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How SHOULD We Discuss Quackery with Innocents and the Not-so-Innocent?

Recents posts by Drs. Albietz and Gorski have highlighted questions that are recurrent on SBM. We are convinced that medicine should be based on real knowledge, to the extent that it exists, and that physicians should be honest; these are matters of science and ethics. How do we reconcile that with heartfelt, if misguided beliefs of patients, their families, and others? When Dr. Albietz wrote that it might have been better for the chiropractor to visit in the same way that “priests, imams, prayer sessions, rabbis, etc visit children within the PICU,” it was reminiscent of Dr. Peter Moran’s hypothetical “witch doctor.” When he lamented academic medicine’s current dalliances with quackery, it brought to mind the NCCAM, David Katz, Andrew Weil, Bravewell , and their enablers.

Dr. Albietz argued that when talking to credulous patients or their families, taking a hard line against quackery is likely to be counter-productive. Most of us would agree with that. Dr. Gorski described a different scenario: after calling a quack “a quack” when talking to a friend of a friend who is a scientist, he concluded that he had been too “blunt.” Several commenters disagreed, but all would probably agree with Dr. Gorski that “you have to know when to pick one way over another; i.e., diplomacy over all out war or vice versa.”

Another Case of Foot-In-Mouth Disease

I recently had an experience strikingly similar to Dr. Gorski’s, during which I castigated myself for my rancor even as I was incapable of moderating it. Fellow blogger Dr. Val Jones was a witness!

A couple of weeks ago there was a meeting in Philadelphia of those involved with, or otherwise interested in the Health Care Renewal (HCR) blog and its related organization, the Foundation for Integrity and Responsibility in Medicine (FIRM). The blog had been started several years ago by Drs. Roy Poses of Brown, Wally Smith of Virginia Commonwealth University, and Russ Maulitz of Drexel. Those three docs lamented recent threats to the core values of medicine:

The Problem: Health care around the world is beset by

  • rising costs
  • declining access
  • stagnant quality
  • increasingly dissatisfied health care professionals.

Physicians fear their core values are threatened. These values include:

  • putting the interests of individual patients ahead of other concerns;
  • practicing with honesty and integrity;
  • keeping patients’ information confidential;
  • teaching the next generation of health professionals;
  • practicing medicine based on science and scientific principles.

Strong but generally unrecognized threats to these values arise from concentration and abuse of power in health care systems, because:

  • health care is increasingly dominated by large organizations;
  • these are often lead by the ill-informed, the self-interested, and even the corrupt.

Thus, the results are:

  • patients and physicians are caught in cross-fires between conflicting interests;
  • patients and physicians are subject to perverse incentives;
  • free speech and academic freedom are threatened;
  • pseudo-science and anti-science are gaining ground.

You can see, especially in the last bullet, why I was attracted to this group. After years of email discussions and blogging, the principals convened a one-day meeting to consider how the movement might grow. It attracted about 50 people from a variety of backgrounds: academic and practicing physicians, medical informatics experts, at least one medical student, the editor of the Annals of Internal Medicine, health policy researchers, a few reporters, my co-author and president of CIRCARE Liz Woeckner, Dr. Val (who had just finished sitting on a panel with Roy Poses at a different meeting), several lawyers (including frequent SBM commenter Marilyn Mann), and more.

There was a dinner at a local restaurant the night before the meeting. About 18 participants were there, spread among 3 tables. I sat between Dr. Val and a physician I’d not previously met, whom I shall call Dr. O. The ambient noise level was high, so most conversations involved only 2-3 people. I can’t remember how it started (did she ask me how I came to be involved with this group?), but at some point I heard myself explaining to Dr. O that I was skeptical of implausible medical claims. That soon led to my offering homeopathy as an example of a claim that doesn’t warrant the slightest credibility, and certainly doesn’t warrant clinical trials.

It might have been then that Dr. O said something like, “I’m a faculty member at the first science-based CAM program in the country.” The inherent contradiction aside, that was a show-stopper if there ever was one. It began to dawn on me that I knew who she was: a “CAM” researcher who has stuck to the relatively plausible end of the “CAM”-scale, namely botanicals, and who has published articles that seem reasonable—when viewed through the prior probability-impoverished lens of Evidence-Based Medicine—if banal. Dr. O has also written some more interesting and useful articles about how industry has influenced medical research and practice, including examples of ghostwriting of papers and effects on prescribing patterns. It is the latter activity that drew her to the HCR/FIRM group and vice-versa.

Dr. O continued by observing that the “homeopathy debate” is a vigorous one among her colleagues, with about equal numbers believing that homeopathy does or doesn’t work. She suggested, however, that all of them agree that it ought to be tested, and didn’t I as well? No, I didn’t; or, more precisely, there have already been billions and trillions of tests of homeopathy, in the form of purposeful or incidental tests of the 2nd law of thermodynamics, and no small, error-prone clinical trials could possibly overthrow those findings. I hoped to make a general point about prior probability that might get her to entertain a more scientific point of view; I wanted to summarize arguments made here and here in just a few sentences. Alas, ’twas not to be.

I’d barely taken my next breath when she said something like, “but how can you dismiss all of CAM research? There are some brilliant CAM researchers!” Yikes. I should know that feeling by now: she got my goat and I was about to say things that I might later regret:

“Who, for example?”

“So and So.”

“So and So? So and So is a fraud!”

“HOW can you say he’s a fraud? So and So is one of my dearest friends!”

“For one thing, his [degree] isn’t even real!”

“That’s not true! [His] medical school looked into that and found out that it was real!”

“Oh yeah? I’d love to see the evidence. I was one of the people who asked [his] medical school to look at the issue, and I doubt that they did it in a thorough way.”

“YOU DID THAT? Do you realize the hell that he went through because of that?”

It was loud in the restaurant, and I missed a lot of what she said next, but I’m pretty sure she called me “a miserable human being.” Shortly thereafter she got up and left, although dinner was barely half over. I’d made an attempt to salvage the conversation (“why don’t we talk about this some other time when we’re more calm and can hear each other better?”), but she was having none of it.

As soon as she left I turned to Dr. Val, who had gleaned but a small amount of what had just happened, and said something like “I can’t believe what an idiot I was. WHY did I have to say that?” Even though, like Dr. Gorski, I believed everything I’d said. The point is, “you have to know when to pick one way over another,” and sitting in a loud restaurant next to someone you’ve just met, who probably assumes that you share fundamental views about medicine, isn’t a time to pick “all out war.”

It’s funny: I got the feeling that Dr. O was more surprised by me than I was by her. I wondered why. Wasn’t she aware that two of the group’s perceived threats to medicine’s core values were “pseudo-science and anti-science”? Had she read a paper written by Roy Poses a few years ago, in which he elaborated on the bulleted points quoted above? In a section entitled “Attacks on the scientific basis of medicine,” Dr. Poses wrote:

Postmodernists argued that clinical trials became pre-eminent not because they are less susceptible to selection bias than are observational studies, but because they somehow gained more political support than did other methods, e.g., ‘in a self-authenticating manner, the double-blind RCT became the instrument to prove its own self-created value system’.’’

