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Posts Tagged ‘morality’

Cervical Cancer Vaccine

Posted by MDViews on October 6, 2005

Gardasil.

That’s the name of the new HPV vaccine seeking FDA approval. It is expected to be approved as early as June 8. It’s a vaccine made by Merck and gives immunity to the two most virulent Human Papilloma Virus strains, 16 and 18. By virulent, I means capable of transforming the cells on a woman’s cervix into pre-cancer–and ultimately cervical cancer–if not detected and treated. That’s what the “Pap” or cervical smear is for. Detecting these abnormal cells early so they can be destroyed in the benign pre-cancer stage before they cause a life-threatening problem.

Merck hopes that the vaccine will be administered to pre-pubescent boys and girls to provide them this immunity. Merck touts this vaccine as the first cervical cancer vaccine to hit the market.

Hold it. What? Boys too? I thought you said this was to prevent cervical cancer in women?

Well, I did. But it’s not as straight-forward as that. The vaccine does not target cervical cancer, and in fact, if I read the news report correctly, it is not intended to. Instead, it targets the HPV virus and provides immunity to it. By extrapolation, then, it should help prevent cervical cancer, since HPV is the agent that causes the most common type of cervical cancer.

So why vaccinate boys? Because HPV is a sexually transmitted disease which is harbored by 50% of sexually active teens and young adults. One cannot get HPV unless one has sex with an infected partner. And sex means boys and girls–so, vaccinate the vector as well as the victim.

This vaccine opens the same can of worms as the Hepatitis B vaccine. Hepatitis B is a liver infection that one can only get by exchanging bodily fluids with an infected person (the same as HIV), ie., blood products, IV drug users sharing needles, inadvertent needle sticks to doctors and nurses (health care workers) or sexual activity. So, does everyone need Hepatitis B vaccine? Sure–if you do IV drugs, plan on getting an infected blood transfusion (very rare), plan to be a doctor or nurse or if you have sex with multiple partners and one is infected.

Does that sound like you? Does that sound like the person you want your child to become? Hepatitis B vaccine can be given to adults if they enter health care and it works just fine. Our blood supply is safe–very safe. Testing continues to improve. So that leaves IV drug use and promiscuous sex as the reasons to vaccinate your child.

Along comes Gardasil. Your child receives the vaccine, maybe at age 10 or 11 and is protected from the consequences of promiscuous sex–at least one of them, the HPV virus that causes cervical cancer.

No woman wants cervical cancer. And no man would want to spread the virus to women, I presume.

So where does that leave the wait-until-marriage-and-have-one-partner-for-life argument? Weakened, that’s where.

Obviously, some parents will not want their children vaccinated against a sexually transmitted disease for moral reasons. But no parent would deny his children protection against cancer. Doctors do not want their patients to get cervical cancer. Doctors will not want the parents of a 10 year old girl or boy to say, “No thanks. We’ll pass.” So if the doctor says, “This is a vaccine against cancer,” –and stops there, parents of boys and girls will likely say ‘yes’. But, if the doctor says, “This is a vaccine against an STD. By stopping the STD, your child is protected from cancer,” –some parents will decline.

What to do, what to do.

I presented this at a hospital meeting last week in the context of being “culturally sensitive” to those who may object, and to lobby for honesty when presenting the purpose of the vaccine.

Oh, my. Did I get a response.

Anger. Indignation. Loud voices. It appears “cultural sensitivity” does not apply if the group likely to object is Christian conservatives. One doctor flat out said it should be presented as a cancer vaccine, not an STD vaccine. Otherwise, we would have to tell patients that cervix cancer is an STD. To which I replied, “You don’t? I do. We have always known that as gynecologists and have not hesitated to inform patients of that. I do it every day.” He was surprised, I think, but remained adamant that this should be presented as a cancer vaccine and that no one should be allowed to refuse the vaccine. Another doctor said that the cancer part needed to be emphasized and the STD part minimized. No one in the meeting backed me. I was alone in my view.

So, what do you think, dear reader? Will you vaccinate your little ones?

Posted in Doctoring | Tagged: , , , | Leave a Comment »

India “Fights” AIDS (or not)

Posted by MDViews on August 6, 2005

From the AP comes this gem. “India to Fight Aids with Female Condoms”. Apparently, India is distressed that the AIDS epidemic continues despite the Indian government’s attempt at pushing condoms. It appears, according to this article, that India is now #2 in the world in cases of AIDS at 5.1 million, just behind South Africa. One third of cases are in women, 15% in “sex workers” and 25% in housewives with one partner.

