In other news, herbal supplements are truly placebos

My favorite news story of the week, herbal supplements don’t contain anything at all apparently. Why should we be surprised that big placebo is selling placebos?

The authorities said they had conducted tests on top-selling store brands of herbal supplements at four national retailers — GNC, Target, Walgreens and Walmart — and found that four out of five of the products did not contain any of the herbs on their labels. The tests showed that pills labeled medicinal herbs often contained little more than cheap fillers like powdered rice, asparagus and houseplants, and in some cases substances that could be dangerous to those with allergies.

Industry representatives have argued that any problems are caused by a handful of companies on the fringe of the industry. But New York’s investigation specifically targeted store brands at the nation’s drugstore and retail giants, which suggests that the problems are widespread.

Heartwarming.

Bill Maher is an astonishingly anti-science anti-vax crank

This week’s Realtime with Bill Maher was just about the most perfect example I’ve seen yet that maybe reality doesn’t have a liberal bias. Due to the measles outbreak becoming a hot-button issue, and the realization that his smoldering anti-vaccine denialism would not go over well, our weekly debate host decided to instead unleash all of his other incredibly stupid, unscientific beliefs about medicine.

This was astonishing. And because his panel, as usual, is composed largely of political writers and journalists, there was no one to provide a sound scientific counterpoint to the craziness. The sole non-crazy person (on this topic) was the conservative guy!

What a turn around for liberalism. It turns out, the problem hasn’t been that conservatives hold the key to anti-science crazy, we just haven’t had a good issue to expose the anti-science of the left wing for a while. Maher goes into a list of things he decides are examples of failures of “Western” medicine (because Eastern medicine has figured out cancer or something).

1. Bill Maher repeats the trope that the vaccine schedule is too much too fast – straight out of the anti-vax denial playbook! Human beings of course can handle thousands upon thousands of antigenic exposures daily. It’s called living on a planet where everything on it is trying to kill everything else all the time. It’s why we have an immune system.

2. Then in a feat of mental gymnastics only an unthinking crank can manage, he jumps into the hygiene hypothesis! He says he’s “not so sure that people who get a lot of them [vaccines] have as “robust” an immune system.” He then goes on to say we’re seeing more allergies and autoimmune disease, maybe vaccines or “environmental factors” are to blame. Now our children suddenly aren’t getting enough antigenic exposures! Our immune systems need to be challenged in order to grow and become strong. This is a fascinating feat of mental gymnastics. The antigen exposure of vaccines is “bad”, but somehow the antigen exposure from, say, measles is “good”. Granted those who have had actual infections develop stronger responses to those infections, there is no evidence that getting these childhood illnesses is protective from other illnesses, or against autoimmune disease. There is no reason to think that exposure to specific viral disease antigens would be protective for autoimmunity, not to mention since the vaccine is viral antigen exposure why wouldn’t it then serve the same purpose? The immune system just doesn’t work that way, and the hygiene hypothesis is about routine exposure to common antigens.

3. He complains none of his doctors have ever asked about his diet, because in his mind, what you eat is the most important thing ever. I can understand this for a couple of reasons. For one, Maher is thin. Generally if patients are thin, seemingly taking care of their bodies, a physician won’t typically interrogate them on their diet. If you then get a screening cholesterol panel that shows a high LDL and low HDL or triglycerides, the physician may start asking questions about diet, recommending exercise, more vegetables, less meat etc. Doctors aren’t here to micromanage your life, we are here to address problems, caution against the more harmful behaviors, and provide general recommendations for which there is good evidence. But in Maher’s mind, which seems to be the mind of the toxin fanatic, the only path to good health is through diet, so a doctor that doesn’t buy into this particular nonsense is a bad doctor. The reality is, there is not great data on which diet is best. There is no evidence that some foods are “super”, or carry some life-extending property. None of the claims made by the promoters of these foods has evidence of the caliber Maher is demanding from vaccines, and most of them have no evidence at all.