And:

Postmodern arguments also underlie some of the current enthusiasm for alternative medicine. For example, …the editors of a prominent published series on alternative medicine…asserted the ‘old cultural war of a dominant culture versus heretical rebellion in politics and religion as well as medicine has begun to transform into a recognition of postmodern multiple narratives’.”

If Dr. O had read that paper, she would have known that the quoted PoMo drivel had been written by none other than…So and So! Copies of the paper were handed out at the meeting; I wonder if she’s read it by now.

The Changing Etiquette of Criticism

The whole matter got me to thinking, for the umpteenth time, about how American society’s view of acceptable criticism seems to have changed in the recent past. Calling a thing by its name, even if unflattering, used to be honorable; now it’s considered shrill, or worse, mean. When Oliver Wendell Holmes, Sr., discussed the views of his contemporary, Samuel Hahnemann, he didn’t give what is now called a “balanced” presentation. Responding to Hahnemann’s claim in the Organon—”It was by these means” (i.e. Homeopathically) “that the Princess Eudosia with rose-water restored a person who had fainted!”—Holmes wondered:

Is it possible that a man who is guilty of such pedantic folly as this—a man who can see a confirmation of his doctrine in such a recovery as this—a recovery which is happening every day, from a breath of air, a drop or two of water, untying a bonnet-string, loosening a stay-lace, and which can hardly help happening, whatever is done—is it possible that a man, of whose pages, not here and there one, but hundreds upon hundreds are loaded with such trivialities, is the Newton, the Columbus, the Harvey of the nineteenth century!

Such stark criticism was still de rigueur only a few decades ago. At the HCR/FIRM meeting, Dr. Scot Silverstein told of his mentor, the cardiac surgeon Victor Satinsky, who had argued “that ‘use of public embarrassment’ was an effective tool in dealing with the corrupt.” It was during his Summer Science Training Program for gifted high school students, taught at the Hahnemann Hospital, of all places, that Satinsky had made that statement.

I realize that this lamentation—the degradation of good criticism in our time—does not apply to such scenarios as Dr. Gorski’s with his friend’s friend or mine with Dr. O. In my case, it was a matter of matching the presentation to the occasion, and I’m afraid I did not do that very well. Nevertheless, we must insist, in the relevant venues, on being honest and unyielding in our criticisms of quackery.

Near the end of the meeting day, I saw Dr. O again. She appeared to be in a conciliatory mood; she even asked me if I would be walking to the train with a few others, including her. I would not be, but I got the impression that there might have been just a scant possibility of communicating without rancor. Maybe not: the charge that I had made is a serious one. Perhaps one day I’ll write about it here, using real names.

The greater issue involving science, medicine, ethics, honesty, and language is even more serious. Dr. Albietz correctly worried that “the next generation of physicians, immersed in the mutually exclusive principles of CAM and EBM, will be poorly prepared to provide the best possible care to their patients.” If the “open forum” that follows the article linked from the first mention of Dr. Poses’ name above is any measure, “poorly prepared” is an understatement.

Posted in: Medical Academia, Medical Ethics, Science and Medicine

Leave a Comment (45) ↓

45 thoughts on “How SHOULD We Discuss Quackery with Innocents and the Not-so-Innocent?

  1. marilynmann says:

    Very interesting, and I know exactly who you are talking about.

  2. Michelle B says:

    Though it is lamentable that criticism in general means pussyfooting around the core issues involved so as not to trample upon the cherished, though totally wackaloon, beliefs of people, it is better to accept that reality and work within its limits–through time, learning from mistakes, skills can be honed such that you can use the acceptable social mores to your advantage and the end result still will be the desired dismantling of the nonsense.

    Calling a quack a quack to the face of someone who may know the quack in question, or at the very least who knows someone who knows the quack, etc., is not worth the risk of shutting down that person’s receptivity to your important points.

    Keeping such memories of your bluntness backfiring fresh, the sharp sense of how you blew it, is the only way to not do it again. So be thankful for such blunders as they provide the foundation that will enable you to hone your skills through structured learning.

    I recall two different ways of handling my ‘addiction’ to mega doses by two separate medical doctors a couple of decades ago when I embraced many aspects of the mega vitamin brigade.

    One, after prescribing an effective medication for my symptoms, phoned my CAM professional (Dr. Serafina Corsello to be precise whose medical license I believe is either in jeopardy or eventually rescinded) and told her on the phone while I was within hearing distance that she was wrong to have denied me proper treatment. He apologized after the call and said that he should not have done that bit in front of me, but his clarity, consistency, and determination influenced me to a large part to eventually and gradually let go my reliance on mega doses of vitamins.

    The second medical professional reviewed my supplemental intake, saw no danger, and gave me permission to continue taking them. His approach was the final nail in the mega-vitamin coffin for me–he no longer made the approach taboo and it became boring to me, since it was no longer a struggle to convince medical professionals that mega vitamin therapy was correct, I finally weaned myself off from it.

  3. nitpicking says:

    “YOU DID THAT? Do you realize the hell that he went through because of that?”

    Correct answer IMO: “No, he went through hell because he faked his degree. It makes no sense to blame ME for finding out about his fraud.”

  4. Val Jones says:

    I’d like to add my perspective as a witness to this interaction – because I must disagree with Kim’s assertion that he was insensitive or inappropriate in any way. I believe he did exactly the right thing, and I fully endorse his approach.

    First of all, Dr. O is an exceedingly prickly and hostile person. She made it her business throughout the FIRM meeting to set the agenda in as many conversations as possible. She even admitted as much in an opening conversation with Kim and me where she said, “Did you two see any clear agenda for the FIRM meeting? I think the handouts were unclear. Maybe we’ll have to take it over.”

    Now, if that opening remark doesn’t make Dr. O’s m.o. crystal clear – I don’t know what does. Soon thereafter I observed Dr. O as she systematically explored the allegiences and interests of the other members of the group, seeking support for her point of view.

    I watched in amusement as she attempted to befriend a neurologist, asking him to send her copies of the pharmaceutical brochures his practice receives, so that she could expose them to public ridicule. The neurologist responded that he was no longer in clinical practice and that he, in fact, had worked for over a decade as a clinical director for a major pharmaceutical company. I watched Dr. O’s smile fade as she searched the room for her next victim (I mean, “ally.”)

    Dr. O participated in my breakout session group at the FIRM meeting, interrupting the moderator and participants as they introduced themselves around a large table. In each case she asked a leading question, aimed at exposing potential bias or “hidden agendas” of the participants. During my introduction, for example, I mentioned that I blogged at Science Based Medicine. She interrupted me to ask if I was paid for my writing, to which I answered, “No, it’s purely voluntary” and she nodded and shrank down in her chair.

