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494 thoughts on “Longing for a past that never existed

  1. Fifi says:

    Dr Hall, it’s interesting that you’re an advocate for Lomborg’s political/ideological position even though he’s been called out by climate scientists as promoting bad science (either willingly or purely by virtual of ignorance). Nothing wrong with having a personal or political position, of course. Pretending that it’s evidence or science based when it’s not, however, is problematic whether we’re discussing medicine or climate change. It’s leaving the realm of reality-based thinking to enter the land of ideology where the great woobeast flourishes. Accusing others of being emotional and irrational or not science-based in the context of someone being critiqued for promoting bad or pseudo science is just weird on an SBM blog (and pretty much a fall back tactic of dishonest pseudoskeptics of all stripes, whether they’re applying pseudoskepticism to medicine or anything else). Just because it sounds “common sense” to you or aligns with your beliefs doesn’t mean his approach is actually evidence or science based – even if he makes a ritual showing of presenting science. You’re making the same kind of error involving confirmation biases that believers of woo do about “traditional” cures and so on.

  2. David Gorski says:

    His critics have responded to errors he made, but they have not responded to his main points which would still be valid if all those errors were corrected.

    Really? How so?

  3. Harriet Hall says:

    Fifi,
    You are reading more into my words than I intended. I’m not an advocate for any ideology Lomborg may support; I’m an advocate for trying to understand what his position is.

    He is clearly evidence- and science-based, although he has made mistakes about what the evidence shows. The percentage of his mistakes is small compared to the percent of facts he got right, and correcting those mistakes would not be enough to change his arguments. Anyway, it is inaccurate to say that such mistakes constitute “promoting bad or pseudo science.” It is more accurate to say that he is promoting good science but made some mistakes in a field that he is not an expert in.

    His whole thrust is not to support any particular ideology but to encourage skeptical critical thinking based on scientific evidence and uncontaminated by emotions and beliefs. His discussion of how money should be spent is not a prescription but a recognition of the practical reality that the money is finite and that we have some hard choices to make. In all the criticisms I have read about him, no one has addressed his main points or even shown that they understood them.

  4. Zoe237 says:

    Dr. Hall:

    “His critics have responded to errors he made, but they have not responded to his main points which would still be valid if all those errors were corrected.”

    Does this make sense? If the premises of your argument are incorrect, what does it say about your conclusion? It doesn’t prove said conclusion false, but it doesn’t prove it true either.

    How would the main point be valid if the premises are in error?

    The same logic has been a defense of Dr. Tuteur- that her premises may be wrong, but her main point remains intact. For example, she disagrees with a targeted c-section rate of 15% proposed by the WHO. One of her premises is that c-sections DO NOT lead to higher maternal mortality (perhaps morbidity). Yet ACOG and WHO say that maternal mortality, while difficult to measure because of confounders, is 3 to 7 times larger with cesarean section. They have loads of research to back that up. Factual errors matter, if left uncorrected by the author. Yes, these are small differences, but small differences matter in the messy world of science. (Look at the tree ring debate in AGW).

    Lomberg was brought up on charges with the Danish Committee on Scientific Dishonesty. The finding was that while the book was scientifically dishonest, it wasn’t fraud because Lomberg wasn’t an expert. I think the ruling was later said aside… I read the book almost ten years ago. The Skeptical Environmentalist and the resulting uproar is really instructive for skeptics of any stripe. (And I really disagree with the witchhunt aspect to silencing opposition in this case). What the lesson is, I have no idea! But the line between a skeptic and a denialist is pretty darn thin.

  5. Harriet Hall says:

    David,

    I explained what I understood Lomborg’s main points to be in my comment at 3:03. They are mostly common sense points about how to think about the subject, rather than specific arguments that depend on the facts his critics say he got wrong.

  6. “One of her premises is that c-sections DO NOT lead to higher maternal mortality (perhaps morbidity)”

    No, that’s not my premise; that’s your misrepresentation of my claims because you’d rather argue against that instead of what I really said.

    You have a curious disregard for the truth.

  7. Zoe237 says:

    Dr. Hall:

    ” I understood him to say that there are various predictions of the extent of global warming and that some of those predictions may be overly alarmist, that it is simplistic to only look at the bad consequences and fail to take into account even the possibility of some good consequences, ”

    This point, for example, must be backed up by correct science. 1. That GW predictions may be overly alarming. 2. That GW may have some good consequences.

    Especially because they go against mainstream scientific thought.

  8. Fifi says:

    It’s also worth noting that someone communicating in an emotional or passionate manner doesn’t automatically mean they’re being irrational or that what they’re communicating isn’t evidence or science based. Passionately held positions can be based on very solid evidence or science (and remain evidence based if one is willing to consider new evidence when it appears and/or if one’s passion is for an outcome rather than an attachment to a certain process or belief). Entirely irrational positions or beliefs, when one considers the evidence, can also be presenting in a very unemotional way. A lot of pseudoscience and pseudoskepticism does this – that’s the ritual or cargo cult aspect of it, how it presents as being scientific or rational but doesn’t actually conform to scientific or skeptical processes or results (it does things like cherry pick evidence, misrepresent the actual science, be unreasonably skeptical in the face of reasonable evidence, etc).

    For instance, while most of us who support SBM probably have very rational reasons for doing so, my guess is that quite a few of us are also passionate about science, medicine and SBM and that contributes to why we participate here.

    Granted, my interest in cognitive science, neurobiology, psychology and emotions – and people, art and how we communicate and perceive the world – probably means I’m biased towards seeing emotions as being as important as reason, and emotions and logic as not being mutually exclusive. Within cognitive science it’s understood that reason and decision making is rarely (barring a neurobiological problem) a purely logical process. When people do have neurological damage that removes emotion entirely from the decision making process it causes all kinds of real world problems. Trying to pretend that one is never swayed by emotion or subject to cognitive biases is really pretty deluded and, not surprisingly, makes one even more prone to being swayed by emotion or unaware of cognitive and confirmation biases.

  9. manixter says:

    And this post will be buried. But—
    You can look at “Little House on the Prairie”
    Narrowly escaped death by malaria (thanks to quinine!), Carrie was always weak and sickly (hookworm?), Mary blinded by measles, Laura healthy, grace healthy, and a son (not in the books) dead in infancy. Milk, butter, and salt pork were the proteins of the diet; other meat was salted and smoked. Crops were lost from locusts, winter, and drought (twice for laura and almanzo’s case, forcing them to move to arkansas). The whole family almost died during the dakota winter when the trains stopped running.
    Additional info– numerous property losses forcing moves through debt that they could not repay for both pa and almanzo. Truely– everything you need to know is in that series.
    Good news on the obstetrical front: Ma made it through 5 pregnancies.

  10. Fifi says:

    Dr Hall – “You are reading more into my words than I intended. I’m not an advocate for any ideology Lomborg may support; I’m an advocate for trying to understand what his position is.”

    Ah but you keep acting like an apologist and making excuses for why his bad science is okay because you think he’s promoting “common sense” so maybe you’re actually communicating something other than you intend via these shaky kinds of arguments that scream “confirmation bias at work”. You support his “common sense” opinion despite the fact that neither you nor he are climate scientists and the people you’ve denigrated as being “emotional” for critiquing him are actually climate scientists. Sounds pretty much like a confirmation bias and, consequently, as if you’re being an apologist for someone you agree with.

    His arguments about how money should be spent have been cut down over and over again. For instance, why not take money away from bankrolling wars to spend on medicine? (You’d have the added benefit of not maiming and killing people in wars and polluting the environment and drinking water, sounds like a win win situation. Of course, it’s not a pro-industry approach, it’s a pro-human one instead. ) He’s creating a false (and emotional!) choice by making it medicine vs environment and you’ve bought into it wholesale!

  11. Zoe237 says:

    Me: One of her premises is that c-sections DO NOT lead to higher maternal mortality (perhaps morbidity)”

    Dr. T: “No, that’s not my premise; that’s your misrepresentation of my claims because you’d rather argue against that instead of what I really said.”

    Really? So you do believe that unnecessary c-sections can possibly kill mothers? If so, I apologize. You have stated on numerous occasions that there is no good data to think that c-sections increase maternal mortality, but I certainly may be misinterpreting. You do acknowledge that unnecessary c-sections can increase maternal morbidity.

    My understanding is that you think the data showing an increase is maternal mortality is flawed by confounding factors, but I haven’t seen any independent corroboration of that opinion.

    Dr. Tuteur: “There’s actually no good data to show that C-sections increase the risk of maternal death, despite a number of studies that make that claim.”

    http://www.sciencebasedmedicine.org/?p=2507

  12. David Gorski says:

    The percentage of his mistakes is small compared to the percent of facts he got right, and correcting those mistakes would not be enough to change his arguments.

    I’m afraid not, Harriet. Lomborg’s mistakes were so glaring, both in quantity and quality, that they easily bring into question his entire thesis, the “common sense” aspects of it notwithstanding, and, more importantly, his mistakes are consistent with allowing an ideological agenda override science. They were not random mistakes, as one might expect if he were just getting it wrong without an agenda. They were all in the direction of either downplaying or denying the severity of AGW. Such a pattern of error always sets my skeptical antennae a’twitchin’, as I like to say. Lomborg also seems to fall into the “either or” fallacy; i.e., the fallacy of the false dilemma. Either we try to reduce malaria or we try to reduce carbon emissions, not both. Yet there is no reason why we can’t do both.

  13. “There’s actually no good data to show that C-sections increase the risk of maternal death, despite a number of studies that make that claim.”

    Yes, that’s what I wrote. I did not say “c-sections do not lead to higher maternal mortality.” They are not the same thing.

