Hard News: Miracles just rate better, okay?
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Jolisa, we are all fine now but it is sometimes helpful to reflect why you did stuff. I shouldn't talk about my kids like this but they are adults now and used to me.
BTW I would really like to recommend a fascinating, well-written autobiography about (undiagnosed) autism and growing up in NZ.
Jen Birch, Congratulations! It's Asperger Syndrome. London, Jessica Kingsley, 2003
You can get it from better bookshops or direct from Jen for $35 - www.aspergers.co.nz
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The viewpoint it *does* matter from, though, is this: scientifically-tested and proven treatments are ones that work for most people most of the time, better than a placebo.
The truth of that statement will be entirely dependent on what your definition of science actually is. If you see it as synonymous with "the practices of the Western medical profession" then I think it is patently false. If you think science is a process, rather than a particular group of people with particular credentials, then it's quite possible that there is an awful lot of science going on outside of what is taught in medical schools, and I would hardly disagree with you. If you confess that a great deal of science is a black art, an accumulation of training, ongoing research and a lifetime of anecdata, then I would agree with you entirely.
You can get anecdata all you like, but if these treatments can't be shown to work better than placebo for a randomly-selected group, then it's no better than chance. Twice a day isn't good enough, especially not for a government-funded health system.
To be honest, a lot of the time, I'd be happy with even a placebo effect. And twice a day may not be enough to justify government funding, but anyone who receives one of the twice daily cures is going to be mighty bitter to hear that their healer got shut down because of a lack of science. Especially if the problem was extreme, and the science hadn't helped.
If they actually harmed people, that is another matter. Then the question of to what extent the people were made aware of the risks and consented anyway comes up. I could, for instance, try some homeopathic remedies for my skin and develop a nasty rash. That would probably be OK - I would only 'spot test' it anyway, so the extent of the rash could be contained. But if some poor unfortunate is told to cover their entire body in it, and has the same reaction, then anywhere else in the world that would be a reasonable ground to sue.
As for the 'known and proven' treatments, there is only one that generally has no side effects - to moisturize. I do that, and it is not sufficient. Everything else is a balancing act of various harms that Western medicine is doing to me every single day. Steroids work but the side effects are pretty severe (and I suffer from them). Phototherapy did not work, and carried a heightened risk of skin cancer. Allergy testing was conducted and found absolutely nothing. Topical immunosuppressants worked a little bit, but nowhere near enough to justify the exorbitant cost. Oral immunosuppressants work for me, but carry quite a high risk of cancer. I've recently discovered another nasty side effect that I was not made aware of - my body has now become so finely tuned to the immunosuppressants that if I fail to take them, I suffer an almost immediate flare up. I mentioned this to my doctor(s) and they say "excellent, that shows it's working". Which is all very well for science but bloody inconvenient for me - now I don't know if I've got a monkey on my back that I will never be rid of (as well as the original condition).
Can you see the appeal of experimentation (which I will conduct in as scientific a manner as possible) in alternative treatments? Frankly, nothing seems too whack at the moment. I'm extremely cautious (to the point of inaction to this time), because flaring skin is no joke.
Whilst individual treatment of particular skin conditions by specific treatments in controlled samples gives us excellent scientific data, this is seldom a practical treatment solution for anyone with a chronic condition. Most likely they have been subjected to many different treatments, and may be on a number of different medications. It's highly possible that only a very small sample of people, period, is on exactly the same combination of treatments that I am on. To that extent all of this medical science is as much of a black art as some homeopath saying "here, try this". Except that the homeopath doesn't have access to quite such powerful drugs on prescription.
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There is a huge amount of "confirmation bias" with alternative therapies (ie "I tried it and got better" has far more impact on our psyche that the dozens of things you tried with no observed improvemnt), which is why any study needs to count the people for whom the therapy did NOT work.
