What did I miss here?

[Diamond]

From the "scientific misconduct blog" a stirring defence of a woman cruelly mistreated by the GMC for her views on homeopathy and deciding its perfectly right for parents to withhold vaccination.

According to the blog:

Quote:

The trial of Dr Jayne Donegan MBBS DRCOG DCH DFFP MRCGP MFHom is highly relevant to the whole process of scientific debate. This August 2007 "trial" has the makings of an important stage play about the nature of science.

Dr Donegan is a medical doctor and family practitioner. She also has some interest in homeopathy. She graduated as a medical doctor at St Mary's Hospital Medical School (London) in 1983. It is reported that she is an excellent doctor. Donegan is however one of several medical doctors in the United Kingdom who holds views about science that have led to selective disciplinary/"fitness to practice" procedures (FTP) by the General Medical Council.

I hold no particularly strong views on vaccination. I agree with most observers (such as the Cochrane Collaboration) that much of the science in this area is exceedingly poor in terms of quality and transparency. I have views about homeopathy that are most unlikely to be viewed sympathetically by Dr Donegan.

However Dr Donegan's "sin" was precisely to do with the science of conventional medicine. She testified in an important court case in which mothers and fathers differed in their views over whether their children should be vaccinated (vaccination is not compulsory in the UK). Two witnesses for the fathers provided a view that would have pleased the Department of Health. Donegan provided testimony for the mothers. She provided a detailed scientific report which concluded that a perfectly rational parent making a decision about vaccination for their own child might well have some valid fears about the integrity and strength of the underlying science. For her sins, Jayne was subjected to a lengthy Fitness to Practice Procedure.

Oh the horror. The other witnesses provided a view that would have "pleased the Department of Health", while the heroic Dr Donegan "provided a detailed scientific report".

Very scientific.

According to Dr Donegan's own website:

Quote:

Dr Jayne Donegan MBBS DRCOG DCH DFFP MRCGP MFHom

August 24 2007 - Statement from Dr Jayne L M Donegan, who was today cleared of serious professional misconduct by the General Medical Council.



" I have always maintained that the court evidence I gave was based on objective, independent and unbiased research and I'm pleased that this has been recognised by today's verdict."

"This has been a very distressing time for me and my family and I would like to thank those who have supported me throughout, and to the legal team assembled by the Medical Defence Union and led by Ian Stern QC."

"I am looking forward to continuing my work, offering my patients the best care I possibly can."

GP & Homoeopath with a special interest in vaccination, promoting health and practical and supportive treatment of childhood and adult infectious diseases and other illnesses

That one word alone should get her struck off. But this is the 21st Century and doctors aren't struck off for prescribing magic water instead of effective medication or putting childrens' lives in danger by providing pseudoscientific evidence to justify the witholding of vaccination.

[fls]

Originally Posted by Diamond

From the "scientific misconduct blog" a stirring defence of a woman cruelly mistreated by the GMC for her views on homeopathy and deciding its perfectly right for parents to withhold vaccination.

That one word alone should get her struck off. But this is the 21st Century and doctors aren't struck off for prescribing magic water instead of effective medication or putting childrens' lives in danger by providing pseudoscientific evidence to justify the witholding of vaccination.

Someone linked to that story a few days ago (don't remember the thread name). I didn't read through all the testimony (there are pages and pages and pages). She had originally been chastized for drawing conclusions that were different from those generally supported by the research. But the council found that because she had included references, so that anybody could go read the original articles themselves, that was okay. I actually found that reasoning a bit bizarre, and I noticed that only one member of the council seemed to be a physician, while the rest were lay-people. I figured I was missing something, so I was going to look into it a bit more, but I forgot (or maybe got busy).

Linda

[DRBUZZ0]

This baffles me: Homeopathy's very foundation is not only scientifically invalid, it's totally illogical and can be demonstrated so with a few very basic thought experiments. You don't need to be a genius to realize that the whole premise is, to put it bluntly: Just stupid and plain absurd

How the hell can one go through medical school and become a licensed doctor and still support homeopathy? It boggles the mind.