    Now, given this background and context – let’s reconsider Kim’s “foot in mouth” claim. Dr. O had no problem whatsoever making everyone uncomfortable with her leading questions and desire to “take over the meeting.” She felt justified in all that she did. Kim, on the other hand, merely told the truth about Dr. O’s friend (that he is a fraud) and was prepared to justify that assertion with compelling evidence. The fact that Dr. O decided to call Kim names (“a miserable person”) and leave the dinner mid-chew, suggests that she was only there to drive an agenda, not engage in rational discourse.

    When she left it felt as if a cloud had lifted, and I contemplated giving Kim a “high-five” at the table, but decided against it, settling for a deep sigh and a broad smile. “Kim is my hero!” I thought, as I reflected on my own personal approach to handling Dr. O (and her ilk): avoidance. Maybe I am the one who acted inappropriately? Perhaps excessive tolerance of misbehavior, domination of meetings, and bullying well-meaning session participants is the real problem here?

    I am grateful for Kim and his courage to stand for truth and integrity – and to face attacks against either head-on and with rational debate. If we had more people like Kim in medicine today, we’d have fewer Dr. O’s driving agendas.

  5. tarran says:

    There is a line between being a fraud and being misguided. The line is mens rea, ones knowledge of a matter.

    I know people who genuinely think homeopathy works and seem unable to grasp the arguments about dilution etc. Since they think it works, they recommend it to others. They aren’t frauds because they don’t know what they are saying is baloney.

    However, I am sure the guy who formulated the “drug” – er. incredibly convoluted process for generating distilled water – does, at some level, recognize that they are peddling baloney. You can see it in the furtive way they conduct business.

    There is nothing wrong in calling a fraud a fraud. In fact, there should be more of it. I mainly teach college freshmen, and I am often non-plussed by their inexperience with being challenged directly. I don’t aim to be a controversial teacher, and my subjects – algebra, calculus and physics – can all be taught in manner that avoids all controversy. Despite this, I often find myself confronted with students who crumple when calmly informed that they are weak in some area and need to do extra work (all of this said in private in a calm voice followed by a concrete set of recommendations as to how they can get back on track). An ever increasing proportion of the population seems to feel that they should never hear an unpleasant fact, ever! The disservice it does to people is that they are allowed to err for far longer and invest more of their time, energy and identity into those errors before they are brought up short.

    A year ago, I had the heartbraking case of a student who was failing algebra, badly. She could not even reduce a fraction. She was extremely angry with me since she told me she had been a straight A student in math all her life. Armed with this false belief, she had taken on huge student loans in what was doomed to be a futile effort to get a Doctorate of Pharmacology degree. Had a math teacher had the guts to tell her she was making mistakes in 7th grade, had they not coddled her and avoided hurting her feelings, the disaster could have been avoided, either by her learning how to do things right, or by deciding to seek a profession that did not require mathematical ability.

    I might not say “X is a fraud”. I might say that “X’s theories are all wrong”. But other than that, I don;t see anything that Dr Atwood should have done differently.

  6. Joe says:

    @Tarran,

    Dr. So-and-so was a fraud for misrepresenting his/her credentials.

    Kimball, that is a great story, and Val’s context makes it better. Thanks.

  7. DevoutCatalyst says:

    I’m a layperson/patient. If you’re not going to tell me Dr. X is a quack, who is?

    I got my first flu shot this year which was a remarkable event for me. The distrust towards SBM that CAM instills within the individual is insidious, and it may linger well after the person comes to their senses.

  8. Harriet Hall says:

    Frauds are people who deliberately deceive. A quack can be anyone who offers an ineffective treatment, whether or not he believes it works. It seems to be politically incorrect today to call someone a quack, but I’d vote for bringing the term back.

    Also, we can separate the individual from the sin: we can say we don’t doubt that he is sincere and well-meaning but he is promoting a quack treatment.

    In retrospect, Kim might have asked her what she would do if she thought he had falsely claimed a degree he didn’t have – wouldn’t she feel morally obliged to question it?

  9. MitoScientist says:

    I just want to say, that as a young medical student, its websites like this that will keep the next generation of physician’s heads out of the sand. As long as you folks keep up the excellent work, there will be young scientists and doctors who will be aware of the encroachment of CAM into science-based medicine, and be better prepared to push back against it. Love the article, and way to stand up to quackery Dr. Atwood!

  10. Karl Withakay says:

    Good point, tarran.

    It’s not rude to point out the Emperor is nude. You shouldn’t have to dance around the issue and question whether the state of the regent’s apparel is consistent with the norm of meeting the minimum standard of appropriate coverage. If the Emperor is offended by having his nudity pointed out, maybe he should put some clothes on or hang out in a nudist colony instead.

  11. hatch_xanadu says:

    So, so true about the changing etiquette of criticism. And it seems these days the folks who insist on *starting* such conversations in the first place are the very folks who come bearing an anecdote and are hell-bent on getting their feelings hurt.

  12. Karl Withakay says:

    (P.S. I know argument by analogy is weak, but sometimes it’s appropriate.)

  13. DevoutCatalyst says:

    One further item, CAM practitioners do not hesitate to call YOUR competence into question, behind your back, confidentially, to their patients. The medical profession is derided as clueless, excepting in the case of trauma, where the ER is generally acknowledged as effective.

  14. The anti-criticism culture is a big problem. It is part of the bigger politically-correct, PoMo, every-one’s a winner culture that has taken over recently.

    Cultural sensitivity is fine – but the problem is that it has crossed way over the line so that it is now considered impolite to defend a standard – any standard. Quality and excellence have been sacrificed at the altar of equality.

    In real life, not all ideas are equal. Some are dumb. Others are demonstrably false. While others are brilliant.

    In medicine the “everything is equal” approach is deadly.

    I think that part of our agenda should be to make honest criticism respectable again.

  15. Prometheus says:

    Bravo, Dr. Atwood! “Dr. O” sounds like one of those people who brighten a room by leaving it.

    I have spent most of my life (all my life since learning to speak) being chastised, reprimanded and excoriated for being “too blunt”, which I have “reframed” as “being too honest”.

    Don’t get me wrong – honesty is not always the best policy, as any man whose wife has ever asked him “Do these slacks make me look fat?” can attest. Excessive and gratuitous honesty is as socially reprehensible as using the dessert fork to eat your salad.

    However, when someone asks me what I think of various “alternative” medical therapies or “alternative” scientific “hypotheses”, I generally assume that they have “asked for it” – as, indeed, they have. If they are offended by my honest opinion, they have only themselves to blame. I am reminded of a psychologist friend of mine who suggested that, in those sorts of circumstances, an appropriate goal is to bring the encounter to a close as quickly as possible and discourage repeat episodes.

    As I have reached what is undeniably middle age, I have started to use a slightly different approach, especially when confronted with a person who may be capable of changing their mind. Rather than confronting them directly when they say something stupid, I ask them “What makes you say that?”

    This has the advantage of putting them on the defensive without having to deliver an attack. I respond to any explanations with a calm, but firm request for data, references, citations, clarifications. Every time I’ve used that approach, the person promoting pseudoscience eventually paints themselves into a corner – all without me ever stating my opinion on the matter.

