"I do not love the bright sword for its sharpness, nor the arrow for its swiftness, nor the warrior for his glory. I love only that which they defend." J.R.R. Tolkien <br>“I come not from Heaven, but from Essex.” William Morris
This is only capable of being the truth because, hidden in the text itself, there is a po-faced admission from the Office of National Statistics: the statistics are “based on the exact spelling of the name given on the birth certificate; grouping names with similar pronunciation would change the rankings”.
Ah, there’s the thing.
If you put together the three variant spellings of Muhammad (Muhammed and Mohammed) then suddenly what is effectively the same name is chosen by 7038 parents.
Why doesn’t the Telegraph lead with that description? I would think it rather more news-worthy.
I came under some criticism following my last article on “one land, one law, one language”. In particular I was challenged to identify what the classical British values look like.
Sometimes this sort of questioning is nihilistic – a request for some sort of conceptually pure vision that can then be academically picked apart endlessly, as a way of not engaging with the presenting issues themselves. It is a way of muddying the waters and avoiding discussion.
Yet answering the question about values is also an opportunity to spell out a little more about what the “one land, one law, one language” vision acutally looks like in practice.
So I want to talk about women, specifically British women, and even more specifically the idea in British society that women have rights, rights to determine their own paths in life in order that they might be enabled to become all that they might be.
These rights have been built up over many years, through progressive political battles – the rights to property, to vote, to be educated and so on. One key right is the ability that women in our society have to make their own decisions over their sexuality and fertility. That is, they have the right to make decisions about what to wear, who to associate with, who to have sex with, when and how to conceive a child and so on.
This is where the sort of cultural clash that concerns me manifests itself clearly. For there are other cultures that deny these rights to women; where, for example, what clothes are worn, what men are associated with, who to marry, whether to have children and so on – these are matters decided by the dominant relative male, normally the father.
Consider the recent case of Amina al-Jeffery, a girl born in Wales to a Saudi Arabian father. When she was 17 she was taken to Jeddah by her rather, purportedly for a holiday, and then placed under and effective ‘house arrest’. Her father is trying to exercise control over Amina in accordance with his own cultural norms – yet Amina grew up in Wales, has a Welsh accent and follows Welsh norms – she kissed a boy, thus displaying ‘un-Islamic behaviour’, and was taken away into exile as a result.
The High Court has now ruled that Amina should be returned to Britain by 11th September. This is good, but will Boris Johnson actually act in accordance with the High Court? I rather doubt it, simply because we know that the Saudi Arabian government is allowed to get away with all sorts of terrors simply because they pay for large military contracts like Al-Yamamah. As is so often the case, it is not just a matter of the law but of the will to apply the law in particular cases, in particular ways.
This is simply one example of the much wider trend related on the one hand to ‘honour’ killings in this country – that is, those women who choose differently to the dominant male of their families are murdered in cold blood – and the systematic child abuse and rape of white women in this country, in staggering numbers, as with Rotherham. In sentencing some of the perpetrators of the Rotherham case, Judge Gerald Clifton told the men “All of you treated the victims as though they were worthless and beyond any respect – they were not part of your community or religion.” Both forms of criminality arise out of a rejection of the British value that grants women a significant measure of authority and autonomy in their own lives, equivalent to that enjoyed by men.
It is clear that there is a particular strain of South Asian Muslim culture which comprehensively rejects our approach, and which has taken advantage of a politically correct culture to embed itself in several of our cities. So do we actually believe that these hard-won rights are worth protecting? Is a woman born in this country entitled to the protection of the British state when she tries to assert British cultural values? Or do we look the other way out of fear of being called racist?
This is the dilemma of the politically correct – which of these two competing values are worth defending? Do you virtue-signal solidarity with women or with minorities? Reality is forcing the choice. We either say that we must discriminate between different cultures, in order to protect British women from the violent exploitation of these minority cultures; or we say that it is always wrong to discriminate culturally, and condemn those British women to yet more decades of abuse.
For me the choice is clear – I want my daughters to grow up in a place that respects their full humanity and their capacity to make informed choices for themselves. That seems to me to be a ‘British value’. The same thing applies to other questions of gender and sexuality – I don’t want to live in a society where gay people are afraid of admitting who they are, or where trans people are scared of being beaten senseless by morons. Yet if we do nothing, that is a present reality for some and an increasing reality for others.
