Michael Jackson and Iatrogenesis (Updated)–Updated (August 24)

Propofol

Propofol

Music icon Michael Jackson died after he was given an injection of Propofol.  Thus, the singer joins Heath Ledger and Anna Nicole Smith in a list of celebrities recently killed by the medical profession (called “Iatrogenesis“).

Update:  It was thought at first that Demerol was the killer, but Edward Chernhoff, the lawyer for the Jackson’s cardiac physician, Conrad Murray, says that Jackson had not prescribed or given Jackson the drugs Demerol or Oxycontin (source AP):

Chernoff says Murray suggested to Jackson’s family that an autopsy be performed. He adds that the doctor did not prescribe or give Jackson the drugs Demerol or Oxycontin. The lawyer says any drugs Murray prescribed were given in response to a specific complaint from the 50-year-old entertainer.

This is not a denial that Demerol had been taken or that it was the cause of cardiac arrest.  This says specifically that Dr. Murray himself did not prescribe or administer the drug.  This is a very carefully worded statement.  Dr. Murray, however, admits prescribing more than one than drug in response to Jackson’s complaint.

Iatrogenic death from prescription drugs is not necessarily the fault of only one physician’s prescriptions but can be a negligant cocktail provided by more than single doctor.  That’s why it is standard procedure when a patient visits a physician for him or her to declare what other prescriptions are being taken.

[MSNBC confirms that Dr. Murray administered several medications of valium, larazepam, midazolam, “several other drugs”, and finally 25 mg of propofol over a 9 hour period.]

Iatrogenesis and Public Health Care

Iatrogenesis is a term that hardly ever enters the public debate on health care.  Any public discussion of the socialization of health care that pays no heed to iatrogenesis is inadequate.  Awareness of iatrogenesis also would call into question the mantle of divinity that we bestow upon physicians, believing that we cannot exist without them.  Yet physicians are contributing to a serious demographic problem of negative population growth.

The word iatrogenesis comes from Greek word, “iatros” (“physician”); and “genesis” (“origin”) and refers to health problems and death caused by medical science. I was first introduced to the word “iatrogenic” by Neil Postman’s Technopoly, ch. 6; Ivan Illich has written a primer on the subject, Medical Nemesis, which is now dated but still largely valid. The first line of his book is: “The medical establishment has become a major threat to health.”

Iatrogenesis is considered by many to be the third leading cause of death in US (conservative estimates of the US death toll due to iatrogenesis to be 225,000 per annum). But I would argue that abortion is also iatrogenenic and is nearly always intentionally fatal to the unborn baby. The death toll in this case is 1.2 or 1.3 million more deaths per year. So now we are at 1.5 million per annum or so people killed in the US by medical science. But then this may only be the tip of the iceberg, since it is not in the best interests of medical practitioners to publicize the number of people they have killed. For example, AIDS may be iatrogenic, if Edward Hooper’s theory (see his book The River) that an experimental polio vaccine used in Belgian Congo in the late 1950 may be the cause of the transfer of the Simian immunodeficiency virus (SIV) from chimpanzees to humans, creating HIV.  The push for assisted suicide and euthanasia will make the circle of iatrogenic death complete, from the young to the old and sick.

A discussion of public health care and socialized medicine that doesn’t take into account iatrogenesis makes an idol out of health care.  Such issues must be approached with sober judgment and care.  I am not saying that physicians can’t help the sick and the injured.  I am saying it really bothers me that we are not publicly aware of iatrogenesis, the leading cause of death.

Here are some examples of iatrogenesis:

Here is another website indicating sources from medical journals and claiming the death rate via iatrogensis is more like 1 million per annum: http://www.ourcivilisation.com/medicine/usamed/deaths.htm

Cosmetic surgery:
http://www.abcnews.go.com/GMA/PainManagement/story?id=4520099
Malaria prophylaxis Lariam: http://www.yourlawyer.com/articles/read/8650
Heath Ledger:
cityroom.blogs.nytimes.com/2008/02/06/heath-ledgers-death-is-ruled-an-accident/

Michael Jackson

During an abortion (mother):
newsbusters.org/blogs/tim-graham/2007/10/23/media-ignore-another-woman-dying-inside-abortion-clinic
http://www.physiciansforlife.org/content/view/867/26/
http://www.physiciansforlife.org/content/view/240/26/