This raises one of the major issues of our time - the rights of patients to choose their own treatments, having been presented with all the alternatives available. In Britain, National Health Policy has stressed this in recent years. In its official publications, the 'Health of the Nation' and the 'Patients' Charter' it has expressed both the wish that GPs respond to the wishes and needs of patients and also the desire that patients take increased reponsibility for their own health.
It sees the provision of health care at the basic, local level as a partnership between patient and doctor, but wants patients to find out more and have more say in their treatment.
This implies the all-important need for knowledge on the part of the patient, plus the power to implement it. That seems to be what is missing now. Leaflet information is readily available about surgical measures to treat cardiovascular disease, but is less readily available about alternative views, such as diet or anti-stress measures. Moreover, leaflets published by heart charities and cardiac information centres tend to, if not exactly trivialize surgical options, at least make light of them. Cartoons are often used to show patients cheerfully contemplating major surgery, with no reference even to medical alternatives, such as drug therapy.
The more realistic view of Professor Vincent is of value: 'Cardiac surgery is clearly a
highly-invasive and very disturbing thing, involving stopping the heart and starting it, and the brain having to be infused. If you take a patient with a good strong heart muscle who is otherwise well, then the chances of surviving surgery are 99 per cent. If you take a patient who's got a poor heart function who may be unwell, then the risk might be 10 per cent mortality. It's quite low: we're not talking about 50 per cent risk of dying of serious complications because they simply won't be selected.'
So what happens to the presumably significant proportion of coronary bypass patients who do not have strong enough heart muscles? Are they told about chelation therapy? According to Dr Perry, only 1 per cent of patients come to chelation because they have been referred by their doctor. 'In addition,' says Dr Perry, 'we are largely seeing patients at the end of their treatment situation when their doctors have given them up.' Dr Perry's view is that the situation will not change significantly, however good EDTA is for patients with circulatory problems, until clinical trials are done.
But who will pay for them? As said before, EDTA's patent has expired so no drug company can monopolize it and recoup their expenditure by hugely profitable sales.
There are those who conjecture that drug companies could be blocking the admission of cheap chelation into the fold of circulatory disease. The primary physician is the key lynch pin in deciding what drugs or treatments are to be recommended to the purchasing/consulting public.
Examining this evidence cannot help but lead, at times, to favouring the latter of the two theories currently on offer as to why EDTA chelation therapy is not accepted, that is, is it a
cock-up or is it a conspiracy?