    Let me give a recent example:

    [HE] “Doctors support vaccination because it brings in so much money!”

    [ME] “Really? I thought that they barely made enough on vaccinations to break even – it was in the New York Times.”

    [HE] “That’s just propaganda – doctors don’t want their profits cut.”

    [ME] “That’s odd. I would have thought doctors would make more money treating people for the vaccine-preventable diseases.”

    [HE] “Well…. the vaccines don’t really prevent disease… they were all going away before the vaccines were intorduced.”

    [ME] “You mean diseases like measles and polio?”

    [HE] “Exactly!”

    [ME] “Then why is measles coming back in the UK now that the vaccination rates are falling? And how about polio in Nigeria, where polio rates skyrocketed after vaccination rates dropped?”

    [HE] “That’s all due to deteriorating hygeine and nutrition.”

    [ME] “In England!?! My, I had no idea they were doing so poorly!”

    It goes on for a bit longer, but you get the drift.

    Dr. Atwood, what you said was nothing to be ashamed of – you are, indeed, to be congratulated for speaking truth to ignorance.

    Prometheus

  16. ama says:

    [*QUOTE*]

    “YOU DID THAT? Do you realize the hell that he went through because of that?”

    It was loud in the restaurant, and I missed a lot of what she said next, but I’m pretty sure she called me “a miserable human being.”
    ———————————————
    [*/QUOTE*]

    CONGRATULATIONS!!!

    Phantastic, superb! And Congrats to Val Jones too!

    The point is: esotters abuse friendlyness. And here you got it:

    [*QUOTE*]
    ———————————————
    It’s funny: I got the feeling that Dr. O was far more surprised by me than I was by her.
    ———————————————
    [*/QUOTE*]

    As I wrote here:

    http://www.theness.com/neurologicablog/?p=434#comment-7578

    Friendlyness is a weapon. In a discussion in a German forum a quack asked “Do you threaten me!?”

    The short answer: “Yes, of course!”

    BOOM!

    Dr. O. of course was surprised. She did not expect that someone had the guts to oppose her mean attack.

    Esotters do not have real arguments. So, to cover their nakedness, they attack in becoming personal. By making people feel uneasy. Many esotters are top experts in that. They make you feel guilty if you oppose them.

    But THEY, of course, have no problem at all in attacking you continously.

    How to get out? Simply by keeping in mind, that it is your RIGHT to say the truth.

    And it is your DUTY to say the truth.

    Face it: The important fact is that otherwise you would lie!

    Even ducking out to avoid a clash is some kind of lie.

    The esotters have no problems in making extreme attacks. Like Dr. O when leaving the table.

    Guess what she would have done if YOU had left the table like that…

    Esotters take the right to behave as they do. But you are not allowed to react in the very same way – as that would be sooooo offensive…

    Esotters are schizophrenic. And they are more than that…

    Here is a new press release:

    http://www.eurekalert.org/pub_releases/2008-12/uu-gdw120308.php

    [*QUOTE*]
    ———————————————
    Public release date: 3-Dec-2008

    Contact: Tomas Furmark
    tomas.furmark[bat]psyk.uu.se
    46-073-683-3487
    Uppsala University

    Genes determine whether sugar pills work
    ———————————————
    [*/QUOTE*]

    I claim that esotters have a number of gene defects.

    Have fun!

  17. ama says:

    @Steven Novella

    >In real life, not all ideas are equal. Some are dumb.
    >Others are demonstrably false. While others are brilliant.
    >In medicine the “everything is equal” approach is deadly.

    The last sentence immediately reminded me of a wave which some decades ago swept from America to Europe: “I am okay, you are okay.”

    It was hyped for a number of years and – like other insane stuff – still is active somewhere.

    I think that there is a key behind it, and the key is genetic.

    Go back in time when in the wild wilderness two animals met each other. Both were predators. They were able to hurt each other, even kill each other. Who would survive? In evolution a strain developed which included a way to handle this situation: “Soothe the other, do not run, do not bite.”

    “I am okay, you are okay.” is the EXACT description of that. I claim that humans do have this in their genes. The consequence is that persons with a certain genetic disposition STRONGLY follow this pattern. AND they force others to do the same, and this way win by imposing psychical stress to the opponent.

    But we are not in the wildernes. We have to stand our grounds.

  18. mjranum says:

    Just tell it like it is an if anyone accuses you of being insensitive tell them you’ve got Asperger’s.

  19. Fifi says:

    To keep blaming an erosion of critical thinking on “Po-Mo” and kids today, is to totally ignore the self congratulatory and non-critical nature of academia that existed before “Po-Mo”. It’s a retro-Utopian vision of academia that fetishizes the past and desires a rolling back of things to a “better” time (though clearly “better” depends on who’s rear projecting) when the people waxing nostaligic could ignore complexity (and impose their non-evidence based and prejudiced beliefs and views of reality on everyone else). In fact, it was this kind of incredible lack of ability to think beyond one’s own social experience and personal/religious prejudices that gave rise to “Po-Mo” to begin with. Mushy thinking happens where humans congregate and self congratulate each other on their shared beliefs (particularly shared beliefs that posit themselves as right/good and others as wrong/bad). It’s not something new in the world or academia or limited to our time.

  20. ama says:

    @Fifi
    If this is “Po-Mo”
    http://acronyms.thefreedictionary.com/Po-mo
    it does not fit. :-)

  21. Fifi says:

    The “everyone’s a winner” culture is just American feel-good self-help culture not PoMo, it’s part of the American myth that class doesn’t exist and that America is a meritocracy. (America isn’t nearly as fluid in terms of changing class as countries like Canada or Australia, a lot of this has to do with access to higher education and equal opportunity. The just-smile-and-be-happy have-a-nice-day thing is part of American culture’s anti-intellectual, pseudo-egalitarian heritage.

    The attacks on reason and science is as endemic within the right wing as the left – in fact it’s made for some very strange bedfellows in US politics. It’s a rejection of the world as it is and social complexity (particularly the social complexity of global cultures) in favor of simplistic, usually nostalgic, non-reality based thinking (ideology that trumps what is). Much as a like Obama, his popularity mainly rests upon retrofuturism – he models what was modern in the 60s (and even earlier than that) as change in 2008. He’s the new and improved Tide with cleaner, brighter action!

    Blaming the current lack of critical thinking on PoMo is reactionary, particularly since PoMo was a reaction against the lack of critical thinking going on both within academia and without. It’s a little internal academic war of reaction that doesn’t acknowledge that it’s not intellectual theories that are changing the world but developments in technological and communication. People often want things to stay the same or go back to how they were. It seems to me that critical thinking demands moving beyond reactionary responses and nostalgia, and merely trumpeting one’s own ideology as superior. It’s hard to think critically when one is clinging to an ideology!

  22. I am flattered by the many commenters who applauded me, but I stick to my opinion that I ought to have been more discreet in that particular context. In the right circumstances, however, nothing less than “damn the torpedoes” will do.