But the one thing that can be said in favor of osteopathy is that at least it involves someone actually having a physical impact on your body, unlike tosh like homeopathy where the "medicine" is often diluted to the point it will contain not a single molecule of the supposedly active ingredient.
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Kyle, thanks for the swift apology. I feel like this was covered on one of Emma's threads although I can't track it down right now; I don't want to derail this discussion, but yeah, general PAS protocol, triggering, respect, etc.
(I know it's easy to joke wildly clear of the mark, having made flippant remarks in the early minutes of the tsunami thread last week that I now regret).
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Or chatting about hands with his mouth on your breasts.
Would be a bit muffled I suspect and just a tad unprofessional frankly.
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Guys, it's not funny. Wasn't then (hence the years of avoiding dentists), isn't now.
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(I know it's easy to joke wildly clear of the mark, having made flippant remarks in the early minutes of the tsunami thread last week that I now regret).
I would like to apologize to you with my hand on my breast, and my foot in my mouth. Feel free to add your own foot, so long as you do it in a forceful way.
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But the one thing that can be said in favor of osteopathy is that at least it involves someone actually having a physical impact on your body, unlike tosh like homeopathy where the "medicine" is often diluted to the point it will contain not a single molecule of the supposedly active ingredient.
That's my view. I was convinced to eat empty "remedies" a few times years ago and, of course, noticed no effect at all. And I reluctantly stood by while a naturopath "prescribed" one pricey, useless remedy after another for our our younger boy, until my darling agreed it was becoming a bit of a joke.
But going to the osteo is a a bit different. I get some manipulation, and I get relief from symptoms.
I'm still a bit struck that Peter is prepared to declare he "fixed" his back by digging the garden, but regards the idea that a skilled massage might provide relief as the seventh sign of the apocalypse.
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And without wishing to start it all up again....
Well, that worked out well, eh? :)
So it makes you feel good, that's nice. I hope lining the pockets of these people eases the pain when the neck manipulation goes horribly wrong or one too many spinal manipulations ends up trapping a nerve instead of freeing up the energy flows.
If they actually harmed people, that is another matter. Then the question of to what extent the people were made aware of the risks and consented anyway comes up.
I wonder how much of the difference between the way a physio will approach a problem, and how an osteo/chiroprator will approach the same problem can be put down to the medical philosphy of 'first, do no harm'?
A physio may be unwilling to really get stuck in because they know how badly things like neck manipulation can go wrong.
But from a personal point of view, when I have a crikked neck, it is a (more or less) informed risk that I'm willing to take. I'm usually in a lot of pain, and want something to loosen that bastard up RIGHT AWAY IF ITS NOT TOO MUCH TROUBLE PRETTY PLEASE. I'm not really in a frame of mind to hang around and let it fade away natually, or with some gentle, gentle guidance.
So, the nub of the problem appears to be: how much of this consent to try something 'alternative', is informed? How does yer average punter sort the risky but effective wheat from the risky but worse than useless chaff?
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I'm still a bit struck that Peter is prepared to declare he "fixed" his back by digging the garden, but regards the idea that a skilled massage might provide relief as the seventh sign of the apocalypse.
Indeed, and unskilled gardening can wreck your back. I think gardening is good exercise if you take care, but anyone who already has a bad back is going to find it extremely unappealing, and possibly dangerous.
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Speaking of chiropractors -- to quote from Simon Singh
"You might think that modern chiropractors restrict themselves to treating back problems, but in fact they still possess some quite wacky ideas. The fundamentalists argue that they can cure anything. And even the more moderate chiropractors have ideas above their station. The British Chiropractic Association claims that their members can help treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying, even though there is not a jot of evidence. This organisation is the respectable face of the chiropractic profession and yet it happily promotes bogus treatments."[12]
see http://en.wikipedia.org/wiki/Simon_Singh#Chiropractic_lawsuit
This article is now the basis of a libel suit against Singh (that also exposes the bogusness of British libel law, and the burden it puts on the defendant, but that is another story).