I want to live in a place which is tolerant and accepting, where every single human being is enabled to make decisions about their own lives in a way that makes it most probable that they will be able to live full and fulfilling lives. That’s a British value worth defending, but if we are to defend it, we need to wake up and realise just how undermined those values have become. We need to discriminate culturally and say – some cultures are worse than others, and we choose the better one.
I have recently returned from a two week holiday in Cuba, a trip taken with three university friends. Some twenty years ago, soon after graduating, we were sat in the living room of the house that we shared in West London, and recognised that our carefree lives were unlikely to stay that way. We agreed that we would put a small amount of money each into a central pot – beginning with £10 a month – in order that, every ten years, we would have enough funds to take a holiday together, to renew our friendships and remember what life was like before career and family commitments took hold. Our first trip was to Mongolia in 2005; this time round it was the turn of Cuba to host our little “Self-Preservation Society” (and yes, it was after one of our regular viewings of The Italian Job that we came up with the idea).
Cuba is a fascinating country, incredibly warm and welcoming, a happy and musical people set in an incredibly green and lush environment. We started our trip in Havana, which is a remarkable city. The architecture was stunning, and it was clear that the city had been incredibly wealthy in the past. Yet it was equally clear that for most of the last fifty years that money had dwindled to effectively zero, and consequently these amazing buildings were often near-derelict. Thankfully, now that the Cuban economy is embracing tourism more thoroughly, there is a new flow of wealth which is allowing the state to slowly renew and repair the built environment in central Havana.
I said to my friends “There’s a sermon in that” – and yes, the necessary teasing did follow. What I had in mind was simply that I saw a parallel between the architecture in Havana and the church. Like Havana, the church has been immensely ‘wealthy’ in the past, by which I don’t just mean money but also the general affirmation of the faith shared by the community. It was a wonderful building. Yet today it is a pale shadow of what it was – it has suffered from decades of neglect. Just like the buildings in Havana, there has been nothing spent on maintenance, and now there is a desperate need for new investment in order to repair all that has gone wrong. And what does the church need to spend money on, in order to restore the building to its former grandeur? I would say simply: teaching the faith.
Back to Cuba. One of my friends has a medical condition which means that he cannot walk very far, and so he has a collapsible bike that he uses to get around, and which he brought to Cuba. Unfortunately, the day before departure his bike acquired a nasty puncture, and our first morning in Havana was then taken up with trying to find someone who might be able to repair it. After a thorough discussion with our guide, we found a small workshop at the back of garage, who agreed to repair the tyre. My friend (who now lives in Germany) was astonished to watch the craftsmanship with which the mechanic took apart the tyre and manually re-threaded the wires in order to make it robust. My friend exclaimed, “I’m going to take this back to Germany and tell them that this is how you fix things!”
Havana is famous for all the 1950s cars that are still driven there – a snapshot of how things were before the Revolution. What this little experience brought home to us was the way in which all those old cars were kept going by some incredibly creative and imaginative engineering. The Cubans are clearly capable of making the most of anything at hand. I should add, however, that this did not extend to emissions control – the air in Havana was incredibly polluted, and I developed a hacking cough that didn’t leave me until I was back on Mersea. I’m sure it had nothing to do with the cigars…
That Revolution has clearly defined modern Cuba. I had the sense sometimes that there was very little history for the Cuban people to celebrate. What seem quite small things, such as a particular battle in the Revolutionary War, were blown up into major museums, and the people who were involved in that Revolution – most especially Che Guevara – were raised up in quite hagiographic ways, with all their personal effects treasured like Medieval relics. Of course, the tensions with the United States have only recently begun to ease. It was clear that this conflict had gone a long way to form the Cuban character, and the state had consistently reinforced a message of Cuba being an independent communist island facing off against the behemoth of a radically capitalist United States.
One striking way in which this difference manifested itself, in Havana and more widely, was the almost complete absence of advertising. The only form of acceptable advertising seemed to be revolutionary slogans alongside an image of Fidel Castro. This one, for example, has the charming slogan ‘Socialism or Death!’