    Until now I was unaware of Dr. O’s behaviour at the meeting the following day, as described by Dr. Val, because I was in a different “break-out” group. That does help put the matter into perspective.

    Joe is correct: What makes So and So a fraud is that he apparently misrepresented his credentials. I say “apparently” because it is not entirely clear. As I’ll explain at some point, all evidence available to the public and to me suggests such misrepresentation. It is possible that So and So has documents that would exonerate him. If so, he has only to make them available for public scrutiny.

    Harriet’s suggestion for what I might have said next is similar to what I wanted to say, but could not. Dr. O was talking, no longer listening, and then she was gone. Perhaps if I’d been headed to the train station the next day…

    Fifi:

    I agree with much of what you write about the American “feel-good” culture, including that it is not a PoMo-generated phenomenon. I don’t agree that the “just-smile-and-be-happy have-a-nice-day thing is part of American culture’s anti-intellectual, pseudo-egalitarian heritage,” even if anti-intellectualism is as American as apple pie. The just-smile part is more a product of another, more recent force in American life: Madison Avenue, particularly as manifested on TV.

    The phrases by So and So quoted in Dr. Poses’s paper, however, are PoMo sophistry at its most unctuous. No point in rehashing previous discussions (here, especially), so I’ll ask you to consider this: It’s apparent that at some point in your life you found something in “post-modern” writings to have been particularly enlightening, or particularly helpful for your understanding of some aspect of culture, or otherwise to have contributed in an important way to your intellectual growth.

    Would you explain what that something was? Understand that I am not being sarcastic or even ironic. I truly want to know, because I’ve enjoyed and respected almost every other thing you’ve written, but I haven’t read anything to change my opinion of PoMo. Perhaps you can teach us something.

    KA

  23. Fifi says:

    Dr Atwood wrote – “The just-smile part is more a product of another, more recent force in American life: Madison Avenue, particularly as manifested on TV.”

    That is very possible, however “as American as apple pie” as a cliché is probably a Madison Avenue created one too! (Particularly since apple pie isn’t distinctly American.) The almost aggressive have-a-nice-day-thing is distinctly American though, whether generated by Madison Avenue or not. Which is not to say people are unpleasant to each other all the time outside of the US, just that they’re not faux pleasant/cheery and grouchiness and general criticism is much more healthily tolerated in most other countries of European heritage, as is (often heated) social discourse.

    I appreciate that you’re not being sarcastic and respect your questions. They’re good ones and obviously I’m giving the impression that I’m a fan of PoMo (which I’m not particularly). I do suspect we have quite different experiences of what it is though simply because I work in art and culture, and obviously art theory and artists have been grappling with issues regarding perspective, observation, cultural meaning and individuality for a long time – not to mention Modernism and the impact of technology.

    As for Post-Modernism, it really depends what it’s being applied to and what version of PoMo you’re talking about (lots of people seem to call things PoMo that have no connection to it that I’m aware of and religious/spiritual people have naively and incorrectly adopted and promoted it to mean that the objective world doesn’t exist – that is NOT what PoMo theory postulates! Or at least none that I’ve ever read). I actually think it is, in general, a faux or incorrect cultural theory that has more to do with NEEDING to have a theory to replace Modernism (painting was also declared “dead” at the same time) than contemporary reality. PoMo is essentially reactionary and misses the point since it’s based in Modernism and on some of the same flawed assumptions about heroic individualism that drove Modernism. That doesn’t mean that Foulcault wasn’t a very astute observer of power structures and the evolution of surveillance culture or that other philosophers and cultural theorist don’t have interesting ideas to share.

    So, while I can see why people might assumed I’m actually standing up for PoMo culture when I speak up about it being bandied around as some form of ultimate evil, I’m not actually coming at this from an either/or position. (I know, very PoMo of me! ;-) )

    The current changes going on have more to do with the transition from being an industrial to an information culture and globalisation. I’m somewhat sensitive to these things being someone who watches/creates culture professionally AND is part of the Gap Generation (sometimes called early Nexus) that sits between the Boomers (industrial age) and GenX/Y (the information age, kids who grew up with computers as part of ordinary life). To me, it seems like a generational war between generations that really don’t understand each other (us Gap Generation people have a foot in both worlds, kind of how young people in the 1920s did as communication and travel changed).

    The technology we’ve developed and are developing has and will continue to change and shape the way we think and communicate in a way entirely apart from what academics write or believe (it’s a false assumption that the theories are driving this change since, in reality, it’s technological change driving the theories…much as I’d like to claim all the glory for words and ideas since they’re what I do and consider personally important ;-)). There is, of course, resistance from the old guard and insistance from the new – and both just assume they’re right but lack the ability to (sorry to be PoMo again) see the issues through each others eyes since their experiences of the world as so different. (I’d even wager that there are neurobiological and developmental differences between the generations.)

    So, I doubt I’ve changed your opinion on PoMo but hopefully I’ve clarified why I find blaming PoMo to be unproductive and a red herring. I can understand why people in academia in the US get up in arms but quite honestly it seems like everyone – on both sides, and there only seem to be two – at the old school established elite universities is fighting a generational war over ideology, not seeing reality for what it is.

  24. Fifi says:

    Oh, and while I do understand that people are fighting general idiocy when they get angry at PoMo academics at Harvard I’ve found the best way to highlight and combat idiocy is to stay outside of making it about duelling belief systems. Why? Because then it’s about dueling ideologies not simply about reality. Which exists whether people shut their eyes or not. I predict the current deepening economic crisis will cause an even bigger split between people who retreat into fantasy (and can afford to do so) and people who are forced to face reality (which will be a harsh awakening for many who were dreaming the American dream, itself at least partly a construct of Madison Avenue).

    The reason why I speak up about it here is that blaming PoMo sounds really reactionary and like huffy dead white men having a tantrum (to use an academic cliché). I’m sorry if that sounds disrespectful to say but if we’re discussing how best to communicate with people and get a message across, it’s perhaps worth discussing. It also reinforces the SCAM accusations that SBM is run by dead white men who want to maintain their power – it’s an approach that isn’t only ineffective, it actively plays into the opponent’s hands. (Though my own intolerance of idiocy does mean I’m making this observation from a glass house of my own – I totally understand needing to vent with like-minded people.)

  25. ama says:

    Isn’t this PoMo stuff a bit esoteric? We drown in words the meaning of we could debate for years without getting any further.

  26. Fifi says:

    Just so you know, I actually wrote a paper in university (back in the 80s) about why PoMo doesn’t really exist except as a descriptor meaning “after modernism” (Modernism itself being a reaction to the technological shift which brought us cameras and speed and radically changed our perception of the world, though most of us wouldn’t realize that since we grew up in a world with cameras and much faster cars). We are, in purely technical terms, in a post-modern age, since modernity was/is a product of the industrial age and we’ve been moving into the information/travel/glabalisation age since the 70s/80s (the 80s brought computers but also time shifting in the form of home video and the introduction of fast cut, non-linear narratives that came from being habituated to disrupted narratives on tv with ads being a large part of that).