[Dr. Imago]

Originally Posted by DRBUZZ0

How the hell can one go through medical school and become a licensed doctor and still support homeopathy? It boggles the mind.

What do they call the person who graduated last in his/her class at the worst medical school in the world? Doctor.

Seriously, there are supposedly (at least in the U.S.) stop-gaps that exist to prevent practitioners who are "dangerous" to the public from retaining the ability to spread their menace to the masses. We have rigorous standardized licensure exams that exist to test the basis of medical/scientific knowledge that demonstrate minimal knowledge to be a safe practitioner. Additionally, there is a period after medical school, called "residency", where the practitioner is supposed to gain further supervised instruction in their specifically chosen medical discipline before being "turned loose" on the public. After that, there is board certification and continuing medical education that one must pursue in order to keep their license and good standing with their practice board.

The problem is, this process is slow and cumbersome and requires due diligence on the part of the "questionable" doctors' practicing colleagues in reporting them for the "chain of custody" to start that would lead to official sanction, censure, or de-licensing by governing bodies. This can literally take years, even if those colleagues actually have the guts to report a "problem" physician. Likewise, there is tremendous personal risk (professional, financial, and emotional) to the courageous reporting physician.

The vast majority of doctors out their practicing are well-intentioned and practice under "standard of care". Still, I've met some, albeit a small minority, who just don't "get it" when it comes to the best course of action in patient care. I can't myself understand how they were able to get through school, the licensure process, and through a residency. I think some of this has to do with the fact that they were able to jump through the hoops early on and demonstrate that "minimum knowledge" in order to become licensed. Once out of that tightly supervised system, bad thoughts and habits can creep back in.

After residency and board certification (which you can achieve within a year following residency for most specialties), there is a period of independent practice where, I believe, these practitioners start to get off track. Remember, these are (generally speaking) not stupid people - they've made it through the "system" so far and they've proved that they can learn medicine. It's just that they are, like others, susceptible to being swayed and biased by their own interpretation of the data they read. It's scary sometimes, and I've seen this in my training, how many physicians don't really apply critical thinking on a daily basis. I fault this to the fact that much of modern medicine has become formulaic and algorithm based, and I think some of these people's subsequent (and often wrongful) notions are borne out of a reaction to the paternilism that the "ivory towers" are telling them what to do; that they don't have any independent say in how they will actually treat their patients outside of what's perceived as the "standard of care" once that's been established.

I can't help but think that many of these wayward physicians narcissistically perceive themselves to be iconoclasts and champions for their patients, and egotistically believe that they know better what to do for their individual patients than any powerful study can tell them. It's the worst form of observer bias, and they rely more on their own empiricism and observation than they do on good science. In other words, they've forgotten the principles of medical ethics they learned in school. In other words, they perhaps don't understand or no longer believe that they have a bigger responsibility to their patients and their colleagues, and somehow think the medicine they practice locally and individually is different (and superior) to that practiced elsewhere.

It often really is only simply a case of egotism gone horribly awry. Other times, clearly, they are examples of people who squeaked through the system and got turned loose on the public, for whatever reason.

-Dr. Imago

[Skeptic Ginger]

Originally Posted by fls

... I noticed that only one member of the council seemed to be a physician, while the rest were lay-people....

Linda

As is often the case as regulators and politicians address medical issues. This is where banding together such as the AMA or medical leaders at the CDC or any group of experts need to speak their collective voice against bad medicine. Politicians and non-medical regulators don't recognize their ignorance.

[brodski]

Originally Posted by Dr. Imago

What do they call the person who graduated last in his/her class at the worst medical school in the world?

MFhom

[Skeptic Ginger]

Originally Posted by Dr. Imago

What do they call the person who graduated last in his/her class at the worst medical school in the world? Doctor....

...The vast majority of doctors out their practicing are well-intentioned and practice under "standard of care". Still, I've met some, albeit a small minority, who just don't "get it" when it comes to the best course of action in patient care. I can't myself understand how they were able to get through school, the licensure process, and through a residency. I think some of this has to do with the fact that they were able to jump through the hoops early on and demonstrate that "minimum knowledge" in order to become licensed. Once out of that tightly supervised system, bad thoughts and habits can creep back in.

