This meeting opened with an apology for the absence of a speaker to address the announced topic. The chairman proposed that we go ahead with discussing the topic for the first half of the meeting and then tackle something new after the tea break. He proposed that we then discuss the Islamic inspired terrorist attacks on the citizens of London on 7th July. There were no dissenting voices and so we proceeded.

The future of medicine touches many of the principles of humanism in that, at least in this country, medicine is a wholly secular affair. Our beleaguered NHS does not have to fund the numerous attempts to affect cures claimed by churches and faith healers although it does support a system of chaplaincy. In fact all efforts to measure the efficacy of prayer in curing people’s ills have shown it to be a pretty worthless exercise. Despite this, we know that many erstwhile patients ascribe their ‘cures’ to the intercession of gods, saints and other holy entities and readily declare they are now well because of divine miraculous intervention.

A short article by Geoffrey Cowley introducing the recent special issue of Newsweek was entitled The Future of Medicine. As one might expect, this dealt largely with scientific and technological developments in modern medicine. Cowley says we look to medicine in much the same way as (some people) do to religion. “Like religion”, he says, medicine “embraces our pain and our fears, and assures us that things can be better. And for all its missteps it often fulfils its promise.” Religion, as humanists often stress, postpones the promise until after death!!

Cowley goes on to remind us that the last 20 years or so has seen the promise of medicine achieved in some instances such as its ability to treat HIV/AIDS and depression. The basic fruits of modern medicine are not available to much of the world and yet progress and promise are still pursued in such expensive areas as personalised prescriptions, stem-cell therapies and ‘silver-bullet’ drugs. And molecular biochemistry is moving so rapidly that it is now envisaged that future treatments may be directed towards helping our sick bodies to manufacture whatever proteins they lack. Finally, Cowley said the challenges of making modern medicine affordable and accessible loom as large as ever.

Over the past few decades, advances in medicine have been helped by extremely refined diagnostic imaging procedures that allow functional images of our organs with techniques that use duplex ultrasound, radionuclide SPECT with x-ray CT, PET/CT, MRI and the use of sensitive external probes capable of scanning the interior magnetic fields set up by biochemical interactions in the brain or other organs. The great problems in this area of medical diagnosis both now and for the future is the enormous expense of acquiring the latest equipment and making it available to all patients. The problem of finding enough ‘experts’ to use them and to interpret results also looks unpromising for the future.

The availability of many of the latest scanning procedures is somewhat better for those with money. Good medicine, like good food and good living is available for those who can afford it and who know where to look for it. However, it has to be remembered that, even in America, that bastion of democratic civilization, some 45 million people are uninsured and only entitled to receive a second class medical service. Some 18,000 Americans die every year for lack of health insurance.

Too much in the tricky realm of medical ethics medicine is driven and controlled by large multinational drug companies which elicit research that is often questionable and sometimes downright unethical as illustrated by the recent Vioxx scandal. The need for medical ethics to be taken seriously, both within the profession itself and by those who serve it, will, I hope, become a major issue for the future. Only then will doctors be able to prevent such appalling scandals as the spread of MRSA in our hospitals that has arisen as much from the careless over-prescription of antibiotics as from a disregard of the basic principles of cleanliness introduced by such worthy pioneers as Semmelweiss and Lister in the nineteenth century.

As can be gleaned from a recent paper by our missing speaker. The notion of informed consent is not sufficiently objective to be glossed over in the way that it often is when researchers are selecting normal subjects and then carry out ‘routine’ procedure on them such as (say) renal biopsy where the risks are considerably higher than the participants have been led to believe. Ethical committees often fail to screen questionable research projects even though their methods are ostensibly linked to the Helsinki Declaration which arose in 1964 out of the Nuremberg Code. The future of medicine will be served well if ethical guidelines are better practised.

Self inflicted or avoidable medical conditions will be just as prevalent in the future as they are today. There was some disagreement about the health hazards associated with smoking - as is always the case when non-smokers debate the issue with smokers! However, the facts speak for themselves. Diseases caused by smoking result in some 7000 hospital admissions per week and 106,000 deaths per year in the UK alone. The world-wide statistics are appalling. And, on another tack, while the poor of the world starve to death, 112,000 Americans die each year from illnesses related to overeating! Few of the medical sophistications we look forward to are likely to affect these problems. Present and future medical services need to find more effective ways of dispensing preventive medicine to unwilling individuals.

The surest way to good health and a high quality old-age, now and in the future, is to preserve what we have by managing our weight, diet and our mental and physical exercise patterns. Scientific medicine may help us to achieve this but, in the absence of divine miracles, we ourselves are in the best position to make the greater contribution.

After our usual tea break we moved to the topic of the recent atrocities on London transport in anticipation of the September meeting when we plan to discuss 'The Theology of Terrorism'. The suicide bombing that occurred in London on 7th July was introduced with readings from my article 'Murder on and below the streets of London' in the July issue of the EHA Bulletin. However, the discussion quickly broadened into an attempt to explore the root causes of such criminal acts by religious fanatics. We came to no conclusions as might be expected but, as humanists, some of us felt the ultimate blame for such wanton cruelty stems from the widespread practice of manipulating the minds of young people into religious superstitions that originated in Middle Eastern deserts long ago. To be prepared to give one’s life for one’s faith is not a new concept as anyone who suffered the indignity of a Christian religious education is probably aware. Martyrdom is a sure way of achieving sainthood, we were told. Modern religious terrorism goes a step further, it has a habit of linking martyrdom with murder. We are told by the murderers or their apologists that this is an expression of disgust with the decadence of western civilisation, exacerbated perhaps by the presence of Western armies in Muslim countries, and that their actions are intended to expedite the day when all democracies will be displaced by systems based on the worship of Allah. Many westerners would agree that their own society is decadent. If Muslims find it so abhorrent they only have to look the other way. In any case, if Muslims consider the ways of the west to be so utterly decadent don’t the murderous events of 7th July only emphasise that their own interpretation of Islam and the rule of Allah is even more decadent?