  14. Harriet Hall says:

    “Either we try to reduce malaria or we try to reduce carbon emissions, not both. Yet there is no reason why we can’t do both.”

    Lomborg doesn’t say we can’t do both.

    Reading a book is an interaction between the reader and the text. People interpret what they read in the light of their personal knowledge, experience, and prior opinions. When I read Lomborg, I got one impression; when others read the books, they got a very different impression. That says more about the readers than about the text. I won’t argue about Lomborg any more: I think it is obvious that all his readers are biased in one way or another, myself included, and further discussion would be as fruitless as the protracted debate about Dr. Tuteur.

  15. weing says:

    David,

    Am I an AGW denialist if I like global warming and want more of it?
    I always looked upon myself as a global warming proponent.

  16. Fifi says:

    Dr Hall – Certainly bowing out of discussing Lomborg is up to you but pretending that his misrepresentation of climate science is no big deal and just a matter of subjective opinion is kind of strange on an SBM blog. Simply owning up to your own bias and claiming that all readers (do you include critical experts here?) are biased has absolutely no bearing on whether he was actually presenting objective science or presenting manipulated pseudoscience with an ulterior motive. Do you apply the same rationalizations vis a vis the accuracy of medical science when you blog and post here? I’d hope not but if this is your general attitude towards scientific accuracy and honesty then it is somewhat disturbing vis a vis SBM too!

  17. Fifi says:

    weing – Maybe you’re a warm monger? Sorry, couldn’t resist the bad pun.

  18. Amy Tuteur on premises:

    “There’s actually no good data to show that C-sections increase the risk of maternal death, despite a number of studies that make that claim.”

    Yes, that’s what I wrote. I did not say “c-sections do not lead to higher maternal mortality.” They are not the same thing.

    I admit it: I don’t see the difference. So this is probably a good opportunity to do some education. Perhaps a post on how to read and talk about science?

  19. JMB says:

    It would be interesting to have SBM examine some of the purported health effects of Global Warming in the IPCC reports.

  20. Harriet Hall says:

    “pretending that his misrepresentation of climate science is no big deal and just a matter of subjective opinion”

    I’m pretending no such thing. This comment is just one more illustration of why further discussion would be fruitless.

  21. Zoe237 says:

    “There’s actually no good data to show that C-sections increase the risk of maternal death, despite a number of studies that make that claim.”

    Yes, that’s what I wrote. I did not say “c-sections do not lead to higher maternal mortality.” They are not the same thing.

    Fair enough, I apologize. I agree, there is a difference between “studies don’t show” and “there is no.” Let me rephrase my original statement, changes in brackets.

    The same logic has been a defense of Dr. Tuteur- that her premises may be wrong, but her main point remains intact. For example, she disagrees [or there is no good data to show] with a targeted c-section rate of 15% proposed by the WHO. One of her premises is that [[there are no good studies that show]] c-sections lead to higher maternal mortality (perhaps morbidity). Yet ACOG and WHO say that maternal mortality, while difficult to measure because of confounders, is 3 to 7 times larger with cesarean section. They have loads of [not without errors, but still valid] research to back that up. Factual errors matter, if left uncorrected by the author. Yes, these are small differences, but small differences matter in the messy world of science. (Look at the tree ring debate in AGW).”

    Btw, the 3-7 range takes into account the presence of confounders.

    Obviously Dr. Tuteur thinks the research is flawed in this area, and that’s fine. Lomberg believes AGW research is flawed. But you still have to back up your assertions with evidence.

  22. Fifi says:

    Dr Hall – Okay, you just asserted that the science he got wrong was no big deal and didn’t change anything he wrote in any meaningful way and any critiques of his science or ideas were “emotional”. Then Dr Gorski corrected you regarding the science part. Then you said you didn’t want to talk about it anymore without acknowledging that Lomborg was actually promoting pseudoscience or misrepresenting science. Whether he was presenting science or using pseudoscience to advance an agenda seems pretty relevant on an SBM blog! Science isn’t just a matter of subjective opinion, that’s why it’s science!

  23. ” I don’t see the difference”

    Saying there is no evidence for x is not the same as saying there is evidence for not-x.

  24. Zoe237 says:

    I think Dr. Hall admitted that some of Lomberg’s data was wrong, just that it didn’t make any difference to his “common sense” positions. I’m sure he was right on a few things in the book. The trouble is figuring out what since most of it was so riddled with errors.

    There certainly is a lot of subjective opinion that goes into environmental solutions, so I agree with Dr. Hall there. THAT’S WHY the ***data*** is so important, to take the subjectivity out. I can’t stress that enough. If the premises are wrong…

  25. Zoe,

    Let’s be honest. You really want to believe that the ideal C-section rate is 15% or less. I pointed out that there is NO evidence to support that contention. Even Marsden Wagner, the WHO official who pushed through the recommendation acknowledges that there was never any evidence. YOU have been unable to provide any evidence for it. Nonetheless you persist in insisting that it must be true and resort to personal attacks to divert attention from the fact that you have no evidence for what you prefer to believe.

    No one is fooled. You attack because you disagree and you lack any other ground to stand on.

  26. Amy Tuteur on evidence:

    “Saying there is no evidence for x is not the same as saying there is evidence for not-x.”

    Good point. I confess to taking mental shortcuts. Since it is never possible to prove a negative, when people say “There is no good evidence for the effectiveness of homeopathy” or “There is no evidence at all for the existence of Russell’s teapot” I interpret that as being the same as “There is no reason to think that… ” or more pragmatically, “Homeopathy doesn’t work/ Russell’s teapot doesn’t exist.” But as you repeat so often, one must always read the entire source to understand whether that is the appropriate interpretation in that individual case.

  27. Fifi says:

    There just seems to be no recognition by Dr Hall that he got his facts wrong…

    Dr Hall – “He is clearly evidence- and science-based, although he has made mistakes about what the evidence shows. The percentage of his mistakes is small compared to the percent of facts he got right, and correcting those mistakes would not be enough to change his arguments. Anyway, it is inaccurate to say that such mistakes constitute “promoting bad or pseudo science.” It is more accurate to say that he is promoting good science but made some mistakes in a field that he is not an expert in.”

    Here Dr Hall dismisses his mistakes regarding the science and claims that there’s no ulterior motive and isn’t promoting pseudoscience. Dr Gorski shows that it wasn’t just getting one or two small things wrong and that there’s a bias (as did the many climate scientists that Dr Hall dismissed as being “emotional”).

    Dr Hall – “They are mostly common sense points about how to think about the subject, rather than specific arguments that depend on the facts his critics say he got wrong.”

    No admission that he got facts wrong here, just that “his critics” said he got it wrong. Of course, his critics were actual climate scientists! Would Dr Hall frame medical scientists’ expertise in this same way in a discussion of medicine when the scientific consensus was being challenged by someone not versed in medical science?

    Really, Dr Hall is being an apologist and claiming on the one hand that his ideas are “clearly science and evidence based” and then claims they’re just common sense so the bad science doesn’t matter because really he’s telling us how to think…um, using bad science and confirmation bias apparently. In this case, “common sense” seems to be code for “agrees with what I already believe”. When a CAM promoter makes these same claims about “common sense” or presents distorted science as evidence we question them – rightly so. The same should apply to all of our own ideas, no matter how much we emotionally feel they’re “common sense” or how sciency they look even if we can’t expertly dissect the science ourselves.

  28. Fifi says:

    “There just seems to be no recognition by Dr Hall that he got his facts wrong…”

    Let me correct that…

    There just seems to be no recognition by Dr Hall that the fact that he got his facts wrong is problematic if she believes his position is science/evidence based and that he’s not promoting pseudoscience in service of an ideological position…

  29. Mark Crislip says:

    “It would be interesting to have SBM examine some of the purported health effects of Global Warming in the IPCC reports.”

    Thanks, I was going to write about bees for Friday, but I have a ton of info and a lecture on weather, climate and infections. Maybe I will do that instead.

  30. Zoe237 says:

    “Zoe,

    Let’s be honest. You really want to believe that the ideal C-section rate is 15% or less. I pointed out that there is NO evidence to support that contention.”

    Again with the absolutes. I’m not sure what the right number is. I do know there are active worldwide and national efforts to lower the c-section rate because of possible increased neonatal and maternal mortality and morbidity from elective cesareans. ACOG along with he US Healthy People guidelines also set some numerical goals. Once again, I can believe you or every medical organization in the world.

    Of course I believe cesareans are necessary sometimes. What I don’t believe is that the 80% being done in Latin America (for example) are, or the 45% rate in some U.S. hospitals. I could say the same about the hysterectomy rate- too many unnecessary surgeries.

  31. “. I do know there are active worldwide and national efforts to lower the c-section rate because of possible increased neonatal and maternal mortality and morbidity from elective cesareans.”

    Now you’re trying to change the subject. I made a claim; you’ve provided no evidence to contradict it. What any organization says or does not say is irrelevant. My claim is true, you misrepresented it and now you are dismissing it.

    You don’t have a problem with my “style,” you have a problem with the substance, but lacking the ability to challenge the science, you resort to personal attacks.

  32. Hjordis says:

    I’ve been following SBM for a few months now. So far I’ve observed that there are a few people here who seem to have a lot invested in attacking both Dr Tuteur and anything she says. I agree with Dr Hall that she is being treated unfairly. The hypothesis that the average life expectancy has more than doubled due to science-based medicine is hardly controversial. There are other writers on SBM who also publish opinion pieces. We get it people, you don’t like her. Move on.