A good rule of thumb is, if a website uses the word “super” as a prefix, they’re full of it. Worse, the toxin hypothesis is nonsense. Toxins are not a significant source of human disease (at least not in Hollywood). Humans are extraordinarily good at detoxifying foods, and just because you’re eating plant material – the diet he promotes – doesn’t mean you’re not eating toxins. Plants are full of toxins they’ve developed over the years to prevent pests from consuming them and their fruit. It just happens that when a human eats a tomato, or chocolate, or one of the many plants we’ve genetically-modified through breeding and selection to suit our diets or learned to process since the birth of agriculture, we have an effective means of detoxifying them. Worse they make claims that non-toxic chemicals are actually toxic. Like glucose! The fuel your own body naturally makes to feed your brain is routinely castigated on the natural foody websites as a killer. This is the chemical your own body turns all these super-foods into! The inability to understand basic physiology is just wonderful.

You want non-toxic? Eat meat. It’s just protein, water and fat, just like us (although even a complete non-toxin like water can of course be toxic at high enough exposure). If you’re feeling sadistic and want to see the toxic effect of a superfood, feed these human foods to a non-omnivorous animal like a cat. They’ll get sick. Many of our “super foods” which the morons on these websites sell as “detoxifying” or laud their anti-oxidant properties (another bogus and unfounded diet hypothesis), are actually full of various plant toxins which we have no problem with because we have awesome livers. So thank your liver, and don’t buy into this toxin nonsense.

Finally other reasons he feels like he’s never heard a doctor ask about his diet (because we do) is he’s either not listening, or maybe he just sees a crappy doctor? So whoever is this magical “Western” doctor that Maher sees, please just ask this silly crank about his diet during the next visit so we don’t have to hear this tired nonsense anymore that doctors don’t care about diet. We do, we just don’t buy into the silly unfounded nonsense of the toxin hypothesis which is likely his real complaint.

4. He says “we overdid antibiotics” – This could be a fair point, however, the doom and gloom about antibiotics not working anymore and our whole medical system collapsing is a bit overblown. After all, most of the antibiotics we have developed over the years were discovered, not invented. We have been taking chemicals developed in the environment by various organisms and using them to suit our purposes. However, the targets of those chemicals have been engaged in this evolutionary war for millennia before we ever even got into it. Bacterial resistance is not “new”, or something created just by humans. We have to see this problem as an eternal struggle that’s been going on between micro-organisms for eons, and if we’re going to participate in it, we have to continue to innovate, just as life has, since the beginning. There is no “winning” here. There will never be a time when we can say we have solved bacterial resistance or have a perfect antibiotic, because we’re learning more and more we have to live with our bacteria in our biome, we can’t kill them all. We just have to keep working, keep innovating, and keep learning so we learn to develop antibiotics that are more specific, more targeted, and yes, more cautiously applied so we can continue to benefit from the ability to control these ubiquitous organisms that help us, are part of our normal physiology and function, but also occasionally overgrow and kill us.

5. He points out “not one country in the world does nearly as much surgery we do” – I recuse myself as I have conflict of interest.

6. He complains “I’ve heard on the news endlessly 2 drinks a day is good for you, I think no drinks a day is good for you.” And again Maher would be wrong. For one, no real medical authority has come out and said, “drink 2 drinks a day.” I’m sorry that the news misled you. I have no doubt there’s a bunch of crummy journalism out there that could be interpreted this way, but it’s not the medical establishment’s fault that science and medicine reporting is so full of bogus nonsense. This is still a controversial medical issue. The data from sources like NHANES show that there may be a protective effect for alcohol consumption with 1-2 drinks a day. This has been seen in multiple other studies, and in other countries. The effect is more profound in men. It might disappear if you eliminate co-morbidities (in other words some people may not be drinking because of health issues making the teetotaler data look worse). Ultimately doctors can’t really recommend you drink, but we typically won’t castigate you for drinking 1-2 drinks a day because the health effects are likely small, and for 1-2 drinks a day, their might be a slight cardiovascular protective effect. Prospective trials suggest 2 maybe even too many. So I would rate this as a major straw man argument. As a doctor I would say, 1-2 drinks a day is probably not harmful, but no one should be drinking saying “this is for my health”.

