Why do people choose to enter medical studies as research subjects?

Notoriously, people get involved in research for money. However, even most clinical trials— the type of study most likely to be associated with cash rewards— do not return significant remuneration for participation, with compensation more often on the order of lunch and bus fare or small token thank you gifts. Many other kinds of studies, such as epidemiological studies and surveys, for example, or studies that desire access to personal medical records to be used in research, offer nothing material at all in return.

Very few people enter studies for access to otherwise unavailable life-saving treatment. Patients with incurable and chronic diseases may enter studies in the hope that they will derive health benefit from participation. More often, they realize that others with their condition in the future are the more likely beneficiaries of their efforts. So, why do they enroll?

I believe that most research participants think it is going to help someone. Concomitant requisites for participants are respect for the general progress of humankind and the desire to be affiliated with the community in what may be an epic battle: human survival.  Some volunteer for enlightenment— the curiosity of seeing what the study involves, learning more about their bodies and health. Some enter for entertainment— social aspects for the lonely, relief from a boring job. But mostly they participate in a study because volunteering for medical research adds meaning to their lives.

We should also acknowledge the virtues of those willing to put themselves on the line for the specific altruism of medical investigations: courage, curiosity, the willingness to look very carefully at themselves and to be precise…maybe even wisdom… maybe even heroism.

If you know me, you know that I regularly grumble about the “health care” discussion. It seems to focus far too much on payer models (who is paying for what) than it does on health. The US is currently 37th by the World Health Organization (WHO)  when it comes to health care. We are behind Costa Rica, and just ahead of Slovenia; France is ranked number 1. No offense, but for a country like the US that spends more than $2.4 trillion on health care each year, we ought to be doing better than less developed countries! In life expectancy, we’re a little better. We’re 24th, with US males living an average of 67.5 years, and US females living an average of 72.6 years.

So what does the Healthy Americans Act do for us? Well, this is another payer model that would guarantee that “all Americans receive private affordable health coverage that can never be taken away.” I rolled my eyes at Senator Wyden when he told me about the plan. “It’s another payer model, designed to make insurance companies even more rich,” I retorted.

Don’t get me wrong, I have nothing against capitalism. However, in the case of health care, the system is set up so that insurance companies, pharmaceutical companies, physicians, lawyers, etc., all benefit when a person is sick. I think we need to shift the focus so that people make money when Americans are healthy. Then we’ll no longer have pharmaceutical companies only looking for treatments for disease, we’ll have them looking for cures. Unfortunately, with the health care plan in play, if a pharmaceutical company cures a disease, a lucrative market is lost.

Senator Wyden explained the philosophy behind the Healthy Americans Act. If all Americans are covered by insurance, and companies are not allowed to cherry-pick only healthy people, the insurance company is now motivated to keep people healthier, or they lose money.

Are they? Or will our premiums just increase? That’s actually another point of the bill. President Obama has suggested that there be an upper limit on health care insurance costs for a family. His original suggestion in 2008 was $2500. While that may have increased a little, it’s still affordable for most Americans. Furthermore, in the Healthy Americans Act, people and families who cannot afford their premiums would be subsidized.

There’s another interesting component of the Healthy Americans Act. Senator Wyden said that staying healthy often requires an individual to change behavior and assume more personal responsibility for his or her health. That certainly fits the philosophy of natural medicine, where prevention and patient empowerment serve as the foundation for creating sustainable self-care.

Are there things I don’t like in the bill? Absolutely. Section 702 promised enhanced drug and medical device approval. The definition and implementation of the word “enhanced” is cause for concern. While we certainly need to look at the way a new product comes into the market (it currently takes too long and costs too much money), it troubles me that the pharmaceutical lobby may have slipped that into the Healthy American Act, which may ultimately hinder the few checks and balances we have in place for our health care.

Nevertheless, Senator Wyden is thinking about adequate, cost-effective health care for all Americans. It’s clear to me that he’s a smart and thoughtful man. He met with President Obama last week—a fact that may have been lost to the media among the Michael Jackson hype. I expect that we will see more of the Healthy Americans Act. You might want to check it out and see the direction your health care is heading.