  27. Fifi says:

    ama – Certainly no more esoteric than continually linking to and promoting a German site on an English blog!

  28. ama says:

    @Fifi

    The forum etc. are multilingual. We have Dutch, Italian, German, perhaps some Norwegian somewhere, and quite a lot of English. And French.

    We connect people: We try to bridge the gap caused by the Atlantic and the language barriers. If you look at it closely, you will see invitations to here or to the neurologica-blog, or to many, many other forums, web-sites, etc.

    What you see from us in the web is only a small part of what we do.

  29. @Fifi:
    “I do suspect we have quite different experiences of what it is though simply because I work in art and culture, and obviously art theory and artists have been grappling with issues regarding perspective, observation, cultural meaning and individuality for a long time – not to mention Modernism and the impact of technology.”

    Not all artists think this way, though. I’m a professional artist, and personally, I tend to want to scream when I hear postmodernism or its associated jargon mentioned. The difference in our personal experiences runs deeper than mere choice of profession.

    That said, it’s nice to see differences in perspective among the commenters here. ‘S why I hang around. ;)

  30. Mojo says:

    DevoutCatalyst wrote:

    “One further item, CAM practitioners do not hesitate to call YOUR competence into question, behind your back, confidentially, to their patients. The medical profession is derided as clueless, excepting in the case of trauma, where the ER is generally acknowledged as effective.”

    Not just clueless, but corrupt, and not just confidentially to their patients. See, for example, the conversation that Prometheus quotes above (“Doctors support vaccination because it brings in so much money!”), or consider the implications of the question that “Dr. O” asked Val Jones (“She interrupted me to ask if I was paid for my writing”). A while back I did a small bit of very informal research into members of a particular CAM organization after it had claimed that its members do not denigrate medicine (i.e. I looked at their websites). Within about an hour I had literally dozens of examples.

  31. Fifi says:

    PerkySkeptic – I wasn’t trying to imply that all artists think a certain way! Or to talk for all artists or art writers! I’m aware that my views on PoMo are my own, as are my experiences. I was actually speaking more about writing and talking about art and cultural theory than making art – the theoretical and philosophical concerns regarding art are something some artists involve themselves in and other artists wouldn’t touch with a 10 foot pole, and obviously there are many different theories and ideas about art (and within that there are some quite vast differences between theory in Europe and the US, and obviously political and social concerns tend to make their way into a lot of art and cultural theory).

    So my apologies if it sounded like I was trying to speak for all artists or art writers. The reality is that some artists fully believe that their work is channeled from the divine, others work with scientists around issues related to contemporary science. Some artists aren’t much more than programmers or doing more than illustrating theory, others are trying to create energy vortexes to trigger the shift so eternal peace will spring up on Earth. And there’s a lot of different people doing their own thing in between. My point was really just that concerns regarding perspective and perception, and the tension between subjectivity and objectivity (or subject and artist and/or art object/experience and audience), are innate to the making of visual art and art theory.

    Modernism was/is just as much bullshit as PoMo really and more driven by maintaining art as a commodity than any form of heroic, radical, groundbreaking lone genius. Every generation has their Damien Hirst or other art stars simply because the art market requires this (scarcity and aura drive the art market, new medias that can replicate or negate the need for an object are difficult to integrate into a scarcity driven commodity system -which is why both cameras and computers have radically changed art and it’s purpose/position/meaning within our culture). The heroic painter is the myth of Modernism (though understandably lots of artists like this idea quite a lot, some to the extent that they’re more interested in being artists than making art).

    I have no probably rambled far off the topic of EBM but I DO think that it’s useful to understand how technology drives culture and changes how we see and think about ourselves, others and the world at large. For instance, advertising, propaganda and art have a very long relationship and advertising has had a huge impact on how people view reality (as has propaganda). There’s been some very interesting articles in Art Forum recently that touch on these issues.

  32. Fifi says:

    Back to the topic at hand, how to discuss SCAM with people in a way that isn’t offensive can be difficult and is something I run into with some regularity. As someone who was raised godless, I treat it socially much as I do religion and politics. I speak up when there’s a blatant falsehood that I know I can debunk in a way that’s accessible and understandable to the people at the table or when I have a key fact that will help people think differently or when faith is being promoted as science. I’ve had some interesting experiences doing this at dinner parties, including discussing it with people who make their living via CAM and are very immersed in the whole hippy side of it (sex, drugs, drum circles and string art like god’s eyes to go with the stringy theory). The biggest problem from my perspective really is the pseudoscience not the woo, the pseudoscience misleads people who are otherwise quite sensible and eggs on the not so sensible! Creating confusion about what is and isn’t science – and dressing up non-science as science – takes away people’s ability to make informed choices and is the ultimate assault on health freedom and freedom of choice. I find it highly ironic (but a predictable use of doublespeak and a political strategy) that the anti-regulators sell their position as being “health freedom”.

  33. Fifi, thanks for clarifying! I understand your point now, and it’s a good one. Yes, indeed, I’ve run into many artists and art historians on many different points along this continuum of perception (and self-perception!), and I do think artists are prone to– shall we say– extremes of commitment to their inspiration. ;) My own early writings about my artistic inspiration were such utter spiritualist crap that my atheist “conversion” has rendered them completely unreadable to me! I guess that’s a big difference in our perspectives right there– you were raised godless (and I presume with more of a rationalist mindset?) and hence you can probably appreciate the differences in artistic philosophies with less UTTER AGONY than strikes me, having grown up steeped like an herbal teabag in woo-woo! *lol* In that regard I envy you– I’ve completely gone off philosophy nowadays, and I used to enjoy it. Maybe someday when I’ve got more distance from my earlier upbringing…

    But, yes! Back to the topic at hand.

    I like the idea of asking the Innocents a lot of questions about why they believe the way they do, with an eye toward steering the conversation toward the need for objective evidence in choosing treatments. Fifi is exactly right that non-science dressed up as science takes away people’s ability to make informed choices. Thus it seems to me the best way to boost their skeptical immune-system is through teaching them, by example, to ask questions of their treatments.

    That said, the lady Dr. Atwood was dealing with was FAR from an Innocent, and I think he handled it exactly the right way! I know from experience in the Woo field that these people are not used to being called on their bullshit, and the more people that take a polite yet firm stand during these social interactions, the better.

  34. CodeSculptor says:

    The conference was clearly about Healthcare, and there was a clearly noted focus on “Integrity and Responsibility in Medicine” and the majority of respectable practitioners are science-based and more fundamentally, practically every effective therapeutic modality is the result of science-based — umm.. science.

    As such, everyone there should be cognizant of the likelihood of skeptical rebuttal, if not an outright challenge to all unusual claims.

    It’s not about tact, or discretion, and clearly your discomfort at the occurrance and even in retrospect demonstrates your humility and sensitivity (kudos to you, for I’ve been far more abrasive and without pity). Confronting such issues is an obligation.