Moreover, chiropractors may actually be dangerous in that it is possible that neck manipulations can cause strokes (albeit in small numbers), so if it is doing no actual good, it could in fact be actively dangerous. (Sort of like Hormone Replacement Therapy, which certainly seems plausible, but turned out to do more harm than good for many women).
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And you inevitably start inspecting yourself for flavorsome elements ...
Oh yes. We’ve been doing the rounds lately with our #1, and I became extremely conscious of exactly how much I was making eye contact with the Child Psychologist, sitting up straight and still for the Occupational Therapist and not mumbling to the Speech Language Therapist. I’m sure they’ve seen it all before though, and probably have a label for those kids too – maybe “NOTMAD – No Odder Than Mum And Dad”.
Oh, and 1 vote for Ibuprofen for lower back pain (which had to be administered out in the vege garden where I had been immobile and in agony for 20 minutes. Bugger gardening).
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Moreover, chiropractors may actually be dangerous in that it is possible that neck manipulations can cause strokes (albeit in small numbers), so if it is doing no actual good, it could in fact be actively dangerous.
Sure, but "relief from excruciating and debilitating pain" is not "no actual good". It is "extremely good", every time I've received it. Sure, there's a danger, but I feel a lot safer about that than I do about my medically prescribed cyclosporin, which contains the risk of cancer (albeit in small numbers).
Furthermore, I don't think it's true that there is 'not one jot of evidence' that relief from various aches and pains can lead to better health in other areas. It would only be bogus if they claimed they could, for instance, cure all ear infections, rather than the much lesser claim that ear infections might be less prevalent in children who can freely turn their heads.
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I love the faith Peter has that if something is 'scientific and clinical' then it must therefore be okay.
Being a highly trained clinical professional does not give you a monopoly on health knowledge. There is more than one way of understanding the world and what makes humans tick, and evidence is not a synonym for science.
What is quite astonishing is that they have survived so long. They have done so because it is not about health or medicine or science, it is a faith position.
That's nothing more than cultural arrogance when it comes to long-established and managed practises like acupuncture that were going for thousands of years before our Euro ancestors moved on from on leeches, trepanning and spells.
Like Hilary, I'll call on western medicine where it seems best and I share reservations about bogus therapies that are dangerous or peddled to the vulnerable. But I will pay attention to evidence about what works that's broader than clinical Randomised Controlled Trials.
I've seen and experienced improvements from non-medical therapies, and I've noted others that did not work and did not make sense. I have experienced good and bad care from medical practitioners over the years and, like Ben, some permissable adverse consequences of approved medicines.
Sure, better information would help people make choices. But "it's only the placebo effect" is up there with "false consciousness" from marxists and it earns the same respect.
It's the insistent defense of science and clinical medicine as the only right way that seems religious in character. Which makes me one of the heretics, I know. But it would be interesting to reflect on why some feel so compelled to be a priest?
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Sure, better information would help people make choices. But "it's only the placebo effect" is up there with "false consciousness" from marxists and it earns the same respect.
I often wish I could buy bottled placebo effect. Unfortunately, the placebo effect is denied to the purely rational and we have to suffer from purely rational aches and pains brought about by our purely rational lives.
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evidence is not a synonym for science
Evidence is what is needed to make something scientific. It's the sine qua non of science.
cultural arrogance when it comes to long-established and managed practises like acupuncture that were going for thousands of years before our Euro ancestors moved on from on leeches, trepanning and spells.
I always use that same argument when I say conjugal rape and slave trading should be legal but it just doesn't seem to wash with people.
seems religious in character
Except that religion is based on no credible evidence whatsoever.
But it would be interesting to reflect on why some feel so compelled to be a priest?
Because believing in things that aren't true is dangerous to everyone. How rational do we have to be? As rational as possible, I'd say.