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Note: Since this article was written President Obama rejected the Health Americans Act, citing the bill as “too radical.”

Dr. Albert Bartlett has brilliantly noted:  “The greatest shortcoming of the human race is our inability to understand the exponential function.”

We are the first generation who inhabits a world in the near vertical stretch of exponential growth in every sector of human society. No (previous) generation in the history of our species has ever experienced this reality. We are currently living through a historically brief phenomenon, which is wholly unsustainable, and which in all probability, has only one outcome.

“No one in their right mind wants to believe any of this to be true.”
~ Daniel Drumright

Nevertheless, it is true.

It is time to face the reality of our situation, and make the tough choices. The first choice is: are we willing to recognize that there are physical realities that are not subject to manipulation by science, technology, faith or hope?

If not, then we need do nothing, and “what will be, will be.”

If so, then there are some other things we need to acknowledge:

We are at an unavoidable turning point in human history, and our actions now will determine whether or not human civilization, and even the human race, will last past the current generation.

Human civilization worldwide is based on the exploitation of non-renewable resources. Many of these resources are now running out.

Anyone who consumes more than they produce is being subsidized, usually by a combination of other people’s efforts and cheap energy.

We are running out of cheap energy. At the levels we currently use energy, there is no functional replacement for our major source of cheap energy (petroleum) available. There is no prospect of a replacement for petroleum in the foreseeable future – not solar, not wind, not nuclear fission or fusion, not coal, not tidal – no source at all.

Based on what we know of the natural dynamic balance of the natural world, in any sound vision of sustainability there will be only a fraction of the current human population.

So, what can we do?

We can change the way we live.  Starting today.

We all live in a web of possibility. There are things we can do and things we cannot do. Every time we make a decision we change the web.

If we all decided tomorrow that we should park our cars and walk to work we could not do it. Most of us live too far a distance from work to walk there daily. What we can do is look for work (or create a new job) that we can walk to.

If we all decided tomorrow that we would stop funding military activities throughout the world we could not do it, because we no longer have the ability to control the parts of our governments that makes those decisions. What we can do is elect different people to office, or better yet, rebuild community from the local level so that we take back control of our lives and our governments.

If we all decided tomorrow that we would have no more than one child, those of us with more than one child would be making the decision too late. And while it is conceivable that we could kill all those “extra” children, I think most of us would find that unacceptable. What we can do is change the social contract so that having only one child per couple is the norm. (If, for four generations, each couple had only one child, the human population would drop to one sixteenth, or 6.25% of its current size. That population may well be sustainable.)

If we all decided tomorrow that we would not buy anything made from plastic, nor use any containers made with plastic, we probably could not do it. What we can do is pay attention to what we buy and what we use, avoid plastic whenever possible, and let our preferences and buying decisions be known.

If we all decided tomorrow that we would repair things rather than replace them we could not always do it. What we can do is, when we buy new (or better yet, used) things, select those that will last for a long time, and can be repaired if and when they need it.

Each action we take influences the web of possibility. When we take responsibility for our decisions we make better decisions. When we avoid using plastic we make it more possible for others to make things that do not contain plastic, supporting the use of renewable, rather than non-renewable resources. When we walk to work instead of drive we make it more possible for others to walk also, and we encourage allocation of resources to support walker sin preference to drivers. We also cut down on air pollution, which helps restore clean air, and hence, supports better health for all. When we prefer locally made products we help create local jobs.

If we focus on living satisfying lives, based on real wealth instead of consumption and distraction, we may find that we are happier, healthier, and no longer facing the imminent destruction of our own lives as well as that of the planet.

“The biosphere which supports all life, and the only life we’ve ever discovered to exist in the known universe, is in an acute and exponential stage of collapse. This is empirically irrefutable. If humanity continues to function under the same economic, political and social ethos it does today, we will simply drive ourselves into extinction, along with most of life on the planet, and in all probability, within our current lifespan.”
~ Daniel Drumright

What do you think?

