John Walker's Electronic House

Rum Doings Special: Special Guest Ben Goldacre

by on Mar.10, 2011, under Rum Doings, The Rest

We’re very pleased to say that in episode 40, 50, 60 and 63 of Rum Doings (a four-way simulcast, and double-length), we are joined by very special guest, Dr. Ben Goldacre. The man behind the Bad Science blog and Guardian column, and the book of the same name, allows us into his London studio to discuss the subjects about which he and we are passionate. We think this was a unique opportunity for the subjects to be discussed with enough space to consider them properly, and for the good doctor to speak in a way that five minute radio interviews cannot.

In a sweary episode, we begin by talking about the peculiarities of those who threaten to sue Goldacre for libel, and the way quacks will create misleading statistics. Then via Nick’s desire for robot doctors, we discuss whether doctors are obliged to tell the truth to their patients, how new technology may change the role of doctors in diagnosis, and the potential for conflicts of interest depending upon how doctors are paid. And Nick lets John speak after the first half hour.

We ponder the potential privatisation of the NHS, and the impact that may have on patients and doctors, what happens when you privatise blood donation, and in turn, the nature of an altruistic act. We ask what doctors should be doing with drugs they know don’t perform better than placebo, even if they appear to help patients.

Dr Ben puts out the interesting idea that doctors should not be the final gatekeeper to a patient’s access to drugs, and indeed whether there should be legitimate access to outlawed drugs. There’s chat about how we should react when we see the vulnerable being tricked by quacks, how much John gets paid for writing in The Cat Magazine, how we can encourage big pharma to get out of their patenting model, and Nick’s LBC caller gets a good few outings.

All three of us express our concerns with the Comic Relief Walkers Crisps campaign, we hear Ben’s “Everything In This Box Is Bollocks” suggestion for letting adverts lie as much as they want, and Nick trots out his Trotsky theories. The idiocy of DRM rears its head, then Nick and John leap on Ben when they see a glimmer of an opportunity to evangelise free software models. And then a last second chat about Richard Stallman brings us to an end.

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21 Comments for this entry

  • John

    Woohoo! This is very exciting.

  • Alex B

    I was certain it would be Gervais – This is equally delighting however. Will listen immediately.

  • mister k

    “This is equally delighting however” Surely that should be more delighting? Actually I’m letting my biases get the better of me. Despite some of his more depressing output Gervais is an interesting and intelligent man… will have some comments on the actual podcast soon too!

  • DXN

    Spectacular! Listening now.

  • jeffers

    this is superb, excellent to hear a discussion like this over a reasonable length of time rather than an interupted 10 minutes max. Thanks!

  • El Stevo

    You really are on a roll lately, John.

  • Jambe

    I like iTunes was decried yet it’s plugged in the blurb at the end of every podcast. It’s a sad commentary, I suppose, on how influential the program is. I don’t find it particularly terrible on the rare occasion I use it but I still prefer alternatives. I just dislike Apple’s track record with censorship and their walled garden ecosystem. Anyway…

    Good chat. I don’t know what to feel about robot docs. I still want human specialists, but I’m fine with robots replacing GPs. However, this supposes people can self-direct the initial phases of their healthcare. I can imagine a system being set up to guide that process… the question is how it would compare to the current GP -> specialist arrangement in terms of efficacy and cost. There’s no reason that GP robots couldn’t be set up to be competitive with and/or adjunct to GP humans so that everybody has a choice in the matter. It’d be like stores with the self checkout next to the human cashier…

    I’m thinking of Star Trek, and how the writers of that series thought of many of these sorts of issues. In most circumstances, various computers do what are now specialist tasks of identifying intricate problems and the human doctor acts merely as a reassuring treatment dispenser. On Voyager the ship’s emergency medical hologram provides primary care for an extended period and thus develops its own personality and eventually what some of the crew argue is sentience.

    Also, yes on the decriminalization of many drugs. Vast human and material capital is being burnt up in drug prohibition. It’s obscene how many people are locked up and basically institutionalized in American prisons for drug offenses. And of course the killing of innocents, and the wasting of money prosecuting drug offenders and paying drug task forces… all the while alcohol is perfectly legal and is demonstrably linked to daily deaths. The hypocrisy is breathtaking.

  • Colthor

    Excellent podcast chaps, thank you.

  • MrsTrellis

    I’m surprised you didn’t ask Dr Goldacre to have a look at your haemorrhoids as well.

  • mister k

    Excellent stuff, really nice discussion. I have been at two conferences recently with a lot of statisticans from the pharmaceutical industry, and Ben Goldacre was mentioned disparaginly at both. The statisticans there argued that they practice statistics more carefully than most academics, but I suspect that

    a-they’re kidding themselves slightly
    b-thats due to regulation

    I also got the impression from several talks that the focus on seeing drugs succeed leads them to slightly bad statisics without even realising it. One talk on a new method (incorpororating historical data using Bayesian hierarchical models) focused on whether the method would help them prove a drug was effective, not how close it would get them to the truth…

    I’m a little intrigued at Nick’s suggestion of a nationalised drug service.. where would the money come for R and D, as pharma is spending more and more (and gaining less and less) on research.

  • Nick Mailer

    Mister K: Ummm.. Where do you think the money comes from now? The money fairy? Seriously, think about that question.

  • mister k

    You mean the money fairy doesn’t exist? To be serious though, you mentioned nationalisation as a cure to patenting, but drug companies make money by selling their drug at hugely inflated prices while the patent still holds, to some extent they have to to make back massive costs (including a currently huge drug failure rate). Now a govt organisation could do that at a not for profit rate, but that would still require patents.

  • Nick Mailer

    Mister K: I ask again. Where do you think the money comes from now?

  • Daniel Rivas

    The money now comes from the private investment drug companies make in the hope of coming up with something patentable and usable, in order to make larger profits.

    The money under the proposed model would come from the private investment drug companies would make in the hope of coming up with something usable, that they would not be able to patent but would earn them vast amounts of money from (presumably combined) international development budgets.

    I don’t see why this is hard to understand, though the likelihood of its being brought about is not especially high.

  • Nick Mailer

    You both miss the point. The money comes from all of us. In either system.

  • Daniel Rivas

    That’s what I said, isn’t it? Where would the profits be coming from if not us?

  • mister k

    OK, I get it.. I guess I’m unused to the concept of full nationalisation to such an extent.

  • MrsTrellis

    There was a programme on the radio recently about GSK which has hived off its R&D department into little pseudo-start ups. Apparently it’s made the whole process much more efficient.

  • Daniel Rivas

    How recent? Is it still online, do you think?

  • Patrick

    Appropriate though evidence-based medicine may be, recall that it is necessarily conservative in its deductions, and has been lampooned eloquently in a BMJ article titled:

    “Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials”

  • MrsTrellis

    Mr Rivas, I don’t know. It was on Radio 4, I think it was In Business.

    Yes, it appears to be available. I think that is the one.