have to be scrutinized and politicized. PEPFAR, for example, has an expeditionary quality, implemented from without, and is designed to save lives. It favors large-scale drug distribution but does not adequately address the issue of public health care infrastructure improvements, or, for that matter, prophylaxis and treatment of opportunistic diseases. Critics have

rightly pointed out that, generally speaking, the strategies underlying new global health interventions are noncomprehensive and ultimately of poor quality.45 Many question their sustainability in the absence of more serious involvement of national governments and greater authority for international institutions to hold donors and partners accountable in the long term. Drugs are ancillary to the full treatment of the disease. Alone, neither money nor drugs nor even a sophisticated pilot model guarantee success. Healing, after all, is a multifaceted concept, and "healing" is no more synonymous with "treatment" than "treatment" is with "drugs." Statistical strategies and corporate profit motives

hover above, by and large missing cultural systems and the interpersonal networks that link patients, doctors, and governments, which are especially important in resource-poor settings, where clinical infrastructures are not improving. This displacement of the local from the planning framework leaves unaddressed the [End Page 1104] clinical continuity necessary for successful AIDS

treatment. As a result, extremely well-endowed efforts—facing the humanitarian paradox of "life-saving drugs versus caregiving infrastructure"—are by and large falling short of the mark, without effecting the changes hoped for.

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Western Health Care has stripped individuals of their ability to treat oneself.Fox and Meier, 08- * IGERT-International Development and Globalization Fellow and ** IGERT-International Development and Globalization Fellow and Public Health Law Program Manager, Center for Health Policy, Columbia University (Ashley Fox and Benjamin Meier, Human Rights Quarterly, “Development as Health: Employing the Collective Right to Development to Achieve the Goals of the Individual Right to Health”, 5-02-08, Project Muse, p. 293-294)

An individual rights framework—an extension of the self-interested paradigm of the market-based global economy—has proven incompetent to speak to neoliberal development in directing state policy for social justice programs. 181 Traditional human rights scholarship views "man" as "a separate isolated individual who, as such and apart from any social context, is bearer of rights."182 This vision of human

rights is rooted in employing autonomy as a means to realize human dignity.183 In the case of public health, however, neoliberal economic policy, despite its emphasis on individualism,184 has taken health out of the control of the individual, determining harm

[End Page 293] at the societal level.185 As seen through the underlying determinants of communicable disease,186 non-communicable disease (e.g.,

tobacco use, obesity),187 and other illnesses, neoliberal economic policy has impinged the right of the informed individual to make healthy choices for him or herself, denying the freedom of choice pivotal to a "capability approach" to the right to health.188 With the individual as the sole rights-holder, human rights organizations have faced difficulties in finding a discursive space to enter the development debate.189 For example, a rights-based approach is likely to give priority to gross violations to a small number of individuals' human rights over less severe but more pervasive violations during

development.190 As argued by William Felice, "[s]een only as individual entitlements, human rights are a difficult conceptual framework from which to tackle structural violence in the global economy."191 Although public health systems, as public goods, are vital to the provision of public health programs in responding to globalization, an individual right is normatively incapable of providing for the realization of these public goods. Combating the health inequalities of a globalized world through human rights will require renewed focus on the collective social determinants of health that facilitate the onset and spread of disease, not simply individual rights.

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Capitalism LinksWestern health systems has exacerbated capitalist tendencies- creating a worse form of health solutions.Fox and Meier, 08- * IGERT-International Development and Globalization Fellow and ** IGERT-International Development and Globalization Fellow and Public Health Law Program Manager, Center for Health Policy, Columbia University (Ashley Fox and Benjamin Meier, Human Rights Quarterly, “Development as Health: Employing the Collective Right to Development to Achieve the Goals of the Individual Right to Health”, 5-02-08, Project Muse, p. 273-275)

Although there lies great potential in economic development for improving the public's health, current international development programs, as facets of neoliberal economic policy, have crippled public health systems and diminished their ability to prevent disease and promote health. Belying their advancement as a source of national development—and consequently, a solution to global poverty68—these neoliberal development programs have resulted in collective health harms at the societal level.69 In harming health, modern processes of economic development impact public health through myriad proximal and distal mechanisms,70 and through these multiple, overlapping processes,71 serve to exacerbate disparities in health between rich and poor.72 The global and national changes brought about by international development policies have denied states the sovereignty necessary to control and sustain their own development and health.73 Further, despite neoliberal globalization's rhetorical homage to individualism,74 [End

Page 274] globalization, in tragic irony, has taken responsibility for health out of the control of the individual, predetermining harm at the societal level and robbing individuals of the autonomy necessary for individual health.75 Thus, while globalization has resulted in improvements in technology and health services for some,

various globalized economic processes are correlated with widening health gaps within states and among states in the developed and developing world.76

