BOOK REVIEW

True love means better information
Love your heart : notes from a cardiologist to anyone with a heart
Vivek K Mehan
Productivity Services International, Mumbai, 1999 Price: Rs 70. pp. viii + 85

Attempts at health education are always welcome, in that they enable people to be better consumers, to approach the system with less trepidation, and to make the best use of health services. This book is appreciated for its effort to respond to the many doubts and fears of people going for diagnostic and therapeutic procedures for heart disease. It describes the cardiovascular system and disease in simple language; it tells the reader what to expect before and after various tests and procedures, and finally, it describes the components of a healthy lifestyle.

Having said this, why do I feel unsatisfied? Because despite the writer´s best intentions, he has produced what is effectively a brochure for cardiac surgery. For example, it is true that an aging population and changing lifestyles may correspond to an increasing rate of age- related conditions including heart disease. However, to support his statement that coronary artery disease has reached “epidemic proportions in our cities”, he cites the “ever growing numbers of ... angiographies, angioplasties and bypass surgeries being performed daily”. Both common sense and a general awareness of the promotion of high technology in the private sector tell us that the excessive numbers of procedures can indicate overuse of the procedures rather than an “epidemic” of heart disease.

Perhaps as a consequence of this unquestioning perspective, the book fails to raise questions that I would have as a potential patient. Such as: what should you ask the doctor if you are told that you need bypass surgery? Unfortunately not one statement in the book suggests that these procedures are overused. The information in this book may reduce people´s anxieties before undergoing procedures, but it cannot make up for an uncommunicative or pushy doctor promoting unnecessary surgery of little benefit and possibly some harm.

SS

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Conference: Ethical Issues in Clinical Trials
A conference on Ethical Issues in Clinical Trials will occur on February 25th and 26th, 2000 at the University of Alabama at Birmingham. Topics include: informed consent, informed consent in special populations; placebo controls; decisions to terminate or repeat trials; multinational clinical trials. For conference registration material, please send name and address to:Harold Kincaid, Center for Ethics and Values in the Sciences, 900 13th St. So., Birmingham, AL USA 35294 or email:kincaid@uab.edu