7. He wails we are Ok with aspartame, and GMOs! / and “One word, Monsanto” – and here we have it, Bill Maher’s clearest example of total crankery, his complete hysteria over GMO. There is a moment then when the conservative John McCormack butts in and points out there is no evidence that GMOs are harmful, and Maher and his panel of ignoramuses are shocked into silence, and one panelist gives this weighty sigh and covers her face in horror and Maher simply sighs. No, Bill Maher, it is we that should be asking you to justify your foolishness here, McCormack, the conservative who should supposedly be the one without the liberal bias of reality asked the right question. Where is your data? Where is the proof? There is no evidence, and worse, no even plausible mechanism by which he can describe the current GMO foods on the market to be harmful to humans. Despite consumption of billions by billions, you can’t point out one sickness or death. Instead they can only resort to the classic denialist correlation trope, which is exactly what the anti-vaxers have done for decades. And if someone wants to talk about the Seralini rat study, please don’t bother. Another retracted paper being the sole source of proof for a bunch of denialists, where have we heard this before?

Finally Maher complains, “we can’t ask any questions.” The classic cry of the persecuted crank! The same whiny response you see from the 9/11 truther, the climate science denialist, or any other individual who has found their ludicrous ideas has bought them some much needed societal shame. No on is telling them they can’t ask questions, but when you repeat the same question, that has been answered, and answered, again and again, and you don’t listen, eventually we are going to lose our patience and say enough! The debate is over! Vaccines do not cause autism. Enough with your crankery. Enough with the harm that has come from this bogus skepticism. We have an outbreak now. We are tired of hearing this question which has been answered and the accompanying obstinance has caused real-world harm.

Maher in this episode performs an astonishing Gish-gallop proving, once again, he deserves to be called out for denialism and being an infectious disease advocate. Can we drop the notion that liberalism is somehow protective against anti-science? Do we remember when he tried to blame cell phones for colony collapse disorder? (I couldn’t resist going to the old blog for that) Maher is resentful that his anti-vax nonsense is compared to global warming denialism. This is exactly like global warming denialism because all denialism ultimately comes down to the same tactics. I think we’ve a good example here of conspiracy (in one word! monsanto!), moving goalposts, cherry-picking, and a whole host of logical fallacies in his little Gish gallop (that’s four of five of the classic tactics). Let us dismiss him as a spokesman for science. He’s too easily impeachable as an anti-science crank.

Hand washing? Really Libertarians?

The latest entry in the “OMG really?” wars is brought to us by the libertarians, who, using the example of the brutal oppression of hand washing regulations, make total fools of themselves.

Speaking during a question-and-answer session at the Bipartisan Policy Center on Monday, Tillis related a story from his tenure in the North Carolina legislature to help explain his overarching philosophy on the finer points of hand-washing.

“I was having this discussion with someone, and we were at a Starbucks in my district, and we were talking about certain regulations where I felt like maybe you should allow businesses to opt out,” Tillis said, in remarks first reported by the District Sentinel. “Let an industry or business opt out as long as they indicate through proper disclosure, through advertising, through employment, literature, whatever else. There’s this level of regulations that maybe they’re on the books, but maybe you can make a market-based decision as to whether or not they should apply to you.”

When Tillis’ interlocutor noticed a Starbucks employee coming out of the restroom and inquired whether Tillis would apply his anti-regulation stance to employee hygiene, Tillis affirmed that he would.

“I don’t have any problem with Starbucks if they choose to opt out of this policy as long as they post a sign that says, ‘We don’t require our employees to wash their hands after they use the restroom,’” he said. “The market will take care of that.”

That’s right folks, now pillars of basic public health and sensible regulation to prevent things like typhoid fever or hepatitis A represents an undue burden on businesses serving the public. I guess we should all have to be our own public health department, and upon entry of any business should have to sign a EULA in tiny print freeing them of responsibility if they have filthy food prep areas, warm refrigerators, and potato salad left at room temperature for days on end. Just imagine this brave new world where every decision you make as a consumer you get to individually vet for basic things like, “will this product poison and sicken me?” or “am I about to die if I consume this?” Because we all have time for such nonsense, or the knowledge, or access to information, and I’m sure we can rely on businesses to always be forthright with consumers about risks of their products.

