Shekaru hudu da suka gabata na martanin Covid, ta kowane ma'auni, ya kasance babban bala'i, amma ya dace da abin da na yi imani shine ƙarshen wasan mutanen da suka aikata wannan ta'asa. Burina shi ne in fita daga tsarin da ake amfani da shi don sakin rigakafin Covid mRNA; ga cikakkun bayanai na doka da na gwamnati da ke kewaye da wannan sakin, da ƙoƙarin daidaita waɗannan dabarun; zuwa ga tarihin tarihi wanda duk wannan ya faru a cikinsa, wanda martanin Covid ya kasance muhimmin sashi; zuwa ga ma’auni na ilimi da falsafa da suka kawo mu halin da ake ciki; jagora, a ƙarshe, zuwa ga ɗaukar nawa akan wasan ƙarshe na ƙarshe. Zan kusanci wannan daga hangen nesa mai inganci (QI).
Wani muhimmin sashi na horo na kiwon lafiya, ilimi, da gogewa a cikin shekaru 50 da suka gabata ya ƙunshi QI. Ya kasance wani muhimmin ɓangare na aikina na ƙwararru, gami da dogon lokaci a matsayin Shugaban Kwamitin QI a ƙaramin asibitin karkara, da Manajan QI a wata hukumar kula da lafiya ta al'umma mai zaman kanta mai zaman kanta wacce kuma ta tsunduma cikin bincike. Tare da gargadin cewa da yawa daga cikin wadanda ake kira "masana" ba su wanke kansu da bambanci ba a cikin shekaru hudu da suka gabata, zan yi noma a gaba.
Uwargidan ayyukan QI na zamani waɗanda aka karɓa a duk masana'antu a duniya shine W. Edwards Deming (1900-1993). Ya sami BA a injiniyan lantarki, da MS da PhD a fannin lissafi da kimiyyar lissafi, na karshen daga Yale a 1928, tun kafin wannan cibiyar ta tashi 'farke.' Aikin Dr. Deming ya ta'allaka ne akan wani abu mai sauki: Babu mugayen ma'aikata; akwai kawai munanan tsarin. Ya fara ɗaukar wannan fage ga masu kera motoci na Detroit a ƙarshen 1940s don nuna musu yadda za su inganta hanyoyin kera motocin su.
A lokacin, tare da Turai da Japan a cikin tatters, Detroit ya mallaki kashi 98% na duk kasuwannin motoci na duniya, don haka sun yarda da shawarwarin Dr. Deming. Daga nan ya tafi Japan, kuma sun amince da ƙa'idodinsa gaba ɗaya. Ya ɗauki fiye da shekaru 20, amma lokacin da girgizar mai ta farko ta faru a cikin 1974, Japan ta shirya da ƙananan motoci masu inganci, masu inganci. Ita kuwa Detroit tana da motoci irin su Ford Pinto, wanda saboda sanya tankin mai, yana da halin fashe idan aka tashi a baya, sai kuma Chevy Vega, wanda wata mujalla ta mota ta bayyana a matsayin tsatsa da aka sassaka! Rabon Japan na kasuwar motocin Amurka nan da nan ya tashi daga kusan kashi 8% zuwa kusan 33%, kuma ba su taɓa waiwaya ba.
Waɗancan abubuwan sun haifar da ɗimbin ƙoƙarin QI a kusan kowace masana'antu. Ya shigo cikin masana'antar kiwon lafiya a tsakiyar 1980s a matsayin maye gurbin shirye-shiryen tabbatar da inganci (QA) waɗanda aka yi aƙalla shekaru goma. Babban abubuwan da ke cikin shirye-shiryen QA shi ne cewa sun fuskanci matsaloli tare da ƙarin sababbin dokoki har zuwa lokacin da tsarin ya cika tare da matakan tsare-tsare da hanyoyin da suka saba wa juna waɗanda ba su yi wani abu ba don inganta kulawar marasa lafiya. QI, a gefe guda, ya kalli tsarin bayar da kulawa don inganta su.
Wannan ya yi tasiri mai kyau a kan kulawar haƙuri, kodayake ba kusan da ƙarfi kamar yadda aka gani a wasu masana'antu. A ganina, wannan shi ne saboda munanan ma'aikata a cikin kiwon lafiya, ko saboda rashin iyawa, rashin da'a / rashin fasaha, da / ko cin hanci da rashawa, har yanzu na iya yin mummunar lalacewa, ko da yaya tsarin tsarin da suke aiki ya tsara.