Modern medicine has made great strides. Vaccines have changed the face of diseases incidence and prevalence in the world. Lethal diseases like small pox have been eradicated and polio significant reduced in the 20th century. However, a vaccine seems far from an adequate cure. Let’s consider vaccines from a naturopathic perspective to address the success of vaccine history.

Naturopathic medicine looks at a person’s ‘susceptibility’ or miasm, which suggests how one copes or reacts to stressors (physical, emotional, spiritual, other) and offers insight into the resiliency of his or her immune system. In other words, a person is more likely to get sick if the body is over compromised or possesses poor coping mechanisms to stress. In the same vein, a miasm also determines the way a person responds to vaccines.

Most people have likely received at least one vaccine in their lifetime, where some have received as many as 15 to 20 vaccines. This surely has conferred protection to diseases; but for some,  has this also come at a cost?

The CDC has stipulated a vaccine schedule starting at the birth. While it may be very relevant to certain countries in the world, remember that this schedule is a great model of public health based on the idea of herd immunity. It is important to understand that giving children vaccines before they are immunologically mature does not give them true protection and explains why multiple booster shots become necessary.

If you are a parent of a young child, or an adult who is in the health care field or if you participate in international travel, I invite you to be an informed participant in your health care. I urge you to understand the basics of immune development. With this information in hand, you can determine with your physician if a vaccine is appropriate; moreover, you can effectively assess an ideal age to vaccinate your child in order to develop a proper immune response. Make sure to evaluate your independent risks vs. benefits and make a conscious decision for your child and yourself.

Some examples to consider when it comes to vaccines:
MMR vaccine: Has three live attenuated viruses: measles, mumps and rubella. It does not have thimerosal.

Potential side effects of MMR vaccine: There are links to autism and the MMR vaccine wherein the vaccine is hypothesized to trigger a cascade of events leading to autism in genetically susceptible children. There are strong correlations in the literature between myelin basic protein antibodies and the antibody to measles. Furthermore, vaccine strain of measles RNA has been found in the intestine of autistic patients with Crohn’s disease (autistic enterocolitis). Currently, the evidence is deemed inadequate to accept a causal relationship in the conventional medical system.

Hepatitis B vaccine: Recombinant or non recombinant hepatitis B virus vaccine derived from hepatitis B surface antigen produced in yeast cells. Contains aluminum hydroxide. Contained thimerosal prior to 2001 in the United States, although some preparations may still contain trace amounts of thimerosal.

Side effects of Hepatitis vaccine: Data from Vaccine Adverse Events reporting system (VARES) show a rate of neurological disorders following Hep B vaccine higher than any other vaccine. These disorders include both demyelinating diseases like multiple sclerosis, optic neuritis, tranverse melitis, and non demyelinating conditions like vertigo and paresthesias. Again, the evidence is deemed inadequate to accept a causal relationship in the conventional medical system.

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This blog post is inspired by the following resources:

Vermeulen, F., Monera, Kingdom bacteria and Viruses, Spectrum material Medica, Vol 1, Emryss Publishers. 2005.

Andrews, H., Zwickey, H., A Seminar entitled “A Vaccine balancing Act”, 2009.

Disclaimer: This blog makes no warranties whatsoever regarding the accuracy, completeness, timeliness, comparative or controversial nature, or usefulness of any information contained or referenced.

Skepticism is the scrutiny of what is presented; an assumption that what is given to us might be faulty or misrepresented. Faith is the belief in what is presented to us; an assumption that what is given to us is true regardless of how faulty or incomplete it seems on the surface.

Both skepticism and faith represent different attitudes of examining, processing, and taking in information. Both approaches are needed to navigate in a world teeming with information, which may be categorized as fully reliable or fully unreliable. Both stances can be misused or abused and result in misnavigation– the skeptic, fixated on disproving everything that he encounters, fails to really take in all information, same goes for a person who fails to scrutinize the validity of information when basing knowledge on blind faith alone. Within each person might exist a tendency towards one end of the skepticism/faith continuum, and awareness of this dynamic is necessary in order for a person to take in information (sensory, extrasensory) in the most efficient, sincere manner.

