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The Weekly Waluation of the Weasel Words of Woo #2

You Can’t Foo’ Stu with Woo!

A Spitzerian (“pointed”) analysis

Last week’s inaugural game elicited several amusing and penetrating analyses, including that of the hands-down Gold Medal Winner, Stu. His was the first entry, introduced in a concise and alliterative imperative, and was both hilarious and timely. It implied most of the points discussed by others. This distinctive combination has moved me to grant Stu a legacy here at the W^5. In the future there may be, undoubtedly no more than once in a very long while, entries that live up to the Soaring Standard of Stu®. If so, they will be Duly Acknowledged.Three readers—Sastra, DVMKurmes, and Skeptico—cited the passage’s perverse celebration of deception, which had also struck me as its seminal contribution to the literature of academic “CAM.” Others, including Will TS, daedalus (as revealed by his self-confessed performance lapse), and pmoran, adduced the unctuous tone and style, which, although hardly new for “CAM” literature, in this lubricous passage mounted a new Pinnacle of Perfidious Palaver®—and is, accordingly, Acknowledged as Such.

Calli Arcale called attention to the authors’ use of the passive voice to evade the truth; yet although the passage was evasive and the passive voice is a popular device for cloaking evasion, in this case the authors achieved phantasm by other means. Consider the most astonishing sentence in the essay: “They never fail to find a problem.” That sentence is in the active voice (its passive form is “A problem never fails to be found”). After a quick perusal I believe that most, if not all, the sentences are in the active voice, but if I’m wrong please forgive me, Calli Arcale; your greater point about duplicity is correct.

I was waiting for someone to observe that amid its turgid language, the passage offers an almost perfect description of quackery. Is it possible that its authors were unaware of that?

Regarding other readers’ discussions of paternalism, maternalism, and religion in medicine, I wasn’t sure whether they were referring to the W^5 itself or to the greater blog, so I’ll respond only by observing that those entities are by no means mutually exclusive. Consider the common depiction of the deity as “father,” or the hoary custom of at least one major religion (that of my own forebears) to refer to its preachers by the same moniker. That religion is also preoccupied with the Mother of the Father’s Son who also just happens to be both the Father Himself and another ethereal Being…it gets very complicated. Which reminds me that the authors of the inaugural passage attribute their assertion in the second quoted sentence to an article that takes “an interpretive or hermeneutic approach” [to] “accounts of religious healing…among Catholic Pentecostals.” Any reader who can tackle the prose in that abstract deserves a heapin’ helpin’ of extra credit.

The New Passage

This week’s passage—which includes its own take on “medical paternalism”—is from the prestigious Institute of Medicine’s 2005 report, Complementary and Alternative Medicine in the United States:

The ethical principles that guide conventional biomedical research should also be applied to CAM research. Legal and ethical issues often arise and sometimes conflict with use of CAM therapies because the decision facing a conventional practitioner or institution may engender a conflict between medical paternalism (the desire to protect patients from foolish or ill-informed, though voluntary decisions) and patient autonomy. The Model Guidelines noted above seek to establish greater balance between physician and patient preferences. In addition, a number of legal rules—including state licensure laws, precedents regarding malpractice liability and professional discipline, state and federal food and drug laws, and statutes on health care fraud—protect patients by enhancing quality assurance, offering enhanced access to therapies, and honoring medical pluralism in creating models of integrative care.

Without rejecting what has been of great value and service in the past, it is important that these ethical and legal norms be brought under critical scrutiny and evolve along with medicine’s expanding knowledge base and the larger aims and meanings of medical practice. The integration of CAM therapies with conventional medicine requires that practitioners and researchers be open to diverse interpretations of health and healing, to finding innovative ways of obtaining evidence, and to expanding the medical knowledge base.

The W^5 Get’s its Own Blog

The W^5 will henceforth appear every other week, alternating with “conventional” material. This will make it easier for me to keep it up and to keep track of which comments are entries and which are not. The time limit for submitting entries (“translations”) will therefore be extended to an entire week. This presents a minor problem with the name of the game…which will now be The Weekly Waluation of the Weasel Words of Woo/2, or W^5/2.

Happy Waluating!

The Misleading Language and Weekly Waluation of the Weasel Words of Woo series:

  1. Lies, Damned Lies, and ‘Integrative Medicine’
  2. Integrative Medicine: “Patient-Centered Care” is the new Medical Paternalism

Posted in: Chiropractic, Humor, Medical Academia, Medical Ethics

Leave a Comment (11) ↓

11 thoughts on “The Weekly Waluation of the Weasel Words of Woo #2

  1. David Gorski says:

    If you have enough time, you could always just do two posts on Friday, a “standard” post scheduled to appear in the morning and W5/2 scheduled for the afternoon. No rules against two posts a day, and I’ve been tempted to do that on occasion. I’m sure it’s only a matter of time before I do. Besides, as you know, in another place, I’ve done way more than that…;-)

    But on to my favorite part of the excerpt:

    Without rejecting what has been of great value and service in the past, it is important that these ethical and legal norms be brought under critical scrutiny and evolve along with medicine’s expanding knowledge base and the larger aims and meanings of medical practice. The integration of CAM therapies with conventional medicine requires that practitioners and researchers be open to diverse interpretations of health and healing, to finding innovative ways of obtaining evidence, and to expanding the medical knowledge base.

    TRANSLATION: Those pesky licensing laws, standards of ethics, definitions of the standard of care, and malpractice laws all greatly interfere with our desire to “integrate” our favorite types of ineffective woo with scientific medicine. They must be changed to be more “open” (i.e., lax) towards our favored modalities.