  33. David Gorski says:

    I think Dr. Hall admitted that some of Lomberg’s data was wrong, just that it didn’t make any difference to his “common sense” positions. I’m sure he was right on a few things in the book. The trouble is figuring out what since most of it was so riddled with errors.

    Exactly. His books discussing AGW are so riddled with errors of science that it’s really quite impossible to figure out when what he is arguing is science-based and when it isn’t if you don’t already know quite a bit about the science. That’s what makes him so problematic. Intelligent and even skeptical people like Harriet can find his arguments compelling because they don’t know the background science.

    A few years ago, I used to be a lot more “skeptical” of AGW. However, then I took the time to learn a bit more about the science, and it rapidly became clear to me that most of my objections were based on a lack of understanding and, in essence, arguments from incredulity and ignorance.

  34. Zoe237 says:

    Dr. Tuteur:

    “What any organization says or does not say is irrelevant.”

    I didn’t say any organization, I said every organization. And scientific consensus may be irrevelant to you. But it is relevant to me, whether it be global warming, targeted cesarean section rates, vaccinations, or anthropological claims about longevity throughout history.

  35. StatlerWaldorf says:

    BillyJoe, I completely disagree with your opinion about Harriet Hall vs. Amy Tuteur’s writings and ways of portraying themselves on this blog. Harriet Hall is generally more well-balanced in her views and considers issues beyond a mere black and white viewpoint. Amy is completely focused on discrediting natural childbirth and its practices. (Still waiting for a definition of natural childbirth though…).

    weing, you can be sarcastic and flex your intellectual muscles – I’m easy prey for you. Enjoy :)

    Hjordis, you haven’t been reading carefully if that is your conclusion. And you might want to also read for a few months on Amy Tuteurs own blog and you will get a better picture of what she is all about.

    I have been quite puzzled how SBM editors could read Amy Tuteurs own blog and view her Ask Dr. Amy website and still accept her as a contributor here. (Unless maybe they do want more controversy and readership for this site…)

    In any case, she is here, and her writing is constantly critiqued even by those who have not encountered her before. Her writing and the responses generated will have to speak for themselves when it comes to quality and bias. I just hope it won’t be to the detriment of the purpose of a SBM blog in the first place.

  36. Plonit says:

    The hypothesis that the average life expectancy has more than doubled due to science-based medicine is hardly controversial.

    ++++++++++

    That’s not Dr Amy’s hypothesis – the post was mainly about modern agriculture.

  37. Harriet Hall says:

    David,

    I am not skeptical of AGW and neither is Lomborg. We all agree that the problem is serious and that action is needed. The devil is in the details.

    In “Cool It,”Lomborg calls for cooling the earth but also cooling the emotional heat of the debate about what actions to take. He advocates a cool-headed scientific approach instead of rushing prematurely into the most radical, expensive procedures based on panic and emotion a la Al Gore (whose movie also contained a lot of errors).

    You may not agree with the ordering of priorities in the Copenhagen Consensus but I hope that you can agree with the general principles. As a doctor, you weigh the risks and benefits of every treatment, and you don’t rush to adopt every proposed new experimental treatment before its value is demonstrated. You don’t get so fixated on treating a patient’s cancer that you neglect to treat his other medical conditions like diabetes and hypertension, some of which might kill him before the cancer does. As a research grant competitor, you understand that funds are limited and priorities must be set somehow.

    That’s what I hear Lomborg saying. I don’t hear his critics responding to any of that. Something is wrong.

    Maybe it’s me. I didn’t go into his books with any conscious bias, but I’m willing to admit that my reading comprehension could be unconsciously impaired by a tendency to optimism and a distrust of alarmism. By the same token, others might be equally and oppositely biased by a tendency to pessimism and catastrophism. The sober, unbiased truth is hard to get at. And even the most accurate scientific data can’t tell us what is the “right” thing to do. That’s a human judgment call.

  38. Harriet Hall says:

    StatlerWaldorf, how can you say “Amy is completely focused on discrediting natural childbirth and its practices” when so many of her posts have addressed other subjects? You have made a general statement that is black and white and is clearly inaccurate and is based on your unsubstantiated opinion – the same sins that Amy has been accused of.

  39. BillyJoe says:

    zoe,

    “The difference between Dr. Hall and Dr. Tuteur is exactly that of QUALIFIERS.”

    So then why are we arguing?
    There were posters here saying that Amy’s opinions on what the science says (regarding herbal treatments) was different from Harriet’s opinon of what the science says. I responded that their views were pretty much the same. For the sake of brevity and impact, Amy assumes the qualifiers. For completeness and clarity, Harriet spells them out.
    With Amy, you have to read between the lines.
    With Harriet, ypou have it all laid out for you.

    “Dr. T’s writing is fine for the back of a cereal box, but I had come to expect more nuance from the bloggers here because of the more knowledgeable readers. I am really really suprised that many can’t see how she overly simplifies complicated medical and science topics.”

    She simplifies for impact.
    Herbal treatments are useless. That is a good take home message. Of course there is a long list of qualifiers but, as long as you are aware of them (as Amy is as she has demonstrated), I have no problem with that take home message. After all, those qualifiers do not alter the basic conclusion that herbal treatments are useless.

    ———————-

    wales,

    “As to differences between Harriet’s style and Amy’s, give me long-winded and accurate any day, over short, strident and inaccurate. Qualifiers are an extremely important part of scientific communication, and Billy Joe’s attempt to gloss over and reconcile Harriet’s and Amy’s style differences as a matter of qualifiers just doesn’t cut it for me.”

    You’ve lost sight of what I was responding to. The point was that Harriet and Amy have the same views on what the science says (regarding herbal remedies), they just have a different way of communicting that view.
    I haven’t anywhere stated which style or method I prefer.
    As to the qualifiers: that is exactly the difference between them – Amy implies them, Harriet spells them out.

    ———————————

    weing,

    “Am I an AGW denialist if I like global warming and want more of it? I always looked upon myself as a global warming proponent.”

    You are a very naughty boy is what you are!
    (A denialist is one who, when presented with facts contrary to his position, instead of confronting them, ignores them and continues on expounding his original position completely unfazed by those contrary facts)

    —————————–

    StatlerWaldorf

    “BillyJoe, I completely disagree with your opinion about Harriet Hall vs. Amy Tuteur’s writings and ways of portraying themselves on this blog. Harriet Hall is generally more well-balanced in her views and considers issues beyond a mere black and white viewpoint.”

    If you are entitled to make that differentiation than perhaps we should also allow that the difference is that Harriet is wishy washy and Amy is direct.
    I prefer to say that their styles are different.

    “Amy is completely focused on discrediting natural childbirth and its practices.

    I don’t think so.
    Either that, or we have been reading different blogs.

  40. BillyJoe on the necessity of qualifiers:

    “For the sake of brevity and impact, Amy assumes the qualifiers. For completeness and clarity, Harriet spells them out. With Amy, you have to read between the lines. With Harriet, you have it all laid out for you.”

    To rephrase: “Harriet says what she means. Amy sometimes (often?) says something different from what she means. Readers must either already know what she means in order to interpolate the qualifiers she omitted (in which case there’s no point in reading anything she writes, because they already know it) or guess (meaning they might guess wrong) or challenge her statements (in which case they are accused of not liking her).”

    I actually prefer the idea that she is deliberately using a pedagogical technique of withholding crucial elements or including distractors to get her readers to think for themselves. If so, it works and I (mostly) appreciate it. (Yes, yes, I know, I am “making this up” on the basis of no evidence.)

  41. BillyJoe on herbal treatments:

    “Herbal treatments are useless.”

    Neither Amy nor Harriet said that.

    Amy said that alternative medicine is useless, and later defined alternative medicine as that which is useless. By that definition, any herbal treatments which are not useless (eg foxglove for dropsy, white willow bark for fever and pain) are not alternative.

    Harriet said that some herbal treatments are (or could be) an exception to the general statement that alternative medicine as useless, though they are inferior to their pharmaceutical counterparts.

  42. David Gorski says:

    He advocates a cool-headed scientific approach instead of rushing prematurely into the most radical, expensive procedures based on panic and emotion a la Al Gore (whose movie also contained a lot of errors).

    If you’re going to tally up errors, then actually I would reiterate that Lomborg had way more errors and flaws in science in just one chapter on AGW in The Skeptical Environmentalist than Al Gore had in his movie and book combined. It’s not even close.

    http://www.lomborg-errors.dk/GoreversusLomborg.htm

    Not that errors alone are the measure, given that both Lomborg and Gore are making political arguments. After all, one huge error can trump a dozen piddling minor errors. However, Lomborg’s errors are not minor. They are also far more numerous and nearly all skew in one direction.

  43. BillyJoe says:

    Alison,

    Your post changes nothing of what I said.

    Okay, Amy said CAM was useless (which means that herbal treatments are useless, no?). But herbal treatment was singled out by Harriet as an exception and she posted the beginnings of a list of qualifiers which I expanded to a large paragraph.

    “Amy said that alternative medicine is useless, and later defined alternative medicine as that which is useless. By that definition, any herbal treatments which are not useless (eg foxglove for dropsy, white willow bark for fever and pain) are not alternative.”

    No, foxglove and willow bark ARE alternative.
    But digoxin, acetyl salicylic acid are not.
    They are herb-based pharmaceuticals.

    “Harriet said that some herbal treatments are (or could be) an exception to the general statement that alternative medicine as useless, though they are inferior to their pharmaceutical counterparts.”