And we thought anti-vax was bad. At least they’re not denying germ theory, just the last 100 years or so of public health and sanitation measures that have drastically-reduced food-borne illness. I guess freedom means the ability to sell poison and tainted meat, albeit with a disclaimer and the wonderful reassurance that if I die from a tainted taco my family can sue for damages (unsuccessfully if the business has a good lawyer).

Can we please not live in such a world?

The Rolling Stone Fallout and What This Means for Rape Victims

I’ve been following the fall-out of the Rolling Stone article a Rape on Campus as well as their evolving preamble to the story, first expressing doubt, then seemingly dismissing Jackie’s account, now falling somewhere in-between with assertions that they have supporting evidence that Jackie was assaulted that night, but no idea of the details. I got a visit from some overly gleeful commenters that seemed to rejoice that the story is a hoax, and Jackie a liar, but it’s clear this situation is more complex. The story contained more than Jackie’s experience, and the focus of our original discussion on the article still is valid. That is, universities and colleges are using internal sexual assault boards to avoid Clery act reporting, and suppress the real numbers and problem of sexual assault on campus. This was largely based on my experience as an undergraduate (albeit over a decade ago) working on such panels and finding them disturbing on many levels. The Cavalier daily features an editorial from a friend of Jackies asking for support because her experience with her in her freshman year was consistent with Jackie’s story, she had an abrupt and negative change in her behavior and shared with her it was from a sexual assault. This is not a hoax, but the story of a hurt and confused girl who was done a disservice by Rolling Stone in their failure to independently confirm the details of her case.

What form should that confirmation have taken? I wrongly believed they had independently confirmed details of that night with Jackie’s friend. To WaPo’s credit, they did real reporting and tracked down those sources who should have provided the confirmation for Erderly’s story. Interestingly it is a mixture of confirmation that something happened to Jackie that night, but also that she had exaggerated in the retelling. My main objection in categorizing the early objections to the article as a smear was that it was largely based on an an armchair critique by Richard Bradley that it just sounded wrong. Granted, that should be the basis for investigation, but not dismissal of the claims. Liz Seccuro, a rape victim while at UVA whose rapist is now in prison was similarly upset by his position that the details were too shocking, and therefore unlikely. Her words a powerful response to his article:

Unlike most people who read the article, I was not shocked by it; I was gang-raped at Phi Kappa Psi at UVA in 1984. My story was a small part of the article, for which I spent hours speaking with Erdely from July through November. I was encouraged that my story — a very public one in the last eight years — would be told again in order to give context to the eerily similar rape of Jackie, the student victim in Erdely’s story.

Over 30 years ago, I told my own story to then student journalist Gayle Wald, who wrote extensively of my rape in the now defunct UVA newspaper, the University Journal. I asked that she use a pseudonym (Kate) for me, and, like Jackie, I begged her not to interview the one man I knew had raped me, as I feared repercussions. There were two other attackers whose names I did not know. When I went to the dean of students at that time, Robert Canevari, I was covered in bruises, still bloodied, and had broken bones. He sat at his big desk across from me and suggested I was a liar and had mental problems for reporting my rape. Some of my new friends told me not to tell, that no one would believe me, that I would ruin my own reputation and that of “Mr. Jefferson’s University.”

Former George journalist Richard Bradley fired the first shot at the Rolling Stone story. “I’m not sure that this gang rape actually happened,” he wrote in a blog post, using brilliant plagiarist Stephen Glass (whom he edited, and who duped him) as a comparison base for the idea that astounding and uncomfortable stories must be fabricated. Though Bradley’s rant was on his personal blog, doubts have now burbled up at established outlets. Jonah Goldberg shares his opinion in an incredibly dismissive piece at the Los Angeles Times — “Much of what is alleged (though Erdely never uses the word ‘alleged’) isn’t suitable for a family paper,” he writes, as if the brutality of an assault could possibly be a measure of its veracity. (His colleague Meghan Daum was more reasonable.) Slate’s Alison Benedikt and Hanna Rosin, posted a thoughtful piece and podcast that asks the journalistic questions without doubting that brutal gang rapes happen.

