Tag Archives: need

In hospital you’re at your lowest ebb. A sugary drink may be just what you need | Ella Risbridger

In an attempt to solve the “obesity crisis”, it appears that the NHS is considering a total ban on the sale of sugary drinks in its hospitals.

A voluntary NHS England scheme to reduce the sale of sugary soft drinks, milkshakes and hot drinks with added sugar syrups failed to take off, and so the idea for a ban to come into effect from 1 July (alongside the new tax on sugary drinks that comes into effect today), is obviously sensible. It’s logical. It’s scientific. We all know, after all, that we should probably all have less sugar, less fat, less caffeine.

It makes total sense – except, of course, at 4am in the ICU waiting room, when all you need is a double-shot hazelnut latte and absolutely none of this to be happening.


This ban could only have been proposed by people who don’t know what it’s like to spend a great deal of time in hospital

I don’t know enough to speak with authority on the “obesity crisis”. What I do know, however, is that this sweeping ban on sugary drinks could only have been proposed by people who don’t know (or have forgotten) what it’s like to spend a great deal of time in hospital. Between 2015 and 2017, I was the carer for my then-partner, who was critically and chronically ill. He was often in hospital, and when he was in hospital, I was there too.

A friend told me that when her daughter, who has leukaemia, was in hospital, the staff wouldn’t allow diet drinks on the ward. “[They] said they were dangerous, and told us constantly to go and get a hot chocolate or a coffee to try and buck us up a bit.”

That’s what it’s like in hospital: you need something to keep you going. I didn’t eat much, I didn’t sleep much either. I didn’t have the time to cook or eat properly. I needed calories, and I needed caffeine. Crucially, it was delicious. Another friend tells me she goes for a syrupy latte after every single appointment, “because having to go to hospital all the time is hard and I want a little pick-me-up”. She’s not alone. Another patient told me she “mainlined lattes” while in a high-dependency unit last year. “Gingerbread was one of the few things I could stomach.”

Syrupy lattes and sugary drinks are for so many of us a tiny, accessible joy in a horrible time; a tiny memo from an outside world that has mostly ceased to exist. Professor John Wass, from the Obesity Health Alliance, said that the reduction in sales of unhealthy food and drink in hospitals would be an important step in the battle against obesity. “It also sends a strong message that the NHS is serious about cutting the amount of sugar in the nation’s diet,” he added.

But if you’re in hospital enough times that a sugary drink on the premises is going to make you obese, you have almost certainly got bigger things to worry about – and probably a team of doctors to do the worrying for you. You’ve already had to relinquish much of your life and your choices to professionals: to lose these last choices – a chocolate bar here, a coffee there – feels like the last infantilising indignity.

“You’re not going to change people’s eating habits when they are not feeling well,” said Duncan Burton, the director of patient experience at Kingston hospital in London, last year – and it’s true. People at their lowest ebb, caught as I was in a terrible limbo, don’t want to be lectured about sugar content. They would just like to get through the night. Who craves a side salad in times of stress? Burton, by the way, is leading a revolution: he has reintroduced breakfast toast, and home baking at tea-time. “If you can get them to eat a piece of cake,” he says “then fine … at least it is some nutrition.”

Food can be a joy and a treat and a pleasure – and there’s little enough of that in hospital. There is a tendency sometimes to forget this: a tendency towards thinking of food simply as fuel. Nutritionists serve up strange, chemical-tasting high-calorie powders and mousses; the menu is often outsourced to the cheapest possible catering company with little regard for either nutritional content or what might tempt a sick person to eat.

And none of this is ideal. Of course it isn’t. In an ideal world I would have eaten properly; got more rest. In an ideal world, there would be enough nurses that no carer would feel they had to be on hand every minute, and doctors would not be working unbelievably long shifts and covering four wards at once. In an ideal world, the menus would be tempting and delicious: real food, cooked properly, with enough for carers and visitors and doctors too. You’d have free tea and coffee-making facilities on every ward, and we would not be outsourcing nutrition to private for-profit companies. No sick person would have to suffer the indignity of microwaved instant potato; no carer would be pacing the halls with a full-fat Coke at 4am, because they’d be sleeping safe in the knowledge that the hospital was adequately and appropriately staffed. In an ideal world, we’d all be safe at home. That’s the crux of the matter. There is nothing ideal about any of this.

People get sick and people get sad. They need comfort and pleasure, and the NHS has precious little of both those things to go around. While that remains the case, the proposed ban feels like a sort of ivory-tower position. Stay sitting up all night, and then do it again, and do it again, by the same bed in ICU, and tell me you don’t end up craving a sugar hit.

Ella Risbridger is a journalist and author

In hospital you’re at your lowest ebb. A sugary drink may be just what you need | Ella Risbridger

In an attempt to solve the “obesity crisis”, it appears that the NHS is considering a total ban on the sale of sugary drinks in its hospitals.

A voluntary NHS England scheme to reduce the sale of sugary soft drinks, milkshakes and hot drinks with added sugar syrups failed to take off, and so the idea for a ban to come into effect from 1 July (alongside the new tax on sugary drinks that comes into effect today), is obviously sensible. It’s logical. It’s scientific. We all know, after all, that we should probably all have less sugar, less fat, less caffeine.

It makes total sense – except, of course, at 4am in the ICU waiting room, when all you need is a double-shot hazelnut latte and absolutely none of this to be happening.