    Yes those qualifiers again.
    They may not be strictly “useless”, but as an alternative to the herb-based pharmaceuticals, would you “use” them?
    Of course not.
    Apart for the active ingredient, they contain other substances which may be neutral and therefore unnecessary, but may have unknown detrimental effects. The active ingredients are present in variable amounts depending on the souce and season, and sometimes not present at all. They may contain unintended contaminants such as arsenic, lead or mercury or deliberately laced with actual pharmaceuticals.

    “I actually prefer the idea that she is deliberately using a pedagogical technique of withholding crucial elements or including distractors to get her readers to think for themselves. If so, it works and I (mostly) appreciate it.”

    Fair enough.
    I think she paints with a broad brush for impact.
    I think her broad brush “CAM is useless” is pretty good in achieving that result. And, with the unstated qualifiers – which don’t add up to much – it is basically the truth of the matter.

  44. StatlerWaldorf:

    “In any case, she is here, and her writing is constantly critiqued even by those who have not encountered her before.”

    Constantly critiqued by the same 5 people, all of whom are lay people, most (? all) who formed their personal opinions without reading the scientific papers and can’t even be bothered to read them even after it is clear that they have misinterpreted them.

    Alex Knapp (not one of the 5) had the virtue of at least being honest about his motivations. He has a personal stake in whether I am right or wrong. He has adopted the paleo diet because he is sure it will keep him healthy, and if I’m right, he has been wasting his time. Even more importantly, if I’m right, he has a lot less control over his health than he’d like to think.

    Plonit is a British midwife and she can reliably be counted upon to support the British midwifery line, regardless of whether it is based on scientific evidence. She chimes in periodically on other topics in the hope of discrediting me, and evidently doesn’t even bother to actually read my posts (e.g: ” [this] post was mainly about modern agriculture.”)

    You, SW, have come from my personal blog where you have submitted more than a hundred comments all glorifying your personal birth choices and demeaning women who make different choices.

    Zoe has not only betrayed her prejudices, but she has demonstrated a fine disregard for the truth by constantly misrepresenting what I write. When confronted she keeps digging herself in deeper: It is laughable when she claims: “And scientific consensus may be irrevelant to you. But it is relevant to me” at the exact same moment she is ignoring the scientific (as opposed to the political) consensus on the C-section rate, not to mention VBAC, breech and just about any obstetric intervention you care to name.

    I’d be concerned if I were being repeatedly criticized by doctors and scientists who provided relevant quotes from appropriate papers. And I’d be concerned if I were being criticized by lay people who provided relevant quotes from appropriate papers. It’s difficult to take seriously the obviously biased criticism from lay people who are so invested in what I critique that they can’t be bothered to read the scientific papers and are virtually impervious to scientific evidence.

  45. Plonit says:

    Plonit is a British midwife and she can reliably be counted upon to support the British midwifery line, regardless of whether it is based on scientific evidence. She chimes in periodically on other topics in the hope of discrediting me, and evidently doesn’t even bother to actually read my posts (e.g: ” [this] post was mainly about modern agriculture.”)

    +++++++++++

    This is an unfair characterisation.

    I’m not sure what the “British midwifery line” is. Perhaps you can explain?

    I certainly do care about whether claims are based on scientific evidence.

    I chime in on non-midwifery topics on this blog as the fancy takes me, and certainly not restricted to your posts (although perhaps you don’t read the other comment threads, and why would you?).

    I have no need to ‘discredit’ you – everyone can read for themselves and form their own judgments.

    My comment that this “post was mainly about modern agriculture” was a direct response to Hjordis’s comment that “The hypothesis that the average life expectancy has more than doubled due to science-based medicine is hardly controversial” and should be read in that context. Agreed, it would have been more accurate to say that the post was about the advantages of modernity in toto, in particular citing modern agriculture and not at all restricted to SBM, in contrast to the hellishness of the past/nature.

  46. BillyJoe on alternative medicine:
    “No, foxglove and willow bark ARE alternative.”

    Amy Tuteur on alternative health:
    ““Alternative” health refers to theories and treatments that are invoked and used despite a lack of scientific support, and often in the face of scientific evidence that shows that they are untrue or don’t work.”

    That’s why it’s important to define terms. My personal definition of alternative medicine is stuff that I can access without a gatekeeper. So foxglove is in there.

    Amy’s definition is that there’s no scientific support for the treatment or its mode of action. By that definition foxglove might or might not be alternative. It works and its mode of action is explained by science (therefore not alternative) but pharmaceuticals are more predictable (therefore science doesn’t support using foxglove over pharmaceuticals if pharmaceuticals are available, therefore alternative in most modern contexts). (My grandfather’s black bag contains, among other things, a standardized digitalis preparation: that is, a herbal preparation that a pharmaceutical company standardized to a certain strength.)

    I’m not saying one definition is better than another (there are a lot of problems with my personal definition); just that defining terms is important.

  47. weing says:

    Regarding the errors in Lomborg’s and Gore’s books. There are many types of errors, some egregious, some not. Wouldn’t a better measure be a ratio of errors to claims? Say, if Lomborg makes a 1000 claims and 500 are shown to be errors the ratio would be 0.5. If Al makes 4 claims and 2 are shown to be errors the ratio would also be 0.5. This would obviate the biasing by “look at all the freaking errors in that book!”

  48. “My personal definition of alternative medicine is stuff that I can access without a gatekeeper.”

    But that’s not a definition shared by anyone else.

    By your definition, Prilosec is alternative medicine because you can buy it over the counter.

  49. StatlerWaldorf says:

    Amy Tuteur said, “You, SW, have come from my personal blog where you have submitted more than a hundred comments ALL glorifying your personal birth choices and demeaning women who make different choices.” (Bold added by me, because it is too funny!)

    Yes, I’ve been reading your blog for quite some time and it is very easy to rack up many comments with the heated discussion there. Please explain how I have glorified my birth choices and point to where I have ever demeaned other women who make different choices. It is a sad world when people can say they had manageable labours with non-pharmacological methods of pain management, uncomplicated births, and were able to breastfeed successfully and that is considered as “glorification” or “demeaning” to those who had other experiences. The choices made for my births were based on me and my partner’s wishes and the circumstances of each pregnancy. I have never commented on your site that all low-risk pregnant women should be homebirthing. Anyone can view my comments in context and decide for themselves.

    If you want to talk about demeaning other women, maybe you should retract your blog entries where you characterize women who don’t birth in hospitals, choose non-pharmacological pain relief, and are pro-breastfeeding as “uneducated”, “egocentric” “sanctimommies”, “stunt-birthers” etc.

    Harriet Hall, you are right, Amy Tuteur has written on a few other topics on SBM, but on her own blog you can see that she clearly loves to rail against pretty much everything natural.

  50. Zoe237 says:

    Hmm, more ad hominem attacks by Dr. Tuteur. How characteristic.

    The reasons that scientists don’t criticize you is that you DON’T ***PUBLISH*** in peer reviewed journals! LOL. It’s very convenient for you to sit around debating laypeople all day. If you didn’t, you might be forced to actually have some evidence behind your claims.

  51. Amy Tuteur on alternative medicine:
    “[Alison Cummins said]“My personal definition of alternative medicine is stuff that I can access without a gatekeeper.”

    But that’s not a definition shared by anyone else.”

    I don’t know. I haven’t asked. Maybe, maybe not. Which is why if I were to discuss “alternative medicine,” I would define it first. But if you were to go up to someone on the street and ask them to define alternative medicine, I don’t know how many would say “anything that doesn’t work,” either. Promoters of CAM include diet and exercise as CAM treatments to prove that CAM is very popular and even scientific. I suspect (but don’t know) that most people think there are some alternative remedies that work, in which case they don’t share your definition either.

    “By your definition, Prilosec is alternative medicine because you can buy it over the counter.”

    Yup, as I said, there are problems with my definition and I don’t promote it over anyone else’s. Perhaps I could say “OTC drugs if used off-label; anything else that doesn’t require a gatekeeper.”

  52. “The reasons that scientists don’t criticize you is that you DON’T ***PUBLISH*** in peer reviewed journals!”

    The reason that the doctors and scientists who read SBM don’t criticize my posts is because the aren’t published in peer reviewed journals?

  53. Plonit says:

    Since commentators do not submit a CV, I’m not sure how you can know whether or not they are doctors or scientists.

    In any case, is David Gorski not a doctor? He has made criticisms on a number of occasions.

  54. wales says:

    Billy joe, I disagree that the appropriate use of qualifiers in science communication is merely a personal style choice. It is necessary for the sake of clarity, accuracy and credibility. I didn’t begin reading sbm over a year ago because of a desire for Fox News type journalism, but for the opposite. You appear to be a champion of brevity and your comments that “I think she paints with a broad brush for impact. “ and “And, with the unstated qualifiers – which don’t add up to much – it is basically the truth of the matter.” Leave me wondering if you believe that impact is placed above accuracy on a hierarchy of effective science writing skills. Science is not about “painting with a broad brush” (and sbm is about science,no?)and I can get that type of broad brush science reporting from any mass media product. I also disagree with the idea that because blogs are “different” (i.e. have a lower bar for accountability and accuracy?) that anything goes. That may be true for most blogs, but my impression was that sbm tries to distinguish itself from the pack. Perhaps my impressions have been wrong for the past year and I should just realize that a blog is a blog is a blog…..hence my decision to view this site as an entertainment venue.

  55. Fifi says:

    Dr Hall – You’re providing a very fine example of how an intelligent and educated person can be seduced by pseudoscience when it confirms their “common sense” feeling or opinion about a subject. Even when the experts have pointed out the bad science and how the science is being manipulated for ideological ends! Because you like the sciency feel of Lomborg’s book, even though you don’t actually have the expertise to analyze the science in this case, and you consider yourself to be “scientifically minded” and agree with his opinions, you give him total credence and just brush off the actual experts as being “emotional”. This is not very different from people into CAM who think that medical pseudoscience supports their opinion or “common sense” belief.