The state remains overwhelmingly present in Cuba, yet most of the population seemed very happy. In part that must be a result of the excellent health-care for which Cuba is rightly and justly famous. In part it must be a result of everyone having plenty to eat. In addition, all Cubans are educated through a national system and, charmingly, all schools have the same uniform, segregated three ways for the three levels of primary, secondary and tertiary. There were always smartly dressed children to be seen going to and fro.
I could see no trace of any racism whatsoever, and in particular, there seemed to be no sense of ‘shame’ according to different body shapes. I did wonder whether the absence of advertising, coupled with a more general equality, helped to make the Cubans so cheerful. I often saw people who might be regarded in our society as having less than ideal bodies who were clearly very much at home in them, with a strong sense of appropriate style and even ‘swagger’. This was wonderful, and I suspect not having to cope with a constant bombardment of airbrushed-perfect bodies had something to do with it.
Their happiness might also have something to do with the music that was continually present. However small the restaurant it would not be long before along came a few men (with an occasional woman) with guitars and maracas and the familiar ‘Guantanamera’. For the most part we greatly enjoyed these. We had booked in to see the world famous ‘Buena Vista Social Club’ on our last night in Havana, but I have to say that we found them disappointing compared to others, especially a band that performed regularly in the bar just a little way down from our hotel, that had an amazing flautist. Yet – and perhaps this is simply the projection of a tourist – music seemed to be more deeply embedded into the rhythms of Cuban life than it does here in England. We brought several CDs back with us!
After two weeks we flew to Gatwick, having had long discussions with each other about what was going to happen with the Referendum (mine was the sole voice in favour of Brexit). We arrived back on the morning that the result was announced. I felt that whilst we as a country might have many things to learn from Cuba I was nevertheless very grateful to be back. I am as proud of this country as the Cubans are of theirs, and it felt magical to be returning from one independent island to another that had just determined to reclaim its own independence. “¡Hasta la victoria siempre!” as Che used to say. Thanks to Ian for photos
Apparently comic book superheroes have replaced the different gods of previous mythologies. Where once the imagination of a child was filled with stories of Hercules, now they have Spiderman. Seems plausible to me.
I read comics a lot when I was a child. I read comics a lot now, but they’re rather different. When I was about 9 my hero was the Hulk. Imagined like this:
Then when I stretched into the teenage years, Wolverine took over – he was a sharper character:
And then when I was in my twenties Frank Miller’s Batman was the one I resonated with:
Two things. The first is that what strikes me now is how angry I was. Just look at the expressions on their faces. Rage. I think a lot of men (boys) have that rage, which is why comics are so popular in certain quarters. It might do the world some good to ponder the roots of that rage. But second, the most interesting ‘comic book’ hero that I identify with now is a man called Spider Jerusalem, from Warren Ellis’ series called Transmetropolitan.
Now, a word of warning – this is not for the squeamish, and probably shouldn’t be read by anyone who considers themselves a Christian – it’s rude, lewd, frequently blasphemous and obscene, and frankly I’m worried about myself for enjoying it so much. But I enjoy it because it is laugh-out-loud funny and I think Spider represents something essential about humanity – he’s awful, but he’s dedicated to the truth. And I think that’s important. He is redeemed by his acceptance of the truth. I suspect that applies to me too.
The thing is, he’s a tremendously angry man. His column in the newspaper/blog is “I hate it here” and the one consistent thing that drives him is his rage against the world. But his rage has a productive outlet – blog articles which expose the powers that be.
I’m not there yet.
But I’d like to be.
That’s what heroes are for aren’t they? – they represent those bits of you that seek expression, and the worship of the hero is what enables those bits of yourself to articulate themselves and, hopefully, come out. (Which is why Christ is the ultimate hero who can’t be replaced – but that’s another post).
This is Spider’s philosophy:
“Let me tell you how it is going to be.
I am free to write what I want, when I want. And you have to come to me to read me.
This is not the same deal as picking up a newspaper for the sports and the TV listings and getting a piece of me too.
You actually have to sit down and poke your feedsite reader and come to me.