After residency and board certification (which you can achieve within a year following residency for most specialties), there is a period of independent practice where, I believe, these practitioners start to get off track. Remember, these are (generally speaking) not stupid people - they've made it through the "system" so far and they've proved that they can learn medicine. It's just that they are, like others, susceptible to being swayed and biased by their own interpretation of the data they read. It's scary sometimes, and I've seen this in my training, how many physicians don't really apply critical thinking on a daily basis. I fault this to the fact that much of modern medicine has become formulaic and algorithm based, and I think some of these people's subsequent (and often wrongful) notions are borne out of a reaction to the paternilism that the "ivory towers" are telling them what to do; that they don't have any independent say in how they will actually treat their patients outside of what's perceived as the "standard of care" once that's been established.

I can't help but think that many of these wayward physicians narcissistically perceive themselves to be iconoclasts and champions for their patients, and egotistically believe that they know better what to do for their individual patients than any powerful study can tell them. It's the worst form of observer bias, and they rely more on their own empiricism and observation than they do on good science. In other words, they've forgotten the principles of medical ethics they learned in school. In other words, they perhaps don't understand or no longer believe that they have a bigger responsibility to their patients and their colleagues, and somehow think the medicine they practice locally and individually is different (and superior) to that practiced elsewhere.

It often really is only simply a case of egotism gone horribly awry. Other times, clearly, they are examples of people who squeaked through the system and got turned loose on the public, for whatever reason.

-Dr. Imago

(my bold)

You addressed the issue that worst graduate from the worst school should still have met a minimum standard. Sometimes the system fails. I recall one nurse who graduated with my class and is currently licensed as an RN who in her 4th year of college couldn't write a complete sentence. (Four of us were to write a paper jointly and 3 of us had to re-write her section.) I, in my naivety, approached the professor because I thought it should be known we had covered up this illiteracy and was basically told to mind my own business. How do you get into college let alone into your fourth year without someone at least putting you in a remedial writing class?

I'm assuming that is too extreme to have happened in med school, but then this was at the University of WA which has one of the highest rated nursing schools in the country. Med schools are competitive to get into but so are nursing schools. And, you have to write an awful lot of term papers during 4 years in any major. There had to have been some 'professor culture' which makes it hard to address this kind of student.

However, I think poor academics and or intelligence is not at the root of most of the woo believing health care practitioners. Look at some of the prominent PhD and MD woo promoters and you will see other thought processes (I might label as thought disorders) at work. You have touched on the subject here.

I think if we were to take some of these highly educated and certainly intelligent people and systematically analyze their personality characteristics we would see at least a couple different but consistent thought patterns among the majority of non-critical thinkers. And maybe there is a continuum and some of these folks just happen to be more extremely disturbed than others.

When I say disturbed, I need to define what I am talking about. Personality disorders which interfere with functioning tend to get labeled as disorders. It's hard to function with paranoid delusions. But I think we overlook differences in thought patterns, in brain organization, when people are more highly functioning. When you get to more mild 'disorders' they can sometimes be defined as a simply outside of a range which has been identified as normal based on some standard which is determined by measuring large groups of people. The MMPI, for example, Minnesota Multiphasic Personality Inventory, is a test devised to determine if your thought processes are outside of the norm. If they are you supposedly have a disorder. I fell close to the limits in a couple areas simply because I was an atheist and young when I took it. There are a number of questions on the test in which god believers skew the norm.

Quote:

Scale 4 — Psychopathic Deviation
Measures social deviation, lack of acceptance of authority, amorality. Adolescents tend to score higher.

I have noted at least some patterns in the behavior of some highly educated presumably intelligent woo promoters like Michael Behe for example. This has not, to my knowledge, been studied extensively and I suggest it is because we don't look for deviancy in thought processes which don't fall into the realm of mental illness. As medicine moves more and more toward evidence based science, and as science advances more and more into evidence based science I think these 'deviants' as I see them, will become more and more distinct. Brain researchers may begin to tell us more about how the thought processes of people like Behe work.