And that’s what’s missing in all of this: the distinction between discussing journalism ethics and dismantling an important discussion because the subject matter seems extremely distressing. Wholesale doubt or dismissal of a rape account because it sounds “too bad to be true” is ridiculous. Is it easier to believe a rape by a single stranger upon a woman in a dark alley? What about marital rape? What if a prostitute is raped? Just how bad was it? We should not have a rape continuum as part of the dialogue, ever.

So, yes, gang rape happens, it happens today on college campuses, just look at Johns Hopkins and Vanderbilts recent experiences, or mass druggings of girls at a frat party. Just because her allegations were shocking was not a good reason to disbelieve them. Just ask Liz Seccuro. Her experience was too similar to just dismiss such allegations based on gut-feelings, and have been confirmed subsequently by an admission by one of her attackers and a criminal conviction. I still believe that this was wrong, and my original complaint that, “Not on any independent investigation, sourcing or facts, they’re smearing this victim.” I still think that’s shoddy reporting and that statement came before I had the Washington Post’s real reporting which came later. What the Washington Post performed was actual journalism, and they successfully demonstrated that yes, there were real problems with Jackie’s facts in this story. However, it’s wrong to say that her story is a “hoax” as the same reporting suggests she was found distraught that night, claimed that she had been assaulted (although with notably different details – no visible injury, claims of being forced to perform oral sex etc.), but more likely her story has been exaggerated in the retelling rather than completely fabricated as many have gleefully crowed in the comments of this and other blogs. Sorry MRAs, her story can’t be dismissed as a hoax, and before we had the data that the Post had, it was unfair to dismiss this story simply because it didn’t conform to what one thinks such stories should sound like. Bradley was right in this instance, but only because he got lucky, he would have been really off if he had been in charge of Liz Seccuro’s story.

My second critique was that in cases such as this there is no benefit of seeking “balance” by interviewing the alleged rapists, and this is a source of legitimate debate among journalists and survivors like Seccuro who believe it will further make coming forward more difficult for fear of retribution. I don’t know what is the right answer or that there is a uniform protocol for every case. In the current incarnation of the Rolling Stone header they say:

We published the article with the firm belief that it was accurate. Given all of these reports, however, we have come to the conclusion that we were mistaken in honoring Jackie’s request to not contact the alleged assaulters to get their account. In trying to be sensitive to the unfair shame and humiliation many women feel after a sexual assault, we made a judgment – the kind of judgment reporters and editors make every day. We should have not made this agreement with Jackie and we should have worked harder to convince her that the truth would have been better served by getting the other side of the story. These mistakes are on Rolling Stone, not on Jackie.

I’m torn, certainly in this case it did not serve the victim that they did not seek this confirmation, but it’s also clear they failed on multiple fronts in confirming the story, including the date of the event which does not appear consistent with a social event hosted at the fraternity Jackie alleges was the location of the rape. I think this should still be left to the victim but journalists in the future should then take extra care to independently corroborate the details of the event, a failure in this instance. A generalization that there should be one way to perform this kind of reporting seems crude, and a poor fit for reporting on such a difficult and sensitive topic for survivors. I think if RS had done a better job confirming the story this would not have been a problem, but only in the face of the holes in Jackie’s particular story does it seem so glaring. There is no doubt that in future reporting the pendulum will swing towards required interviews with the alleged attackers, this strikes me as a disservice as there is more than one way to skin this cat.

So what have we learned? What can be done better in the future? The consensus seems to be that Rolling Stone screwed up and it isn’t Jackie’s fault. The evidence seems to be that Jackie was sexually-assaulted, but in the time since she has expanded her story in the retelling. This is not her fault, this is a very human failing, memory is fluid, and her experience traumatic. Many (including Bradley)have pointed out we will likely never figure out the “truth” now at this late date, but dismissing her story as a “hoax” is also likely a disservice to the truth.