  2. Kimball – also feel free to post up the w^5 on Saturday. Weekends are good for lighter entries, and there is currently nothing on Saturday.

    I’m sure you noticed how quickly David and I volunteered you for extra work. :)

  3. David,

    You caught me with my pants down (OK, that’ll be the last joke at the expense of the beleaguered ex-governor). I usually don’t have the time, which is why I decided to cheat on y’all (stop it awready!) by settling for the fast and easy charms of the W^5—every other week, of course. I may come to have enough time, or just be cocky enough, to discharge my two responsibilities on the same day (with a suitable refractory period between the two times). [ouch]

    KA

  4. Steve and David,

    Aren’t you being kind of hard? Although come to think of it, the W^5 on Saturday would make a nice climax to the week.

    KA

  5. Stu says:

    Thanks for the praise. I actually blushed.

    No pressure, then, for this entry:

    The ethical principles that guide conventional biomedical research should also be pretended to be applied to CAM research. Legal and ethical nuisances often arise when CAM kills or harms someone and sometimes conflict with scamming desperate people out of money by use of CAM therapies, because the decision facing a conventional practitioner or institution may engender a conflict between medical paternalism (the desire to protect patients from foolish or ill-informed, though voluntary decisions) and a patient’s God-given right to believe CAM propaganda and think they know better than people who slaved for over a decade to learn how to actually heal them. The Let The Patient Harm Themselves Already Guidelines noted above seek to establish greater balance between physician and patient preferences, by which we mean the patient always knows better. In addition, a number of legal rules—including state licensure laws, precedents regarding malpractice liability and professional discipline, state and federal food and drug laws, and statutes on health care fraud—annoyingly protect patients by checking up on CAM snake oil, offering enhanced access to faith-based therapies, and honoring CAM’s right to pretend to be actual medicine in creating models of taking all of the credit and none of the blame.

    Without rejecting what has been of great value and service in the past (such as blood-letting, tithing and animal sacrifice), it is important that these ethical and legal norms be brought under critical scrutiny and be neutered when they get bothersome along with medicine’s expanding knowledge base (except the pesky parts that contradict CAM), and the larger aims and meanings of medical practice, such as shaking down the patient for as much money as humanly possible. The integration of CAM therapies with conventional medicine requires that practitioners and researchers throw out everything they know about science and pretend CAM actually does something, to finding innovative ways of obtaining evidence (such as accepting the irrefutable fact that anecdote+anecdote=data), and to expanding the medical knowledge base with things that aren’t actual knowledge.

    Wait. Did we say that out loud?

  6. TsuDhoNimh says:

    “After a quick perusal I believe that most, if not all, the sentences are in the active voice, but if I’m wrong please forgive me”

    They are technically in active voice, but the consistent use of the active voice of the modal verb “can” is straight from Weasel Word Wun-Oh-Wun. http://www.englishpage.com/modals/can.html explains modal verbs … they are worse than passive voice because it allows one to express all sorts of possibilities without ever having to make them happen.

    “Can generate” is not the same as “generates”. One implies the possibility, however remote, and the other is a statement that can be tested.

    I’m a grammar nazi by trade.

  7. TsuDhoNimh [aren't you the official East Asian grammar consultant for Click and Clack, "the tappet brothers?"],

    Right you are, in both the instant and the general cases: weasel words are favorites of the “CAM” cabal. Heil stickler!

  8. Michael X says:

    Translation via elipsis.

    … [E]thical principles … should … be applied to CAM research.

    Legal and ethical issues often arise … with use of CAM therapies.

    … the decision facing a conventional practitioner or institution … engenders a conflict between medical [ethics] and [CAM]

    … [N]ot rejecting what has been of great value and service in the past, … these ethical and legal norms .. scrutin[ize] the integration of CAM therapies with conventional medicine … and … to finding innovative ways … to expand [our] … base.

  9. wertys says:

    *Without rejecting what has been of great value and service in the past, it is important that these ethical and legal norms be brought under critical scrutiny and evolve along with medicine’s expanding knowledge base and the larger aims and meanings of medical practice*

    They don’t say what it is that has been of great value in the past. Principles? Iron kettles? Horses?

    I agree critical scrutiny is required, as it is of all claims made in healthcare. No argument from me there. But there appears to be a suggestion that the ethical norms should evolve, as the aims of medical practice enlarge. I thought (and I’m old-fashioned this way) that the aims of medicine had not really changed since before Hippocrates, ie to relieve human suffering brought on by infirmity and disease. Medicine’s knowledge base is expanding but again that shouldn’t mean that ethical standards change. And how does this discussion relate to rejecting faithful old trusty things that have been of service?

    *The integration of CAM therapies with conventional medicine requires that practitioners and researchers be open to diverse interpretations of health and healing, to finding innovative ways of obtaining evidence, and to expanding the medical knowledge base.*

    This is a non sequitur from the first part of the paragraph. It seems to attempt to imply that there is an imperative to integrate sCAM into the medical profession, when there is no such imperative (unstated major premise). I also disagree that if such a miracle is to be achieved, that it requires the medical profession and the science based healthcare enterprise to change. What is required is for proponents of sCAM to provide scientific evidence of their treatments being both plausible within the known principles of biology and in fact physics, and effective. I am very concerned about the implication that ‘innovative ways of obtaining evidence’ might mean that we should throw in the scientific method and begin believing any shit that gets served up with a smile. I simply refuse to do that. The final meaningless phrase would again appear to be self-evident. Nobody can object to increasing the sum of medical knowledge. However the authors are using it as a ‘dog whistle’ to make a special plead that sCAM should be part of the body of legitimate medical knowledge. Well guess what. it already is ! We know a lot about how it is implausible and ineffective….

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