There seems to be a second continuum, perhaps called open vs. closed mindedness, which is intrinsically related to the individual’s ability to navigate the first continuum efficiently and sincerely. In an open-minded state, the individual can discern situations when healthy skepticism is warranted due to potentially unreliable sources, and when faith in a phenomenon or idea might be valuable even when full mechanisms or explanations aren’t available. On the other hand, in the closed minded state, one might fall prey to extremism and imbalance; perhaps sticking dogmatically to one end of the skepticism / faith axis or letting one’s emotions bias one’s decision making capability in terms of which stance to use in a given situation.

Examining naturopathy from within, while also considering naturopathy’s ardent skeptics, made me want to consider this balance for naturopathy as a profession. Are naturopaths really as dogmatic, close-minded, and ill-informed as the internet skeptics claim them to be? Are we as open-minded as we claim to be? Do the internet skeptics have any capacity for faith, any true acceptance of phenomenon they might not be able to explain? Is there any validity to the myths being circulated on the internet, and should naturopaths address these?

Ultimately, as a future naturopathic doctor who seeks to contribute to the profession, my main question is: does naturopathy have the inner awareness which allows it to navigate its own axis of skepticism and faith that will allow it to mature?

I brainstormed this project with Derek Andre, ND1 partner in crime, partly inspired by our own experiences with skepticism and religion. My own personal journey through the extremes of this continuum, from a young skeptic who questioned everything, including my own existence, to a several years of long immersion in a religious cult, in which I threw all my rational impulses willingly upon the altar of faith, has taught me the values and pitfalls of both extremes. On the one hand, engaging in skepticism taught me to search beyond the surface of things, to not take things for granted, and to forge a worldview that was uniquely my own. On the other hand, plunging into religion taught me the value of faith both in discerning intuitive, extrasensory information as well as in cultivating a state of body/mind/spirit that seeks the greater unknown.

For this project, Derek and I are collaborating with some of the most vocal internet critics of naturopathy to assemble arguments and perspectives that “debunk” and criticize naturopathy- websites like naturowatch.org and the skeptic’s dictionary. We’ll be parsing their information, summarizing their arguments for them, double-checking these summaries with them, and coming up with a master list of the main criticisms of naturopathy. The next step is an interview project in which NCNM professors, administrators, and students will be videotaped while answering questions related to their journey in and passion for natural medicine. During the interviews of the professors, we will present the arguments collected from the skeptics and record their responses, which will then be presented on a separate website or blog that will serve as a forum for the skeptics and naturopaths.

My hope with this project is to bridge the gap between the two parties; to show the skeptics that there are people within naturopathy, like myself, who are interested in the truth and who love questioning things as much as they do. Also, I hope to present the manifold arguments of the skeptics to ND’s in a non-inflammatory and organized way. Ultimately, I hope to open a dialogue between the two groups so that each might learn from the other.

Stay tuned for more updates and contact me below with any questions!

We wanted to shift perspectives on research and natural medicine in an artful, introspective way.

Secondarily, but certainly not as a matter of rank, we also wanted Helfgott to pop up as a resource on the first page using common search engines like Google or Yahoo when someone investigating words like: “natural medicine research.” Quickly our team of researchers took to the task, armed with search engine optimization (SEO) and the helpful advice of an NCNM student Eric Grey, founder of the Chinese Medicine website Deepest Health. Our dynamically combined efforts unfolded and evolved and, more importantly, we have effectively learned how to communicate the muscle behind the medicine.

No longer crawling like an infant, but rather surfin’ like a pro, Helfgott has created a dynamite web of knowledge about the science and thoughtfulness of natural medicine, detailing the interconnectedness between research, clinical medicine, and health reform. Everything is just an ingenious click away.