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Western Medicine Bad

The separation of body from mind is characteristic of Western scientism that justifies pharmaceutical pillaging, medicinal, and cultural hegemony - Wredford, 2005 (Jo Wredford, Researcher at the Aids and Society Research Unit (ASRU) within the Centre for Social Science Research (CSSR) at UCT as well as a Sangoma, “Missing Each Other”, Lexis, 2005)

Whether comparisons of ‘popular’ medical beliefs (Feierman, 1985: 112) are valid or not, African and biomedical ontologies, whilst they have common roots, have become fundamentally unlike one another, their dissimilarities resting in their constructions of the causation of ill-health (Horton, 1993: Ch. 7). Traditional African healing draws upon a cosmology of ancestral connections and spiritual power to explain and verify its efficacy (see Beattie, 1966; Horton, 1993; Hountondji, 1997; Noel, 1997; Winch, 1972). The igqirha, for example, considers the human body as part of a cyclical structure, simultaneously social, spiritual, emotional, physical and non-material (Buhrmann, 1984; Feierman, 1992; Iwu, 1986; Janzen, 1992; Ngubane, 1992; Turner, 1992; Willis, 1999). Characterised by a reverence for ancestral authority established through ties of clan and kinship, treatment may involve addressing, and if need be, altering, relationships, both material and spiritual (Gualbert, 1997: 236). To treat the sick in isolation from this ‘ontology of invisible beings’ (Appiah, 1992: 112) – the spiritual community of the ancestors (or indeed, of the living community) – is almost inconceivable (Iwu, 1986; Ngubane, 1977; Yoder, 1982). In contrast,

spirituality rarely finds a place in the practice of biomedicine. 5 Western medicine’s inclination to separate mind and spirit from the body encourages the consideration of illness in terms of botched biochemistry (Cunningham and Andrews, 1997: 5-6). The human body becomes a ‘thing’ to be worked on, altered, adjusted, and

ultimately (as Margaret Lock’s researches into organ transplants suggests) rebuilt (2002a: 47). As the boundaries of scientific medicine increase, sickness categories tend to increase, until to be healthy seems almost aberrant (Scheper-Hughes, 1987: 26; Harding, 1997: 145); meanwhile behaviourist strictures, somewhat paradoxically, attempt to

shore up the utopian ideal of an ‘inalienable right to health’ (Lock, 2002b: 251). The science underpinning biomedical theory and practice, supported by an increasingly powerful and profit-motivated drug industry (Cullet, 2003; Millen

and Holtz, 2000; Millen, Lyon and Irwin, 2000), have together appropriated an intellectual and pharmaceutical superiority which is employed to justify biomedicine’s legitimacy as the universal medical model (Ingstad, 1989:

269). This situation certainly applies to the South African medical experience, where the spiritual practices of traditional medicine have at best been expected to live in ‘mute coexistence’ with biomedicine

(Hountondji, 1997: 15); running alongside, they are nonetheless marginalised.

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Western Medicine depletes natural resources unsustainably whereas indigenous cultures traditionally conserve environmental resourcesLumpkin, 2001 (Tara W. Lumpkin, Anthropogist with development experience,. “Perceptual Diversity: Is Polyphasic Consciousness Necessary for Global Survival?” Anthropology of Consciousness. Vol. 12, No. 1, pp. 37-70, 2001)

If people's health can be improved by going to a shaman or by using perceptual processes such as ritualistic healing as I concluded in the previous section, then what is the connection between using intuitive perceptual processes and maintaining or increasing the health of ecosystems and the

biosphere? I propose that cultures that validate the use of a variety of perceptual processes, that is cultures whose realities are polyphasic, are more likely to take better care of the environment than are monophasic cultures. As Bruce Wilcox and Kristin Duin (Wilcox and Duin 1995) point out, nonindigenous and non-traditional societies usually do not have the same rational utility approach to natural resources as traditional indigenous peoples.

Non-traditional peoples degrade and deplete their resources in an unsustainable manner (Wilcox and Duin 1995:49-51). Conservation of natural resources among indigenous peoples is "effectively based on a knowledge of functional utility and institutionalized in the form of taboos." Wilcox and Duin have documented a strong positive correlation for ecological diversity and cultural diversity. Regions that are biologically diverse tend to have many distinct and diverse cultures, the exception being mangrove swamps, which are biologically diverse but do not support a correlative number of indigenous populations. Research conducted by Machav Gadgil of the Indian Institute of Science in Bangalore and his collaborators revealed that traditional endogamous groups in India divided the available biological resource base so that different groups could exploit different niches (Wilcox and Duin 1995). For example, some groups specialized in honey gathering, others in shifting cultivation, and so forth. This type of resource exploitation is far more efficient than industrialized resource exploitation that homogenizes the resource base reducing biocomplexity

and cultural diversity. Furthermore, as Wilcox and Duin explain, utility of resources depends upon the perception of the user of those resources: where an industrialized resource user might see only trees that can be cut into board-feet, a traditional honey collector might see trees that can hold honey.