    If we spot anyone treating a patient with a protocol that is not merely less than effective, but rather KNOWN to be harmful, then we have the obligation to intervene, don’t we?

    If someone is spouting nonsense, then professionalism demands that we challenge them. Sure, it doesn’t have to be “carpe jugulum” — but adults, especially in a gathering of such professionals no longer need kid gloves.

    The challenge in an impromptu confrontational really could only have occurred if someone was attempting to defend the preposterous.

    It may be of no comfort, but you really handled it admirably, and I wish (sometimes) that I had your temperance.

  35. Fifi says:

    Perky Skeptic – “I do think artists are prone to– shall we say– extremes of commitment to their inspiration. ;-)

    Yes, yes they (we ;-) ) can be. Of course, the difference is that being fanatical or dedicated enough to nail oneself to a VW (and I do respect many artists who use their bodies as a medium), isn’t the same thing as being into medical woo and practicing it as medicine since only people’s sensibilities get offended by art, no one actually gets hurt. (Generally speaking anyway!)

    I agree with you entirely about the “far from Innocent”. I think there are a number of different approaches that can be taken here but it does depend on what kind of person you’re dealing with. If you’re dealing with someone running a con for the money, they’ll probably be well versed in marketing and obsfucation, they’ll essentially be pitching any audience so expect the tactics of someone trying to make a sale. (If I’m feeling tolerant I’ll just screw with them until they either promote something outrageous or get caught in a lie, or have to go on about “alternative” science rather than pass off their product as being legitimate according to actual science. If I’m not, I try to walk away! ;-) ) If you’re dealing with someone who’s faith-based, there’s not much point in being direct or reasonable (they want to argue for their faith, which by definition is impervious to reason and evidence). Evangelists are committed, whatever their belief they relish the crusade!

    I think, having grown up around medicine and being well aware of medicine’s imperfections/limitations and abilities, I find intentional quackery highly unethical and unintentional quackery sad (since it’s usually coming from well-meaning but misinformed people who do have a genuine desire to help themselves and others). It is true that a lot of people just indulge others who promote wacky beliefs to keep the peace and dismiss them as being a bit of a harmless fool, so often these people don’t get called on their bullshit. However, if someone is suffering from mental health issues that lead them to having weird beliefs and hearing the voice of god, it can be a bit of a different matter if they’re within one’s social circle.

  36. “However, if someone is suffering from mental health issues that lead them to having weird beliefs and hearing the voice of god, it can be a bit of a different matter if they’re within one’s social circle.”

    Or one’s relatives. ;)

  37. Fifi says:

    Perky Skeptik – *lol* Yes. I’ve got lots of good friends who believe in magic of various kinds – I’m open about my beliefs (or non-beliefs) but I don’t force them on them and I’ve certainly learned as much from them over the years as they may have learned from me. Besides, I’m ultimately just as interested in people’s personal mythologies and how they got there and where it takes them as I am in facts. (Though lord of the spaghetti dances help me, I do love a juicy fact! ;-) ) Most of the richness and joyful experiences of life (as well as our suffering) is wrapped up in our personal and cultural narratives. Both the rational and the irrational have a place in living a rich life :-) The secrets in developing both in constructive ways and knowing which to apply when – I’m still working on these….

  38. Fifi says:

    I also agree with CodeSculptor – in a professional context it’s almost an obligation to confront professional fraud. This is a person either knowingly or naively (I think we’ve established she was intentionally promoting misinformation) attempting to corrupt professional integrity. Really, shouldn’t this be rather vociferously put in its place (like outside the professional context where it is given tacit approval when no one speaks up). My question is,how many other professionals at that conference didn’t speak up because they either buy into what she’s promoting or just because they want to avoid confrontation? The reality is, to change the direction of a group of people all it takes is one person standing up and taking an ethical position (they will usually either be stoned to death or followed into battle – it’s the risk of the stoning that keeps people quiet when they see all kinds of unacceptable behavior). Action always entails risk but sometimes the cost of inaction is much higher than that of action – both action and inaction are choices.

  39. Apreche says:

    This isn’t just a problem in medicine, it’s a problem in our entire society. Anyone who acts in a harmful, but legal, manner, either intentionally or out of ignorance, can not be attacked as long as they are pleasant in their demeanour.

    Nice old farmer Joe who milks his cow and sell the raw milk, sans pasteurization, can’t be attacked. If you attack farmer Joe, you become the bad buy because you are mean and he is nice.

    There’s a really nice guy who is the coach of the local little league team. However, the team always loses, and the kids are not happy or having fun. To suggest changing the coach makes you mean, and the bad guy, even though you are right.

    If someone’s computer is messed up, but it’s all their fault for downloading viruses and such, you can’t tell them that it’s their own fault. They’re a victim, and you’re being mean to them! Now you’re the bad guy for trying to help them realize that they are victims of their own ignorance.

    You go down on the street and there are some Scientologists. If you try to tell people that they are a dangerous cult, you’ll only be helping the culties out. You make them look like perfect angels next to your mean old self.

    The fundamental problem here is that the world is not pleasant. Fantasy is always more pleasant than reality. Magic cure-all ointments are always more pleasant than painful surgery. Magical flying unicorns are more pleasant than nasty bacteria.

    So even if you are the nicest, most pleasant, and charismatic person, it is impossible to beat out someone selling lies if you are selling the truth. Getting people to accept reality is like getting a child to take bad tasting medicine. I’ve been pretty much convinced that the only way it’s ever going to happen is with at least a little bit of force, thus providing a moral dilemma that I have no answers to.

  40. Apreche says:

    Also, this comic is very relevant.

    http://www.boasas.com/?c=300

  41. MOI says:

    I, too, can be a little too forceful and blunt with my criticisms. I’m learning how to be more tactful but it’s hard. Oh, I remember this one conversation I had with a friend’s mother. She works for a real woo-woo chiropractor. We ended up in a pretty heated argument over a foot detoxifying machine. Afterward I knew that my approach was too forceful but it’s a learning process. It’s hard when someone is telling you that the sky is green when you know damn well it’s blue. You try not to look at them like they’re crazy, but they know what you’re thinking. It takes a total change of attitude to get your point across effectively.

  42. W.L. Reinholt says:

    This is a group from within the chiropractic profession who see the unscientific foundation of chiropractic…and more specifically what they are subjected to in college regarding vacination.

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    Author Topic: DC has problems with not vaccinating kids (Read 13 times)
    recaman
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    Re: DC has problems with not vaccinating kids
    « Result #1 Today at 11:44am »

    ——————————————————————————–
    DC–I just bet your “problems” with immunization is a result of the chiro-nonsense your were taught in chiro-school Yes?
    The Chiropractic profession had always badmouthed vaccines as a general issue. In the past the chiropractic community has asserted that specifically the measles-mumps-rubella vaccine was a cause of autism; that children should not receive this vaccine, that children are excellent subjects for chiropractic adjustment because after all, childbirth causes subluxation’s and according to the chiropractic paradigm the chiro-adjustment can help boost the immune system.
    All of this is scientific BUNK of course, as the recent federal appeals court affirmation of three lower court rulings demonstrates. The chiropractic belief that cracking someone’s back brings them any closer to a state of improved health is utter nonsense. This unscientific hocus-pocus can be dangerous, as in the case of the person who decides to follow the advice of his chiropractor and NOT get children immunized against measles, rubella, or mumps. Chiropractic subluxation theory is not only a fraud; it is a dangerous fraud that threatens the health of society.