So, the solution is obvious. Empower women by providing cheap, “female condoms”. I won’t go into what a female condom is or how it works. Suffice it to say, it has never caught on in the US.

Oh dear. Where to start.

First, AIDS or HIV, the virus that causes AIDS is 100% preventable. You, dear reader, can make yourself nearly 100% safe from the AIDS virus. Since it’s spread requires the transfer of blood or bodily fluids from one person to another, prevention is easy. Don’t use IV drugs and share needles. Wait until married to have sex and then have one partner for life. Oh, and try to limit your number of blood transfusions, although with current testing the blood in the US in nearly 100% free of the AIDS virus. Of course, you could get in a horrible car accident and lose lots of blood, require a transfusion to recover and get one of the six tainted units that has been estimated for the entire US this year. Or you could be married and your spouse has an affair with an HIV infected person and bring the virus back to you. Not unheard of, but I would say it’s a problem that is relatively rare. So, I guess saying that HIV is 100% preventable may be a slight overstatement–but not much of an overstatement.

Second, the data on the prevention of HIV transmission by condom use is very iffy. The one study that showed condoms of benefit of which I am aware found that couples with one infected partner with both aware of the HIV status of the other and both aware that condoms had to be used during sex or the virus would be spread showed just a slightly less risk of transmitting HIV to the other partner than a couple with one infected partner in which the other partner was unaware of the infected partners status so that condoms were not used or not used reliably. In other words, although condoms should theoretically provide good protection, practically speaking, condoms do not even in couples with one infected partner and both knowing that without adequate protection during sex, the virus will be spread to the other. Sobering.

And, I know of no good studies regarding the “female condom”. But I can guess. The “female condom” is more difficult to place, will be less liked by the male partner and I would expect it would generally not be used. But when it is, I would not be surprised to find similar data showing little or no benefit.

No mention of the Indian government encouraging monogamy for men and women. No mention of eliminating brothels in which prostitutes ply there trade, apparently with the blessing of the Indian government. No mention of abstinence before marriage and one partner for life. (As an aside, “sex workers” and “clients”? Really. Does renaming the world’s oldest profession make it any less than what it is?)

I wonder if we will see a follow-up article in two or three years to see if the Indian government’s attempt at “…Fight[ing] AIDS with Female Condoms” works. I won’t hold my breath.

Posted in Medical Issues | Tagged: , | 2 Comments »

Brave New Liberal World–Forced Prostitution

Posted by MDViews on January 31, 2005

The UK Telegraph tells of a woman in Germany who may lose her unemployment benefits for not taking a job as a whore. Uh…Prostitute. Uhhh….commercial sex worker. Whew! It’s so hard to know what we are calling prostitutes these days.

Apparently, prostitution was legalized in Germany two years ago. As a result, “sex worker” is now a legitimate employment opportunity in the former Weimar Republic. It seems that a woman, unemployed and receiving unemployment benefits, was asked by a brothel to come and “work”. She turned them down.

Under a law passed last year, she may now have her unemployment benefits cut because she turned down a legitimate work opportunity.

As if whoring was the moral equivalent of say, welding parts on a BMW.

Most of you have probably never met a prostitute, so your concept of a prostitute may resemble Julia Roberts in “Pretty Woman.” Well, I have provided medical care for several woman who made their living as strippers and prostitutes. Glamorous is not an adjective I would attach to any of them. The usual “commercial sex worker” that I encountered was monetarily very poor. She usually had poor hygiene (smelled bad), poor dentition (rotting teeth), one or two children, (usually not living with her) and a past history of multiple surgical procedures (cesarean sections, laparoscopies for pelvic pain and others). She was generally quite unattractive and often moderately overweight which apparently did not decrease her appeal to those who craved her service.

Maybe the prostitutes are different in Hollywood or in major cities from the prostitutes in southeast Iowa and western Illinois, but I really doubt it.

Prostitution is a crime to my way of thinking. And not a victimless crime, I might add. The poor woman who finds herself in this lifestyle by choice or force has usually been abused by boyfriends and rarely comes from a stable home environment. Most often alcohol or drug abuse are this woman’s companions. Social diseases are common, even for those who use latex protection. Many of these diseases are viruses carried for the rest of her life. Although she bear full responsibility for her actions, these extenuating circumstances and more help explain her behavior.

She is victimized by the sexual male uninhibited by societal mores or personal morality. With her, he is free to satisfy himself in whatever perverted way he wishes.

This sex without obligation or consequence encourages males to stay unattached, unmarried sexual predators further weakening the family and denigrating the role of women.