Not surprisingly, our web presence has grown tremendously, thanks to you all, and we achieved our goal in just two short years. Yep. We’re officially 2 years old, and we’re still pulling out all the stops. The fruits of our labor, i.e., the www.HelfgottBlog.com website, has ripened into a heavily trafficked virtual hub. Our Helfgott Blog and resourceful Community Resources Pages serve as viable outlets for websufers who wish to learn about CAM’s latest research as well as read poignant commentary on the culture of contemporary medicine. And just to brag a little bit about our stats: the Helfgott blog sees on average an astounding 10,000 viewers per month, and our Helfgott Blog receives on average 250 hits per day!

Ooh-de-lally! Now that’s preachin’  using the purposeful poise of a little finger, outstretched in just –the– right direction, simply serving to pique your curiosity about an underlying meaning behind the bare necessities of life.

The Helfgott initiative began as a plain-spoken step towards internet media, yet in the wake of our achievement, we continue to grow by leaps and bounds. Thanks so much for the support, we would be virtually nowhere with out all of you tuning in….

Yet, no one seems to know about natural and sustainable forms of medicine outside of our little Pacific Northwest bubble! Moreover, those that do know about us seem hell-bent on debunking natural medicine philosophy… and I would even venture a guess that most have not even walked into a naturopathic or Chinese medicine clinic. But, I digress. This article was not meant for a Captain Obvious crowd, nor is it meant to fan any flames… quite the contrary. My proposal is to seek out how we can all work together to solve the health care crisis. If we learn to understand one another, we can build bridges to reduce suffering and sickness, or dare I propose to truly prevent the pandemic cancers and diabetic conditions plaguing our society.

Heather Z., Director of the Helfgott Research Institute, has focused her efforts on not necessarily fighting fire with fire, but rather trying to see existing ‘arguments’ and look for ways to increase all levels of understanding surrounding natural medicine and its respective research. Current scientific methods, most responsibly the linear cause-and-effect model, are unable to elucidate the mechanisms behind more holistic forms of medicine. This is not surprising to most organically minded individuals because our world is truly interconnected and that the inter-dynamic relationships of medicine’s mechanistic actions must be assessed in a weblike fashion. In other words, we don’t live in vacuum and therefore it doesn’t make sense to only study medicine using a singular and specific mechanistic format.

To explain the beauty behind the principles of natural medicine, is to design an interconnected, multi-disciplinary web using databases (such as Practice Based Research Networks aka PBRNs and Informatics). Creating this new point-of-view approach to researching populations, therapeutic modalities, and disease is paramount to solving our current health care crisis. This stands as a critical issue when we attempt to translate our philosophy into words and terms (such as publications by means of symptom indexes, standardized tests and biomarkers) that other, more rationally minded scientists and clinicians can understand and embrace… especially when it comes time to talk legislation and the world of ‘evidence-based’ medicine.

How you can help change the paradigm:
The articles below serve as examples from websites denouncing naturopathic medicine, Chinese medicine, and NCCAM (a portion of NIH designated for complementary and alternative medicine research). It will give you a small taste of the ‘atmosphere’ around medicine’s science-based agenda…. The comments are also worth sifting through, as most importantly, this demonstrates other areas of misinformation and misunderstanding surrounding holistically-minded medical communities.

Naturopathic medicine
Chinese medicine and acupuncture
Research and NCCAM

I’ve found that surveying conventional scientific websites and publications a helpful and successful exercise, as it allows me to think on my feet and be prepared when talking in mixed company about what it is that naturopathic and Chinese medicine practitioners do. Luckily, I also have my feet planted firmly in both scientific and organic worlds, as my resume foolhardily follows the footsteps of Renaissance men such as Richard Feynman and Leonardo DaVinci. More often than not, I can take a negative perspective and change it to a positive point of view for our philosophy and alma mater, or in the very least, get a nod of recognition for natural medicine’s ability to effectively assess and treat on several tiers (mental, emotional, physical, and spiritual) with multi-faceted tools. Most of the spin-doctoring, so to speak, has more to do with examining the bigger picture and demonstrating that models of scientific examination are simply out-dated, archaic, and remain unable to truly assess and treat the whole individual. Our current health care system as well as patient dissatisfaction within mainstreet’s medical model is my case in point.