This ban could only have been proposed by people who don’t know what it’s like to spend a great deal of time in hospital

I don’t know enough to speak with authority on the “obesity crisis”. What I do know, however, is that this sweeping ban on sugary drinks could only have been proposed by people who don’t know (or have forgotten) what it’s like to spend a great deal of time in hospital. Between 2015 and 2017, I was the carer for my then-partner, who was critically and chronically ill. He was often in hospital, and when he was in hospital, I was there too.

A friend told me that when her daughter, who has leukaemia, was in hospital, the staff wouldn’t allow diet drinks on the ward. “[They] said they were dangerous, and told us constantly to go and get a hot chocolate or a coffee to try and buck us up a bit.”

That’s what it’s like in hospital: you need something to keep you going. I didn’t eat much, I didn’t sleep much either. I didn’t have the time to cook or eat properly. I needed calories, and I needed caffeine. Crucially, it was delicious. Another friend tells me she goes for a syrupy latte after every single appointment, “because having to go to hospital all the time is hard and I want a little pick-me-up”. She’s not alone. Another patient told me she “mainlined lattes” while in a high-dependency unit last year. “Gingerbread was one of the few things I could stomach.”

Syrupy lattes and sugary drinks are for so many of us a tiny, accessible joy in a horrible time; a tiny memo from an outside world that has mostly ceased to exist. Professor John Wass, from the Obesity Health Alliance, said that the reduction in sales of unhealthy food and drink in hospitals would be an important step in the battle against obesity. “It also sends a strong message that the NHS is serious about cutting the amount of sugar in the nation’s diet,” he added.

But if you’re in hospital enough times that a sugary drink on the premises is going to make you obese, you have almost certainly got bigger things to worry about – and probably a team of doctors to do the worrying for you. You’ve already had to relinquish much of your life and your choices to professionals: to lose these last choices – a chocolate bar here, a coffee there – feels like the last infantilising indignity.

“You’re not going to change people’s eating habits when they are not feeling well,” said Duncan Burton, the director of patient experience at Kingston hospital in London, last year – and it’s true. People at their lowest ebb, caught as I was in a terrible limbo, don’t want to be lectured about sugar content. They would just like to get through the night. Who craves a side salad in times of stress? Burton, by the way, is leading a revolution: he has reintroduced breakfast toast, and home baking at tea-time. “If you can get them to eat a piece of cake,” he says “then fine … at least it is some nutrition.”

Food can be a joy and a treat and a pleasure – and there’s little enough of that in hospital. There is a tendency sometimes to forget this: a tendency towards thinking of food simply as fuel. Nutritionists serve up strange, chemical-tasting high-calorie powders and mousses; the menu is often outsourced to the cheapest possible catering company with little regard for either nutritional content or what might tempt a sick person to eat.

And none of this is ideal. Of course it isn’t. In an ideal world I would have eaten properly; got more rest. In an ideal world, there would be enough nurses that no carer would feel they had to be on hand every minute, and doctors would not be working unbelievably long shifts and covering four wards at once. In an ideal world, the menus would be tempting and delicious: real food, cooked properly, with enough for carers and visitors and doctors too. You’d have free tea and coffee-making facilities on every ward, and we would not be outsourcing nutrition to private for-profit companies. No sick person would have to suffer the indignity of microwaved instant potato; no carer would be pacing the halls with a full-fat Coke at 4am, because they’d be sleeping safe in the knowledge that the hospital was adequately and appropriately staffed. In an ideal world, we’d all be safe at home. That’s the crux of the matter. There is nothing ideal about any of this.

People get sick and people get sad. They need comfort and pleasure, and the NHS has precious little of both those things to go around. While that remains the case, the proposed ban feels like a sort of ivory-tower position. Stay sitting up all night, and then do it again, and do it again, by the same bed in ICU, and tell me you don’t end up craving a sugar hit.

Ella Risbridger is a journalist and author

Why we need to talk about prostate cancer | Letters

Both George Monbiot (I have been diagnosed with prostate cancer, but I am happy, 14 March) and Bill Turnbull (Former BBC breakfast host Bill Turnbull has prostate cancer, 6 March) have performed a service to men by sharing their shock at discovering they have prostate cancer. Bill wishes he had had PSA testing more often than every five years; George says that this standard assessment is of limited use. I agree with Bill and take issue with George. My prostate cancer was discovered by two private PSA tests taken 11 months apart. My Gleason score was nine out of 10. I was finally clear of cancer last year after 14 years of treatment. I suggest things could have been a lot worse if I had not had these two tests within a year.

George should have mentioned the Prostate cancer risk management programme whose aim is: “… to ensure that men receive information about prostate cancer and the associated risks, and clear and balanced information about the advantages and disadvantages of the prostate specific antigen (PSA) test. This will help men to decide whether they want to have the test.”