I believe, as in my original “never event” article is that the problem rape on campus is one of inadequate data. Slate has an interesting summary of the research although I strongly disagree with their repetition of the MRA nonsense that “forced kissing” is somehow not sexual assault. Minimizing acts of sexual assault that fall short of penetration is ridiculous. Non-consensual kissing, groping, fondling, grabbing etc., is assault, and it’s sexual. That aspect of the RS article actually still stands. Colleges and universities should not be internally adjudicating violent crimes in kangaroo courts, it’s a disservice to victims and the accused. It hides the data on rape, while abusing the due process civil rights of those accused of crimes. They just have no damn business getting involved in judging any serious criminal infractions.

And there may be some good that comes of this in the form of a new bipartisan bill which may prevent colleges from hiding the data.

On Wednesday morning, eight senators announced the bill, the Campus Accountability and Safety Act. Senator Kirsten Gillibrand, Democrat of New York, said the legislation would impose significant financial penalties on colleges for noncompliance with new federal mandates to release data about sexual violence on campus.

Every college would be required to participate in the survey and publish results online, and the penalty for colleges that don’t report sexual assault crimes, as required by the Clery Act, would increase to $150,000 from $35,000 per violation.

Colleges would be required to supply confidential advisers to victims and train counselors. Athletic departments would not be allowed to handle sexual assault complaints. Colleges would need to coordinate a uniform plan with local law enforcement agencies. And the bill would provide federal funding to create and distribute an inexpensive, anonymous annual survey that asks all undergraduate students about experiences with sexual violence. Parents and students would be able to see the data, which may influence their decisions when applying to college.

“Right now schools have reason to repress reporting and be focused on public image rather than being focused on the problem, because there is no real penalty for not accurately reporting and there is no standardized survey,” said Nancy Cantalupo, a research fellow with the Victim Rights Law Center and a researcher at the Georgetown University Law Center, who acted as an informal consultant during some stages of the bill’s creation.

Ms. Dauber says transparency is the single most important change that Congress could bring about. “Absent transparency, we don’t know what problem we are trying to solve and we have no idea how to solve it,” she said. “We are just fumbling around in the dark. When you want to change, you take an honest inventory of your situation.”

Damn right. So hopefully there is a silver-lining in this ordeal.

Excellent GMO debate hosted at Intelligence Squared – a summary

The GMO debate hosted by Intelligent Squared was excellent and informative. I admit I learned things from listening and that’s always a bonus, but it’s worth watching to see the “respectable” arguments against GMO posed and dealt with very effectively by the pro-side in this debate. Spoiler alert, the pro-GMO side spanked the anti-GMO, going from 30% pre-debate in support of GMO (~30% against and 38% undecided) to 60% in support of GMO post-debate with anti-GMO only climbing 1% to 31. While voting on points of science and data is largely irrelevant, science is not democratic, it is reassuring to see that when the arguments are laid out it’s clear which side convincingly has science on its side. It also suggests that maybe the audience didn’t enter as polarized as one might expect.  And Bill Nye (who is a bit foolish on this issue) makes a cameo in the audience, and asks the first question.  I wonder if he was one of the 60%?  He’s being cagey about it on his twitter account.

It’s a bit long so I can summarize the dominant points. From the pro-side led by Robert Fraley
Executive VP & Chief Technology Officer, Monsanto and Alison Van Eenennaam Genomics and Biotechnology Researcher, UC Davis:

1.  This is a promising technology, still early in its potential, which has the benefit of solving problems with food-security such as plant disease, pests, and need for fertilizers, and may have future productivity and environmental benefit  by allowing greater yields from existing farmland.  Some of these benefits have already been realized like the rescue of the papaya.

2. It has direct benefits for the environment by encouraging no-till farming and decreased pesticide use (roundup-ready and bt products).