However, I would also like to note that this article is by no means a condescending commentary towards conventional medicine. In fact, most well funded universities have access to some rather tantalizing tools, of which may help solve the puzzle of how to explain acupuncture, naturopathic approaches, and observational, multi-pronged research to conventional medicine. SEED’s February 2009 issue, aptly entitled “Science Can Fix This” is right on the money. Perhaps the sharing of ideas and machinery can help unfold the black boxes enshrouding placebos, acupuncture meridians, and other mind-body modalities. As it stands now, the proposal to defund NCCAM, the dandelionian counterpart to ivy-league research, appears rash and impulsive, especially considering that most ‘alternative’ therapies are older than the pharmaceutical and bio/genomic approaches of today. Defunding or discrediting NCCAM would not only act as a disservice to the 36% of US citizens who seek out alternative medicine, but would potentially eliminate any means to explore alternative therapies given today’s equally ailing economy.

There is, in the very least, something to be said for medicines that have lasted for thousands of years, carefully carried, planted and propagated across continents and newfound lands.
Whether we, as natural medicine proponents, agree or not with ‘evidence-based’ ideas, that’s the direction that mainstreet’s medicine is heading… and governmental funding is certainly following….

Therefore, I feel compelled to say to advocates of natural medicine: We walk the walk, but do we talk the talk?

Paradoxically natural medicine just might be the solution to health care’s current problem (recall that our philosophies are based upon prevention, right?); yet if we do not reach out and work to help scientists/western-minded clinicians decipher natural medicine, then we remain part of the problem.

Furthermore, the lock-and-key, limiting reagent to our time-sensitive equation to fix health care may be, in part, due to our inability to effectively communicate. A sincere attempt between all parties is in order. An appropriate analogy would be a foreigner looking for a restroom in a overseas country; if a failure to transmit critical information occurs, then the delicate balance within cultural context is surely upset… on both sides of the equation. Translation of naturally oriented philosophies is key to genuinely moving medicine in the direction of preventative medicine. Call me crazy, but I simply refuse to settle for pap-smears and blood glucose monitoring as a means to an end for the definition of ‘prevention.’

As a firm believer in the power of the public and sustainable medicine and of the pen, I think it’s time to step up the plate, friends, our voices are presently not loud enough to be heard over the crowds. Conventional scientists possess powerfully intellectual minds; therefore, let us look for ways to explain natural medicine in terms they understand. Moreover, if we truly follow both medicines’ philosophies, we must “first do no harm.” Therefore, it is vital that we embrace our differences, set aside the gloves, and try to see eye-to-eye with a common goal: to build bridges between our medical communities and construct an effective model that delivers simple, yet high quality, affordable medicine. I’m betting that the solution to our health care crisis is really that simple.

Here Ye! Here Ye!

Medical interpreters desired.

Phone lines are open and ready for business. Please spread the word to those that can expedite the above mission.

Needless ranters need not apply.

Thank you.

Ps. Here is a helpful, comprehensive starting point for natural medicine, other than the obvious, if you need one.

Today I awoke from my dream
early on a Sunday morn

On my right, blue jays greet the world
Yellow rivers flow in the petals of daffodils
and Chinese checker marbles stare up to the bubbles
That is sky.

To my left I read a scientist’s proclamation:
“I want to write the Paper that says:
This is how many earths there are.”

What if all scientists were really poets
yet squinting with kaleidoscoped eyes
Modified wayfarers
… in a material world
chasing dragons in Perti dishes
constructing paper forts akin to that of Saint Asimov
collecting and congregating
bubbling around new found lands
feeling rough edges of the present moment
Black boxes just waiting to be opened.