Yin amfani da abin da ya gabata azaman tsalle-tsalle, yanzu zan nuna hanyoyin da aka juyar da ƙa'idodin QI da matakai a cikin kiwon lafiya don tura ƙayyadaddun ajanda. An fitar da maganin rigakafin Covid mRNA, wani magani na bincike na Mataki na 3, ƙarƙashin Izinin Amfani da Gaggawa (EUA). Ta yin haka, Hukumar Binciken Cibiyoyi (IRBs) musamman da aka dora wa alhakin yin bita, amincewa, da kuma sa ido kan duk wani bincike kan batutuwan dan Adam, an keta su.
Sakamakon haka, Code ɗin Nuremberg, wanda ke ɗauke da sanarwar izini, Rahoton Belmont, rufewa a tsakanin sauran abubuwa, yancin kai na jiki, da buƙatun tsarin bayanai da tsarin sa ido na tsaro don tuta matsalolin da wuri-wuri an yi watsi da su gaba ɗaya. Waɗannan abubuwan sa ido, a zahiri, ƙoƙarin QI ne ko da ba a yi amfani da wannan kalmar ba a lokacin da aka haɓaka da aiwatar da su.
Na bayyana a wani wuri cewa da an kiyaye tsari na yau da kullun, da an ba da izini da ya dace, kuma miliyoyin mutanen da suka sha maganin a lokacin da aka fara samu sun ƙi. Bugu da ari, idan an yi bayanan da suka dace da kuma sa ido kan tsaro, da alama an cire maganin daga kasuwa a ƙarshen bazara na 2021, kafin ma a yi la'akari da shi ga yara a ƙarƙashin shekarun 18. Ganin cewa an sanya waɗannan kariyar a wuri don mayar da martani ga kisan-kiyashi na likita (Holocaust da gwajin Tuskegee), za ku yi tunanin cewa za su zama sacrosanct.
Bugu da kari, halaccin amfani da EUA a cikin farar hula yana da matukar wahala, a mafi kyawu. Kwanan nan, muna da sabbin ka'idoji daga FDA waɗanda ke ba da damar IRBs su amince da bincike a wasu lokuta ba tare da buƙatun izini na sanarwa ba. Za mu iya tunanin samun yanayin da za a sanar da annoba ta gaba a cikin wata unguwa kusa da ku, kuma za a ba da shawarar jab "lafiya da tasiri" (ko wajabta) wanda zai sami hatimin IRB na amincewa, amma ba tare da sanarwa ba! Idan aka yi la’akari da abin da muka gani a cikin shekaru hudu da suka gabata, wannan ba abin farin ciki ba ne.
A farkon watan Janairu, rubutuna na Brownstone, Wariyar launin fata, Anti-Semitism, kisan kare dangi, da Eugenics a cikin Zamanin Covid ya ba da mahallin tarihi don amsawar Covid. Na nemi in nuna alaƙa tsakanin ƙungiyoyin ci gaba a Amurka da Jam'iyyar Nazi ta Hitler, da kuma yadda dabarun da aka yi amfani da su a wancan lokacin (tsoro, rarrabuwa, yaudara, tilastawa, tsoratarwa, ba da labari) suna da rai kuma cikin koshin lafiya, kuma an yi amfani da su zuwa mummunan tasiri a cikin shekaru huɗu da suka gabata a matsayin ginshiƙan ginshiƙan martanin Covid. Waɗannan dabarun suna adawa da ƙa'idodin QI na kiwon lafiya da aka sani.
Rashin halayen halayen da kurakuran akida waɗanda suka ba da gudummawa ga yanayin halin yanzu an bayyana su sosai a cikin gidan Rob Jenkins, Rushewar Ƙwararru, kuma a cikin sakon Bert Olivier, Kan Wokism da Gidajen Karya. A gare ni, mahimmin batu shine an sami cikakkiyar hutu daga QI ta ƙungiyar da Olivier ke magana a matsayin masu ci gaba na 'farke'. A yawancin lokuta, sun maye gurbin bambance-bambance, daidaito, da haɗawa don QI. Abin takaici, wannan siffa ce da ta faru a kusan kowace masana'antu, gami da kiwon lafiya. Duk da yake akwai ragowar ƙwararrun ƙwararrun kiwon lafiya waɗanda suka gani ta hanyar yaudara, kuma suka yi ƙoƙarin bin ƙa'idodin QI, yawancinsu an yi barazanar rasa aikin yi ko lasisi, shiru, tsinewa, da/ko sokewa.
