Inside Medicine: Science over politics

From the Sacramento Bee

Published: Sunday, Oct. 23, 2011 - 12:00 am | Page 17I

For more than a decade, I have raised questions about the efficacy of routine prostate cancer screening (PSA tests) for middle-age men at average risk of prostate cancer.

Yes, prostate cancer is a horrible illness, but the PSA test just isn't accurate and is plagued by serious problems.

After careful review, the U.S. Preventive Services Task Force has issued a new recommendation regarding the test. For men at only average risk of prostate cancer (no family history), the benefits of the test are unlikely to outweigh the harms.

Part of the problem is that most older men will eventually develop abnormal cells in their prostate. We have labeled these as "cancer" cells, but the vast majority of men will never be affected by these cells. For those who have the serious form of prostate cancer, we aren't sure how effective our treatments are and whether they actually prolong life. Nearly half the men who receive treatment are plagued by serious side effects like impotence and incontinence.

Why did it take so long to publish these recommendations when the science has been very clear for a long time? Our scientific community has been too timid to stand behind and defend good science in the face of political and emotional opposition. The opposition to most good medical guidelines – or good science in general – are those who feel the science stands in the way of their money, power, or self interest – urologists in the case of prostate cancer screening, oil companies in the case of offshore drilling or banks in the case of improper loans.

The task force was ready to issue these prostate cancer guidelines nearly three years ago, but it was broadsided by a political storm over similar recommendations against routine mammograms for women ages 40 to 50 with only an average risk of breast cancer. Similarly, that debate wasn't so much about the science as it was about politics, money and self interest.

At last the task force mustered its courage and tackled an issue that again has resulted in political controversy. My hope is that we can stay focused on the science.

These recommendations are only about good medicine. The task force has no political agenda, and it is not trying to save money. What doctors and the public need is unbiased, scientifically sound advice about what in medicine works and what doesn't. That is the charge to the exceedingly smart men and women who sit on the task force.

We have learned that too often we cannot trust those with a strong self-interest – those who make their living treating the disease in question or making the drug or device. The task is exactly the group of scientific experts who should be making these recommendations. Bravo.

UK: Students fear plans to reform law on squatting may outlaw sit-ins

From the Guardian

Government proposals to criminalise squatting may also outlaw occupation-style protests and sit-ins, student leaders, trades unionists and lawyers have said.

Plans to make trespass a criminal offence appear in a recently published justice ministry consultation paper that seeks to make it easier to evict squatters from unoccupied commercial and residential property. Currently, trespass is a civil offence and property owners must take squatters through the civil courts.

Lawyers fear that outlawing trespass, the ministry's strongest proposal, will also have the effect of banning peaceful sit-ins, a protest tactic that is favoured by students and workers.

National Union of Students national executive member Michael Chessum said the NUS would mount a campaign to make it "politically impossible" for the government to introduce such a law.

"It will be a fundamental affront to the right of students to protest if occupation was criminalised," Chessum said.

"I have no doubt that if the government tries to criminalise occupations … we would mount a campaign to make it politically impossible to stop student occupiers occupying." Last autumn thousands of students occupied dozens of campuses in an attempt to stop a tripling of tuition fees to £9,000.

Chessum added that criminalising trespass could change the environment on campus and lead to "war" between management and students involving police and courts.

"The idea that peacefully occupying your own campus might be taken away from you is something that we simply won't take," he said.

He added that many students also squat and the proposals would also be resisted on this basis.

"Students and young people in particular are thrown out into a world in which there are vanishingly few jobs and housing is an absolutely massive crisis [for them] … and will defend the right to squat" he said.

Teresa Mackay, a regional organiser for the Unite union, said anti-squatting legislation had become a big issue for unions and they were planning to submit their concerns to the government's consultation process, which closes on 5 October.

"I have spoken to other trade unionists about this and they do feel that almost that the attack on squatters is a bit of a smokescreen when you think that of the battles that are going to possibly take place over the next few years," she said. In a statement, the Ministry of Justice (MoJ) denied that its intention was to criminalise occupations and said the consultation was aimed specifically at squatting. On page nine of the consultation it suggests that any new law might want to exempt occupation protests from criminalisation.

But Giles Peaker, a housing solicitor, said it would be difficult for the legal system to distinguish between squatting and politically-based occupations.

"The consultation suggests that certain kinds of occupation might possibly be excluded, including things like students occupying university property, it doesn't say that they will be, and the suggestion appears to be you would have Ministry of Justice licensed protests – permitted and not permitted.

"Is it necessarily for the MoJ to be the ones proscribing what constitutes a valid form of protest and what doesn't? … The potential for legal grey areas is huge."

The concerns come after the Telegraph revealed that the Conservative party had been give £3.3m by property developers in recent years. Squatting activists believe any new law could be used as a way of placing the costs of evictions on to the public purse at a time when vacancy rates for commercial property have grown during the recession.

Cat Brogan who was evicted by St John Hackney Joint Charities trust from a squat in Well Street, Hackney last month, said that if squatting was criminalised it would be "unaffordable and unenforceable" and would put the burden on tax payers.

"[Criminalising squatting] means that you are using taxpayers money to pay for costly evictions for rich landlords and rich property owners who have vast swathes of property that they leave empty for land banking," she said.

Responding to fears an MoJ spokesperson said: "These proposals are not targeting legitimate forms of protesting but those people who enter and occupy homes or business properties without permission.

"No decisions on our squatting proposals have been made and we await with interest the responses to the consultation which is due to be published this autumn.

"Our consultation will tell us more about the types of people who squat and the extent of squatting. We particularly welcome the views of any organisations that are likely to be affected by our proposals."