One pattern I have noticed is along the lines of narcissism you are describing here. In my non-systematic, non-professional, bordering on guesswork observations, I think some of these persons perceive they have been slighted in some way and they may imagine getting even and personal satisfaction by expecting to be vindicated in the future and expecting to be the one person who was right all along. With cases like Behe's I wonder also if once one invests one's professional career pursuing some failed hypotheses that it might be too painful to admit you were wrong. And who knows how the religious beliefs imprinted on young brains affects later thought processes.

All thought processes are not intelligence based. There are different aspects of intelligence as well. That nurse who couldn't write a complete sentence could have had excellent skills in some other area. I think rationalists/skeptics could make advances looking more into why intelligent people believe weird things. I think we would find a few who are just faking it for the money. Seeing Kevin Trudeau make millions certainly professionals are not above lying for a profit. And I think we would uncover certain underlying fallacies or thought processes which contribute to woo believing professionals. These are the experts by education who when their research is rejected by their peers, take their case to the public instead. It's a very dangerous situation because unlike the peers, the public is frequently defenseless.

[Deetee]

[quote=Diamond;2939064]From the "scientific misconduct blog" a stirring defence of a woman cruelly mistreated by the GMC for her views on homeopathy and deciding its perfectly right for parents to withhold vaccination.
The blog also says:

Quote:

We will no doubt read nothing at all of this in the Medical Journals (or we will perhaps read yet another distorted version of a medical "scandal" in the BMJ that skirts around all of the relevant principles and lessons in favour of a few lurid but irrelevant personal details).

This has been covered in the one medical journal I see, the BMJ, and not at all in the way the blog suggests it would do.

Extracts from BMJ (2007;335:416-417, 1 September):

Quote:

At both the original hearing and the appeal the judges criticised Dr Donegan's evidence. Mr Justice Sumner said, "I am compelled to the reluctant conclusion that in this case Dr Donegan has allowed her deeply held feelings on the subject of immunisation to overrule the duty she owes to the court." At the appeal Lord Justice Sedley said: "Most of the published papers cited by her in support of her views turned out either to support the contrary position or at least to give no support to her own. Not to mince words, the court below was presented with junk science."

Quote:

Although the courts lodged no complaint, the GMC began an investigation and announced last October that Dr Donegan would face a charge of serious professional misconduct. After a three week hearing in Manchester, which ended last week, the GMC panel concluded that all of the substantive charges against Dr Donegan were unproved.

Quote:

Dr Donegan agreed that she had cited research whose conclusions differed from her own, but the panel accepted her argument that she had performed her duty by providing the references.

Quote:

Sheila Hewitt, who chaired the panel, told Dr Donegan: "The panel were sure that at no stage did you allow any views that you held to overrule your duty to the court and the litigants. You demonstrated to the panel that your report did not derive from your deeply held views, and your evidence supported this."

Whether she is a homeopath is beside the point. This was about her evidence regarding vaccination. I feel the GMC were rather too aggressive in trying to bring charges of misconduct in this case and I feel the outcome of the hearing is correct.

In the original trial and appeal, Donegan effectively "lost" her case, and she did quote selectively - something we are all perhaps prone to do - but in her case her duty was to the court not her clients to provide as unbiased a perspective as possible. IMO the fact that she did not do this properly is hardly grounds for a misconduct charge that could potentially have led to her being struck off the medical register.

I think the GMC have developed a little Hitler mentality about doctors in general since Shipman - not only must they scrutinise everything doctors do, but they must be seen to be doing it, so they will try and bring cases against doctors for almost any perceived deficiency.

[Deetee]

I've looked at the transcripts in more depth.

It seems that Donegan's skin was saved by the testimony of a certain Dr Fletcher appearing as her expert witness. He seems to have been a very eminent doctor involved with research pharmacology and was with the MRHA, Committe for safety of Medicines and various other august bodies before he retired (not a moment too soon IMO).

He has something to do with the MMR litigation, as he said he was bound by confidentiality relating to litigation when asked to comment on that particular vaccine. my guess is that Donegan's law firm (Clifford Miller associates - Miller has been a prominent contributer to antivaccine correspondence pages in the medical journals in the past) is also involved with the MMR litigation, and that this particular expert witness is acting for the firm in both of these instances.

