Friday, 22 August 2014

Mother’s Little Helper

How Boots is trying to turn us all into Stepford Wives

Boots is selling a product called Kira Low Mood Relief which, it says, ‘helps relieve the symptoms of slightly low mood and mild anxiety’. The product is targeted at women – the advert says it is ‘inspired by women and their lives’ (more specifically, middle class, first world women).

It is part of the Kira range of lady products and costs £15.99 for 30 day’s supply. There is no male equivalent of the Kira range. It is presumably not named after Major Kira in Deep Space Nine.

What’s in Kira Low Mood Relief?
The active ingredient is St John’s Wort. There is some evidence that this is effective for mild depression although, as the NHS site points out, it has ‘potentially serious interactions that can occur with other commonly used medications’, for example the contraceptive pill, HRT, all depression medicines, blood thinning treatments, epilepsy treatments, HIV treatments and immunosuppressants. The active amount contained varies from product to product so research findings may not be relevant to any particular one.

There’s nothing strictly illegal here, Boots isn’t selling empty promises as it is with its collagen products (also for women) – as I wrote here.
But the contents are beside the point.

What is Low Mood?
The NHS web site describes low mood as including ‘sadness, an anxious feeling, worry, tiredness, low self-esteem, frustration and anger’. But Kira Low Mood Relief is aimed at slightly low mood. In other words feeling a little bit glum, grumpy or not quite as perky as you did when you were twenty.

In the olden days, it would have been described as a touch of anomie, ennui, melancholia, black bile, feeling lugubrious or phlegmatic.

As the NHS points out ‘Most people experience ups and downs in their life, and can feel unhappy, depressed, stressed or anxious during difficult times. This is a normal part of life. However, a low mood will tend to improve after a short time’.

Some people are naturally more Pollyanna than others. What’s more, sometimes the only sane response to adult life is to howl at the moon.

The Pursuit of Happiness
This is the crux of the matter. No one feels happy all the time. No one wakes up every day feeling like Julie Andrews singing The Hills Are Alive.

Boots is trying to medicalise being alive, being human. Or more specifically, being female. It’s telling you it’s your right and duty to feel happy as Larry all the time. If you don’t there’s something wrong with you and, for £15.99 a month, the magic pills can fix you.

The marketing makes Kira Low Mood Relief sound like soma, the State-produced comfort drug in Brave New World. Kira LMR is the pill for every ill that doesn’t really exist. It’s Boots’ way of trying to turn women into Stepford Wives, smiling vacantly as they buy their polenta. Because it really is for middle class women who want something that sounds ‘natural’. Thank god for Boots giving a name to that vague feeling that life should be better that I get now and then. It’s not just me, it’s a real thing with science words and I can take a pill for it. It’s not an existential crisis after all.

There is no automatic right to be happy all the time. Dis-ease is not a disease.

There’s even some evidence that feeling low sometimes can be useful.

Marketing works on creating discontentment or fear and providing the solution. This is just one product but there is an increasingly pervasive sense that it is our duty to ourselves to be happy, productive little workers, parents, lovers and shoppers. Unrealistic expectations lead to disappointment. If that disappointment can be given a name and a product to fix it, the shareholders are happy.

I really am feeling glum, what can I do?
Get over yourself. The NHS is more humane than me and offers some sensible solutions that include exercise, healthy diet, sleep, less alcohol and talking through problems.

In other words, do all the boring, sensible things you know you should be doing. And, if the symptoms are more serious or persistent, see the doctor. But there’s no money to be made in common sense advice. A cup of tea and a chat with your mates might help, so might a glass of wine, but Boots doesn’t have tea shops or a license to sell booze. Major Kira would most definitely not approve.

Tuesday, 15 July 2014

Mirage Men

A film by Mark Pilkington, Roland Denning, John Lundberg & Kypros Kyprianou
Based on the book by Mark Pilkington
85’ plus extras.
£10 (available here)

I’m not much interested in conspiracy theories or UFOs. Government cover-ups and alien sightings are not my kind of weird. But people who believe the unbelievable definitely are.

In the early fifties, as the Cold War gained momentum, the CIA began to monitor and influence the huge growth in public interest in UFOs.

In the 1980s scientist Paul Bennewitz thought there was a government conspiracy to cover up alien crashes and close encounters. He spied on Kirtland Air Force Base and filmed what he ‘knew’ was UFO activity. He thought he was saving the earth from an alien invasion. What he was actually filming were secret military activities.