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Western Medicine BadWestern medicine either assimilates or eradicates indigenous healing practices and practitioners in the name of science. Traditional medicine is an ideal point to begin challenging hegemonic discoursesDei, 1994 (George J. Sefa Dei, Professor of Sociology at Ontario Institute for Studies in Education, Anthropology and Education Quarterly 1994)

Metaphorically speaking, indigenous Africa is black. For many people in North American societies, “blackness” has also become a political metaphor for identification with the disadvantaged and the ignorant. The Afrocentric discourse contains some uncomfortable truths for some European

scholars. With traditional medicine as a valid form of knowledge challenging existing hegemonic, Western discourses concerning scientific medicine become threatened. Eurocentric science perceives indigenous practices as “backward”, “savage”, and “barbaric”. In an era in which the marginalization of African peoples’ experiences and the subjugation of their identities have become more problematic than ever, the devaluation of the spiritual, social, and healing practices of indigenous Africans by Western science has evolved into a systemic destruction of their culture and identity itself. As respected custodians of cultural traditions and knowledge who continually pass on local traditions from one generation to the next, local healers occupy multiple social and political roles central to their society. Privileged as a superior “scientific” system, Western medicine uses its pervasive authority to remove them from these roles by forcing itself on indigenous societies as the only system of knowledge able to “diagnose”, “treat”, and ultimately “cure” the diseases that afflict them.

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2AC Iatrogenesis

Case outweighs and empirically disproven- hospitals have not caused extinction- only ___________________________ risk human extinction.

Non Unique/ Inevitable- Hospitals will always exist. The disad doesn’t stop other nations from increasing hospitals. Only a risk they are good

No Impact- Health Care statistically gets better over time- heart disease provesKaiser Foundations, 2007 (The Henry J. Kaiser Family Foundation, Private Funding Orgainzation, “How Changes in Medical Technology Affect Health Care Costs”, http://www.kff.org/insurance/snapshot/chcm030807oth.cfm, March 2007)

Heart disease and its consequence, heart attack, is the leading cause of death in the U.S. and a good example of how new technology has changed the treatment and prevention of a disease over time.  In the 1970s, cardiac care units were introduced, lidocaine was used to manage irregular heartbeat, beta-blockers were used to lower blood pressure in the first 3 hours after a heart attack, “clot buster” drugs began to be widely used, and coronary artery bypass surgery became more prevalent.  In the 1980s, blood-thinning agents were used after a heart attack to prevent reoccurrences, beta-blocker therapy evolved from short-term therapy immediately after a heart attack to maintenance therapy, and angioplasty (minimally invasive surgery) was used after heart attack patients were stable.  In the 1990s, more effective drugs were introduced to inhibit clot formation, angioplasty was used for treatment and revascularization along with stents to keep blood vessels open, cardiac rehabilitation programs were implemented sooner, and implantable cardiac defibrillators were

used in certain patients with irregular heartbeats.   In the 2000s, better tests became available to diagnose heart attack, drug-eluting stents were used, and new drug strategies were developed (aspirin, ACE inhibitors, beta-blockers, statins) for long-term management of heart attack and potential heart attack patients.   From 1980-2000, the overall mortality rate from heart attack fell by almost half, from 345.2 to 186.0 per 100,000 persons. 3

No impact- Doctors are improving in the status quo.Kaiser Foundations, 2007 (The Henry J. Kaiser Family Foundation, Private Funding Orgainzation, “How Changes in Medical Technology Affect Health Care Costs”, http://www.kff.org/insurance/snapshot/chcm030807oth.cfm, March 2007)

The continuing flow of new medical technology results from other factors including the desire by professionals to find better ways to treat their patients and the level of investment in basic science and research.   Direct

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IatrogenesisLee Quinn7WJ - HPSWPage 61 of 72providers of care may incorporate new technology because they want to improve the care they offer their patients, but they also may feel the need to offer the

“latest and best” as they compete with other providers for patients.  Health care professionals,

like people in other occupations, also may be motivated by professional goals (e.g.,

peer recognition, tenure, prestige) to find ways to improve practice.   Commercial interests (such as pharmaceutical companies and medical device makers) are willing to invest large amounts in research and development because they have found strong consumer interest in, and financial reimbursement for, many of the new products they produce.   In addition, public and private investments in basic science research lead directly and indirectly to advancements in medical practice; these investments in basic science are not necessarily motivated by an interest in creating new products but by the desire to increase human understanding.