    We all tend to think our own opinion or approach is “common sense”, it’s a very common form of confirmation bias and cognitive trap. It’s why you get engineers and graduates of computer and political science who think that the “science” part or having done statistics means they’re equally qualified in medical science. Climate science is complicated and we certainly don’t know everything (this is also true of medical science) – that’s why reliable experts are so important and discussions need to be based on good science (meaning in reality!). It’s also why proponents of pseudoscience and experts who bastardize science for ideological reasons need to be weeded out AND we need to be vigilant for the tendency for confirmation biases in ourselves. It’s one good reason to read ideas and to talk with people we disagree with, be they experts or not.

    And, yes, the Al Gores, Lomborgs and the energy industry (from oil/gas, hydro to “alternative”) – and their other public faces – all have ulterior motives that include money, fame and power. Just because all these competing commercial and ego interests that pose as left/right (liberal/conservative) are using the issue of climate change to further personal, political or corporate agendas doesn’t mean that climate change and environmental damage from pollution isn’t happening. It’s just disaster capitalism in action, it’s hardly a new way to make oodles of cash (one good reason to know history is to be able to see patterns repeat themselves). Scientists have been discussing the impact of climate change, environmental pollution and finite resources since the 1970s. Of course, no one really listens to scientists – particularly when it requires making changes and there’s a lot of money and power at stake and industry has more clout. (Poor Carter tried to wake up the US regarding energy independence and the environment but was trounced out of office for it. Then the decades of deregulation got rolling – under both neo-liberals and neo-conservatives.)

    If you’re genuinely worried about clean water then reducing and cleaning up industrial pollution and domestic waste is essential, as is not polluting the land and water during wartime by using depleted uranium weapons, or mining by removing whole mountain tops, and so on. There are a 101 reasons – many of them public health reasons – to reduce industrial pollution of our environment and to recognize that we need to use finite resources more wisely. Technology is undoubtedly part of the solution but so is simply stopping doing some really stupid things for short term profit or because we’re energy gluttons. If you’re concerned about malaria, not using poor nations as industrial dumping grounds and factory fodder is part of that picture.

    Dr Hall, clearly you share some political views with Dr Tuteur and feel aligned with her on a wide variety of subjects. I don’t particularly take issue with that if you’d both be honest about your personal biases (with yourselves and us) instead of insisting that your personal opinions or beliefs are evidence based when they’re not. Dr Tutuer has shown herself to be entirely uncritical of the commercial aspects of medicine, and of pseudoscience when promoted by industry. Her prejudices lead her to make up lies/emotional accusations about those she disagrees with for ideological reasons (often in areas where she is clearly not an expert).

    Starting from her first blog, she’s been called out by medical researchers for misinterpreting data or research methodology and assigning nefarious intent to researchers she disagrees with (which is an attempt to manipulate using emotion). Clearly she’s not exactly an expert or experienced vis a vis medical research (being a practicing doctor IS different than being a researcher). Her post on antidepressants not only accused psychologists of having nefarious intentions but entirely ignored the professional context of the discussion within psychology and psychiatry about anti-depressant use. She also ignored the well-known fact that pharmaceutical companies got caught red handed cooking data around SSRIs (surely relevant to the discussion). She focused on one meta-study to try to discredit all criticism of SSRIs, she ignored a critical story by a much more qualified expert than herself in the NYT to make sensationalist accusations about lack of context and sensationalism in MSM reporting (which is pretty ironic), and so on.

    All of these are the tactics of woo merchants that peddle pseudoscience to promote an ideological position and Fox news reporters and not of SBM bloggers or skeptical thinkers. Skepticism has to be universally applied – and we also need to be skeptical about our own “common sense” feelings and beliefs – for it to be true skepticism. If we simply routinely read or support opinions because they align with our own then we’re simply feeding a confirmation bias. If we want to constantly reduce complex issues with areas of scientific uncertainty to sensationalist opinion pieces that contain no scientific evidence on an SBM blog we have no grounds to complain when the MSM does it (in fact, we’re bigger hypocrites). There’s nothing wrong with opinion pieces or a good rant – many of us enjoy reading them and having our emotional reactions and biases confirmed (and some of us enjoy having them challenged). The problem arises when we try to pass off our opinions and emotional rants as being science, or distort or misrepresent the scientific evidence (or scientists) to support our personal bias, or try to claim scientific authority in fields we’re not experts in and dismiss the experts as being “emotional” or having nefarious intent when there’s no evidence that they do. So far Dr Tuteur has done all these things repeatedly and then claims to be being victimized for being called out on doing so (unless it’s a research scientist doing so who’s caught her inappropriately presenting evidence, then she’s all about the suck up…which would be fine if she was actually learning from it and didn’t simply then repeat the same emotionally-based ad hominem type of attack to try to discredit a research scientist she disagrees with yet again!) All of these things combined are what make Dr Tuteur into a cargo cult science blogger and makes it a real shame that she’s using SBM as a platform to promote ideological positions as SBM rather than using this platform to educate lay people about SBM, how science and medicine work, and the difference between science and pseudoscience and how to spot bloggers and writers that promote pseudoscience.

  56. wales says:

    Fifi: “(being a practicing doctor IS different than being a researcher)” Dr. Tuteur is not a practising doctor, correct?

  57. Zoe237 says:

    “The reason that the doctors and scientists who read SBM don’t criticize my posts is because the aren’t published in peer reviewed journals?”

    My point was that you aren’t even a part of the conversation in the scientific community on cesarean section or anything else.

    But since you mention it, there have been several doctors and scientists on this website who have criticized or questioned your leaps of logic, including Dr. Hall (AAP/ACOG position on circumcision), Dr. Gorski (the point of a metaanalsysis), TimMills (log graphs), Edgar (pretty much everything), winddriven (cesarean section, can’t remember the exact objection), and then there are the dozens of commenters who I have no idea who they are, but have been critical. Of course, most of these are with errors in your logic, not necessarily your conclusion. Particularly critical of the numerous errors and direct contradictions in your circumcision post.

    As for academic ob/gyn researchers, I’ve only seen one, possibly two, agreeing or disagreeing with you.

    Your trademarks are false causation (life expectancy and numerous “conclusions”), false dichomoties (cesarean section or unattended homebirth), ad hominem attacks of midwives, continuous assignment of nefarious intentions or academic misconduct to researchers (Johnson and Daviss, McDormand, Villar, Glezerman, the depression scientists from last week), hasty generalization (Colorado midwives association), conclusions from anecdotal evidence (individidual homebirth stories), appeals to emotion (630 babies will be killed by breech deliveries!!!), and numerous strawman (midwives demean women who want epidurals, for example). And appeals to common practice (that’s the way it’s done, so it must be right).

    Oh, and on your intro to the board, there were several medical doctors who were “stunned” that sbm had chosen you.

  58. mgmcewen says:

    Most people eating organic food aren’t longing for a past that never existed, they simply worry about the effect of things like pesticides on their children or want to support more environmentally friendly production methods. Nothing makes me more annoying than the fallacy that organic = ancient production methods. Having worked in a science department at ag school that did work on organic production methods, let me tell you they were’t using horse-drawn ploughs. What they were doing is developing alternative methods to improving productivity to rival Monsanto & Co. using SCIENCE…not ancient magical augers or buckets drawn by goats. You should really attend a real organic ag conference…all the presentations are about science. Maybe you are confusing biodynamic, which is about ancient magical stuff, with organic.

    And who said that paleo dieters want to go back to the stone age? We simply advocate eating food that is good and appropriate for humans in an evolutionary context. You don’t have to be a luddite to simply want to eat human food.
    http://huntgatherlove.com/content/human-health-quadrants

  59. StatlerWaldorf says:

    Zoe237 said, “The reasons that scientists don’t criticize you is that you DON’T ***PUBLISH*** in peer reviewed journals!”

    Amy replied, “The reason that the doctors and scientists who read SBM don’t criticize my posts is because the aren’t published in peer reviewed journals?”

    Do all the scientists on SBM read the ob-gyn studies you are discussing in your blog articles to be able to accurately critique your critiques? I do believe that other scientists have asked questions about your statistical analysis in previous blog articles. Perhaps publishing in peer reviewed journals in your medical specialty could be quite beneficial for advancing science and academia in your field, especially since other researchers have got it wrong in numerous cases?

    Let’s call a spade a spade. You don’t want to contribute to obstetrics and gynecology through research and discussions in the fora of your peers, but would rather focus your intellect and energy on becoming a successful Internet blogger as a Fox News style pseudo-medical expert and moral pundit. “Ask Dr. Amy”! Fair enough, but don’t claim to be flying the flag for science-based medicine.

  60. wales says:

    Billy Joe said in defense of Amy’s style “With Amy, you have to read between the lines.” Is this really the goal of science writing, to prompt readers to substitute their own intuitions and biases for objective fact stated with clarity and precision? I think not (sbm editors, correct me if you disagree.)

  61. Fifi says:

    It does seem very much like blogging at SBM is about career/reputation/audience/customer building for Dr Tuteur and not actually about truly being a skeptical blogger and supporter of the practice of SBM. She reminds me of Penn & Teller (who I find entertaining but who veer into pseudo-skepticism and sensationalism, and have professional ties with industry that blatantly influence what they promote at times). Why does it appear this way?