I often wish I could buy bottled placebo effect. Unfortunately, the placebo effect is denied to the purely rational and we have to suffer from purely rational aches and pains brought about by our purely rational lives.
LMAO.
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Sure, there's a danger, but I feel a lot safer about that than I do about my medically prescribed cyclosporin, which contains the risk of cancer (albeit in small numbers).
Which possibly has more to do with general human inability to accurately calculate risk/reward ratios than anything else.
There is more than one way of understanding the world and what makes humans tick, and evidence is not a synonym for science.
Evidence is not a synonym for science, but science is the only strictly evidence-based "way of understanding the world". It's also the only one based on quantifiable, replicable results. Now, not everyone who does science (or claims to, a whole 'nother kettle of fish) will get it 100% right 100% of the time. But it's the best thing we've got.
(As for other ways of understanding the world - no, not really. Understanding what makes humans tick, yes, because it's still too complex for us to have worked out all the kinks yet. Understanding the rest of the world? No.)
It's the insistent defense of science and clinical medicine as the only right way that seems religious in character
I don't know if there's a skeptic's bingo card, but if there were? This would be on it.
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I love the faith Peter has that if something is 'scientific and clinical' then it must therefore be okay.
Being a highly trained clinical professional does not give you a monopoly on health knowledge. There is more than one way of understanding the world and what makes humans tick, and evidence is not a synonym for science.
The funny thing is though, chiropractors dress themselves up as clinical professionals. There is one at the end of my street, and he has an office that looks like a doctor's office (and even has the title "Dr" on his nameplate), and most likely dresses in a white coat. They have journals which are peer-reviewed by other chiropractors, and do their level best to look like clinicians.
I am not saying that chiropractors cannot sometimes help people (although this help may largely be a testimony to the power of the placebo effect). but they make far stronger claims about their services than appear to be justifiable by the facts, and their overall theoretical paradigm appears to have no basis in biological reality.
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When clinical medicine becomes as good as it thinks it is, my response to the rejoinders above will be more nuanced than "meh".
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Yes, sure Russell you can cherry pick individual studies, but look overall at the totality of the data like the Cochrane Reviews do and that apparent positivity evaporates. It boils away in the stats as the random noise that it is.
Peter, it would be silly of me to get into a citation duel with you but I did look it up. My understanding is that the 2004 Cochrane Review found that manipulation was no better than standard treatments for acute or chronic low back pain, but not that it was a sham. Another Cochrane Review in the same year found that manipulation, with exercise, was beneficial for neck pain with or without headache. Subsequent Cochrane reviews have found no benefit in treating period pain or asthma.
I think there is enough evidence of the efficacy of osteopathic treatment for lower back pain to suggest that my subjective experience of symptom relief is not imagined.
But I'm a bit over this now. In neither of the threads in which this issue has been discussed at length did I seek to make an issue of it in the first place. I feel like I'm in someone else's war. I just occasionally go to a guy who fixes my back and encourages me to go to the gym.
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When clinical medicine becomes as good as it thinks it is, my response to the rejoinders above will be more nuanced that "meh".
Ok. I'll see whatever it is chiropractors and osteopaths can for a sore back, and raise you polio, smallpox, scarlet fever, and tetanus. Oh, and modern public health.
Meh.
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As an aside, I think it is both hilarious and vaguely nutty that we at PAS argue heatedly about, erm, chiropractors and copyright. Where are our righteous environmentalist vegans and snarky childfree/breeder wars? Are we even *on* the internet?
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I'm sure there's a vaccination debate coming up in our future.
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I'll see whatever it is chiropractors and osteopaths can for a sore back, and raise you polio, smallpox, scarlet fever, and tetanus. Oh, and modern public health.
A palpable hit. It is very easy to overlook how widespread and devastating a lot of these things were beofre modern medicine.
But you forgot ricketts, diptheria, and typhus.
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I'm sure there's a vaccination debate coming up in our future.
I'm closing the site down.
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