It would appear that in both George’s and Bill’s cases, they did not receive clear and balanced information about the test. The implication is that surgeries need to have a notice on the wall that draws men’s attention to their rights under the risk management programme. And, if their GP does not inform them, they should make the first move.
Robert Redpath
Jordans, Buckinghamshire

It is commendable that George Monbiot shares with us his experience of prostate cancer diagnosis. Also his happiness in where it puts him in his life. It is so important to inform and educate men about this disease, to broadcast the news far and wide. Anecdotally, following 15 years of PSA monitoring due to family history, then two biopsies that make your eyes water a bit, I too was diagnosed with this disease. Like George, I am overwhelmed by the love and support from friends, family and the teams of NHS radiologists who irradiate me daily with their linear accelerators. There is almost a social group in the waiting room, where we prepare for our treatment. A dry camaradie exists and humour too, as we fill our bladders to bursting point with water and insert our microenemas, so the radiologists can see what they’re aiming at. (Big shout out for the radiotherapy teams at the Churchill hospital, Oxford.)

Cancer is the great leveller. But there is room for happiness when you do realise, by comparison, how lucky you are. Good luck with your treatment, George.
Gordon Cooper
Flackwell Heath, Buckinghamshire

I was diagnosed with prostate cancer, with a Gleason score slightly higher than George’s. I opted for radiotherapy rather than surgery, and the seven weeks I spent travelling five days a week to the Churchill hospital in Oxford were an eye-opener for me, since I have never had any contact with the NHS beyond my (very good) general practice and the odd minor operation. At every stage I was dealt with courteously, informatively and sympathetically, often by staff who were not English. There were six radiotherapy machines, each costing about £2m, to which I had free access, along with the ancillary hormone treatment. The true cost of my treatment came home to me when I read in the Guardian last week of the man who has lived in the UK for over 40 years who was asked to pay £54,000 for a course of radiotherapy for his prostate cancer.

Unless there is a change of government soon, this unique healthcare organisation will be irreparably damaged by politicians who despise anyone who is not rich, who use private medicine, and who advocate the discredited use of PFI companies that make profits from selling inferior and overpriced services to the NHS.
Karl Sabbagh
Bloxham, Oxfordshire

George Monbiot’s response to his diagnosis and forthcoming radical surgery for prostate cancer is impressive and inspiring for others in similar position. But there is a third choice of treatment other than the rather dismal choice between surgery or radiation – namely high-frequency ultrasound, which has fewer side effects and – as with a friend of mine – can be very effective. For some reason it has a lower profile, but is available – and would appear a far less daunting prospect.
Andrew Broadbent
London

Thank you, George, for that courageous and necessary writing. We admire your brave and clear-sighted approach to your private crisis. Thank you for sharing your thoughts, so that we can emulate your attitude. And we all wish you well in your surgery and aftercare. May the force be with you.
Frances Middleton
Norwich

George is fit and healthy and his prostatectomy should be very successful. I had the same operation nine years ago and I have no doubt that my life was saved by my excellent GP who insisted that I had regular annual PSA tests. Although my Gleason Score was only 4.5, my doctor was concerned by the sudden increase since my previous test and “for peace of mind” (his and mine), he suggested a biopsy. Like George, my cancer was aggressive and the operation was carried out in under a month. Fortunately, the lymph glands were unaffected and apart from the expected debilitation following major surgery, I was soon fitter than before the operation. Erectile dysfunction is an expected side-effect, but don’t worry, George, medication will help that.

All men should have regular PSA tests from age 50 and, if there is a family history of prostate cancer, tests should begin earlier. Delay does kill. I am looking forward to reading George’s next article following his discharge from hospital.
Joe Haynes
Reading, Berkshire

Thank you, George. I have just been diagnosed too and, at 77, I like the idea of being part of this season’s smart young men. And I like the reasons you give for being happy. They make a lot of sense. My hormone treatment started yesterday and every member of staff was wonderful, kind, thoughtful, skilful and reassuring. Like you, I am happy, but I am also very angry. The idea that the government is determined to sell this national service off to US private business is unbearable.
John Airs
Liverpool

George Monbiot has covered everything accurately. His urinary tract infection bad luck turned out to be life-saving good luck. For me a hip replacement pre-op test discovered a heart condition, treatment for which led to the diagnosis of prostate cancer, early developing, responding well to the simplest treatment. Definitely good luck. “All the smart young men have it this season” – no, but all the smart men of any age should be aware of it, speak of it and check for symptoms. I’m old enough to remember when tuberculosis was unmentionable. Let’s not fear to speak of prostate cancer. All the best with the surgery, George.
Denis Ahern
Stanford-le-Hope, Essex

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We need to use gene editing wisely but also embrace its vast potential | Mary Warnock

The Royal Society has recently published the results of an extensive survey of the attitudes of the general public to genetic modification. This sent my mind back to 1990, when the human fertilisation and embryology bill was going through parliament.

The emphasis, at least in the House of Lords, where the bill started, very soon switched from remedies for infertility to the new concept of eliminating some heritable diseases. IVF could be used to select embryos in the laboratory that did not carry the disease and implant one or two of those in the mother’s uterus. At the time, it was also speculated that one day it might be possible to eliminate a faulty gene from a live embryo after a pregnancy had been established, rather than at the pre-implantation stage.

I remember being astonished by how little this had to do with infertility, which was, after all, in the title of the bill, and what the committee I chaired had been set up to consider.

It came about almost entirely because of the enthusiasm of a then newly appointed crossbencher, Lord Walton of Detchant, who was a neurologist especially concerned with the condition of Duchenne muscular dystrophy, a heritable disease for which there was no cure. The bill became law as much because of his persuasiveness in the matter of genetic modification as because of the help it would afford to those suffering from infertility.