    1-Dr Tuteur appears to use the blogosphere to promote herself as a product (a book, an iphone application, “personal advice” for sale on her own blog). Kind of odd at SBM since other doctors who use their credentials or professional authority to sell opinions, woo/ideologies or products/books are regularly taken to task here (and rightly so). There’s a commercial driven conflict of interest here that the other SBM bloggers simply don’t have (that I’m aware of anyway, most seem very, very ethical in this regard and have no monetary interest in skeptical blogging or promoting a public image of themselves as skeptical…as retired or practicing doctors and researchers they generally seem to genuinely care about good science and medical practices).

    2-Dr Tuteur doesn’t seem to actually be as engaged in practicing professional medicine or academic research as much as she is with promoting herself as a commercial medical expert/brand (with associated products, including her reputation/expertise, to sell at $4.95 a “personal” email…medical advice by email…really? What’s next? Fortune telling?). Actually it’s pretty clear that despite liking to be sciency and elevating herself on an SBM soapbox to legitimitize her opinions, Dr Tuteur isn’t actually experienced as a medical researcher and is hostile to researchers that don’t support her ideological position (going so far as to make ad hominem attacks on them and casting aspersions on their professionalism). Hence the cargo cult aspect of her presenting as an SBM blogger.

    3-Then, like many dodgy experts there’s incomplete bio info to be able to properly contextualize her expertise (fair enough in PR terms to promote what sells, a bit dodgy in SBM terms not to provide full disclosure regarding current and past professional experience). She reminds me of Dr Phil in this regard (the mistaking folksy “common sense” for actual scientific evidence, the vagueness about current credentials, the down home cosiness of using a first name, etc). There’s no disclosure on her bio here on SBM that she’s got commercial interests that involve selling her “expert” opinion…or that increasing traffic to her own site by being controversial here or elsewhere may well bring her increased profits and at the very least improves her visibility and, with SBM’s blessing, her brand’s “authority” and marketability. In PR the “there’s no bad publicity” motto is common because it’s all about visibility and being in opposition to another brand (natural childbirth) makes business sense. In SBM blogging and scientific research, good reputation and scientific authority can be greatly damaged by bad publicity based on bad behavior and promoting bad science.

    4-Dr Tuteur uses all the same tactics as woo merchants in trying to discredit commenters, research scientists who don’t support her opinion and those she’s in financial competition with; in cherry picking the science she presents to support her pre-existing opinion and doing a cargo cult ritual of being scientific; and by trying to pass off opinion as SBM. The fact that she’s critical of anything “natural” and seems to associate anything medical that isn’t pharmaceutical or surgical with woo, and is totally uncritical of pharmaceutical companies and the commercial aspects of medicine, makes her a one sided pseudo-skeptic. (Besides, what isn’t natural for goodnesses sake?! talk about perpetuating a false idea about nature and reality!)

    5-She’s also acting exactly like woo merchants when she claims she’s being “censored” when she’s being called on doing the things woo merchants do, or when she claims everyone else is being emotional and she’s being scientific (when all she’s doing is projecting her own motivations on others or making unfounded accusations), or when she writes something incorrect and then goes back and changes it after the fact and then claims people have misunderstood what she wrote and are “out to get her.” Another very problematic habit she has is that she pontificates and claims expertize in areas where she’s very clearly not at all up on the latest research or qualified as an expert in! (And yet she mades ad hominem attacks on actual experts in the field and accuses them of bias!)

    It’s pretty outrageous (but interesting) to watch all this unfold on an SBM blog. It also makes me curious as to how she ended up blogging here…. How did she? Who recommended her? Where they aware that she makes money selling herself as a “skeptical blogger” and Dr Amy is a brand and not really just an SBM blogger without these kinds of conflicts of interest?

  62. Zoe237 says:

    “2-Dr Tuteur doesn’t seem to actually be as engaged in practicing professional medicine or academic research as much as she is with promoting herself as a commercial medical expert/brand (with associated products, including her reputation/expertise, to sell at $4.95 a “personal” email…medical advice by email…really? What’s next? Fortune telling?). ”

    Are you serious? $4.95? Did not know that.

    My main confusion is why she’s allowed to plug in old blog entries of hers, when everybody else writes new, pertinent entries every week.

  63. $4.95 is the special introductory offer to have Dr. Amy explain to you how likely it is that you, personally, are pregnant right now.

    Otherwise, it’s $14.95 for a detailed answer to any question about a woman’s health.

    “Do you prefer a confidential, personal response?

    Do you need a long and detailed response?

    Purchase a guaranteed, detailed, personal e-mail response to your question by ordering below.

    Disclaimer: Keep in mind that this is not medical advice and is not a substitute for medical advice. Only a doctor who has examined you and is familiar with your medical records can give you medical advice.

    Ask Dr. Amy.com accepts credit cards and PayPal. You do not need to have a PayPal account to purchase Premium Services.”

    http://www.askdramy.com/premium.html

  64. Fifi,

    Lots of words, but no actual facts. Just your personal opinion repeated over and over again. A number of people have already chastised you for your obvious bias, and asked you to stop. No one is fooled.

  65. “$4.95 is the special introductory offer to have Dr. Amy explain to you how likely it is that you, personally, are pregnant right now.”

    See what I mean about a personal desire to discredit because you feel threatened? You’ll throw anything against the wall to see if it will stick in the hope that you can convince yourself and others that they don’t have to listen to me. It’s not working.

    Do you know how many questions I get each month? One or two. I instituted that method to cut down on the hundreds of personal e-mails I otherwise get each day, and it has been very effective.

    How about sticking with the actual facts? Or do you avoid them because you know you can’t win?

  66. Fifi says:

    Yes, I just discovered that she charges for “expert advice”! I’m really pretty surprised that the SBM editors think this is okay if they knew about it. And to be clear, making a living as a practicing physician or medical researcher is a different thing in the context of SBM blogging – if one is honest about their professional affiliations – than making a living selling oneself as a brand or commercial expert where the blogging is part of your PR, branding or reputation building and is actually part of making a profit. It’s not like being an SBM blogger actually makes you more money as a physician or is a source of income – and if you’re a truly skeptical blogger that takes on unscientific medicine across the board then it may even harm your chances of being hired or promoted.

    Of course, now that I know that Ask Dr Amy is a commercial site and Dr Tuteur is selling herself/her identity as a brand, it makes many of her tactics here make more sense than they first did to me. It’s why context matters for understanding anything – be it a scientific study or an opinion piece. Context and how inappropriate to the context of SBM Dr Tuteur’s post were is what first made the alarms go off for me because her posts are so similar to those of CAM cargo cult science bloggers and her tactics are no different than sketchy PR image management shenanigans…walks like a duck, quacks like duck…produces and sells quackery like online medical advice (for entertainment purposes and not meant as medical advice of course)….hmmm…. What I would really like to know at this point is how Dr Tuteur came to be blogging at SBM and if the editors knew about her commercial interests when they hired her and, if they did, why they don’t see this as a conflict of interest or at least worthy of disclosure in her bio…

  67. Comments on this post alone:

    Alison: more than 40

    Zoe: more than 40

    Fifi: more than 30

    And most say the same thing over and over again, not to mention the same thing they have posted on other threads for completely different topics.

  68. Plonit says:

    Don’t be silly, people! Ask Dr. Amy doesn’t need to make money from answering email questions, there’s plenty of revenue from carrying GoogleAds for sites like this -> http://www.ourpregnancymiracle.com

  69. Plonit says:

    And don’t forget

    Plonit: 10 (oops, 11 now) but then I had 40+ comments on a post by Kimball Atwood. Not quite sure what that is meant to show….

  70. Amy Tuteur on Alison Cummins:
    “You’ll throw anything against the wall to see if it will stick in the hope that you can convince yourself and others that they don’t have to listen to me.”

    Not listen to you about what? You keep saying that I am defending myself against your truth, but I have no idea what you mean. I often agree with you, and when I challenge you it’s most often about your logic.

    “Do you know how many questions I get each month? One or two. I instituted that method to cut down on the hundreds of personal e-mails I otherwise get each day, and it has been very effective.”

    That sounds very savvy!

    Other medbloggers have disclaimers explaining that they can’t respond to personal questions, but I’m sure your method works just as well.

    “How about sticking with the actual facts?”

    The quote from your website is a fact. I didn’t offer any commentary or interpretation at all.

    “Or do you avoid them because you know you can’t win?”

    Can’t win what? I have no idea what you’re talking about. I wasn’t aware that I was fighting anything. As I stated in my comment upthread, “I actually prefer the idea that [Amy Tuteur] is deliberately using a pedagogical technique of withholding crucial elements or including distractors to get her readers to think for themselves. If so, it works and I (mostly) appreciate it. (Yes, yes, I know, I am “making this up” on the basis of no evidence.)” My conjectures might be completely wrong — that’s typical for conjectures — but how is that a war?

  71. Zoe237 says:

    “$4.95 is the special introductory offer to have Dr. Amy explain to you how likely it is that you, personally, are pregnant right now.”

    Alison, how much is it to tell if I’m pregnant by phone?

    That’s just rich.

  72. Plonit says:

    http://felopio.com/

    Also advertised on Ask Dr Amy.

  73. Alex Knapp says:

    Amy,

    Alex Knapp (not one of the 5) had the virtue of at least being honest about his motivations. He has a personal stake in whether I am right or wrong. He has adopted the paleo diet because he is sure it will keep him healthy, and if I’m right, he has been wasting his time. Even more importantly, if I’m right, he has a lot less control over his health than he’d like to think.