Bari yanzu mu ɗauki ƙa'idodin QI, mu ga yadda suke aiki ga mulkin ƙasa. Bisa ga sakamako mai ma'ana (matsayin tattalin arziki, 'yancin motsi, da ikon yin zabi na rayuwa), zan nuna cewa sanarwar 'yancin kai, Tsarin Mulki, da Dokar 'Yanci (tushen Jamhuriyyar Tsarin Mulkinmu), da tsarin shari'a da tattalin arziki da ke fitowa daga waɗannan takardun suna wakiltar mafi girman tsarin mulkin da bil'adama ya ci gaba. Ko...idan kai dan iska ne, tsarin Amurka shine tsari na biyu mafi muni da aka taba kullawa… tare da kowane tsarin mulki da aka daura a farko! Don haka, duk wani ƙoƙari na QI a fagen mulkin ƙasa dole ne ya nuna fifiko akan ingantaccen sakamako da ake gani a ƙarƙashin tsarin yanzu.
Masu ci gaba sun yi imanin cewa suna da hanya mafi kyau, amma bari mu dubi ƙarƙashin murfin. Ɗaya daga cikin tushen tushen ci gaba tun daga farkonsa shi ne cewa ɗan adam ya sami ci gaba mai kyau tun lokacin da aka sanya takaddun kafa da aka ambata a baya, ta yadda waɗannan takardun kafa sun tsufa kuma ba a taɓa su ba.
Wannan jigo yana nan da rai kuma a yau, kamar yadda ayyukan masu ci gaba na 'farke' suka nuna; ƙungiyar da ke kula da ilimi, tsarin gudanarwa, kafofin watsa labarai na yau da kullun, kuma a halin yanzu, Fadar White House. Waɗannan ayyukan sun haɗa da sake rubuta tarihin kafuwar mu (watau Aikin 1619); lalata tsarin al'adu da shari'a (ta hanyar buɗe kan iyakoki, gwagwarmayar shari'a, da ra'ayi mara kyau na adalci na zamantakewa wanda aka tsara don haifar da jin dadi); lalata tattalin arziƙin (sake ta hanyar buɗe kan iyakoki waɗanda ke mamaye ababen more rayuwa na zamantakewar jama'a, da ɓarnatar da kashe kuɗi akan sabuwar “barazanar da ke akwai”); zuwa ga cikar burin ruguza takardun kafa mu, sannan a ce sun gaza.
A hakikanin gaskiya, ba komai ba ne face annabci mai cika kai, amma idan kun mallaki tsarin ilimi, za ku iya tsara abubuwa yadda kuke so, kuma ba wanda zai zama mafi hikima. A zahiri, tunanin sihiri a cikin hidimar akida ya share ƙa'idodin QI a gefe.
A matsayina na wanda ke bibiyar waɗannan ci gaban kusan shekaru 30, na lura da sauyi a dabarun kai hari kan takardun kafa mu. Tsawon shekaru, malaman Tsarin Mulki masu ci gaba za su nemo hanyoyin da za su kawo karshen tafiyar da Kundin Tsarin Mulki. Ba kuma!
A yau, suna yunƙurin yin yunƙurin yi wa Kundin Tsarin Mulki zagon ƙasa, suna ganin sun sami gagarumin tallafi don aiwatar da wannan cikin nasara. Wataƙila suna da gaskiya. Duk da haka, idan sun ci nasara, wawaye masu amfani waɗanda suka haifar da taro mai mahimmanci ba za su zama kome ba sai masu cin abinci marasa amfani, da zarar an cimma manufofin ci gaba, kuma tsarin mulkin kama-karya ya tabbata. Da fatan waɗannan mutane za su gane kafin lokaci ya kure cewa wannan ba zai inganta rayuwar su ba (QI), don haka, ba kyawawan halaye na ƙasa ko ɗaiɗaikun mutane ba ne.
-
Steven Kritz, MD likita ne mai ritaya, wanda ya kasance a fagen kiwon lafiya tsawon shekaru 50. Ya sauke karatu daga SUNY Downstate Medical School kuma ya kammala zama na IM a Asibitin Kings County. Wannan ya biyo bayan kusan shekaru 40 na ƙwarewar kiwon lafiya, ciki har da shekaru 19 na kulawa da haƙuri kai tsaye a cikin ƙauyen ƙauye a matsayin Kwamitin Certified Internist; Shekaru 17 na bincike na asibiti a wata hukumar kiwon lafiya mai zaman kanta-ba don riba ba; kuma sama da shekaru 35 na shiga cikin lafiyar jama'a, da tsarin kiwon lafiya da ayyukan gudanarwa. Ya yi ritaya shekaru 5 da suka gabata, kuma ya zama memba a Hukumar Binciken Institutional Review (IRB) a hukumar da ya yi bincike a asibiti, inda ya kasance shugaban IRB tsawon shekaru 3 da suka gabata.
Duba dukkan posts