But the procedures that John Walton foresaw took very much longer to come into practice than he had expected and we are now again considering the issues that arise from genetic modification in humans, though this time not only embryonic humans.

The Royal Society survey is an extremely careful investigation of the views of three panels of “ordinary” people, based in London, Norwich and Edinburgh, concerned, respectively, with genetic modification of humans, plants and animals other than human.

The survey was carried out over a considerable period and with a great deal of internal communication. It is not surprising, therefore, that people changed their minds, or modified their opinions, during the course of the inquiry. But one thing that emerges most clearly from the report is the common thirst for more knowledge. Again and again, participants complained that they were inhibited from expressing an opinion about new developments in the field by their ignorance of which therapies were currently being used and which were in the pipeline.

The motivating force behind the survey was the thought that the new possibilities of curing disease by genetic modification could be of benefit to large numbers of people, many of whom suffered from conditions hitherto untreatable. It is therefore essential that these new possibilities should be widely understood and that there should be no room for suspicion that research is being carried out behind closed doors or that there is help available to which no one has access.

Among the London group, those concerned with the application of the new techniques to humans, a surprising number held the view that the benefit of the techniques lay in the matter of equality: everyone, whatever their disease or disability, would have a chance to benefit from the new therapies. But this would depend on the cost of genetic treatment, which might well be prohibitive for a cash-strapped NHS. Nearly everyone agreed that the new techniques should not be used frivolously, that is, they should be used for the treatment of serious diseases, especially heritable diseases, not for aesthetic reasons, such as the production of “designer babies”.

This moral imperative immediately introduces the idea that the use of genetic modification requires regulation and this is something that was acknowledged by almost all the participants in the survey, whether they were concerned with crops, animals or humans.

Wild rice is grown in a new greenhouse at the University of Arizona


Wild rice is grown in a greenhouse at the University of Arizona, where scientists have fully mapped and sequenced the genetic code of the rice plant. Photograph: Gary Williams/Getty Images

Many of those surveyed expressed the hope that such regulation should be global; however, that seems to me pure fantasy. Think of the difficulties in establishing global agreement on the management of pollution. In this case, we must simply try to regulate for ourselves and hope that, if we can get it right, others will follow.

There was one concern of the report with which I had little sympathy and that was the matter of consent. A number of people expressed anxiety that, if a child were genetically modified so that that child, and their children, would no longer suffer from an inherited disease, they would have had this done to them, as well as to future generations, without their consent.

Obviously that is true. And obviously in many cases it is desirable that consent be assured before action is taken that involves someone else. But if you are being rescued from an intolerable situation, surely your consent can be taken for granted. If, in order to prevent my being burned to death in a house fire you fling me over your shoulder and run – you don’t need to stop to ask my consent. So, if you can act so as to spare a child, and future generations of children, the sufferings of disability, surely you do not need their consent to take the necessary actions. Sometimes, I feel that people engaged in these discussions underestimate the awfulness of having a profoundly disabled child.

And this leads to my next point: there were those whose response to the inquiry was to suggest that it was wrong to try to find ways to remove or alleviate the sufferings of those who have genetically determined disabilities. To suggest that one might hope to eliminate disability was the same as to hope to eliminate disabled people. And this was discrimination.

But this argument, though I have frequently encountered it, often put forward with passion, seems to me very weak. To say of someone that his life would be better if he were not disabled is not the same as to say that it would be better if he did not exist. But, on the whole, there was little of this in the findings of the survey. It has been a useful and enlightening exercise.

Mary Warnock is a moral philosopher and life peer

We need to use gene editing wisely but also embrace its vast potential | Mary Warnock

The Royal Society has recently published the results of an extensive survey of the attitudes of the general public to genetic modification. This sent my mind back to 1990, when the human fertilisation and embryology bill was going through parliament.

The emphasis, at least in the House of Lords, where the bill started, very soon switched from remedies for infertility to the new concept of eliminating some heritable diseases. IVF could be used to select embryos in the laboratory that did not carry the disease and implant one or two of those in the mother’s uterus. At the time, it was also speculated that one day it might be possible to eliminate a faulty gene from a live embryo after a pregnancy had been established, rather than at the pre-implantation stage.

I remember being astonished by how little this had to do with infertility, which was, after all, in the title of the bill, and what the committee I chaired had been set up to consider.

It came about almost entirely because of the enthusiasm of a then newly appointed crossbencher, Lord Walton of Detchant, who was a neurologist especially concerned with the condition of Duchenne muscular dystrophy, a heritable disease for which there was no cure. The bill became law as much because of his persuasiveness in the matter of genetic modification as because of the help it would afford to those suffering from infertility.

But the procedures that John Walton foresaw took very much longer to come into practice than he had expected and we are now again considering the issues that arise from genetic modification in humans, though this time not only embryonic humans.

The Royal Society survey is an extremely careful investigation of the views of three panels of “ordinary” people, based in London, Norwich and Edinburgh, concerned, respectively, with genetic modification of humans, plants and animals other than human.

The survey was carried out over a considerable period and with a great deal of internal communication. It is not surprising, therefore, that people changed their minds, or modified their opinions, during the course of the inquiry. But one thing that emerges most clearly from the report is the common thirst for more knowledge. Again and again, participants complained that they were inhibited from expressing an opinion about new developments in the field by their ignorance of which therapies were currently being used and which were in the pipeline.