    Why -specifically- are you concerned about getting your child vaccinated? Is it becuase you are more afraid of one child getting autism than a lifethreatening illness? If so , is it because of chiropractic teachings that all immunizations are “bad”? Think again . I also wager you are not old enough to remember polio as a very real threat. Think again. It is not vaccinations that are dangerous- it is a organized system that sells itself as “alternative health care” when in fact it is a system based on faith healing , ignorance and unscientific notions about the cause of illness and disease straight from the 19th Century

    The article below was taken verbatim from MSN.

    THURSDAY, Feb. 12 (HealthDay News) — There’s no scientific evidence that childhood vaccines such as the measles-mumps-rubella vaccine caused autism in children of parents seeking compensation from a federal fund, a U.S. court ruled Thursday.
    The ruling, which involved test cases of children from three different families, was a setback for parents who had filed claims seeking monetary awards from a U.S.-run vaccine compensation program. More than 5,500 such claims have been filed. The claims were reviewed by the Office of Special Masters, part of the U.S. Court of Federal Claims.
    “It was abundantly clear that petitioners’ theories of causation were speculative and unpersuasive,” the court said in one of the three cases ruled on Thursday. The court also said “the weight of scientific research and authority” was “simply more persuasive on nearly every point in contention,” the Associated Press reported.
    Federal health experts applauded the decision.
    “The medical and scientific communities have carefully and thoroughly reviewed the evidence concerning the vaccine-autism theory and have found no association between vaccines and autism,” the U.S. Department of Health and Human Services said in a statement on its Web site. “If parents have questions or concerns about childhood vaccines, they should talk with their child’s health care provider.
    “Hopefully, the determination by the special masters will help reassure parents that vaccines do not cause autism,” the statement added.
    The court still has to rule on claims from other families, as well as families who contend that thimerosal, a preservative that’s no longer used in most routine children’s vaccines, caused autism in their children.
    But, a judge did hint at future decisions when he stated, “The petitioners have failed to demonstrate that thimerosal-containing vaccines can contribute to causing immune dysfunction,” the AP said.
    Thursday’s ruling is unlikely to end the long-standing dispute over whether childhood vaccines can cause neurological disorders such as autism, as opponents continued to stake out familiar sides of the debate.
    “From a medical standpoint, the special master has decided that the legal claim was not supported by the scientific evidence,” said Dr. Robert Frenck Jr., professor of pediatrics at Cincinnati Children’s Hospital and a member of the American Academy of Pediatrics’ committee on infectious diseases. “That the scientific evidence was indicating that there really was not a relationship between MMR plus thimerosal and autism.”
    In a prepared statement, Dr. Joseph Heyman, board chairman of the American Medical Association, said: “Three recent rulings by the Special Masters of the U.S. Court of Federal Claims provide even more overwhelming evidence that there is no association between vaccines and autism or related disorders. Vaccines are one of the best public health accomplishments of all time and have proven time and time again their ability to keep horrific diseases at bay. Measles, rubella, and polio are among the success stories of diseases eliminated in the U.S., but are still active in other countries and could rebound here.”
    Dr. Barbara Trommer, associate director of the developmental center at Maimonides Medical Center in New York City, said, “The message to parents should be that the health benefits of vaccines far outweigh the risks.
    “I wish it [Thursday's ruling] were enough to quell the controversy, but I fear that it might not be enough,” Trommer added.
    On this point, at least, some opponents agreed.
    “This is going to fuel the controversy. This could have the effect of further freaking parents out,” said James Moody, director of SAFE MINDS (Sensible Action for Ending Mercury-Induced Neurological Disorders) and a director of the National Autism Association. “Always in test litigation, you win a few, you lose a few. This [ruling] is unremarkable, although we would hope for something better.”
    According to Moody, the basic research needed to determine whether or not childhood vaccines are safe still hasn’t been done, and, because doubt exists, the court should have ruled in favor of the families.
    “When we ask kids to take vaccinations, we make a sacred bargain with them as soldiers in the war against infectious disease that if they are injured regardless of what the injury is, that we’ll take care of them,” he said.
    According to Moody, families can also take their claims to civil courts.
    Autism Speaks, an advocacy group for children with the condition, said in prepared statement: “Today the National Vaccine Injury Compensation Program ruled that the combination MMR vaccine — with and without the preservative thimerosal — did not contribute to three particular children’s autism. These latest rulings are limited, and do not mitigate the need for further scientific investigation.”
    Thursday’s decision follows a published report earlier this week that the British doctor whose 1998 paper fueled international fears of a link between childhood vaccines and autism had manipulated and changed the data to make his case.
    An investigative report by the Sunday Times of London stated that Dr. Andrew Wakefield and his colleagues altered confidential and public records to support their claim that eight of 12 autistic children attending a routine clinic at Wakefield’s hospital had developed symptoms of autism only days after they were given the measles-mumps-rubella vaccine. But, almost all of the children had developed symptoms of autism well before receiving the shot, according to published reports.
    Wakefield denied the allegations in the Sunday Times of London report.
    Since Wakefield’s original paper was published in The Lancet, numerous studies have failed to find a link between the MMR vaccine and autism.
    In February 2008, British researchers reported in the Archives of Disease in Childhood that their large study failed to uncover a connection. The researchers based their finding on a sample of 240 children — 98 who had been diagnosed with autism, and two comparison groups: 52 children with special educational needs who were not autistic; and 90 children who had no developmental problems.
    And a large-scale U.S. Institute of Medicine review in 2004 also failed to uncover a link between childhood vaccines and autism.
    The National Vaccine Injury Compensation Program was created in 1988 as, among other things, a venue for resolving vaccine injury claims. In 2001, parents began filing claims contending that some childhood vaccinations could cause autism spectrum disorders. The Office of Special Masters issued a general order in 2002, establishing a procedure for addressing this so-called “Omnibus Autism Proceedings.”
    According to CNN, the families filing claims fall into three categories: those alleging that MMR vaccines and vaccines containing thimerosal in combination can cause autism; those claiming that only thimerosal-containing vaccines can do such damage; and those who claim MMR vaccines not including thimerosal can cause autism.
    Thursday’s court ruling concerned only families in the first category, the news network said.
    The U.S. National Institutes of Health says that one American child in 150 has been diagnosed with autism, although experts wonder if that increasing number is due in part to better diagnoses and a broader definition of the disorder.
    More information
    The U.S. Centers for Disease Control and Prevention has more on childhood vaccinations.

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