Three Cheers for Government Research

By Richard P. Holm MD

It was 1948, in Framingham, Massachusetts, when more than 5,000 people were first questioned about lifestyle, physically examined and blood tested. It was the beginning of the Framingham Heart Study, a government funded project, which has continued to this day. Every two years these same individuals are very carefully re-studied. In 1971 their children were added to the study, and in 2002 their grandchildren were entered.

Prior to this time little was known about the general causes for heart disease and stroke. In 1948, the rates of these conditions had been increasing steadily since the beginning of the century. How much is related to environmental factors and how much is inherited were the questions? Is it nurture or nature, and what can we do to make things better?

Over the years we have learned a lot from the Framingham data and we continue to discover from this large investigation why people develop heart disease and related conditions.

Now a similar survey called the National Childrens Study (NCS) is about to begin. The scope and diversity of the people in this research program is so much broader than from Framingham, however. It will involve 100,000 children, from representative counties all across the US, including right here in Brookings county. The NCS will follow these children from even before they are conceived until age 21.

It is important to note that, like in Framingham, no special interest group, such as the Pharmaceutical Industry or Medical Testing Industry, financially sponsors the NCS. Our government, specifically the U.S. Department of Health and Human Services along with the U.S. Environmental Protection Agency, is the fiscal supporter for this splendid and colossal effort.

I believe that our government should be much more involved in sponsoring research like the NCS and the Framingham Study; since industry sponsored studies, although important, have an inherent bias.

It is with the gathering of such information that we may finally learn what causes conditions like obesity, asthma, autism; or what influences intellect or mental health. Is it nurture or nature, and what can we do to make things better?

Are South Dakota's Current Abortion Laws Hurting Doctors?

By Shawn Vuong

While many South Dakotans are glad we are done with "Initiative 11" Zita Lazzarini thinks South Dakota has already taken it too far.  Today in the NEJM, Lazzarini says that the current law that was passed in 2005 known as the "abortion script" threatens the physician-patient relationship.

At one level this type of law pushes our state's beliefs onto doctors and patients.  Also, the abortion script may actually be keeping doctors from giving scientifically based information to allow for an informed consent.  Lastly, Lazzarini says that if we let the states push it this far, what's next?  Who knows what other ethical dilemmas the state will try to push onto doctors & patients.  

If legislatures can mandate that physicians provide women with ideological, vague, intimidating, and false information about abortion, what is to stop them from intruding further into physician–patient discussions regarding end-of-life decisions, the use of future stem-cell–basedtherapeutics, the efficacy of birth control, or the role of condoms in preventing sexually transmitted infections?

How important is the doctor-patient relationship to you?  Whether you are pro-choice or pro-life should not make a difference in this issue.  Imagine that you are in the hospital with your loved ones, and the doctor was mandated to tell you and make you sign paperwork that the end-of-life decisions you and your loved ones are making are wrong.