Further discussion on some of these issues was then postponed until our next Thursday meeting on 25th August. Those present were asked to bring with them any relevant material they could find.

Anthony Constable

Stories in the national press and TV this week represent an interesting combined picture. The Piano Man who was silent but a missing person for more than 4 months after being found dripping wet off the Isle of Sheppey has spoken and identified himself. He has been discharged from hospital with a diagnosis of mental illness. Pat Robertson, the leading TV Christian Evangelist in the US, a former Republican presidential candidate and a right-winger has declared in favour of political assassination and has thus turned terrorist. We have also been treated to recurrent images of illegal Israeli settlers in Gaza displaying frenetic tenacity towards a God-given destiny that is at variance, even, with the majority opinion within Israel itself. And finally animal rights protesters have claimed victory in setting themselves even further away from society's view of how far free speech can be allowed to extend without damage to common interests. All this takes place as the Muslim community in Britain are concerned, rightly, with the similar problem of where and how their religious freedom shades off into sheer fanatic extremism with the need to be understood and treated as a dangerous mental aberration. Followers of the Pope are no strangers to ongoing publicity over mass hysteria - widely undiagnosed but based on a non-scientific, or partly scientific, God-given authority.

The Dame Janet Smith 5-volume report on the General Medical Council raises disturbing questions on how far protection of the profession's authority is their main concern rather than protection of the public. Unfortunately there is a large minority in the responsibly-minded section of the general public who see an artificially elevated status of doctors as necessary. This is clearly connected with exaggerated expectations on the part of many patients, though presumably not the reluctant ones who form a group we cannot afford to ignore. Some further details on the tensions within the Council may show themselves on the 7th, 8th and 9th of next month, when I myself am due to appear before a panel on Fitness to Practice. Watch this space.

This book traces the history of anti-humanist ideas from opponents of the Enlightenment, through Nietzsche and the philosophers influenced by him, to the postmodernists. There is also a chapter on C.G. Jung, whose flirtation with nazism and whose anti-Semitism are well known: less well-known perhaps is the Jungian mumbo jumbo which influenced today’s New Ageism. Wolin challenges the view that postmodernism is a movement of the Left, showing the connections since the 1930s between certain intellectuals and right-wing politics.The book is heavy going for those such as myself who have no grounding in political theory, but should interest anyone with a broad interest in current affairs and their background. It is particularly good on Heidegger, on whom Wolin has previously published, and the long-lived Hans-Georg Gadamer (1900-2002).

There is no such thing as man (human being), only men within particular cultures, say the particularists such as Maistre (1797), and more recently Levi-Strauss, who argued against cross-cultural communication (Wolin, p5), as against the universalising Enlightenment thinkers with their declarations on the Rights of Man etc. Anthropologists have a vested interest in the diversity of the cultures they study, and one can imagine their dismay at its erosion by a homogenising American popular culture which leaves them with little to write about. Particularism says nothing about quality: you can argue either that all cultures are good in their own way, or that some are better than others. Herder, lined up here as a “cultural relativist” (p6), took the former view when it suited him, but moved to the latter when during his lifetime he saw a change from the dominance of French culture, and a consequent sense of German inferiority, to a rise in national self-confidence as a dazzling array of geniuses - Goethe, Schiller, Mozart, Beethoven, etc. - appeared in the German-speaking world.

In his final chapter Wolin describes the American dystopia as seen by French postmodernists, and not only by them: Disneyland is “to culture as fast food is to gastronomy” (Max Gallo). One might add, from a very different viewpoint, the late George Kennan, who thought American pop culture made the USA a laughing-stock in the rest of the world. But what the French postmodernists feel towards the USA is something deeper than vulgar anti-Americanism: some deeper hatred underlies the glee with which Baudrillard greeted the 9/11 disaster of 2001. Wolin shoes how silly (and, I would add, how callous) such an attitude is: those universalising thinkers of the Enlightenment created a moral discourse which underlies present-day international law: perhaps Baudrillard would prefer the world to sit back and not bother to seek out Radovan Karadic and his general and bring them to account for the Srebrenica massacre.

Wolin writes of the postmodernists “bask[ing] in the freedoms of political liberalism - to whose institutions they [owe] their brilliant careers - while biting the hand that feeds them” (p312). Similarly I sometimes wonder (with Derek Hill) what happens when they walk out of their lecture-rooms and into the everyday world of common sense: they must lead a double life.

Charles Rudd

Year with the first two digits lopped off appears as only one step less ridiculous than it would be if we allowed only one digit per month. November (11) and December (12) would then become 1 and 2, indistinguishable from January (01) and February (02). Numbering the months strikes one as illogical anyway, in that they consist of a varying number of days. The first three letters of each month would it seems serve much better and, with the concluding suggestion below, save having to insert spaces, dots or flashes (usage varies) between days, months and years. If the letters were all lower case jan, feb . . . or all capitals JAN, FEB . . . then certainly it would avoid use of the shift key on a keyboard. But to return to the year – why, in the UK and US, does it have last place instead of first in the date? And that brings us to the final and overriding anomaly of giving the day and month in differing positions according to which side of the Mid-north Atlantic one is on. A simple improvement would be to always write either day, month, year or year, month, day even though the latter remain preferred for mathematical reasons.

R.C. 2005aug25