It was Richard Doty’s job to mislead the UFO community for the government. He describes himself as a professional liar, so how much what he says in the film can be trusted is open to debate.

Doty was sent in to convince Benn he really did have evidence of aliens, with help from the NSA who went as far as making SFX to convince him. The plan was to discredit him so no one took him seriously and thereby protect what the government was really up to. The targeting of Benn coincided with the development of stealth plane technology.

Doty says he eventually tried to stop Benn who became increasingly paranoid and deluded – not surprisingly. Doty even told Benn (some of) the truth but Benn refused to believe him. Tell a believer the truth and they think it’s a double bluff.

One of Doty’s tactics was to make the believer think they were one of the ‘chosen few’ given access to secret information. William Moore, who was well-respected in the UFO community, thought Benn was being given disinformation but he was getting the truth. The 1947 Roswell crash had been pretty much forgotten by the public until Moore wrote about it, under Doty’s influence.

The disinformation campaign was designed to appeal to prejudices and beliefs. As Doty says, he mixed truth with disinformation to make it more plausible, more appealing. According to Pilkington, belief in aliens and cover-ups is now self-sustaining with little need for government input.

The film interviews people on both sides. There are people who genuinely believe that human evolution has been manipulated by aliens, that the Vatican knows the truth and that cattle mutilations in Dulce, New Mexico in the seventies were done by aliens. Some of them believe the US media has long been used to make the public believe that aliens are purely fictional.

On the other side, there are ex-government agency men who talk about the disinformation campaign – apparently no one in America has to sign any kind of official secrets act.

The psychology of UFO believers and conspiracy theorists is fascinating. These are not stupid people. They are however all male with the exception of Linda Howe, a journalist targeted by Doty. This may be bias in the film-making but footage from conferences does appear to confirm a definite male bias in this particular delusion.

One question the film doesn’t address is why so many people think aliens are targeting the USA. There’s no mention of similar conspiracy theories in other countries for comparison.

The film raises some interesting questions. Was the US government cruel and possibly criminal to manipulate people, sometimes to the verge of a breakdown or were they just protecting national security? Governments have long used propaganda, especially in war time; is feeding belief in aliens any worse than other examples of lying to the public? Are we all entitled to the truth all the time no matter the consequences?

Is it a case of caveat emptor and do gullible people deserve to be taken in? If a government agent offers you ‘secret’ information, would you trust them? Some of the tactics used by Doty and others are pretty funny and, with the exception of Benn, is anyone really harmed?

The film illustrates well how people can become willing accomplices in their own deception. That applies to us all if the right buttons are pushed. We are all only selectively suspicious. Once someone starts believing in something and invests time and energy in it, that belief becomes emotionally weighted and part of identity. This makes it very hard to let go. It’s like admitting a relationship is failing or giving up belief in a god.

Mirage Men is high quality, the interviews with believers, ‘secret’ agents and debunkers are balanced and unbiased. Or is it yet another piece of US government-funded propaganda to misdirect our attention? The truth is out there but once you start to question, be prepared to end up at a conference with a lot of very badly dressed and probably single men. As one conference attendee says: “It must be true – they don’t have conferences about leprechauns”.

Sunday, 8 June 2014

Carry On, Regardless

Dr Peter Saunders, the Chief Exec of the Christian Medical Fellowship** has written a pamphlet called Live and Let Live, opposing assisted dying.

Dr Saunders has chosen his moment because Lord Falconer’s Assisted Dying Bill will receive its Second Reading in the House of Lords on 18 July. Lord Falconer’s proposals would apply only to terminally ill, mentally competent patients with strict legal safeguards.

These are some of the arguments Dr Saunders uses against changing the law. He makes no distinction between euthanasia, assisted suicide and assisted dying - legally, medically or morally. There is no detail on what assisted dying would involve, just fear-mongering and moralising. This is a complex issue but for the CMF it’s just wrong, full stop, no debate.

Murder is against the ten commandments. Our lives belong to God not to ourselves so euthanasia, suicide and assisted suicide are wrong.

Patient autonomy, informed choice and doing what is in the patient’s best interest are tenets of medical ethics. The pamphlet should really be called Live and Force to Live. The sanctity of life argument is concerned only with quantity, not quality.