3. It is not necessary to see the issue as one of GMO vs conventional breeding as the technology is used in addition to conventional techniques

4. Resistance is a problem with all technologies, including conventional pesticides and herbicides, that’s not a good reason not to pursue a technology as you wouldn’t use that as an excuse to stop investigating new antibiotics.  Evolution happens.

5.  There is a broad scientific consensus that the technology is safe including organizations such as NAS, AAS and the Royal Academy as well as numerous other international scientific bodies.  Extensive research on safety and experience since implementation in 1997 do not suggest any harm despite consumption by billions – this was acknowledged by the anti-side as well.

6. There is not a believable hypothesis or theory that can describe how the technology will cause a specific harm to human or animal health and that has been borne out by studies so far.

 

From the anti-side led by Charles Benbrook Research Professor, Center for Sustaining Agriculture and Natural Resources and Margaret Mellon Science Policy Consultant & Fmr. Senior Scientist, Union of Concerned Scientists:

1. The technology has not lived up to the hype, lots of promising technology is “in the pipeline” but we’ve only seen a handful of beneficial products and no game-changers for agriculture.

2. The early promise of the technology is the basis for much of the pro-GMO arguments, as time has gone on resistance of weeds and pests has limited the economic and yield benefits.

3. The technology results in resistant weeds and bugs, and increased spraying of herbicides which may impact human health (although they agree they have no data to back this up)

4. Pursuing GMO distracts from better conventional breeding strategies to deal with problems such as drought, and disease.

5. There may be harms from the technology that may not become evident over the time scales we have observed so far.

6. We have seen ecological harm in some animal populations such as the monarch butterfly, and bees.

7. Safety profiles haven’t taken into account the rapid roll-out of new technologies as the products are progressively altered with each generation and “stacked”.  And the safety studies have not been as thorough as critics have suggested they should be.

There is a lot of back-and-forth on all of these points, and the pro-side does a good job frankly dismantling each of them.

Overall I agree with the audience, the anti-side does not provide a compelling argument not to pursue the technology, nor do they provide a mechanism for a realistic theoretical harm, other than some vague idea that over huge timescales maybe something will come up.  In particular the argument from Charles Benbrook that we should only pay attention to products on the market so far, and ignore the potential future applications I found galling and just pure Luddism.  This is still a relatively new technology as applied to agriculture, although in medicine, as the pro-side points out, we have fully incorporated GM treatments in the form of insulin and other biologics which have revolutionized many fields of medicine and will likely revolutionize many more including cancer, heart disease (the new anti-cholesterol drugs being investigated are GE-biologics), etc.  Multiple times they push a false equivalence that somehow GM takes away from conventional techniques, which is hotly, and effectively countered by the pro-side who both point out that a majority of their research still is based on conventional techniques.  Finally the suggestion of harm to the monarch butterfly is a side-effect of the herbicide resistant crops being more effective (less milkweed = less food for monarchs) and the suggested link to bee die-offs is completely specious.  I am left somewhat confused, as always, over the debate about whether GM has truly resulted in a decreased use of chemical pesticides, according to the anti-side, the good data on those benefits are from early in the application of the technology, and the benefit has decreased or reversed over time.  They do not present data, or evidence from peer-reviewed literature on this claim, however, saying “if you talk to farmers”.  Thus I credit this as low level evidence for their side.  Consistently the pro-side discusses results from the peer-reviewed literature, the anti-side is really presenting a “god of the gaps” argument and argument from uncertainty.

 

What do you guys think?

NYT Helps in Typical Rape-victim Smearing

We should have predicted this when we discussed the UVa Rape story in Rolling Stone last week, it was just a matter of time before people would start suggesting the central figure in the story, Jackie, might be fabricating. I would be surprised if this response did not occur, because sadly it is so typical. What I’m surprised by is that the New York Times, is credulously repeating this smear led by Richard Bradley, and Jonah Goldberg of all people.