Some of the stuff this chap came out with in the Donegan case was amazing.
e.g.

Quote:

"The views she [Donegan]has expressed [against vaccination] may not be in line with Department of Health recommendations but are commonly voiced in general practice and the general public and are in line with my opinion”

When asked about this he had no evidence but that he had contact with lots of GPs and it was a feeling that was "expressed frequently".

WTF? This is evidence?

Here is what he said about pertussis vaccine, which as we all know has been exonerated fully from causing neurological damage. Dr Fletcher seems to be re-writing history and suggesting that people like the CSM did suspect neurological damage, even when they said they didn't;

Quote:

I would like to reiterate the fact that it is a continuing problem to decide whether or not the various neurological adverse effects that have been observed are temporally associated with the administration of pertussis vaccine, or vaccines which contain pertussis vaccine. The origin of this problem was probably somewhere about 1975 or 1976. The Committee on Safety of Medicines considered it on several occasions and the job was handed over to a particular senior medical officer who continued to spend, I think, about two or three years in doing this, scrutinized a large number of individual patient reports rather than going through epidemiological type studies, which I think the committee had decided were probably not appropriate in this particular circumstance. That was a committee decision. At that time the overall impression given to the Medicines Division and the Committee was that there probably was a causal relationship here but that perhaps the evidence available was insufficient to put that in solid terms, and it was left as a need to put further warnings in the official literature that was available to doctors.

And this type of hearsay is counted as evidence?
I wonder what the CSM would have to say about this.

[fls]

Originally Posted by Deetee

I've looked at the transcripts in more depth.

It seems that Donegan's skin was saved by the testimony of a certain Dr Fletcher appearing as her expert witness. He seems to have been a very eminent doctor involved with research pharmacology and was with the MRHA, Committe for safety of Medicines and various other august bodies before he retired (not a moment too soon IMO).

I've also looked at the transcripts in more depth. It is my impression that the committee was essentially asked to weigh the evidence with respect to vaccines and did not have the skills and knowledge necessary to do so, or were not provided with adequate information. The scientific evidence (as usual) was obfuscated by the process of examination and cross-examination, making it appear as though Donnegan's reading of the literature was not unreasonable.

Linda

[Deetee]

Originally Posted by fls

I've also looked at the transcripts in more depth. It is my impression that the committee was essentially asked to weigh the evidence with respect to vaccines and did not have the skills and knowledge necessary to do so, or were not provided with adequate information. The scientific evidence (as usual) was obfuscated by the process of examination and cross-examination, making it appear as though Donnegan's reading of the literature was not unreasonable.

Linda

I would agree.
They seem to have been swayed by blanket statements like this from the venerable Dr Fletcher:

Quote:

“It is indisputable that over the past 100 years the profound influence of improved social conditions and the quality of health care has been responsible for a major reduction in morbidity and mortality. The extent to which national vaccination programmes have contributed to this reduction is difficult to assess”.

When Dr Fletcher was cross examined, the defence lawyer cleverly interrupted proceedings on several occasions.

Examples from bits of cross examination
E.g. On the subject of cherry picking quotes to support one's own view from articles when the paper's authors view is contradictory to one's own:

Quote:

Q I was asking you whether you agreed that, first of all, you cannot misquote research. I am sure you agree with that?
A Well, no, you cannot put in inverted commas something which is not there; yes. I mean if you are literally meaning the same words quoted, no, you could not do that, I agree.

Q Nor should you quote part of a sentence that leaves out the rest of the sentence and the sense of the sentence may be thus changed?
A I do not know how to answer that one really, because I do not know whether that is right or wrong. I really do not know the answer to that one. I think it is done many, many times, otherwise it is very difficult to know where you should end in such a thing.

Q Do you agree that you should not quote out of context?
A If you are meaning “quote”, again as I have said before, the use of the precise wording that the author has used, yes, I would agree with that; but if it is a paraphrase of that, then I think that would be possible.

Q Do you think that if you disagree with the conclusions of an author, you should at least make that clear, in terms of a report that you are relying on?
A I think if you make that clear right from the very beginning as an overall statement, yes, but I do not think you have to repeat it each time you say it or do that, no.

