When a patient enters Psychoanalysis, they are starting a difficult therapeutic endeavor which promises to increase their distress in the short term in the interest of potential (though not guaranteed) longer term benefit. The work of analysis is often so difficult (after all, we are trying to discover those "objectionable" things about a person that they haven't wanted to let themselves know), that it requires a fair amount of discomfort to supply the motivation to move the process along. Not everyone is willing or able to make such a commitment.
In a similar vein, when a patient arrives in the emergency room in great pain, the appropriate course of action for the Physician is to withhold pain medications until a diagnosis is arrived upon, even if the diagnosis is incomplete and provisional; prematurely treating pain can mask symptoms that would be determinative, thereby leading to inappropriate treatment and a poor longer term outcome.
In both cases, it can be very trying on the treating professional to tolerate pain in their patients (people who go into medicine and mental help tend to have an abundance of compassion for their patients) but it is done for the best of reasons and with an ultimate positive outcome in mind. For a professional to accede to his or her own desire to offer premature compassion and succor would be to short change the patient and possibly condemn him to long term dysfunction.
At the moment, we are seeing this conflict being expressed within our own society, with evidence of significant deleterious effects. It is a cliche to say that the Democrats are the party of compassion, but there is a grain of truth to it. As well, the MSM has recently determined that overt expressions of compassion and caring by news-people (remember Katrina) is an appropriate stance for them to take (and aggrandize) and trumps their obligation to present facts and the logical reports that would emerge from such fact-based reporting.
The confused thinking that leads to imagining that compassion is the core of therapeutic action is a recurrent problem for our overly-(pseudo)-therapized society.
Today's examples come from the New York Times and Eli Lilly and Company Pharmaceuticals.
The Times editorial about the West Virginia coal mining disaster last week is a classic of innuendo and misdirection.
Why did it take nearly 12 hours for enough rescuers to gather so they could attempt their first descent toward the 13 miners trapped with limited emergency oxygen?
....
This devastating timeline is at the core of a detailed report by Ken Ward Jr., a reporter for The Charleston Gazette in West Virginia, that questions whether some of the 12 fatalities might have been prevented by a faster, better-organized rescue effort. Signs of hope persisted for 10 hours into the tragedy, according to one desperate note found down below.
The emerging facts are not encouraging about the roles of government safety officers and of the companies that are so routinely allowed to dominate in running the mines, even down to the rescue effort at Sago. National requirements about maintaining readily available rescue teams have gradually been allowed to erode in the 29 years since the last overhaul of mine regulations....
At the same time, vital positions at the federal Mine Safety and Health Administration have gone unfilled in recent years, inviting only further laxity on the part of companies that have been allowed to outsource their safety responsibilities to off-site contractors that are not subject to regular federal inspections. And the safety administration, which once maintained rescue experts at regional offices, now has them dispersed across the nation on the theory that they can be summoned fast enough to save lives.
Warning signs have abounded in recent years. Yet The Gazette found that a plan begun a decade ago to upgrade the mine rescue program was quietly scuttled by the Bush administration. The pro-company bias of the administration is itself a factor deserving full investigation if the inquiries now being promised are to have any credible effect.
The Times, under the guise of compassionate liberalism which they routinely champion, cleverly manages to construct their editorial in such a way as to suggest that mine safety and the health and welfare of miners has been allowed to slide during the Bush years. Obviously, the Bush administration, in thrall to industry, values coal production much more highly than the lives of the workers; there is almost no other way to read the editorial.
You would have to have a heart of stone not to feel compassion for the miners who perished and for their families; further, the question whether the rescue attempt could have and should have started earlier is certainly important and worthwhile to explore. However, both Dinocrat (who has spent time underground in mines) and Newsbusters, point out some serious flaws in the Times reporting; as opposed to the Times, they actually use real data to make their case. For purposes of clarity, I have taken the liberty of reversing the time line from the Newsbusters post:
How about the truth? Here is relevant data The Times could have easily accessed from the Federal Mine Safety and Health Administration Coal Mine Fatalities page (chart can be found here):
Sourced Raw Data by year --1995 - 47; 1996 - 38; 1997 - 30; 1998 - 29; 1999 - 34; 2000 - 38; 2001 - 42; 2002 - 27; 2003 - 29; 2004 - 28; 2005 - 22
You can draw your own conclusions from the data; Dinocrat goes back to the 1930's with his data and points out that mine fatalities since then have dropped from over 1500 a year to the current less than 2 dozen.
There are almost certainly many reasons for the drop in mine deaths. Mining is an extremely dangerous and hazardous profession; it always has been and in many parts of the world (China, for example) large scale mining disasters are, sadly, fairly regular occurrences. Of course, the single best way to minimize mining deaths would be to return to open-pit strip mining, but I didn't see that mentioned in the Times. Their faux-concern is for the miners and their families with the tacit message that any deaths from coal mining disasters can be laid at the feet of those who have the power to protect the innocent, victimized miners.
A missive from Eli Lilly arrived in the mail yesterday. Eli Lilly brought Strattera to the market a couple of years ago for the treatment of AH/HD (Attention Deficit/Hyperactivity Disorder). I am not interested in arguing the pros and cons of medication for AH/HD or its over- and under-diagnosis; I am interested in looking at how risk has been presented and assessed. Recent news reports suggested that Strattera could increase the risk of suicidal ideation (thoughts) in adolescents and children treated with the medication. There is some justification for such warnings since too often such medications are prescribed by Pediatricians or General Practitioners who may not fully appreciate the necessity (and usually don't have the time) for the careful monitoring any child or adolescent should have when started on any psychoactive medication. However, in response to the FDA advisory, Lilly took the step of adding a "Black Box" warning to their medication information, which will certainly limit its future use. You might think this is a step to be applauded but the actual data suggest the most likely outcome will be to bring additional harm to those very patients who most need Strattera by making it more likely they will be placed on more dangerous and less effective medication; all this for a minimal diminution of risk.
Pooled analyses of short-term (6 to 18 weeks) placebo-controlled trials of Strattera in children and adolescents (a total of 12 trials involving over 2200 patients, including 11 trials in ADHD and 1 trial in enuresis) have revealed a greater risk of suicidal ideation early during treatment in those receiving Strattera compared to placebo. The average risk of suicidal ideation in patients receiving Strattera was 0.4% (5/1357 patients), compared to none in placebo-treated patients (851). No suicides occurred in these trials. [Emphasis mine-SW]
I would suggest the aberrant statistic here is 851 adolescents with no thoughts of suicide over a several month period; since up to a third of all adolescents have suicide thoughts (as opposed to a small fraction who actually make attempts) at one time or another, a risk of zero is extremely unlikely.
So, what does Strattera have to do with a West Virgina mining disaster?
While it might seem that there is nothing in common between the West Virgina miners and the victims of Strattera, there is, in fact, a significant underlying set of beliefs and fantasies involved in both. The fantasy is that life can and should be lived risk-free and that those in power have the obligation and the necessity of ensuring that the passive dependents of their beneficence live risk-free lives. Anytime a poor outcome occurs, someone (with deep pockets or political power) must be charged with responsibility and taken to task.
We see this fantasy being exhibited by our MSM and their Democratic allies in the War in Iraq, and in the war on terror here at home (viz the NSA "wiretap" imbroglio.) Of note, they are ably assisted by an often unscrupulous part of the legal profession who have mastered the art of extracting money from deep-pockets by way of liability claims and class action suits.
The corollary is, if anything, even more dangerous; that is, that there is literally no benefit or value that is ever worth a single life. This is a prescription for paralysis, passivity, and surrender.
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