One commentator I heard defined each society’s primary role as civilizing its male children and preventing them from becoming adult barbarians. That may be true.

Yet the liberals and feminists argue that prostitution is a victimless crime and not really a crime at all, just a business exchange between adults. As such, it should be regulated, not criminalized. But if it is just business, just a job, legitimate work, then the situation in Germany is the result. So Germany proposes punishment (removing unemployment benefits) for a woman who declines this “employment opportunity.”

So, this means that the crime of prostitution, with its abuse of women, with its proclivity to disease, with its emotional scars, with its encouragement of the male monster is no longer a crime in Germany. Not only is it no longer a crime, but it is now a legitimate occupation. Not only is it a legitimate occupation, but now a woman must participate in this detestable act or be punished by the state.

This is the world turned on its head.

Solomon spoke about people like that, people who love evil and hate justice.

Proverbs 2:12-14 Wisdom will save you from the ways of wicked men, from men whose works are perverse, who leave the straight paths to walk in dark ways, who delight in doing wrong and rejoice in the perverseness of evil,…

Proverbs 28:5 Evil men do not understand justice, but those who seek the Lord understand it fully.

I pray for these woman trapped and drawn into this “job” and for the society that allows it.

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Minnesota nice can be a vice

Posted by MDViews on January 27, 2005

Those of you not from Minnesota or its environs may not have heard of “Minnesota nice.” “Minnesota nice” is a peculiar behavior exhibited in large measure by Minnesotans. It’s so prevalent that it now holds the moniker, “Minnesota nice.” It’s probably a hold over from our Scandinavian roots, where the state was viewed as “good”, people were viewed as “good”, everyone was a Lutheran and everyone treated everyone else–dare I say–nicely. (Not to be confused with “Nicely-nicely” from Guys and Dolls.)

I’m not originally from Minnesota, but was born just 20 miles from it in SD to a Scandinavian clan–so I think I have an understanding of “Minnesota nice.”

What are the characteristics of Minnesota nice? Well, first and foremost, it is non-confrontational. It’s just not nice to confront. So one does not confront.

Husband: Why can’t you ever have supper ready, the eight kids fed, the house cleaned, the cows milked and the snow shoveled before I get home?

Normal wife: Get off your high horse and give me a hand, you no-good lout. And by the way, you complain like that again, and you’ll be sleeping with the sheep tonight!

Minnesota nice wife: I’ll try harder next time, dear. Do you want me to repair the combine, too?

Second, it is nice, no matter what. It is always affirming of others, regardless of their brutish behavior.

Patient to nurse: I left my husband and six kids to take a job as a stripper.

Normal nurse: You’ve got to be kidding! Don’t you love your kids?

Minnesota nice nurse: Oh, that’s nice. Do you like your new job?

You get the idea.

Minnesota nice is a non-judgmental, tolerant way of looking at the world. Maybe that’s why Minnesota has been such a liberal state all these years. No one has the courage to say, “You must be crazy!” or “What were you thinking?” or “Behave yourself!”

Gene Edward Veith, a writer for WORLD magazine wrote a piece a couple of years back called, “When Nice is a Vice”. It’s a great article which I dig out from time to time to read again. It has a stong message for “Minnesota nice” people. And also a message for those meek Christians who somehow view Christianity as a variation of “Minnesota nice.”

The point of his article is this: “niceness” is admirable and a behavior quality to which many strive, but is not in and of itself, a virtue. “Niceness” can be a sin.

The virtues, traditionally, are justice (giving people what they deserve), temperance (controlling our appetites and passions), fortitude (having the courage to do what is right) and prudence (making sure what we do has the desired effect). Those four along with faith, hope and love constitute the seven virtues.

Often these virtues will conflict with “being nice”. As Mr. Veith put it:

A boss may choose to be nice and nonconfrontational with an employee, when justice would demand that he be fired. Economic policy might try to promote generosity to the poor, out of nice intentions, while actually harming them through unintended consequences, a violation of prudence. Sometimes niceness can be an excuse to take the easy, pleasant way to avoid an unpleasant problem, a violation of fortitude, or to give rein to one’s sentimental feelings, a violation of temperance.

So,if I do not have the courage to disapprove of sin, and instead, am non-confrontationally “nice”, I’ve done the King and the Kingdom no service.

So, dear reader, Christians are not always “nice.” They confront sin with courage. They love justice. They are careful enough to see that their actions have the desired effect. And they control their passions.

Those four added to faith, hope and love will make a life well-lived.

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