Q Somewhere you have to make it clear that the authors whom you are quoting, or going to quote, do not actually agree with you?
A I suppose that may well be every single paper that there is there, if there are fragments of it with which you do not agree, and I would probably say that I do not agree with a large amount that is in the stuff that has been provided here. Well, I suppose if you are going to say that we have to repeat that each time we have said it, okay, I do not object to that, but I would not have thought that it was strictly necessary in a report.

Huh??? This is an "expert" on assessing evidence who is answering these simple questions, or an expert on evasion and the use of logical fallacy?

How about this gem:

Quote:

Q Do you take the point that I am seeking to put to you?
A I am not sure whether I do, or not.

Asked about his reasons for not being able to appear on another day:

Quote:

THE CHAIRMAN: Did you say Dr Fletcher has a problem for Monday and so he could not return on Monday?

THE WITNESS: That is correct. I cannot.

MR KARK: If the worst came to the worst would it be possible to video link Dr Fletcher, or is he away? Can we ask where you will be on Monday, just in case?

THE WITNESS: I will not be at my home, no.

MR KARK: Can we ask which city you will be in?

THE WITNESS: I do not know, because I am - no, I do not have the determination to do that at the moment. That is why I cannot get here.

The rest of Dr Fletcher's cross examination degenerates into even more muddled thinking.

EG

Quote:

Q “By the end of October 1995, Britain’s Committee on Safety of Medicines had received 1202 reports describing 2735 suspected adverse reactions …”,

and then could I ask you to go about five lines down where do you see that:

“There were 91 reports of serious neurological reactions (including 61 reports of convulsions); but reported rates of encephalitis, convulsions, and Guillain-Barre syndrome were lower than the background prevalence of those conditions”.

Now obviously you understand what that means, do you?

A What it says is that there were 91, I presume, yellow card reports.

Q I suppose they may have been yellow cards, or not, but ---
A However you need to multiply that by ten, because there were 910, actually, because that is the agreed figure. So we have to say there were actually 910 reports of serious neurological reactions, because that takes into account the underreporting.


[Here Fletcher is trying to inflate any estimates of adverse effects by saying there is 90% under-reporting on the yellow card system]

Q Well say there were 910, but:

“… reported rates of encephalitis, convulsions, and Guillain-Barre syndrome were lower than the background prevalence of those conditions”?

A I do not understand the sentence, I am afraid.

Q The background prevalence means in the wider population, does it not?
A I am sorry?

[This guy sat on Committee of Safety of Medicines Panel and the MHRA???????? Sheesh!!!]

Q Does not the background prevalence mean in the wider population, so in other words it was lower in these subjects than it would be in the population generally?
A I cannot comment on that, because I do not know the source of that information. I would need to evaluate.

Q That is what it says.
A You are right that the word “report” has been used twice, but I do not know whether they are comparable with one another. I would need to know where that came from.

Q Let us go to the next sentence, which we can read I think without having to go elsewhere:

“The one report of subacute sclerosing panencephalitis occurred one month after vaccination in a child with a history of wild measles infection some years earlier; thus it is unlikely that the vaccine was responsible”.

Dr Donegan has accepted I think - I am afraid I have not got the transcript in front of me - that perhaps those words should have found their way into her report, but you read this yourself. It is rather important, is it not, to include those words - those last words?

A I am sorry, could you say that again. I have lost track of this again, I am afraid. I am sorry about that.

Q She writes:
“One report of SSPE occurred one month after vaccination. The child had a history of natural measles infection some years earlier”,
and she stops there.
When you read that, did you take it that there was a potential link there between the vaccination and the occurrence of SSPE?

A I think I was probably very, very sceptical about these figures altogether and I am not sure what I thought about that at that time.

Q So, you cannot help us?
A I do not think I can on that one, no. I am sorry, but many of these reports have figures in which really carry such a measure of uncertainty about them that it is extremely difficult to draw any conclusions from them. They are guesswork, as much as anything else, and I cannot really know whether these figures are right or wrong.

