Although I’ve heard of NICE somewhat disingenuously described as representing ‘Nazis Independent of Clinical Experience’, rx the acronym stands for the National Institute for Care and Health, story an organization within the Department of Health which provides national guidance and advice to improve health and social care in the UK.
Inevitably there are doctors who feel that NICE guidelines are far too condition-related or focused on treating specific diseases rather than recognising that illnesses manifest in and affect people very differently. Believing that people usually need treatment plans tailored to their body/mind/spirit make-up is the essence of the Whole Person Medicine approach. However on this occasion I come not to bury NICE but to praise her.
This week’s New England Journal of Medicine (NEJM) the prestigious Boston-based medical journal, features an article called A NICE Delivery which compares the role of doctors in birth in the USA and UK in relation to an evidence-based review on the safety of home confinements by NICE.
The UK review concludes that ‘healthy women with straightforward pregnancies are safer giving birth at home or in a midwife-led unit than in a hospital under the supervision of an obstetrician.’ This triggered applause, thought, criticism and debate in the US (just read the comments section!) but in me it generated only nostalgia and joy. It was reading Frederick Leboyer’s poetic masterpiece, Birth Without Violence in 1978 that pushed me to see human beings primarily as subjects rather than objects (of science). I met this pioneer of natural childbirth in Paris 1n 1982 (and later another French pioneer of natural childbirth, Michel Odent in London) and obstetrics became the first area of medicine in which I saw how the generosity of spirit of Whole Person Medicine and the rigour of medical science can co-exist harmoniously.
NICE is better known for being evidence-based rather than ‘nice’, but on this occasion – for this doctor at least – it was both.