No Impact and Turn- Hospitals empirically reduce diseases- statistics prove. Only stopping now has a risk of re-emergence. Wahdan, 1996 (M.H. Walden, eastern mediterranian Health Journal, “The epidemiology transition”, http://www.emro.who.int/publications/EMHJ/0201/02.htm, 1996)

Several changes have occurred in the quantity, distribution, organization and quality of health services that have contributed to the epidemiological transition. The discoveries and technological developments of the twentieth century, such as the development of antibiotics and antimicrobial agents, insecticides, vaccines and diagnostic and therapeutic technologies, have resulted in remarkable progress in the prevention and control of many diseases and in the effective management of many others. One of the most dramatic victories has been the eradication of smallpox. Another evident success has been the reduction of morbidity and mortality from diseases for which there are available protective vaccines such as poliomyelitis, diphtheria, tetanus and measles. It must, however, be remembered that relaxation of vaccination efforts can very quickly result in the re-emergence of these diseases as happened with poliomyelitis in Pakistan and is now the case with diphtheria in Russia and Ukraine. Although therapeutic interventions have been the key element in saving millions of lives each year and in reducing some of the serious complications that often follow infection, they actually do not modify the probability of

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IatrogenesisLee Quinn7WJ - HPSWPage 62 of 72becoming ill (except in so far as early treatment reduces the risk of spread of infection to others). In chronic diseases, this type of intervention actually produces the paradoxical effect of increasing the absolute morbidity level.

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Ext. 3: Tech AdvancesMore Evidence- Pre-Term BabiesKaiser Foundations, 2007 (The Henry J. Kaiser Family Foundation, Private Funding Orgainzation, “How Changes in Medical Technology Affect Health Care Costs”, http://www.kff.org/insurance/snapshot/chcm030807oth.cfm, March 2007)

Another example of how advances in technology have changed health outcomes over time is in the treatment of pre-term babies, for which very little

could be done in 1950.  But by 1990, changes in technology, including special ventilators, artificial pulmonary surfactant to help infant lungs develop, neonatal intensive care, and steroids for mother and/or baby, helped decrease mortality to one-third its 1950 level, with an overall increase in life expectancy of about 12 years per low-birthweight baby

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Economy Solves Your Impacts

A stable economy ensures innovation and sustainable health careKaiser Foundations, 2007 (The Henry J. Kaiser Family Foundation, Private Funding Orgainzation, “How Changes in Medical Technology Affect Health Care Costs”, http://www.kff.org/insurance/snapshot/chcm030807oth.cfm, March 2007)

Many factors influence innovation in medical care.   Consumer demand for better health is a prime factor.   Research shows that the use of medical care rises with

income: as people and the nation become wealthier, they provide a fertile market for new medical innovations.  Consumers want medical care that will help them

achieve and maintain good health, and advances in medical technology are perceived as ways to promote those goals.     Consumer demand is affected by the increased public awareness of medical technology through the media, the Internet, and direct-to-consumer advertising.Health insurance systems that provide payment for new innovations also encourage medical advances.  Medical treatments can be very expensive, and their cost would be beyond the reach of many people unless their risk of needing health care could be pooled

though insurance (either public or private).   The presence of health insurance provides some assurance to researchers and medical suppliers that patients will have the resources to pay for new medical products, thus encouraging research and development.  At the same time, the promise of better health through improvements in medicine may increase the demand for health insurance by consumers looking for ways to assure access to the type of medical care that they want.

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Bioterrorism Turn

Drug’s key to solve bioterrorismGillis, 2001 (Justin Gillies, Writer for Washington Post, “Scientists Race for Vaccines,” Lexis, November 8, 2001,)

