Not long ago, when the president announced that Tylenol caused autism, he commented that leucovorin, a cancer medication, treated the condition. It was disturbing to see the outsized impact the pronouncements of a nonscientist had on the public, despite counterstatements by autism scientists to the contrary. I can fully understand the response. What mother-to-be would take the chance, even if untrue, that Tylenol may cause autism? Or if parents have a child with autism, would they not be willing to try anything, no matter how bizarre, that may aid their child? Many would do so.
I can also see the perspective of clinicians. Given minimal study of leucovorin in children, its use, especially long-term, perhaps even lifelong, would entail significant risk. What is known about its use in treating cancer is irrelevant to treating autism. In essence, it would be an uncontrolled experiment, and I can easily envision upset parents, if their child were injured or killed, suing the physician, and civil attorneys eager to aid them, as this would set a precedent for a lucrative income stream. As is typical in such actions, the fact that the parents asked for the treatment would bear no weight with a jury.
This would also set another undesirable precedent of clinicians providing whatever treatments patients wanted, as lawmakers, eager to please parents and assure reelection, without seeking or ignoring expert guidance, would enact legislation requiring clinicians to use a medication on request. This is not a ridiculous scenario as state legislators have passed laws to allow the sale of ivermectin without a prescription to treat coronavirus disease 2019 (COVID-19) and other conditions for which it is worthless. Equally moronic, the Louisiana legislature considered a bill to penalize clinicians who provided meningitis vaccine! Truly, the inmates are running the asylum!
This type of thinking is not unique but has occurred many times in the past and in various parts of the world. These instances arise when enough people fear they are losing control of their lives and the world around them. Invariably these people idolize a past that never existed, except in their minds. They also seek simple answers to complex situations and distrust those who do not provide them. Although it is thought by many that these odd beliefs are limited to certain religious groups and a political party, this is a myth. There are those on the left who have been and are equally as addled, and bizarre ideas shift from side to side of the political spectrum. The present, unreasoning fixation on trans rights to the almost total exclusion of other groups with limited civil rights is an example of left illogic. The euphemism “pregnant person” to avoid offending the minute number of trans men who may become pregnant is an example. However, biologically, as only female humans can gestate, the term “person” is incorrect as it mistakenly conflates gender with sex.
Equally ridiculous is the near fanaticism with which some former colonial countries, now independent, eagerly eschew all influences of their former colonizer, including modern medicine, in favor of indigenous ways, somehow believing in their equivalence, leading to increased disease and death. Medical schools in India no longer teach anatomy as it is nonessential to traditional medicine, while the New Zealand pharmacist licensing examination includes questions on Māori treatments for illnesses.
I respect history and cultural diversity. I do not support the “melting pot” concept where everyone is supposed to adopt the same, homogeneous culture. I believe that people should have freedom of choice about their personal health, but only to the extent that no one else is harmed, effective medical care displaced, or the community becomes responsible for the costs and damages resulting from their choice.
The Indian Health Service combines modern and indigenous practices, providing comfort to patients and encouraging them to seek medical treatment, rather than relying on traditional cures alone. The only native activities forbidden are those that conflict with treatments or that could harm the patient. But even then, staff will work with the patient to seek a compromise. This practice could be used with others with strong cultural backgrounds or as a means of working with those who prefer alternative treatments, at least in limited situations.
I doubt, however, that if one is convinced that the COVID-19 vaccine is poisonous, that they would agree to take it, even if they could use ivermectin concurrently. If they reject the vaccine, reach the point of serious illness, and seek medical care, it should only be provided if they pay for it themselves. Even if they have health insurance, ultimately any cost is passed to the community as higher payments or taxes. Society is based on reciprocal responsibilities, and individuals cannot have certain choices without corresponding accountability, and with nonscientific treatments, this resides with those who choose to use them.
M. Bennet Broner is a medical ethicist.