And I will tell you things that will make you laugh and I will tell you things that make you uncomfortable and I will tell you things that will make you really fucking angry and I will tell you things that no one else is telling you.
What I won’t do is bullshit you.”
I think that’s the only promise a blogger should make. And I shall try very hard to live up to it.
When we are baffled about what we might do with respect to a particular problem, it can be worthwhile first to consider what not to do. Here are some examples.
Donald Trump, the Republican presidential candidate, has called for compulsory registration of all Muslims in the United States. Here is a perfect example of historical ignorance leading to morally repugnant thinking. Anyone who has any historical sense whatsoever will immediately ask – what next? Shall they be required to wear yellow stars sewn into their clothing? This is how the evils of Nazism began to take root in 1930s Germany. The Holocaust did not happen all at once but rather the human rights of Jewish people were progressively dismantled over time. First the Jews were identified, then they were segregated, then they were shipped in cattle trucks to Auschwitz. We cannot defend an open and tolerant society by disregarding all the human rights that make us who we are. Let us trust that Mr Trump quickly sees the error in his thinking and abandons these evil plans.
Our Prime Minister, David Cameron, has called for our country to join in with air strikes in Syria. Please remind me: who we are trying to attack at the moment, Mr Cameron? After all, a few years back you were calling for air strikes against the forces of Assad, and supporting what became ISIS. Now we want to support Assad against ISIS? Is that with the Russians or against them? Is that with the Turkish government (presently profiting hugely from the oil sales that come via ISIS) who are our NATO ally or not? Committing our armed forces to an area of conflict, where our past actions bear a significant burden of responsibility for shaping the present fiasco, must surely be based upon extremely clear and convincing reasons, ideally ones which command wide public assent. Without those things a desire to act militarily is just so much knee-jerk posturing.
Earlier this year the Prince of Wales visited Saudi Arabia to pay his personal condolences to the Royal Family following the death of their King. In amongst other matters there was doubtless discussion about the ongoing major arms sales to the Saudi regime. After all, the UK has been selling arms to the Saudis for many years. Some of those sales were even investigated by the Serious Fraud Office, until political pressure forced them to stop. Let’s remember what Saudi Arabia is – it is a feudal monarchy that retains the death penalty for gays and adulterers and from that country came 19 out of the 20 hijackers on 9/11. The particular strain of Islamist nutjobbery which dominates ISIS has clear roots in the Wahhabi ideology which is dominant in Saudi Arabia. This ideology cannot tolerate any compromise with the West – and it is this ideology which is preached in all the mosques financially backed by the Saudis throughout the world, including many in the UK. Perhaps we need to be clearer as to which sorts of ideology help mutual flourishing in our society, and which do not?
If we are to engage constructively with this present crisis we would surely benefit from some clear and honest thinking and conversation about these issues. We face an ideology that is committed to the destruction of our western ways of life. As a minimum, might I propose that we stop financially and militarily supporting that ideology?
The critique of our society which that ideology offers is not entirely without merit. By which I mean that it makes sense to significant numbers of Muslims – for if it did not make any sense, nobody would support it. According to a BBC survey earlier this year, one in four British Muslims “have some sympathy for the motives behind the attacks on Charlie Hebdo in Paris”. Clearly our society is doing a very poor job at assimilating those who come to this country with different values. This is where we need to concentrate our energies – not in some vainglorious foreign adventuring, or in short-term political posturing, or simple money-grubbing obsequiousness to murderous dictators.
The philosopher Karl Popper, writing in ‘The Open Society and its Enemies’ (written during the Second World War), argued that for a tolerant culture to exist, it must tolerate all things except for intolerance. He wrote, “If we extend unlimited tolerance even to those who are intolerant, if we are not prepared to defend a tolerant society against the onslaught of the intolerant, then the tolerant will be destroyed, and tolerance with them.” This is the situation that we are presently living in.
It is undoubtedly true that most Muslims are not suicide bombers. Most Muslims – as with most human beings – simply want to live a peaceful and prosperous life within which they can love their families and pursue the goods that God has given them to seek. Yet it is also undoubtedly true that most suicide bombers are Muslims and that, in the last fifteen to twenty years, whenever there has been a terrorist attack, the chances of one of the perpetrators being named Muhammed is pretty high.