There are plenty of Biblical examples of killing that is not wrong. There are plenty of wars and massacres sanctioned by God, who even got hands-on and slaughtered the first born of the Egyptians himself. Many religious people support capital punishment, particularly in the US. But then, it’s easy to be selective with which bits of the Bible suit your argument.

Death is not the end. For non-believers, assisted suicide may be ‘propelling them towards a judgment for which they are unprepared. This may be the worst thing we could ever do for them’.

By ‘non-believers’ he means non-Christians, so not just atheists but people who sincerely believe in other religions. There’s always the chance of a deathbed conversion. We’re all lost little lambs who can’t be trusted to make our own decisions. This goes against ethical principles of patient autonomy and informed consent, which they’re happy to apply in other areas of medicine, as long as they have the CMF stamp of approval.

The CMF and Dr Saunders cannot claim to represent all believers. The 2010 British Social Attitude Survey found that 71% of religious people agreed that a doctor should probably or definitely be allowed to end the life of a patient with a painful incurable disease at the patient’s request.

Religious views, unlike the ten commandments, are not set in stone. They evolve constantly. In the past, the Church disapproved of inoculation, vaccination, quinine as an anti-malarial and the use of chloroform in childbirth. Just because a minority of believers currently oppose assisted dying does not mean that they always will. At some point, they will move on to some other area of medicine or scientific break-through and condemn that. They’re fickle like that.

The CMF is also well out of step with society as a whole (not that this has ever bothered them). The 2010 British Social Attitude Survey found that 82% of the general public believe that a doctor should probably or definitely be allowed to end the life of a patient with a painful incurable disease at the patient’s request.

A change in the law would put pressure on the vulnerable

This is the slippery slope argument; it is fear-based, not evidence-based. The way to stop something sliding down a slope is to build a wall across it. That’s what a new law would do. It would also make it easier to identify and prosecute suspicious deaths.

People may feel obliged to die to relieve their families of a burden, especially in tough financial times, they claim. The new law is very specific about who can apply for assisted death; it would not be a free-for-all for anyone who wants to die or feels they should and would involve only a very small number of people. A 2013 report from Oregon shows that only 0.2% of deaths in that state were by assisted dying and this figure has been stable for six years.

The evidence (as opposed to the fear-mongering) shows that an assisted dying law has worked in Oregon for over 16 years. There have been no cases of abuse and no calls to extend the law beyond terminally ill, mentally competent adults. In addition, in Holland in the 1990s, doctors rejected around two thirds of patients who requested death.

Members of the medical profession and disability advocates oppose it because it is dangerous

The CMF pamphlet doesn’t discuss the various and complex reasons why doctors and disability activists are opposed to assisted dying. They don’t want a debate, they want to lay down the law.

As with abortion, doctors would not be forced to do it, there would be conscience opt-outs. For those medical professionals who see assisted dying as the final part of patient care, a new law would give them clear guidance so that they could be compassionate and humane without risking prosecution.

The 2007 British Social Attitudes survey found that 75% of people with a disability believed that a person with a terminal and painful illness from which they will die should be allowed an assisted death. There are genuine concerns among disability activists that need to be addressed sensitively through debate and careful legislation but the CMF don’t say why it would be dangerous. They get out the pitchforks and flaming torches and whip the villagers into a frenzy of fear for their lives about a non-specific monster hiding in the barn. That’s their MO.

The principle of double effect

This is treatment that may shorten life, for example large doses of morphine for pain relief that are also fatal. This apparently is not considered assisted dying because the effect is foreseen but not intended. You may have trouble getting your head round the difference because it’s nonsense. But currently it’s nonsense that keeps doctors on the right side of the law. It’s not enough for patients and it’s not fair on doctors.

Hospice and palliative care are better alternatives
The 2013 Oregon report found that 90% of people who requested assisted dying were already in hospice care. It’s not an alternative to this care, it’s part of it. For some people, hospice care is enough but others should have the choice of the time and the way their lives end so that they can die with dignity – not just for themselves but for their families too so that they can make the most of the time that remains.

At the moment, there is the option of going to Switzerland but this is expensive and thus excludes many people. It also means that people may die sooner than they want to for fear of not being able to get there when they really need to.

The CMF’s position is not humane and it’s not compassionate. Nor is it well-informed. CMF members, like anyone else, are entitled to their beliefs but in trying to foist them onto the whole population, its members want their own moral purity enforced at the expense of the suffering of others. As usual.

