Roundabout
Which-Doctors
By KATHARINE WHITEHORN
'Whiclirs great, strength has always been, not °nIY that it doei objective justice to its subject, but that justice is seen to be done. It sets outs before you the reasons for its conclusions as well as the conclusions themselves: the tests, the re- sults, the limitations of the knowledge, the extent to which one product varies from another, as well as the mere fact that it varies: su, that it is P9ssible to go through the tests and to decide, for some particular purpose, on a product quite different from the Best Buy. It never says, 'The experts say that this should withstand three-ton Pressure in normal conditions'; it says, 'We loPPed it a hundred times and it didn't break.' b is a distinction which is more important than' one realises, since plenty of other institu- ti011s claim expertise and objectivity. It is not C11°Ogh for Which?'s readers to believe that the conclusions are sensibly arrived at they need to be able to demonstrate this to unbelievers, especially the ones who operate simply from a 'arge, generalised and largely justifiable distrust °f 'they,' This is Which?'s protection and its strength. but in one respect the shining armour is slipping. When CA refers to anything touching on medi- *tat matters, they are becoming all too apt to use vaguer terms and to rely on unseen and un- sPecified medical advisers in a way in which they rely on no other experts. There were some signs °f this even as long ago as January, 1960, when 'n their report on sun lamps they said : 'There i s no medical evidence that a sun lamp will ti any more than give you a tan, and a feeling "..t warmth and well-being'--in spit: of the fact at certain doctors undoubtedly have prescribed sunray treatments. _ Zut the most worrying example is the ex- a_ 'nation of Remedies tot Colds in the latest Zulaber. Which? have conducted no tests of their e,1111 they have referred to the researches of the common Cold Research Unit at Salisbury; their conclusions consist of the various pills, unguents, sprays and what-nots listed under categories thus: 'Antiseptic Gargles: No evidence that this does prevent colds'; or 'Inhalants and Inhalers: 'Will give relief from congestion symptoms' (1 like 'congestion' in this context: suggests the germs elbowing each other about in a smoke- laden night-club, which is exactly what it feels like). There is no reference to actual tests; the final facts alone are presented, and even they come in disquietingly vague form. 'There is no evidence, acceptable to doctors specialising in the subject, that you can prevent the cold viruses from infecting you by using antiseptic gargles.' What evidence is acceptable to doctors specialis- ing in the subject? What evidence was offered that they rejected? We are not told.
`There is no evidence that quinine is effective against colds.' Many of us would say there was; we are prepared to be proved wrong, but we are only being told we are wrong—a very different thing. Again, `no one should go into the cold for half an hour after using the in- halant.' Why not? Earlier on, we are told (to, I imagine, the surprise of many) that the Common Cold people found no evidence to connect catch- ing a cold with being cold; so one might suppose that the shiver that might follow going out after inhaling would be harmless.
The great strength of the classic Which? re- ports on baldness, and on hormone creams was. that, while providing a background of approved medical fact to help the reader Understand what was being discussed, 'they simply went out and tried these various things. Readers did not have to say, 'Which? said the doctors didn't believe it'; they could say, 'Which? tried it out on a number of people and it didn't work.' And they presented the results straight, including the various 'psychological factors' that destroyed the neatness of the experiment as a yes-or-no mechanism. Nobody is suggesting that CA has to conduct all its tests itself: without the in- tegrity of certain independent laboratories CA could hardly exist, and even tempting things like the strength of beer are hardly tested in 'the office alone. But if they use someone else's tests, it is up to them to establish not only the integrity of the testing body, but the sense and frame- work of the testing that went on.
It isn't that the medical evidence cannot be taken on trust--but that it ought not to be. For two reasons. The main one is the fallibility--or perhaps I should say variability—of medical evi- dence generally. You only need to look at the report of a trial in which both sides produced medical witnesses; or the history of any medical discovery—invariably opposed furiously for as long as possible by the mass of the medical pro- fession—to realise that the image of a united and infallible body of medical opinion is one that the public has largely created for its own comfort. And a good deal of medical opinion tends towards disregarding those physical effects that have no obvious physical causes—the fashionable way of doing this now being to put all unhelpful variables down to psychological in- fluences. Medical evidence, like any other that proceeds from obscure sources and changes every few years, should be taken with a pinch of salt; and in all other fields Which? is the pinch of salt. But if the salt shall lose its savour . . .
Which? should not be persuading intelligent people to take more on trust in any field. But its good name is at stake as well—and Which? knows the value of a good name alp right (that is why they refuse to allow products they have praised to use their name, lest anyone should think they were paid for the praise). It must not get itself confused, as its circulation extends to less and less penetrating people on the fringes of consumer interest, with all the other 'tests show' and 'doctors say' sources of pseudo-infor- mation with which the ear politic is so constantly larded. If medical matters arc so far out of its sphere that it cannot attempt its own indepen- dent assessment of them, then it should stay clear of medical subjects. It must provide a second opinion or stay out of the consulting- room altogether.
Correspondence column: it wasn't Cardinal Richelieu who invented mayonnaise, apparently, but the Marshal Duke of Richelieu's chef during the 'siege of Mahon. Another correspondent, however, gladdened my heart by pointing out• that the machine in the Best of Britain display on which the Scottish tweed was being made was of Swiss manufacture. Hal
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