U.S. scientists, spurred into action by the events of Sept. 11, have begun a concerted assault on bioterrorism, working to produce an array of new medicines that

include treatments for smallpox, a safer smallpox vaccine and a painless anthrax vaccine. At least one major drug company, Pharmacia Corp. of Peapack, N.J., has offered to let government scientists roam through the confidential libraries of millions of compounds it has synthesized to look for drugs against bioterror agents. Other companies have signaled that they will do the same if asked.These are unprecedented offers, since a drug company's chemical library, painstakingly assembled over decades,

is one of its primary assets, to which federal scientists usually have no access."A lot of people would say we won World War II with the help of a mighty industrial base," said Michael Friedman, a onetime administrator at the Food and Drug Administration who was

appointed days ago to coordinate the pharmaceutical industry's efforts. "In this new war against bioterrorism, the mighty industrial power is the pharmaceutical industry."Researchers say a generation of young scientists never called upon before to defend the nation is working overtime in a push for rapid progress. At laboratories of the National Institutes of Health, at universities and research institutes across the land, people are scrambling.But the campaign, for all its urgency, faces hurdles both scientific and logistical. The kind of research now underway would normally take at least a decade before products appeared on pharmacy shelves. Scientists are talking about getting at least some new products out the door within two years, a daunting schedule in medical research. If that happens, it

will be with considerable assistance from the nation's drug companies. They are the only organizations in the country with the scale to move rapidly to produce pills and vials of medicine that might be needed by the billions. The companies and their powerful lobby in Washington have been working over the past few weeks to seize the moment and rehabilitate their reputations, tarnished in recent years by controversy over drug prices and the lack of access to AIDS drugs among poor countries. The companies have already made broad commitments to aid the government in the short term, offering free pills with a wholesale value in excess of $1 billion, as well as other help. The question now is whether that commitment will extend over the several years it will take to build a national stockpile of next-generation medicines. A good deal of basic research is already going on at nonprofit institutes that work for the government under contract, and scientists there say they are newly optimistic about the prospects of commercial help. "The main issue is, can we get the facilities?" said John Secrist III, vice president for drug discovery and development at Southern Research Institute in Birmingham, which is looking, under federal grant, for antiviral drugs to treat smallpox. Given the new mood in the country, he said, "if we come up with a molecule that's going to be of help, then I have no doubt that we could very rapidly convert that into doses for humans." Many of the projects that could lead to new drugs and vaccines were underway before Sept. 11, thanks partly to an extensive commitment NIH made two years ago. Others, like the smallpox project Eli Lilly initiated, have been started from scratch in recent weeks. Before Sept. 11, NIH had planned to spend $93 million on next-generation bioterrorism research this budget year. That was nearly double the amount in the prior year, but now the actual figure is likely to jump by tens of millions. Other parts of the government, including the Department of Defense, are spending millions

as well, often in cooperation with NIH. Much of the immediate focus is on better defenses for smallpox and anthrax, two bioterror agents theoretically capable of killing millions. Smallpox was eradicated from the United States in 1949 and from the rest of the world in 1978. The last remaining stocks of virus are supposedly secure in two repositories in the United States

and Russia. Some terrorist groups are feared to have gotten their hands on virus samples from Russia, and if that's true, they could set off a worldwide epidemic. Stopping such an outbreak would require mass vaccinations. The government has a stockpile of old smallpox vaccine, but the supply is limited. It is, moreover, a primitive product, not substantially different from the vaccine discovered by English physician Edward Jenner in 1796

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IatrogenesisLee Quinn7WJ - HPSWPage 66 of 72ExtinctionOchs 02 – MA in Natural Resource Management from Rutgers University and Naturalist at Grand Teton National Park [Richard, “BIOLOGICAL WEAPONS MUST BE ABOLISHED IMMEDIATELY,” Jun 9, http://www.freefromterror.net/other_articles/abolish.html]

Of all the weapons of mass destruction, the genetically engineered biological weapons, many

without a known cure or vaccine, are an extreme danger to the continued survival of life on earth. Any perceived military value or deterrence pales in comparison to the great risk

these weapons pose just sitting in vials in laboratories. While a "nuclear winter," resulting

from a massive exchange of nuclear weapons, could also kill off most of life on earth and

severely compromise the health of future generations, they are easier to control. Biological

weapons, on the other hand, can get out of control very easily, as the recent anthrax attacks has demonstrated. There is no way to guarantee the security of these doomsday weapons because very tiny amounts can be stolen or accidentally released and then grow or be grown

to horrendous proportions. The Black Death of the Middle Ages would be small in comparison to the potential damage bioweapons could cause. Abolition of chemical weapons is less of a priority because, while they can also kill millions of people outright, their persistence in the environment would be less than nuclear or biological agents or more localized. Hence, chemical weapons would have a lesser effect on future generations of innocent people and the natural environment. Like the Holocaust, once a localized chemical extermination is over, it is over. With nuclear and biological weapons, the killing will probably never end. Radioactive elements last tens of thousands of

years and will keep causing cancers virtually forever. Potentially worse than that, bio-engineered agents by the hundreds

with no known cure could wreck even greater calamity on the human race than could persistent radiation. AIDS and ebola viruses are just a small example of recently emerging plagues with no known cure or vaccine. Can we imagine hundreds of such plagues?