For more information:
The Dignity in Dying web site.
Classic Cases in Medical Ethics by Gregory E Pence (I used the 4th edition, 2004)
Easeful Death by Mary Warnock & Elisabeth Macdonald (2008)
Medical Ethics by Tony Hope 2004
Lord Falconer’s Bill

**The CMF claims to represent over 4,000 UK doctors and around 800 UK medical students. I’ve written several pieces about them over the past few years. These are some of them:
CMF on gender reassignment surgery
CMF on mental illness
CMF on abortion

Thursday, 13 February 2014

You’ve Never Had It So Good

Are people now softer than they used to be? Was the older generation a bunch of toughies who quietly got on with whatever life threw at them? Humans are resilient and adaptable. We wouldn't still be here if we weren't. No generation has all the Moral Fibre.

With all the reporting about the floods and bad weather, some people have been saying that we’ve become a bunch of Walter the Softies, we should suck it up and get on with it, Spirit of the Blitz and all that. It’s a recurring theme, this is just the latest incarnation of it.

There is no way to make a meaningful comparison between the generations. Old people did without central heating, washing machines and other conveniences that make our lives easier. They got through the twentieth century wars. We have never had to cope with these conditions so there is no way of knowing how we'd respond.

What's more, they never knew any different. If you forced their living conditions on us we would not have their experience since birth so could not be able to cope instantly. A bit like if you put an urbanite down in the jungle and expected them to survive.

TV programmes where people have to live for a month like Victorians or whatever are rubbish because Victorians learnt from birth how to keep food with no fridge and entertain themselves in the evenings (hey everyone, let’s gather round the piano and have a séance while coughing our lungs up from consumption).

A lot of people in ye olden days died young from disease, poverty, poor sanitation, failed harvests, childbirth etc etc so they weren't exactly made of iron. Do the ones who survived really want us to go back to those conditions to see who would be tough enough to make it? Or do they think that we should all shut up and be grateful that food isn’t rationed? Check out the number of food banks and stop moaning that you have to wait longer for your pensioners bus pass and hitch a lift on a horse and cart like they did when you were a kiddie then, granddad.

When I was little we had no central heating, no phone and a beast of a washing machine that must have been a nightmare for my mum. People with more money probably had better stuff and easier living but does that make me tougher than them? I hate being cold. I’d have the central heating up high from October to April if I could afford it and didn’t care about global warming. Was my mum softer than her mum because she didn’t have to wash everything by hand and put it through the mangle?

The last time there were major floods, and during the war, there were only radio and newspapers. There may have been sensationalism to sell papers but there was a lot less of it and it was far from immediate. There were major floods in 1928, 1952 and 1953. In the last one, over 300 people drowned. In the Bristol Channel Floods of 1607 at least 2000 people died. At these times, most people had no idea if others were whinging or getting on with it.

There were no TV crews sticking a camera in someone's face in 1928 asking them how they felt and encouraging them to be devastated or angry to liven up the programme with some 'human interest' bollocks. During the war, it was all stiff upper lip, plucky little Brits and other propaganda to maintain morale. There are always whingers and copers but with social media, 24 hour TV news and so on, we are force-fed tragedy and adversity as entertainment. There’s a lot less news in someone just getting on with it than in some old lady whose cat has been drowned and whose photos of her wedding to her recently dead husband have been destroyed. Or: ‘So tell me, how do you feel about your drowned baby?’

Although there are many advantages to having more information, there is also the downside that we are being selectively fed factoids and told how to feel about them. For some reason, the floods in Northern Ireland have not made it onto mainstream news, for example. There is political capital to be made out of domestic disasters for all parts of the political spectrum, too.

As a sidenote, some are saying that if you’re dumb enough or rich enough to live in a flood plain, what do you expect? This is ignorance based on the smugness of people living somewhere not flooded and the assumption that if they were flooded, they would cope just fine. It’s the same mindset as the generational sneering.

I’m getting to the age where I could look at young people and say ‘you’ve got it easy’ and go into a Four Yorkshiremen routine. Are young people soft and lazy, do they have a sense of entitlement and need to be taught to have ‘character’ at school as some MPs are now saying?

Maybe. There is no metric to tell us. Perhaps all teens and twenty somethings are a bunch of jessies and I’m not as tough as my gran was with her outside loo and no hot running water and she was not as tough as my great gran with her twelve kids (who would probably have welcomed easily accessible contraception). If younger people are feeble, whose fault is that? Who brought them up that way?

