Ray asked:

> A number of recently published papers suggest that treating the
> "asymptomatic" child is unethical, but first we must define the term
> 'asymptomatic'. Does this purely mean "without pain" or does it also mean
> "without the signs of pain-free developing deformity". For example, would
> you say that a child with a developing exostosis over the 1st
> metatarso-cuneiform is symptomatic or asymtomatic?

Dorland's medical dictionary defines a symptom as "any subjective evidence
of disease or of a patient's condition, ie: such evidence as perceived by
the patient" (my emphasis).  Interestingly, an "objective symptom" is
defined as "one that is evident to the observer".

So there's the choice - a patient-oriented definition or good old fashioned
medical paternalism.  For what its worth, I prefer the former, as the
latter lends itself to "disease mongering" whenever there's unscrupulous
practitioners, trusting patients and dollars involved.  I'm sure that my
irises have a few blemishes, my liver hasn't been cleansed lately and my C2
is probably subluxed, but I'm doing fine, really...

Regards,

Hylton

Hylton B. Menz
B Pod (Hons)
Associate Lecturer
Division of Podiatry
University of Western Sydney - Macarthur
PO Box 555 Campbelltown
NSW 2560 AUSTRALIA

ph: (+61) 2 4620 3759, fax: (+61) 2 4620 3792
work e-mail: [log in to unmask] (only checked on Mondays)
home e-mail: [log in to unmask]
UWS Podiatry web page:
http://fohweb.macarthur.uws.edu.au/podiatry/welcome.htm
Staff member page: http://fohweb.macarthur.uws.edu.au/podiatry/hylton.htm

PhD student
Falls & Balance Research Group
Prince of Wales Medical Research Institute
High St, Randwick
NSW 2031 AUSTRALIA
Prince of Wales homepage: http://www.powmri.unsw.edu.au



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