HUMAN EXTINCTION IS NOW POSSIBLE. Ironically, the Bush administration has just changed the U.S. nuclear doctrine to allow nuclear retaliation against threats upon allies by conventional weapons. The past doctrine allowed such use only as a last resort when our nation’s survival was at stake. Will the new policy also allow easier use of US bioweapons? How slippery is this slope? Against this tendency can be posed a rational alternative policy. To preclude possibilities of

human extinction, "patriotism" needs to be redefined to make humanity’s survival primary and absolute. Even if we lose our cherished freedom, our sovereignty, our government or ourConstitution, where there is life, there is hope. What good is anything else if humanity is extinguished? This concept should be promoted to the center of national debate.. For example, for sake of argument, suppose the ancient Israelites developed defensive bioweapons of mass destruction when they were enslaved by Egypt. Then suppose these weapons were released by design or accident and wiped everybody out? As bad as slavery is, extinction is worse. Our generation, our century, our epoch needs to take the long view. We truly hold in our hands the precious gift of all future life. Empires may come and go, but who are the honored custodians of life on earth? Temporal politicians? Corporate competitors? Strategic brinksmen? Military gamers? Inflated egos dripping with

testosterone? How can any sane person believe that national sovereignty is more important than survival of the species? Now that extinction is possible, our slogan should be "Where there is life, there is hope." No government, no economic system, no national pride, no religion, no political system can be placed above human survival. The egos of leaders must not blind us. The adrenaline and vengeance of a fight must not blind us. The game is over. If patriotism would extinguish humanity, then patriotism is the highest of all crimes.

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Disease Turn

Medicine is key to solve disease- prefer our evidence- it assumes the newest R&DI.F.P.M.A. 3 (International Federation of Pharmaceutical Manufacturers Associations – non-profit, NGO representing more than 60 national industry organizations, Dec., “Neglected Diseases and the Pharmaceutical Industry” http://www.ifpma.org/Documents/NR235/Brochure_Neglected%20Diseases.pdf, 2003)

Nevertheless, neglected diseases definitely require adequate actions and solutions. These diseases impose a great social burden on the poorest populations, impairing their already very low economic productivity. Consequently, we should all argue for a solution that would best utilise the existing capacities and

mobilise all the stakeholders. The pharmaceutical industry, as a unique source of new medicines, has initiated and participated in numerous programmes and partnerships aiming at improving health outcomes in developing countries. These initiatives can serve to develop an adequate approach to tackle the problem of neglected diseases. They are briefly discussed below. The pharmaceutical industry is an unquestionable pillar of the medicinal innovation. Over decades, it has discovered and developed treatments for all major diseases affecting the world’s population. Infectious diseases have always been one of the key components of pharmaceutical companies’ R&D budgets. Because of new infectious diseases emerging and old ones mutating, the pharmaceutical industry has never stopped its R&D efforts to discover and develop new needed treatments.

ExtinctionSteinbruner 98, (John D., Senior Fellow @ Brookings Institution “Biological weapons: A plague upon all houses.” Foreign Policy Winter97/98 Issue 109, p85, 12p, EBSCOhost, 1998)

It is a considerable comfort and undoubtedly a key to our survival that, so far, the main lines of defense against this threat have not depended on explicit policies or organized efforts. In the

long course of evolution, the human body has developed physical barriers and a biochemical immune system whose sophistication and effectiveness exceed anything we could design or as yet even fully understand. But evolution is a sword that cuts both ways: New diseases emerge, while old diseases mutate and

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IatrogenesisLee Quinn7WJ - HPSWPage 68 of 72adapt. Throughout history, there have been epidemics during which human immunity has broken down on an epic scale. An infectious agent believed to have been the plague bacterium killed an estimated 20 million people over a four-year period in the fourteenth century, including nearly one-quarter of Western Europe's population at the time. Since its

recognized appearance in 1981, some 20 variations of the HIVvirus have infected an estimated 29.4 million worldwide, with 1.5 million people currently dying of aids each year. Malaria, tuberculosis, and cholera-once thought to be

under control-are now making a comeback. As we enter the twenty-first century,

changing conditions have enhanced the potential for widespread contagion. The rapid growth rate of the total world population, the unprecedented freedom of movement across international borders, and scientific advances that expand the

capability for the deliberate manipulation of pathogens are all cause for worry that the problem might be greater in the future than it has ever been in the past. The threat of infectious pathogens is not just an issue of public health, but a fundamental security problem for the species as a whole.