The motivating force behind the survey was the thought that the new possibilities of curing disease by genetic modification could be of benefit to large numbers of people, many of whom suffered from conditions hitherto untreatable. It is therefore essential that these new possibilities should be widely understood and that there should be no room for suspicion that research is being carried out behind closed doors or that there is help available to which no one has access.

Among the London group, those concerned with the application of the new techniques to humans, a surprising number held the view that the benefit of the techniques lay in the matter of equality: everyone, whatever their disease or disability, would have a chance to benefit from the new therapies. But this would depend on the cost of genetic treatment, which might well be prohibitive for a cash-strapped NHS. Nearly everyone agreed that the new techniques should not be used frivolously, that is, they should be used for the treatment of serious diseases, especially heritable diseases, not for aesthetic reasons, such as the production of “designer babies”.

This moral imperative immediately introduces the idea that the use of genetic modification requires regulation and this is something that was acknowledged by almost all the participants in the survey, whether they were concerned with crops, animals or humans.

Wild rice is grown in a new greenhouse at the University of Arizona


Wild rice is grown in a greenhouse at the University of Arizona, where scientists have fully mapped and sequenced the genetic code of the rice plant. Photograph: Gary Williams/Getty Images

Many of those surveyed expressed the hope that such regulation should be global; however, that seems to me pure fantasy. Think of the difficulties in establishing global agreement on the management of pollution. In this case, we must simply try to regulate for ourselves and hope that, if we can get it right, others will follow.

There was one concern of the report with which I had little sympathy and that was the matter of consent. A number of people expressed anxiety that, if a child were genetically modified so that that child, and their children, would no longer suffer from an inherited disease, they would have had this done to them, as well as to future generations, without their consent.

Obviously that is true. And obviously in many cases it is desirable that consent be assured before action is taken that involves someone else. But if you are being rescued from an intolerable situation, surely your consent can be taken for granted. If, in order to prevent my being burned to death in a house fire you fling me over your shoulder and run – you don’t need to stop to ask my consent. So, if you can act so as to spare a child, and future generations of children, the sufferings of disability, surely you do not need their consent to take the necessary actions. Sometimes, I feel that people engaged in these discussions underestimate the awfulness of having a profoundly disabled child.

And this leads to my next point: there were those whose response to the inquiry was to suggest that it was wrong to try to find ways to remove or alleviate the sufferings of those who have genetically determined disabilities. To suggest that one might hope to eliminate disability was the same as to hope to eliminate disabled people. And this was discrimination.

But this argument, though I have frequently encountered it, often put forward with passion, seems to me very weak. To say of someone that his life would be better if he were not disabled is not the same as to say that it would be better if he did not exist. But, on the whole, there was little of this in the findings of the survey. It has been a useful and enlightening exercise.

Mary Warnock is a moral philosopher and life peer

We need to use gene editing wisely but also embrace its vast potential | Mary Warnock

The Royal Society has recently published the results of an extensive survey of the attitudes of the general public to genetic modification. This sent my mind back to 1990, when the human fertilisation and embryology bill was going through parliament.

The emphasis, at least in the House of Lords, where the bill started, very soon switched from remedies for infertility to the new concept of eliminating some heritable diseases. IVF could be used to select embryos in the laboratory that did not carry the disease and implant one or two of those in the mother’s uterus. At the time, it was also speculated that one day it might be possible to eliminate a faulty gene from a live embryo after a pregnancy had been established, rather than at the pre-implantation stage.

I remember being astonished by how little this had to do with infertility, which was, after all, in the title of the bill, and what the committee I chaired had been set up to consider.

It came about almost entirely because of the enthusiasm of a then newly appointed crossbencher, Lord Walton of Detchant, who was a neurologist especially concerned with the condition of Duchenne muscular dystrophy, a heritable disease for which there was no cure. The bill became law as much because of his persuasiveness in the matter of genetic modification as because of the help it would afford to those suffering from infertility.

But the procedures that John Walton foresaw took very much longer to come into practice than he had expected and we are now again considering the issues that arise from genetic modification in humans, though this time not only embryonic humans.

The Royal Society survey is an extremely careful investigation of the views of three panels of “ordinary” people, based in London, Norwich and Edinburgh, concerned, respectively, with genetic modification of humans, plants and animals other than human.

The survey was carried out over a considerable period and with a great deal of internal communication. It is not surprising, therefore, that people changed their minds, or modified their opinions, during the course of the inquiry. But one thing that emerges most clearly from the report is the common thirst for more knowledge. Again and again, participants complained that they were inhibited from expressing an opinion about new developments in the field by their ignorance of which therapies were currently being used and which were in the pipeline.

The motivating force behind the survey was the thought that the new possibilities of curing disease by genetic modification could be of benefit to large numbers of people, many of whom suffered from conditions hitherto untreatable. It is therefore essential that these new possibilities should be widely understood and that there should be no room for suspicion that research is being carried out behind closed doors or that there is help available to which no one has access.

Among the London group, those concerned with the application of the new techniques to humans, a surprising number held the view that the benefit of the techniques lay in the matter of equality: everyone, whatever their disease or disability, would have a chance to benefit from the new therapies. But this would depend on the cost of genetic treatment, which might well be prohibitive for a cash-strapped NHS. Nearly everyone agreed that the new techniques should not be used frivolously, that is, they should be used for the treatment of serious diseases, especially heritable diseases, not for aesthetic reasons, such as the production of “designer babies”.