We simply cannot tolerate this, for if we do then we shall cease to exist. By ‘we’ I am not referring to our biological existence; rather, I am referring to all the things which make up British life. I like the fact that we live in a country where sexual orientation is no longer a matter for legal investigation and blackmail. I like the fact that we live in a country where my daughters can receive a full education alongside their brothers and are enabled to pursue their own interests. I like the fact that we – still, just – enjoy a culture of free speech and open debate in which the pursuit of truth is allowed to proceed without government interference. If we tolerate the intolerant then all these good things, and many more, will come to an end. That is what I mean by saying that ‘we’ shall cease to exist.
I do not believe that we can engage properly with ISIS and all the other strands of Islamic terrorism without properly rooting ourselves in our own deepest traditions. We cannot succeed militarily without engaging intellectually – and that means spiritually. Without it, military means are pointless and self-defeating. Yet we also cannot engage spiritually unless we recognise our own spiritual blindness, the way in which we have turned away from spiritual truth in favour of materialist and utilitarian ends. We have to assert our values, and we can only do that when we have rediscovered them for ourselves.
Gibbon’s analysis of the decline of the Western Roman Empire remains of value for us today. He argued that it was the moral corruption of Rome that rendered it vulnerable and impotent in the face of new challenges. We do not have to suffer the same fate.
1. He was completely in the wrong about Dr Carneiro. The fact that he blew up so badly at such an early stage was something of an warning sign.
2. I want him to stay. Arrogant it might be, but he is the best manager that Chelsea have ever had (possibly excluding Carlo) and he has earnt the right to work through this.
3. There are parallels with other third seasons – but the difference is that I think he genuinely wants to stay. Give him the chance Roman! Don’t go back to the previous serial changes! Let him build the club and dynasty! He’s only just won the league for you after all…
4. In football terms the problem actually seems straightforward – Matic was off the pace at the beginning of the season, and his preference for sticking Fabregas in that central two is not working. Without the defensive shield the back four are over-exposed, most especially Ivanovic, who really needs to be dropped. That, and Hazard isn’t carrying the team in the way he did last year. For now I’d recommend: Begovic; Rahman, Cahill, Terry, Azpi; Loftus-Cheek, Mikel (with Matic to take that spot back in due course); Hazard, Oscar, Willian; Costa (or Remy!).
5. I hope his visit to his dad helps to calm him down. I wish Roman would ring him up and just say ‘chum, you’ve earnt the right to one bad season, you’ve got time to sort it out’. If not, it looks like he’s about to have a melt down.
Ah well, it’s never boring being a Chelsea fan. We are the champions!
I believe that science is in need of a Reformation. By that I mean that science as presently practiced has travelled a very long way from its origins as a holy endeavour, characterised by humility in the face of the truth. The way that science is presently practiced involves a very great deal of intellectual dishonesty and manipulation, and these egregious faults pass generally unnoticed simply because of the immense social capital that “science” has generated as a result of technological success.
Scientists as such have a certain authority in our culture as they are seen as those who possess a form of knowledge which is beyond normal understanding, and the results of that knowledge are often awesome and inspiring – the moon landings being one particularly visible success. Yet there are clear limits to what science can tell us, and the distance between what an authentic scientist might say (authentic meaning one who has humility before the truth) and what a contemporary scientist might say (contemporary meaning one who simply makes bold claims without being able to back them up) is very stark.
Let us return once again to Richard Dawkins, the erstwhile Professor for the public understanding of science. When Dawkins writes about science, especially about evolutionary biology, he is excellent – a compelling writer, lucid, vivid, and able to explain complex phenomena in a way that the intelligent lay reader can understand. Dawkins has authority in this subject area because it is an area in which he has been trained thoroughly and in which he has decades of experience as a teacher. If you want to understand evolutionary biology then I can unhesitatingly recommend his writings.