    I’m not quite sure what you’re getting at. Don’t we all have a stake in our personal healths? I mean, I’m interested in Science-Based Medicine in the first place because I want to know what the best treatments are for particular conditions. I have an annual physical with my doctor because I want to ensure that I’m in the best possible health I can be because the best available evidence indicates that regular checkups help to promote health. Likewise, I eat a paleo diet because the best available, peer-reviewed medical research that I can find indicates that it’s the best way to lower the risk factors for chronic conditions such as heart disease, diabetes, etc.

    You keep insisting that I “wasting my time,” in adopting a diet geared towards lowering my risk factors for chronic disease but you have consistently failed to back up your statements with any citations to the literature to demonstrate that my position is false. You say that diabetes is a condition of old age, and yet in the Lindeberg 2007 study I cited above, it’s worth noting that of the Type II diabetics who were given a paleo diet, every single one had normal fasting glucose levels and normal insulin sensitivity by the end of the study. Every single one. And this article isn’t an outlier or the only piece of research demonstrating similar results, either. This greatly undercuts your thesis that Type II Diabetes is merely a disease of old age.

    Every time you have asked me for research to support my claims, I have provided it. So now let me ask you this: what is your evidence to support your thesis that diet has no impact on risk factors for heart disease and diabetes?

    And if you reply with a “you’re twisting my words” argument, feel free to clarify your position. I simply ask that you support whatever position that you do hold with actual evidence.

  74. Fifi says:

    Dr Tuteur – It’s not particularly relevant how much money you make at the moment by selling your expertize on your Ask Dr Amy website, being unsuccessful doesn’t mean you haven’t tried to commercialize your expertize and that you aren’t trying to sell medical expertize online. Nor does it mean you’re not overly invested in maintaining a public image or protecting a brand in a way that creates a conflict of interest on an SBM site. (And may cause some confusion for you regarding SBM as a practice and your professional/personal identity as a “skeptical blogger” that means ego comes into play in areas that should be about evidence.)

    You may have fooled some people with your posturing as an SBM blogger and skeptic – just like CAM and antivax pseudoskeptics and climate change deniers fool some people by posturing as if they’re promoting science and skepticism – but you’re actually pretty easy to spot for anyone who is a critical thinker familiar with certain PR/propaganda/debating techniques and who isn’t just looking to affirm a particular bias they share with you. (The fact that you constantly assume that anyone who critiques you is promoter of your pet peeves and not an advocate of SBM only strengthens the impression you’re into black/white thinking and not actually SBM.)

    You’re particularly easy to spot for those of us who are familiar with the tactics used by people peddling CAM pseudoscience (and marketing/propaganda techniques). You don’t actually need to be able to analyze all the scientific studies to do this as a skeptical thinker, there are rote clichés and tactics that get used when people are doing cargo cult science blogging or misrepresenting ideology as being evidence/science-based and you’ve used most of them. Also, if one is at all interested in basic cognitive science or psychology then it’s easy to spot the cognitive traps us humans fall into unconsciously if we’re not on guard for them, and sometimes even when we are. You really don’t seem to be very well informed in these areas (but then you’ve expressed some hostility towards cognitive science and psychology and seem to equate then with woo so that’s not surprising).

  75. “there’s plenty of revenue from carrying GoogleAds for sites like this -> http://www.ourpregnancymiracle.com

    Hmm. You make 100% of your income by practicing midwifery. Why should we dismiss your criticism because of your obvious economic conflict of interest?

  76. Fifi says:

    Dr Tuteur – My repeating my analysis of the way you communicate can certainly be brushed off as personal opinion. You keep doing the same things over and over again, so I point them out again. (For instance, you were called out on your very first blog for inappropriately accusing researchers of having nefarious motives and fiddling data – an emotional and ad hominem attack – and then you did exactly the same thing again in your blog about antidepressants. Yet you cherry pick data to promote a personal opinion over and over again…this particular blog post was pretty much nothing but personal opinion about an area you’re clearly no expert in!)

    Since you keep making the same claims to be being victimized and projecting motivations onto commenters here over and over again as if doing so makes it true, clearly you don’t actually have a problem with that kind of thing when you’re doing it yourself! When you start acting like a reasonable SBM blogger instead of behaving like a desperate narcissist frantically engaged in image control, you’ll get treated like the other SBM bloggers do. Your personal narrative about the kinds of responses you get is as faulty as it is self-aggrandizing – it’s also very familiar from antivaxers and the most nutty alt med promoters!

  77. Plonit says:

    Exsqueeze me? Midwives in the UK get paid for doing their job (which includes employing the best available evidence) regardless of whether their recreation is commenting on SBM or yoga. And regardless of the positions they take on SBM (or indeed in yoga). So…I’m not sure what your argument is regarding conflict of interest….

    It surely is strange for an SBM blogger to get revenue from GoogleAds for services such as this http://felopio.com/

  78. Plonit says:

    I think my reply may have got eaten by moderation, but you obviously know nothing about the remuneration of UK midwives if you think any economic benefit accrues from my “web presence”.

  79. Amy,

    Yes, I comment a lot. As I stated upthread: “I follow her blog for the community of argumentative commenters that she builds.” I haven’t gone through every single comment, but in my first 14 comments I responded to you 5 times and to other commenters 11 times.

    I responded to your request for explanation of why it might be unjustifiable to conflate population health and population size; to your explanation of the Down syndrome theory of menopause; to your request for evidence that parental longevity leads to increased child survival; and to your definition of alternative medicine.

    I don’t recall discussing any of these topics on any other thread, which is why this thread is interesting.

  80. Fifi says:

    Heh. Plonit is a practicing health professional like the practicing doctors and researchers who blog and comment on this site are – it’s not at all the same as selling yourself as a brand or online expert (plus plonit is not promoting herself professionally, she’s discussing medical issues and the evidence using a pseudonym). Sure she makes her living as a midwife but she does so as a part of a medical system where she isn’t competing for customers and works cooperatively with OBs. You may as well accuse Dr Gorski of having a conflict of interest or any of the other working medical professionals here. However, none of them stand to profit from writing their blogs (or commenting here). You stand alone in being in the position of having a commercial aspect to your identity as an online “skeptical” blogger and are clearly marketing a Dr Amy brand and not just sharing professional expertize regarding SBM or certain issues.

    It’s pretty telling that you can’t actually discern what is and isn’t a conflict of interest!

    1. David Gorski says:

      You may as well accuse Dr Gorski of having a conflict of interest or any of the other working medical professionals here.

      In all fairness, that’s not entirely true. I’m paid for my other blogging gig. It’s not a lot compared to what I make at my real job, but it’s not just a few bucks a month, either, and it’s based on traffic. One could argue that I have a conflict of interest in maintaing that other persona. On the other hand, I try hard to keep that persona (mostly) separate from my work at SBM, although regular readers of both recognize that from time to time I crosspost. Sometimes I recycle text between the two, although hopefully in the context of making two sufficiently different posts that they’re both worth reading. Sometimes I resurrect old posts from my other blog that I am particularly proud of and update them for SBM. Sometimes I cobble together old posts from my blog relevant to the topic at hand, update them, and add a new section about whatever new development that inspired my post. Most of the time, though, I write new material for SBM.

  81. Fifi says:

    Some of my posts are getting delayed by “waiting in moderation” too. No biggie but kind of entertaining in light of Dr Tuteur’s highly emotional claim that we are trying to censor her ;-) I do enjoy irony! (And am well aware that it’s more likely a software thing and not a personal attempt to silence – self mocking sarcasm on – my oh so powerful commentary because Dr Tuteur is so scared of my insights and how I challenge her deeply held beliefs! Sarcasm off/ that said, she does seem to mistake critique of style or content as a personal attack and be fond of using ad hominem attacks against researchers she’s writing about and doesn’t agree with.)

  82. wales says:

    Fifi, speaking of sbm bloggers “However, none of them stand to profit from writing their blogs (or commenting here).” Do you know this for a fact? I know nothing of the compensation agreements between the sbm bloggers and what I gather are affiliated entities Science Blogs or Seed Media, or what corporate entities might be contributing to Science Blogs and Seed Media and SBM. Anyone have any information to offer? I ask that purely in the interest of transparency and imply no conflict of interest, merely questioning the assumption that no profits are involved in blogging for sbm.

  83. Alex Knapp says:

    Plonit -

    I don’t think it’s fair to criticize Amy on the basis of her Google ads. As the owner of a site that runs Google ads myself, I know that you have virtually no control over what pops up–often to great frustration. For example, when I was commenting on one of SBM’s great takedowns of acupuncture on my blog and went further on about it (acupuncture being something I can’t help railing against), it was only natural that ads FOR acupuncture showed up!

  84. Fifi says:

    Plonit – To be fair, most site owners have little control over which google ads appear on the site. I wouldn’t even take issue with google ads really myself. For me the issue is that she sells medical advice online as part of her Ask Dr Amy brand (and it’s as a “premium service”). When I looked up ownership of the site, it was indicated that she also owns other domain names. I have no idea if any of them are active or make any money (or if that’s accurate, but then I don’t trust Dr Tuteur to be honest either at this point anyway). However an SBM blogger really should be giving full disclosure regarding their commercial interests and associations – being transparent about one’s associations is a pretty basic part of being ethical in science and SBM blogging too!

    cubestat says she made $30 a day from ad revenue 9 months ago and, when I updated, that she now makes about $17.50
    http://www.cubestat.com/www.askdramy.com

    And the Whois search results…
    http://whois.domaintools.com/amytuteur.com

    Whois Record
    Registrant Search:
    “Amy Tuteur” owns about11 other domains
    Email Search:
    is associated with about 12 domains
    is associated with about 232,100 domains
    is associated with about 364,632 domains
    Registrar History:
    1 registrar
    NS History:
    1 change on 2 unique name servers over 4 years.
    IP History:
    1 change on 2 unique name servers over 4 years.
    Whois History:
    16 records have been archived since 2007-10-25 .
    Reverse IP:
    283,150 other sites hosted on this server.