Q Do you agree that, in order to avoid misrepresenting the true position, Dr Donegan should have included at least the full sentence that she was quoting from which concluded with the words, “… thus it is unlikely that the vaccine was responsible”?
A No, I do not think it was necessary to include that.

Q You do not think that was necessary?
A No, I do not think that was necessary. No, I do not.

Yet....... This born again woo was somehow seen as a believable witness by the panel?

PS - Seems I was wrong and that it is Alexander Harris who are behind the MMR litigation, not Clifford Miller.

[JJM]

Dr. Fletcher:

Quote:

It is indisputable that over the past 100 years the profound influence of improved social conditions and the quality of health care has been responsible for a major reduction in morbidity and mortality. The extent to which national vaccination programmes have contributed to this reduction is difficult to assess.

Many of you have quicker access to the data than I; but I can't let this pass. How young was the judge?? Over the past 50 years one disease after another has disappeared precipitously after the introduction of each vaccine. Surely someone in the court knew that.

[fls]

What bugs me is that this finding will now be used by the anti-vax crowd to bolster their position, as though the presentation of skewered and twisted information to non-experts in an adversarial setting has anything to do with real scientific discourse.

Linda

[Deetee]

Originally Posted by JJM

Dr. Fletcher:Many of you have quicker access to the data than I; but I can't let this pass. How young was the judge?? Over the past 50 years one disease after another has disappeared precipitously after the introduction of each vaccine. Surely someone in the court knew that.

It was a General Medical Council fitness to practice hearing, not a court proceedings.
The judgement was determined by a panel with a lay chairperson (female) two lay members (one female), one doctor, and one solicitor.
I wonder how they all voted, and whether there was consensus.
An old codger of a judge may have seen through this transparency. The judge in the original High Court hearing did, so it seems, when the court determined that 2 girls should be vaccinated and the Donegan testimony was heavily criticised.

All said and done though, I believe Donegan did not deserve to be stuck off the register. Its probably the correct outcome for the wrong reasons, and the case should probably never have come before the GMC in the first place.

[Skeptic Ginger]

This is one of those areas the scientific community needs to address. Courts including juries, legislators and in this case a panel with 2/3 lay people on it are often in positions to make decisions about scientific matters based on marketing and persuasion skills and techniques of those presenting the evidence. It is a serious problem.

[Dr. Imago]

Originally Posted by skeptigirl

Courts including juries, legislators and in this case a panel with 2/3 lay people on it are often in positions to make decisions about scientific matters based on marketing and persuasion skills and techniques of those presenting the evidence. It is a serious problem.

Having heard the governor of my fair state speak one time about "nosocomial infections", I came to a personal conclusion about this topic you address and about which I agree is a huge problem. It seems certain attorneys, who make up the majority of professional politicians I might add, are particularly vulnerable to this: after being briefed by an "expert" in a particular field, they then believe that they too have become an expert, or at least have and understand the best expert knowledge, on that subject.

In my case, I heard the good governor spout out several things that were factually correct. He then extraplolated that knowledge into further "conclusions" about the same topic that were - quite simply - completely wrong and, instead, demonstrated at best a sophormoric understanding of the actual issue.

I am an expert at taking care of patients in the hospital, and I am well aware of the complex issues involved in healthcare delivery. I bristled at listening to this man sciolistically tell me how to do my job better to the full extent that I became inwardly embarrassed and disappointed that I had actually voted for him.

-Dr. Imago

[Dr. Imago]

Originally Posted by skeptigirl

All thought processes are not intelligence based. There are different aspects of intelligence as well.

I couldn't agree with this more. This is (among other reasons) why it is imperative, as a practitioner, not to get emotionally involved in an individual's course of illness or outcome.

People who believe they are right, and have invested their self-esteem in that belief, have raised the emotional stakes in their subsequent conclusions. The ego (for lack of a better term) can be fragile and easily bruised, especially in the medical field where reputations are built on being "correct" and definitive in diagnosis and treatment, as well as most parsimoniously arriving at that correct diagnosis and treatment. This can be an especially difficult challenge when there exists any controversy or lack of consensus, right or wrong and evidence-based or not, on what exactly is the correct diagnosis and treatment.

-Dr. Imago