The first half of the twentieth century was apparently some Golden Age of Character and Resilience, the yardstick against which we are all now being measured. But no doubt the ancestors of our grand and great grandparents would look at them and say ‘You think you had it hard? Try coping with the Black Death or living through 1816, you feeble poltroons’.

If the Tories get their way, we will all soon be living in the world of our great grandparents with no functioning NHS or welfare state. Let’s see who whines and who copes then. And by coping, I don’t mean ‘be rich enough not to care’.

Thursday, 9 January 2014

Collagen Con

Yet another example of ‘If something seems too good to be true, it probably is’, also known as ‘Always look a gift horse in the mouth’.

After Christmas, a lot of us make a resolution to lose weight and get fit. Some of us prefer to cheat and get the effect without the effort. One way to look better without exercise, diet or buying a corset is to improve the way our skin looks. We’re all supposed to want healthier, clearer and, of course, younger-looking skin.

Boots is selling two products it claims will increase collagen. This is the company that sells homeopathic ‘remedies’ so can we trust them that these products will have any effect?

The short answer is NO.

What is collagen?
Collagen makes up about a third of the protein in the body; it’s in bones, muscles, and organ tissues. In the skin, it acts a bit like scaffolding; along with keratin and elastin, it gives skin strength, elasticity and structure.

As we get older, the body makes less collagen. Women’s bodies naturally make less than men’s and lose it at a rate of about 1% per year. Women have naturally lost almost half of skin collagen by the time they’re 50.

What are Boots selling?
Two products in particular are being widely advertised. They are Pure Gold Collagen and Active Gold Collagen. Both cost £35.99 for ten bottles. The recommended dose is ‘drink 1 bottle per day for 4 weeks, preferably 8 weeks or longer for greater benefits’. Eight weeks’ worth would cost over £200 and there is no indication that this would be enough to solve the problem forever or whether it needs to be taken indefinitely.

What are they claiming?
The claim for both Pure Gold and Active Gold is that they are ‘based on a formula specifically developed to offer a unique combination of collagen and supplements for good absorption and bioavailability.’
The other ingredients are slightly different in each but both also contain zinc, copper, vitamin C, vitamin E, vitamin B6 and biotin.

Bioavailability means the quantity or fraction that is absorbed and can be used by the body.

Does it work?
It occurred to me that the body might not absorb collagen taken in this way. I asked Alastair Duncan, Principle Dietician at Guys and St Thomas' Hospital in London what he thought. He replied ‘The collagen in the supplement will not work - it is a protein, and will be digested into amino acids which we'd get from everyday food. That leaves the vitamins and minerals - they might help in someone with an unbalanced diet, but you could buy these for a few pence’.

Are skin creams any more effective?
Boots also sell various skin products that claim to help with collagen loss, like this one or this one for pregnant women. Might they work any better? Not according to this doctor, who writes ‘Most collagen molecules applied to the skin in lotion, cream or gel forms are far too large to be absorbed into the dermis - they merely lie on the surface and get washed or rubbed off. There are some companies that are selling micronized collagen which are meant to be small enough to be absorbed into the skin, but it is unlikely these micro molecules would be in any form useable by skin cells. It is also highly likely that any collagen that actually manages to penetrate the skin would be challenged by the body's immune system as a foreign body.’

Does it matter?
Although anti-ageing and skin products are now being targeted at men, it is still principally women who are the core market being touted the elixir of youth. As the population ages, this market is expanding. Boots is a trusted brand so people expect anything they buy there to work.

If anyone is prepared to waste £200 to look younger, then isn’t it a case of caveat emptor? There’s no evidence the products do any harm and they’re not being forced on children as some parents do with ‘alternative’ medicine.

Boots are exploiting a niche in the market. It’s what companies do if they want to make profits for the shareholders. They’re not charities. No one forces a fish to swallow the baited hook. Fishermen could put a little tag on the lure saying ‘Warning: may contain hooks’ but the fish would still bite because they can’t read. In the same way, most customers can’t read between the lines and apply a bit of science to work out that they’re being hooked on an expensive product that will do nothing for them.

As ever, the only things that helps protect skin and slow down ageing are tediously predictable: avoid sunlight and smoking, eat a healthy diet with plenty of fresh fruit and veg, exercise regularly. Unless Boots is planning to develop a sideline as a greengrocer, the only anti-ageing product they should be selling with a clear conscience is sunblock.