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Hegemony TurnMedicine is key to competitivenessMarketwatch, 12-15-08, Online

"It has become increasingly clear that continued leadership in medical innovation has a direct correlation to job growth and U.S. competitiveness, as well as the health of all Americans," said Former Congressman Dick Gephardt, who moderated the

discussion. "This region is home to some of the country's most innovative universities and biotechnology and pharmaceutical companies who together employ hundreds of thousands of Pennsylvanians - making it an ideal place to discuss how we can ensure continued health and economic security through medical innovation."

That’s key to hegemony.Segal, 2004, (Adam Segel, Is America Losing its Primacy? Foreign Affairs)

The United States' global primacy depends in large part on its ability to develop new technologies and industries faster than anyone else. For the last five decades, U.S. scientific innovation and technological entrepreneurship have ensured the country's economic prosperity and military power. It was Americans who invented and commercialized the semiconductor, the personal computer, and the Internet; other countries merely followed the U.S. lead.

Today, however, this technological edge-so long taken for granted-may be slipping, and the most serious challenge is coming from Asia. Through competitive tax policies, increased investment in research and development (R&D), and preferential policies for science and technology (S&T) personnel, Asian governments are improving the quality of their science and ensuring the exploitation of future innovations. The percentage of patents issued to and science journal articles published by scientists in China, Singapore, South Korea, and Taiwan is rising. Indian companies are quickly becoming the second-largest producers of application services in the world, developing, supplying, and managing database and other types of software for clients around the world. South Korea has rapidly eaten away at the U.S. advantage in the manufacture of computer chips and telecommunications software. And even China has made impressive gains in advanced technologies such as lasers, biotechnology, and advanced materials used in semiconductors, aerospace, and many other types of manufacturing.

Although the United States' technical dominance remains solid, the globalization of research and development is exerting considerable pressures on the American system. Indeed, as the United States is learning,

globalization cuts both ways: it is both a potent catalyst of U.S. technological innovation and a significant threat to it. The United States

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IatrogenesisLee Quinn7WJ - HPSWPage 70 of 72will never be able to prevent rivals from developing new technologies; it can remain dominant only by continuing to innovate faster than everyone else. But this won't be easy; to keep its privileged position in the world, the United States must get better at fostering technological entrepreneurship at home.

Nuclear warKhalilzad ’95 (Zalmay, director of Strategy and Doctrine Program at RAND, US ambassador to Afghanistan; “Losing the moment? The United States and the World after the Cold War,” Washington Quarterly, Spring 1995, p. ln)

Under the third option, the United States would seek to retain global leadership and to preclude the rise of a global rival or a return to multipolarity for the indefinite

future. On balance, this is the best long-term guiding principle and vision. Such a vision is desirable not as an end in itself, but because a world in which the United States exercises leadership would have tremendous advantages. First, the global

environment would be more open and more receptive to American values -- democracy, free markets, and the rule of law. Second, such a world would have a better chance of dealing cooperatively with the world's major problems, such as nuclear proliferation, threats of regional hegemony by renegade states, and low-level conflicts.

Finally, U.S. leadership would help preclude the rise of another hostile global rival, enabling the United States and the world to avoid another global cold or

hot war and all the attendant dangers, including a global nuclear exchange. U.S. leadership would therefore be more conducive to global stability than a bipolar or a multipolar balance of power system. 

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Economy TurnMedicine is key to the economyDavy, 2002 (Gale Daavy, Executive Director of WABRE - Wisconsin Association for Biomedical Research and Education, Biosciences Wisconsin, http://www.wabre.org/report_two/bio13.html, 2002)

Most economists, businesspeople, politicians and members of the public now recognize that innovation and new technology are vital to economic development in the 21st century. The concept of a new economy is based upon growth in high technology sectors and a lessening reliance on primary production and manufacturing industries. When we think of the new economy, we might think of computers, dot coms, and internet

billionaires. But the new economy is based upon more than just these factors. The true new economy is built upon innovation and its greatest impact is felt in technology sectors. Innovation is the process of creating new applications and products from existing technologies and it leads to the invention of new systems, oftentimes combining technologies, to accomplish new tasks. Innovation in data processing technologies and home-computing led to the first economic wave of the new economy.  Communications technologies, the second wave, coupled with computing led to the internet and changed the way we work, communicate, do business, purchase goods, learn and utilize our leisure