This moral imperative immediately introduces the idea that the use of genetic modification requires regulation and this is something that was acknowledged by almost all the participants in the survey, whether they were concerned with crops, animals or humans.

Wild rice is grown in a new greenhouse at the University of Arizona


Wild rice is grown in a greenhouse at the University of Arizona, where scientists have fully mapped and sequenced the genetic code of the rice plant. Photograph: Gary Williams/Getty Images

Many of those surveyed expressed the hope that such regulation should be global; however, that seems to me pure fantasy. Think of the difficulties in establishing global agreement on the management of pollution. In this case, we must simply try to regulate for ourselves and hope that, if we can get it right, others will follow.

There was one concern of the report with which I had little sympathy and that was the matter of consent. A number of people expressed anxiety that, if a child were genetically modified so that that child, and their children, would no longer suffer from an inherited disease, they would have had this done to them, as well as to future generations, without their consent.

Obviously that is true. And obviously in many cases it is desirable that consent be assured before action is taken that involves someone else. But if you are being rescued from an intolerable situation, surely your consent can be taken for granted. If, in order to prevent my being burned to death in a house fire you fling me over your shoulder and run – you don’t need to stop to ask my consent. So, if you can act so as to spare a child, and future generations of children, the sufferings of disability, surely you do not need their consent to take the necessary actions. Sometimes, I feel that people engaged in these discussions underestimate the awfulness of having a profoundly disabled child.

And this leads to my next point: there were those whose response to the inquiry was to suggest that it was wrong to try to find ways to remove or alleviate the sufferings of those who have genetically determined disabilities. To suggest that one might hope to eliminate disability was the same as to hope to eliminate disabled people. And this was discrimination.

But this argument, though I have frequently encountered it, often put forward with passion, seems to me very weak. To say of someone that his life would be better if he were not disabled is not the same as to say that it would be better if he did not exist. But, on the whole, there was little of this in the findings of the survey. It has been a useful and enlightening exercise.

Mary Warnock is a moral philosopher and life peer

Antidepressants do work – but children need someone to talk to

Nearly a decade ago I found myself perched on the edge of a hard chair in a dark doctor’s office. I was 13 and struggling a lot with self harm, body image, and the simple task of keeping myself alive. Shuffling my feet and wondering how I ended up here, I remember not fully understanding what was happening when I was handed a little green prescription for Fluoxetine – an antidepressant drug often better known as Prozac.

Back then, my frame of reference for mental illness was pretty minimal. All I knew was that I felt numb and I wanted everyone to leave me alone. The thought of something being able to help felt so far away it was almost laughable. Antidepressants had never crossed my mind. Everything I knew about them was framed around the words of American emo bands or soap operas. As the doctor handed me the prescription, I remember it was talked about as the most natural thing in the world. “We’ll give you a course of pills and go from there.” What? Go where? Am I really hopeless enough that only drugs can fix this?

In 2008, I was just one of 40 million people worldwide taking a green-and-yellow pill each day. I was sceptical. How could anything make me feel better? But, 10 years down the line, I still pick up my prescription every month and cannot imagine my life without Prozac.

Last month, I read about how a major study had confirmed that antidepressants do work. The headlines – “The drugs do work” and so on – suggested that we were right all along to medicate depression as soon as it presents itself.

This message should be welcomed and will hopefully battle the stigma surrounding antidepressants. But, for children in particular, there is more to it. In June last year, it was reported that almost 65,000 young people in England, including children as young as six, were taking antidepressants . Guidelines from the National Institute for Health and Care Excellence (NICE) state that they should only be given to teenagers and children with moderate or severe depression, when psychotherapy has failed. It also states that medication should always be taken in concert with other support, such as talking therapies.

Here is where my concern lies. When I was handed my first prescription, I was told that was the starting point, and that I could not possibly start any therapy without the medication. Before then, I had not seen a fully trained psychotherapist – nor did I even have a full diagnosis from the specialist team sitting in front of me. While I cannot predict how things would be if they had been handled differently – by offering children medication, before giving them the chance to talk to someone, we are telling them we would rather write them a prescription than listen to what they have to say. In moments of intense pain and suffering, children are often left not understanding what is happening to them and, instead of offering them a caring hand to hold, we are giving them a medicinal cold shoulder.

Yes, the pills do work. I’m not afraid to say that they have changed my life, and I honestly believe that without them, things would be very different for me now. But there are a whole host of other things being used to tackle depression that cannot be ignored. The entirety of my teenage years were defined by talking therapies, medication, hospital appointments and care plans. It was never the case that I was going to take the magic pills and things would get better for me, and to suggest that the drugs were responsible for saving my life would be to dismiss a lot of hard work by a lot of wonderful people. Countless therapy sessions and a close, trusting relationship with a dedicated nurse helped me get to the bottom of my illnesses and understand how to manage them. My family rallied around and learnt everything they could to be supportive and understanding. This came along with hospital care and, above all, my own hard work to get through it. Medication is an excellent tool for treating depression – but it is just that – a tool in part of a much more complex selection of resources.

I have sympathy with a system which is struggling among government cuts and lack of strategy, and can understand that sometimes offering medication is the first thing we can do in a child and adolescent mental health service with a wait of up to 18 months for initial support. As a society, we need to work harder to support – not just a quick-fix pill.