However, what Dawkins is presently best known for is his writings on religion. This is not his area of academic expertise. He has not received any training in this area at all, and he has no academic experience. What Dawkins has done is use the authority that he has accrued as a writer in the sphere of evolutionary biology to try and strengthen his case in a different area. This is intellectually illegitimate; it is a form of fraud. As most people have little expertise in this area, and as most people give authority to ‘scientists’, Dawkins is given a hearing. Yet for those who actually have expertise in this area Dawkins’ arguments barely reach the level of being wrong. As the Marxist atheist Terry Eagleton memorably put it, “Imagine someone holding forth on biology whose only knowledge of the subject is the Book of British Birds, and you have a rough idea of what it feels like to read Richard Dawkins on theology.” I say this with authority because this is an area in which I have been fully trained and in which I have years of experience teaching – so yes, in this arena my qualifications are indeed much greater than those of Dawkins!
Dawkins is simply the most obvious example of a scientist who is cashing in on the general respect given to science by our culture in order to advance a different agenda. The subject of my last article, the medical-pharmaceutical-industrial complex is another. Modern medicine is indeed a marvellous thing. The ways in which we understand the mechanisms of the body and can often repair it when they go wrong, from broken bones to treating heart disease, this is wonderful and worthy of as many prayers of thanksgiving that we can muster. Yet the pharmaceutical industry has taken advantage of the trust that we give to doctors, a trust which is very much a subset of the trust that we give to scientists in general, and has manipulated that relationship in order to make money. Scientific research – that on which our whole system of modern medicine relies – has been systematically abused and distorted in order to serve the financial interests of huge industrial conglomerates, and any idea of intellectual humility before the truth was abandoned long ago.
A further example comes when we look at the issue of ‘climate change’, what used to be called – and what used to be more honestly called – ‘global warming’. The allegation was that as a result of modern industrial development we were pumping dangerous levels of carbon dioxide into the atmosphere, as a result of which the global temperature was going to continuously increase. The IPCC produced regular bulletins giving predictions about what was going to happen (they still do this, even though there hasn’t been any increase in global temperatures for around 17 years now, and counting). Yet we often hear reference to the figure of 97%, as in ‘97% of scientists believe in global warming’. Once again, we have an argument which is only given a hearing because of the general authority that is given to scientists. As soon as that figure is subjected to any sort of rigorous scrutiny – Where did it come from? How was it arrived at? – then the figure falls apart, as it is based on incredibly shoddy and manipulated research (those who are interested in the detail I would refer to the blog Climate Etc written by Professor Judith Curry, one of the world’s leading climatologists). Whenever you hear someone mention this figure, our Prime Minister perhaps, be certain that it indicates a profound ignorance about the subject being discussed.
The religious reformation began with an awareness that the institutions of the church had lost touch with their own highest purposes, and had succumbed, as human institutions so often do succumb, to the very human frailties of greed, vanity and pride. I believe that, taken as a social institution, science has succumbed to the very same vices. Just as the church was reformed by a protest movement, so too must science be reformed. Just as the church was renewed by a return to first principles – the slogan used was ‘ad fontes’ – so too must science return to its own best practice, restricting itself to saying only what can be known, and not prostituting its authority in search of worldly success, whether that be celebrity or cold, hard cash. Put simply, science will only be able to properly be itself when it recognises that it cannot function without those human virtues that I have mentioned, of humility, integrity, honesty, self-discipline and the like – and most of all, when it recognises that those foundations on which it depends can only be established on spiritual terms. In other words, science will only be able to function properly as science when it both remembers and honours the original queen of the sciences: theology.
In recent years many of the insititutional pillars of society have fallen into disrespect. Politicians, obviously, but also journalism, the priesthood, the police, many others. Groups that were trusted who have now fallen from grace. Are doctors going to be next?
This is a question raised by Ben Goldacre in his extremely stimulating book ‘Bad Pharma’, which I read on holiday. Goldacre is a qualified medical doctor and psychiatrist, and presently a lecturer at Oxford. In his book, published in 2012, Goldacre sets out to show, in his words, that “Drugs are tested by the people who manufacture them, in poorly designed trials, on hopelessly small numbers of weird, unrepresentative patients, and analysed using techniques which are flawed by design, in such a way that they exaggerate the benefits of treatments. Unsurprisingly, these trials tend to produce results that favour the manufacturer. When trials throw up results that companies don’t like, they are perfectly entitled to hide them from doctors and patients, so we only ever see a distorted picture of any drug’s true effects.”