time.  Bioscience innovation may not be as obvious to the general public, but it figures to have just as great an impact. In one sense, bioscience innovation has been with us since early civilization. Man has made a habit of learning about living organisms and manipulating them to his benefit. That process was slow and steady and gave us almost all of our food and fiber crops and livestock.  Much of Wisconsin's old economy is based upon almost ancient bioscience technology. Beer, cheese and bratwurst all represent ancient food manufacturing technologies. Today bioscience is contributing to a third wave of development in the new economy. At the same time, medical device manufacturers were able to combine computer imaging and bioscience technologies into new products. Most of the basic research into imaging technologies was conducted at research universities, medical schools and teaching hospitals. In the 1970s University-based biomedical researchers and pharmaceutical companies began an exploration into what would become known as biotechnology. Their goal was to create new ways of manipulating living organisms in order to take advantage of biological traits in plants, animals and humans. That work has led to an explosion in biotechnology information - to new treatments and cures for human illness - and to new crops and improved livestock. Biotechnological research and development techniques and applications have been thoroughly integrated into academia and industry.  The traditional leaders in bioscience industry, pharmaceutical and agricultural companies, were quick to adopt biotechnology techniques and applications. During the two decades following these early advances in biotechnology, pharmaceutical companies proliferated and grew. Traditional agricultural companies grew as well and hundreds of small companies were formed to develop and market new agricultural products and techniques. From 1980 to 1993, the US witnessed an explosion in these primary areas of Bioscience industry - biotechnology (pharmaceutical and agricultural) and medical device (particularly imaging) manufacturing. While scientific discovery fueled this explosion, it took a legislative catalyst to set it off. In 1980 Congress passed the Bayh-Dole Act which gave universities the right to license discoveries that were based upon federally funded research. Prior to Bayh-Dole, companies faced difficult hurdles in getting new discoveries into application. The Bayh-Dole act allowed academic research institutions to benefit from their scientific discoveries and it paved the way for technology transfer - allowing companies to license technology for development and marketing. Prior to 1980, fewer than 250 U.S. patents were issued each year to universities. In 1998, more than 2,500 patents were issued to universities. Discovery, innovation, and the creation of new technologies are directly related to the magnitude of sponsored research conducted at universities. The 1998 licensing survey conducted by the Association of University Technology Managers found that 132 U.S. universities received 9,555 invention disclosures and filed 6,518 patent applications (O)ne invention disclosure was received for approximately every $2 million of expenditures and one patent application was filed for every $3 million of expendtures.(Rayburn). While the Bayh-Dole act was not limited to bioscience innovation, it has been most effective at ensuring that bioscience technologies, including medical, pharmaceutical and biotechnological products and services have been developed to the public's benefit. After a downturn and a period of mergers and acquisitions in the early 1990s, the pharmaceutical, medicinal and botanical industries (as they are known to economists) experienced a rebound in the last half of the decade. A growth in research and development

investment subsequent to consolidation has resulted in new products, a growing workforce and increased revenues for this segment of the bioscience economy. In 2001, research-based pharmaceutical companies will invest $30.5 billion in R&D. This represents an 18.7 percent increase over expenditures in 2000 and more than triple the investment in 1990.   This year, $23.6 billion in R&D will be spent within the United States by both U.S.-owned and foreign-owned companies. The pharmaceutical industry is increasingly multinational in scope. Most major research-based companies market products throughout the world. Historically, the centers of global research have been in large countries that foster free markets

and thus innovation. Approximately 36 percent of pharmaceutical R&D conducted by companies worldwide is performed in the United States followed by Japan with 19 percent of global R&D. Of 152 major global drugs developed between 1975 and 1994, 45 percent were of U.S. origin, 14 percent orignated in the U.K., and 9 percent were of

Swiss origin. During 1980-1995, innovative U.S. firms were able to globalize (launch in the

U.S., Europe, and Japan) their new drug products at a rate more than quadruple that of 71

IatrogenesisLee Quinn7WJ - HPSWPage 72 of 72European companies. In the rapidly growing field of biotechnology, U.S. firms have a commanding lead in patenting their innovations.Of the 150 genetic engineering health-care patents issued by the U.S. Patent and Trademark Office in 1995, U.S. applicants received 122.

Nuclear WarMead 92 (Walter Russel, Senior Fellow for US Foreign Policy at Council on Foreign Relations, “Depending on the kindness of strangers,” New Perspectives Quarterly, Summer, p. 28, Academic Search Elite)

If so, this new failure--the failure to develop an international system to hedge against the possibility of worldwide depression--will open their eyes to their folly.

Hundreds of millions-- billions--of people around the world have pinned their hopes on the international market economy. They and their leaders have embraced market principles—and drawn closer to the West--because they believe that our

system can work for them. But what if it can't? What if the global economy stagnates--or even shrinks? In

that case, we will face a new period of international conflict: South against North, rich against poor. Russia,

China, India--these countries with their billions of people and their nuclear weapons will pose a much greater danger to world order than Germany and Japan did in the '30s

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