I am grateful for the support and love I received to get me to where I am today, and medication has been a valuable part of that. But I wonder, if people had not been so quick to prescribe the pills, perhaps I would be able to imagine my life without them today.

Antidepressants do work – but children need someone to talk to

Nearly a decade ago I found myself perched on the edge of a hard chair in a dark doctor’s office. I was 13 and struggling a lot with self harm, body image, and the simple task of keeping myself alive. Shuffling my feet and wondering how I ended up here, I remember not fully understanding what was happening when I was handed a little green prescription for Fluoxetine – an antidepressant drug often better known as Prozac.

Back then, my frame of reference for mental illness was pretty minimal. All I knew was that I felt numb and I wanted everyone to leave me alone. The thought of something being able to help felt so far away it was almost laughable. Antidepressants had never crossed my mind. Everything I knew about them was framed around the words of American emo bands or soap operas. As the doctor handed me the prescription, I remember it was talked about as the most natural thing in the world. “We’ll give you a course of pills and go from there.” What? Go where? Am I really hopeless enough that only drugs can fix this?

In 2008, I was just one of 40 million people worldwide taking a green-and-yellow pill each day. I was sceptical. How could anything make me feel better? But, 10 years down the line, I still pick up my prescription every month and cannot imagine my life without Prozac.

Last month, I read about how a major study had confirmed that antidepressants do work. The headlines – “The drugs do work” and so on – suggested that we were right all along to medicate depression as soon as it presents itself.

This message should be welcomed and will hopefully battle the stigma surrounding antidepressants. But, for children in particular, there is more to it. In June last year, it was reported that almost 65,000 young people in England, including children as young as six, were taking antidepressants . Guidelines from the National Institute for Health and Care Excellence (NICE) state that they should only be given to teenagers and children with moderate or severe depression, when psychotherapy has failed. It also states that medication should always be taken in concert with other support, such as talking therapies.

Here is where my concern lies. When I was handed my first prescription, I was told that was the starting point, and that I could not possibly start any therapy without the medication. Before then, I had not seen a fully trained psychotherapist – nor did I even have a full diagnosis from the specialist team sitting in front of me. While I cannot predict how things would be if they had been handled differently – by offering children medication, before giving them the chance to talk to someone, we are telling them we would rather write them a prescription than listen to what they have to say. In moments of intense pain and suffering, children are often left not understanding what is happening to them and, instead of offering them a caring hand to hold, we are giving them a medicinal cold shoulder.

Yes, the pills do work. I’m not afraid to say that they have changed my life, and I honestly believe that without them, things would be very different for me now. But there are a whole host of other things being used to tackle depression that cannot be ignored. The entirety of my teenage years were defined by talking therapies, medication, hospital appointments and care plans. It was never the case that I was going to take the magic pills and things would get better for me, and to suggest that the drugs were responsible for saving my life would be to dismiss a lot of hard work by a lot of wonderful people. Countless therapy sessions and a close, trusting relationship with a dedicated nurse helped me get to the bottom of my illnesses and understand how to manage them. My family rallied around and learnt everything they could to be supportive and understanding. This came along with hospital care and, above all, my own hard work to get through it. Medication is an excellent tool for treating depression – but it is just that – a tool in part of a much more complex selection of resources.

I have sympathy with a system which is struggling among government cuts and lack of strategy, and can understand that sometimes offering medication is the first thing we can do in a child and adolescent mental health service with a wait of up to 18 months for initial support. As a society, we need to work harder to support – not just a quick-fix pill.

I am grateful for the support and love I received to get me to where I am today, and medication has been a valuable part of that. But I wonder, if people had not been so quick to prescribe the pills, perhaps I would be able to imagine my life without them today.

Antidepressants do work – but children need someone to talk to

Nearly a decade ago I found myself perched on the edge of a hard chair in a dark doctor’s office. I was 13 and struggling a lot with self harm, body image, and the simple task of keeping myself alive. Shuffling my feet and wondering how I ended up here, I remember not fully understanding what was happening when I was handed a little green prescription for Fluoxetine – an antidepressant drug often better known as Prozac.

Back then, my frame of reference for mental illness was pretty minimal. All I knew was that I felt numb and I wanted everyone to leave me alone. The thought of something being able to help felt so far away it was almost laughable. Antidepressants had never crossed my mind. Everything I knew about them was framed around the words of American emo bands or soap operas. As the doctor handed me the prescription, I remember it was talked about as the most natural thing in the world. “We’ll give you a course of pills and go from there.” What? Go where? Am I really hopeless enough that only drugs can fix this?

In 2008, I was just one of 40 million people worldwide taking a green-and-yellow pill each day. I was sceptical. How could anything make me feel better? But, 10 years down the line, I still pick up my prescription every month and cannot imagine my life without Prozac.

Last month, I read about how a major study had confirmed that antidepressants do work. The headlines – “The drugs do work” and so on – suggested that we were right all along to medicate depression as soon as it presents itself.

This message should be welcomed and will hopefully battle the stigma surrounding antidepressants. But, for children in particular, there is more to it. In June last year, it was reported that almost 65,000 young people in England, including children as young as six, were taking antidepressants . Guidelines from the National Institute for Health and Care Excellence (NICE) state that they should only be given to teenagers and children with moderate or severe depression, when psychotherapy has failed. It also states that medication should always be taken in concert with other support, such as talking therapies.