Goldacre supports these contentions throughout his book building up a detailed critique of the pharmaceutical industry and the way in which it systematically distorts the medical process at every stage. The motivations for the pharmaceutical industry to do this are quite straightforward, given that it is a multi-billion pound industry and a successful new drug can mean the difference between a company flourishing and failing. However, in pursuit of that economic end, Goldacre documents the ways in which the industry undermines the scientific process in order to make more profit. The material that Goldacre presents is utterly shocking, and if I had any residual faith in the science lying behind much modern medical and psychiatric treatment, it has certainly vanished now.
Goldacre describes one example from when he was working in General Practice, which relates to the drug Reboxetine (Edronax), which is used as an anti-depressant. He had a patient who was not improving on other drugs, and was considering using Reboxetine to see if it had a beneficial effect. He looked at the available literature which seemed positive, and agreed with his patient that it was worth trying, and duly wrote out a prescription. However, shortly after this, a review of all the research on Reboxetine was published, which for the first time included data from medical trials that had not been published (one of the main ways in which the pharmaceutical industry manipulates things is by only publishing information about trials that show their drug in a favourable light, whilst suppressing information that is critical). Goldacre writes, “I did everything a doctor is supposed to do. I read all the papers, I critically appraised them, I understood them, I discussed them with the patient and we made a decision together, based on the evidence. In the published data, reboxetine was a safe and effective drug. In reality, it was no better than a sugar pill and, worse, it does more harm than good. As a doctor, I did something that, on the balance of all the evidence, harmed my patient, simply because unflattering data was left unpublished.”
The problems that Goldacre are describing are recognised as serious problems by some influential voices. The British Medical Journal, for example, recently published an editorial written by Goldacre entitled “How medicine is broken, and how we can fix it” so there are some grounds for hope. However, very little of substance is changing, and the pharmaceutical industry continues to operate with a great deal of freedom in how it manipulates the scientific process.
What really needs to happen is that the light of public attention needs to shine on this area in a sustained and intensive way. We need to become as worked up about what is happening in pharmaceuticals as we are about all the other scandals of our time. All institutions run the risk of becoming cocooned in their own ways of thinking and patterns of life, and sometimes it takes an outsider to come along and say ‘this is simply not right’. MPs doubtless thought that claiming expenses for the draining of their moats was simply how things were done; journalists doubtless cynically accepted that phone-tapping was the way in which the truth was discovered; church hierarchies were doubtless concerned that priests accused of child abuse had to be given a chance for redemption. In the same way I believe, following Goldacre, that the medical profession needs to be told that the present practice of relying on the pharmaceutical industry as the principal guide for the benefits or otherwise that come from any particular medicine is not acceptable.
I suspect that this will be a very difficult process because there is something different about the medical profession at the moment that doesn’t apply to the other examples. In our current society, as I have said many times, “science” operates in the role that theology used to, in that it is the overarching and dominant form of knowledge, which incorporates all others. Those who are learned in this form of knowledge are the priests of our contemporary age and, in particular, those who provide forms of healing on the basis of that form of knowledge function in the modern world in a very similar fashion to ancient shamans. Sometimes the healing can be entirely ritualistic, as is most apparent when considering the difference in effectiveness between anti-depressants and placebos (sugar pills) – both have the same healing effect, which rather suggests that such healing as takes place is a product of the ritual visit to the tribal medicine man. In other words, what we are dealing with here is not a simple, practical, technical problem that can be solved by the application of sufficient determination and good will. No, here we are seeking to topple the gods of our society, and Goldacre is a blasphemer and heretic.
There are, obviously, many ways in which the pharmaceutical industry has helped the common good, and Goldacre gives credit where it is due. However, it is equally clear that the present system is broken. I would thoroughly recommend Goldacre’s book to anyone who is interested in this subject. I shall be following the ongoing conversations with great interest.
It would appear that I am still having problems with the comment system on this blog – they should be being sent through to me immediately (so that I can reply to them promptly) but this is not happening, and I don’t yet know why. Apologies – especially to Tess and dover1952. I shall investigate and try and solve the issue.