  85. Plonit says:

    Ultimately, you are responsible for what appears on your own website.
    If you regularly have prominent advertising for sCAM products trading on the misery of infertility (e.g. http://www.naturalypure.com , in addition to those already posted upthread) – then you have some responsibility for that.

    No one forces anyone to carry GoogleAds. People who do so are willing to sacrifice editorial control in return for the income generation.

  86. Plonit says:

    Lost in moderation again…let’s just say you cash in your integrity when choose to carry advertising with no control over the content.

  87. Fifi says:

    Dr Gorski – Thanks for being open about it and owning up to how you may have a conflict of interest that you need to be aware of. I wasn’t aware of your other blogging gig was paid but I was aware you also blogged under a (notorious) pseudonym elsewhere because you mention it in your bio. Since you don’t mention what it is or link to it though, you’re hardly using this blog to drive traffic there. (Though perhaps NOT giving out the info and mentioning notoriety is a clever bait and switch type of scheme to get us all out there trying to solve the puzzle…mouhahaha.) No, seriously, you seem to have managed to divide the two in an ethical and honest way – unless it’s Big Pharma or Big sCAM paying you to blog or some such and then it would be relevant because of the potential influence on what you publish here.

    Conflicts of interest and confirmation biases happen – it’s just part of reality and part of SBM is being honest about these things and mitigating their effect as much as possible. That’s why I’ve been taking issue with how Dr Tuteur makes her arguments (accusing research scientists of being biased simply because she disagrees with them and they don’t confirm her biases, and using so many of the same emotive, sensationalizing and flat out dishonest tactics that are so often critiqued by bloggers on this very site…even Dr Tuteur while she’s busy doing the same thing!)

  88. Zoe237 says:

    “Comments on this post alone:

    Alison: more than 40

    Zoe: more than 40″

    I have no idea the point you were trying to make here, but it was 34 at the time you made that comment. Mostly in response to people quoting me.

    I’m not sure it’s entirely ethical to charge people to tell them if they are pregnant by EMAIL!!, particularly when one is not licensed or insured. But others would know far more about that me, and I do note the disclaimers.

    I think Plonit was being tongue in cheek with her comment about Dr. Tuteur’s ad revenue.

    So doctors don’t get paid to blog here? Why does Dr. Tuteur never write new material for the blog like everybody else? I have to say the number one reason for me reading this particular website (as simple as it sounds) is that there are no ads and I can change the size of the text. But then, what is the funding source?

  89. Fifi says:

    Wales – SEED media publishes the science magazine SEED and hosts ScienceBlogs. It’s worth familiarizing yourself with if you’re interested in science and good magazines (though their fondness for humanism and art, and some other factors, does make me positively biased towards them).

    http://seedmagazine.com/

    http://en.wikipedia.org/wiki/Seed_(magazine)

  90. JMB says:

    As far as the discussion of Dr Tuteur’s style, I think most medical doctors would recognize the style as a provocative style of teaching used by attending physicians and residents to get medical students to think for themselves. The goal of the style was to teach students how to think, beyond just regurgitate facts for a test. There is a difficult transition for a medical student graduating from the task of answering questions on a test, to the task of making decisions to help a patient. The attending would often make a statement that would result in a lot of discussion, but a lot of errors in thought processes would be revealed and opened up for criticism. That was a process not easily duplicated on a test. Usually the statements by the attending were carefully crafted (often by years of experience and repetition) to scatter traps for unsuspecting students.

    I used to teach in medical school. I remember how a group of PhD educators complained about my use of such techniques in computer aided instruction. Such a style is not common in general education, but common in medical education. Is it justified? That’s a matter of opinion. However, it is effective at getting some students to be much more circumspect about how to solve a problem using medical literature. It is pretty hard to come up with other methods of teaching problem solving, other than practical experience. It is an attempt to develop some skills in medical students before they assume responsibility for care of a patient as a resident. While the teaching could be pretty harsh, the price of incompetence in a resident is high. It does tend to give a unique flavor to discussions about science by medical scientists.

    It may seem harsh in a blog, but I can guarantee it is tame compared to medical school (although medical schools may now be much kinder and gentler). Strip away the emotional overlays, and there is still an underlying emphasis on interpretation of scientific evidence. To make a recommendation for a patient based on scientific evidence requires a rigorous approach by the professional doctor to evaluate scientific evidence. That ability is not easily taught.

    Many medical students didn’t like that approach, so the backlash is to be expected. I don’t think there is any motivation in the approach, other than it helped Dr Tuteur, so Dr Tuteur feels others should be exposed to the method for possible benefit.

    SBM is not a peer reviewed journal publishing original scientific observations, so the articles are not required to have the same rigor in observation and citation. The author may request such citations from responders, so that the critical review can be applied to such papers.

  91. Fifi says:

    zoe – “I’m not sure it’s entirely ethical to charge people to tell them if they are pregnant by EMAIL!!,”

    Actually, it’s even more like fortune telling since it’s about telling people their chance of getting pregnant…oh, wait…it could be either… Either way, it does seem like it’s taking advantage of desperate women who should simply be seeing a doctor to either find out if they’re pregnant or able to become pregnant (both situations that women can feel rather anxious and emotional about and both conditions that can’t really be evaluated via email in any meaningful way).

    “Premium response: Chance of pregnancy – This is a personal e-mail response detailing the chance of pregnancy in your specific situation.”

  92. JMB,

    Makes sense to me. That was essentially the conclusion I’d come to, though I hadn’t made the link to pimping.

    Question: is it normal for attendings to complain that their medical students are censoring them when the medical students notice they are being pimped?

  93. Harriet Hall says:

    Full disclosure:

    SBM bloggers are not paid. In fact, I had never been paid for any of my writing until this January when “O, The Oprah Magazine” started paying me to write a short column. I maintain my own website and I pay for that myself. I have never been paid for public speaking, either, except for receiving a small honorarium for being on the faculty of The Skeptic’s Toolbox last summer. I have never been paid anything by Big Pharma and I have not even been in the same room with a drug rep in the last three decades. Oh, and some of my SBM material is not new: I have reprinted or linked to articles I have written for Skeptic, e-Skeptic, and Skeptical Inquirer and to the PowerPoint presentation I gave at the Skeptic’s Toolbox.

  94. Fifi says:

    JMB – I don’t buy your explanation since there are other factors at work here and Dr Tuteur’s style and even the content of her posts has more to do with how CAM pseudoscience promoters operate than any medical scientist or doctor I’ve known (including ones that teach). There’s nothing particularly educational about the way Dr Tuteur writes, unlike Dr Crislip, Dr Jones, Dr Gorski or Dr Novella. Sure they sometimes have axes they’re grinding but they’re very rarely simply promoting personal opinion about subjects they’re not experts in as SBM! Nor are they promoting themselves as a brand.

  95. Plonit says:

    Crikey JBM, I now have an image of Sir Lancelot Spratt of St. Swithin’s

  96. Zoe237 says:

    “As far as the discussion of Dr Tuteur’s style, I think most medical doctors would recognize the style as a provocative style of teaching used by attending physicians and residents to get medical students to think for themselves. The goal of the style was to teach students how to think, beyond just regurgitate facts for a test. ”

    JMB, how would you describe this style of teaching or writing? Can you describe the use beyond medical school, since I’m unfamiliar with teaching medical students?

  97. Zoe237 says:

    “SBM bloggers are not paid. In fact, I had never been paid for any of my writing until this January when “O, The Oprah Magazine” started paying me to write a short column.”

    Finally, a reason to pick up O magazine for the first time! Does that mean Dr. Oz is not in there anymore? (I really really can’t stand that man).

    Thanks for the explanation.

  98. Fifi says:

    JMB – I don’t expect SBM to be peer reviewed. I do, however, expect a blogging collective that calls itself Science-based Medicine and purports to support and promote SBM to actually do that. Why? Because otherwise all you’re doing is giving credence to the critics of SBM in the eyes of the public and presenting an image of science that has nothing to do with the ethical practice of science or educating the public. This isn’t a beat up on the interns session, this is SBM blogging that’s meant to support SBM and educate the public about what is science and what is pseudoscience…or at least I thought that was what this site is about!

    Dr Hall – That’s pretty funny that you’re writing for Oprah’s magazine, all things and her history here and with CAM considered. No doubt you’ll fit right in with “common sense” Dr Phil and Dr Oz who both promote woo and Suzanne Summers….hey, maybe you’ll even get your own TV show. Fun aside, maybe that means she’s actually learned something from that whole Secret death sauna debacle and is backing away from the woo (or is at least trying to polish her image). One can only hope. I’d say you’re more influenced by having worked in the military than anything else from what I’ve read of your posts and certain very traditional perspectives you promote. I don’t find that particularly problematic, even when it is clear that you have a bias you’re unwilling to own up to (which I only ever really noted on the circumcision thread where you refused to acknowledge that having performed circumcisions may lead a doctor to not want to see them as being harmful).

  99. Fifi says:

    Plonit – I believe you can also ask for certain ads to be restricted but it’s pretty time consuming. That said, I’ve always found the google ads on skeptic sites to be very funny since they’re almost always advertising woo of some kind. Not much of a problem on a skeptics site really. However I can see how it could lead someone visiting a site with questions about pregnancy to click on one and wander down the path of woo assuming it was somehow sanctioned by the site (fi they don’t understand how google ads work).

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