Here is where my concern lies. When I was handed my first prescription, I was told that was the starting point, and that I could not possibly start any therapy without the medication. Before then, I had not seen a fully trained psychotherapist – nor did I even have a full diagnosis from the specialist team sitting in front of me. While I cannot predict how things would be if they had been handled differently – by offering children medication, before giving them the chance to talk to someone, we are telling them we would rather write them a prescription than listen to what they have to say. In moments of intense pain and suffering, children are often left not understanding what is happening to them and, instead of offering them a caring hand to hold, we are giving them a medicinal cold shoulder.

Yes, the pills do work. I’m not afraid to say that they have changed my life, and I honestly believe that without them, things would be very different for me now. But there are a whole host of other things being used to tackle depression that cannot be ignored. The entirety of my teenage years were defined by talking therapies, medication, hospital appointments and care plans. It was never the case that I was going to take the magic pills and things would get better for me, and to suggest that the drugs were responsible for saving my life would be to dismiss a lot of hard work by a lot of wonderful people. Countless therapy sessions and a close, trusting relationship with a dedicated nurse helped me get to the bottom of my illnesses and understand how to manage them. My family rallied around and learnt everything they could to be supportive and understanding. This came along with hospital care and, above all, my own hard work to get through it. Medication is an excellent tool for treating depression – but it is just that – a tool in part of a much more complex selection of resources.

I have sympathy with a system which is struggling among government cuts and lack of strategy, and can understand that sometimes offering medication is the first thing we can do in a child and adolescent mental health service with a wait of up to 18 months for initial support. As a society, we need to work harder to support – not just a quick-fix pill.

I am grateful for the support and love I received to get me to where I am today, and medication has been a valuable part of that. But I wonder, if people had not been so quick to prescribe the pills, perhaps I would be able to imagine my life without them today.

Antidepressants do work – but children need someone to talk to

Nearly a decade ago I found myself perched on the edge of a hard chair in a dark doctor’s office. I was 13 and struggling a lot with self harm, body image, and the simple task of keeping myself alive. Shuffling my feet and wondering how I ended up here, I remember not fully understanding what was happening when I was handed a little green prescription for Fluoxetine – an antidepressant drug often better known as Prozac.

Back then, my frame of reference for mental illness was pretty minimal. All I knew was that I felt numb and I wanted everyone to leave me alone. The thought of something being able to help felt so far away it was almost laughable. Antidepressants had never crossed my mind. Everything I knew about them was framed around the words of American emo bands or soap operas. As the doctor handed me the prescription, I remember it was talked about as the most natural thing in the world. “We’ll give you a course of pills and go from there.” What? Go where? Am I really hopeless enough that only drugs can fix this?

In 2008, I was just one of 40 million people worldwide taking a green-and-yellow pill each day. I was sceptical. How could anything make me feel better? But, 10 years down the line, I still pick up my prescription every month and cannot imagine my life without Prozac.

Last month, I read about how a major study had confirmed that antidepressants do work. The headlines – “The drugs do work” and so on – suggested that we were right all along to medicate depression as soon as it presents itself.

This message should be welcomed and will hopefully battle the stigma surrounding antidepressants. But, for children in particular, there is more to it. In June last year, it was reported that almost 65,000 young people in England, including children as young as six, were taking antidepressants . Guidelines from the National Institute for Health and Care Excellence (NICE) state that they should only be given to teenagers and children with moderate or severe depression, when psychotherapy has failed. It also states that medication should always be taken in concert with other support, such as talking therapies.

Here is where my concern lies. When I was handed my first prescription, I was told that was the starting point, and that I could not possibly start any therapy without the medication. Before then, I had not seen a fully trained psychotherapist – nor did I even have a full diagnosis from the specialist team sitting in front of me. While I cannot predict how things would be if they had been handled differently – by offering children medication, before giving them the chance to talk to someone, we are telling them we would rather write them a prescription than listen to what they have to say. In moments of intense pain and suffering, children are often left not understanding what is happening to them and, instead of offering them a caring hand to hold, we are giving them a medicinal cold shoulder.

Yes, the pills do work. I’m not afraid to say that they have changed my life, and I honestly believe that without them, things would be very different for me now. But there are a whole host of other things being used to tackle depression that cannot be ignored. The entirety of my teenage years were defined by talking therapies, medication, hospital appointments and care plans. It was never the case that I was going to take the magic pills and things would get better for me, and to suggest that the drugs were responsible for saving my life would be to dismiss a lot of hard work by a lot of wonderful people. Countless therapy sessions and a close, trusting relationship with a dedicated nurse helped me get to the bottom of my illnesses and understand how to manage them. My family rallied around and learnt everything they could to be supportive and understanding. This came along with hospital care and, above all, my own hard work to get through it. Medication is an excellent tool for treating depression – but it is just that – a tool in part of a much more complex selection of resources.

I have sympathy with a system which is struggling among government cuts and lack of strategy, and can understand that sometimes offering medication is the first thing we can do in a child and adolescent mental health service with a wait of up to 18 months for initial support. As a society, we need to work harder to support – not just a quick-fix pill.

I am grateful for the support and love I received to get me to where I am today, and medication has been a valuable part of that. But I wonder, if people had not been so quick to prescribe the pills, perhaps I would be able to imagine my life without them today.