Still, some journalists have raised questions about the story. Richard Bradley, who as an editor at George magazine was duped by the former New Republic writer and fabulist Stephen Glass, said in an essay that he had since learned to be skeptical of articles that confirm existing public narratives. “This story contains a lot of apocryphal tropes,” he wrote. Others, including Jonah Goldberg, a Los Angeles Times columnist, compared the case to rape accusations in 2006 against three lacrosse players at Duke University who were subsequently cleared and speculated that the Virginia story might be a hoax.

First, I’ll give you Richard Bradley might be legitimate, but his argument is completely speculative. He says it merely sounds odd to him. Hardly newsworthy. But then Jonah Goldberg? Author of “Liberal Fascism”? Who gives a damn what he thinks about anything? On the basis of basically one credible reporter’s feeling, they feel this deserves an article suggesting Jackie was not a credible source. Not on any independent investigation, sourcing or facts, they’re smearing this victim. And their argument about Rolling Stone’s reporting being adequate is highly debatable.

The subject of the article, who was identified by only her first name, had requested that her assailants not be contacted, and Rolling Stone decided that her situation was too delicate to risk going against her wishes, according to people familiar with the reporting process who declined to be identified because they were not authorized to speak publicly.

News media critics questioned the article’s reliance on a single source. “For the sake of Rolling Stone’s reputation,” said Erik Wemple, The Washington Post’s media critic, “Sabrina Rubin Erdely had better be the country’s greatest judge of character.”

So, the story should be rejected because they didn’t contact the rapist for his take on the story? Let’s predict how that would go. The guy would either say, “no comment”, “it never happened”, “I don’t know what you’re talking about”, or “talk to my lawyer.” If he was stupid he would admit some culpability or suggest it was consensual, thereby giving a future prosecutor an edge in establishing the fact of the crime. There, I filled in the blanks. Do they really think that would add anything to this story, or result in it not being reported? This is total nonsense.

Worse, it ignores the focus of the story, which isn’t about the facts of the victims allegations but in how my Alma Mater handles such allegations which is clearly sourced from discussions with several school administrators including the president Teresa Sullivan.

Can we call this anything but typical victim smearing? How dare the New York Times thoughtlessly promote this unethical critique of Rolling Stones reporting and this rape victim. This isn’t based on independent investigation, sourcing or facts, but on the feeling of one reporter, the reliable victim-bashing of a right-wing ideologue, and a misplaced argument about the value of obtaining “balance” by talking to an alleged rapist who (if he was smart) would undoubtedly be completely unhelpful or silent.

The point of Rolling Stone’s article was not to investigate a gang rape, but to expose how this University (and other universities as we discussed) similarly use internal rape boards to sweep crimes like these under the rug and avoid Clery Act reporting. NYT does a disservice to this victim, and other victims, by smearing Rolling Stone and Jackie in this fashion, without any real independent investigation or reporting. Maybe it’s time we write a letter to their ombudsman. I suggest you join me. Write to their public editor Margaret Sullivan at public@nytimes.com.

Also in today’s New York Times, another Cosby victim has come forward alleging sexual molestation when she was a minor. It strikes me as ironic, that this type of casual smearing of victims is the exact problem that allows serial rapists to thrive. Until we support victims, and stop reflexively accusing them of making rape allegations up, men who rape will have no problem moving from victim to victim without fear of justice.

Rape on Campus Should be a Never Event

The Rolling Stone article, “A Rape on Campus” should be a must read for every one who attends college, plans to attend college, or has children or loved ones on a college campus, especially one with a significant fraternity presence. UVa is my alma mater for two of my degrees, but this story reminded me more of my experience as an undergraduate at Bucknell University, a small, private, liberal arts university in Pennsylvania which is also dominated by fraternity culture. My experience there with sexual assault was not as a victim, but as a member of one of the pseudo-legal sexual assault boards, which I believe contribute to this problem of pervasive sexual assaults on college campuses. In the course of my time at Bucknell I was intimately involved with the intramural justice system, such as it was, and over the course of about 2 years I figured out what a tragedy such systems are, both for the victims of crime but also for the accused and for our rape culture as a whole. These systems do not serve any recognizable form of justice, and instead only exist to create an illusion of responsiveness to serious crime on campus by universities, while doing a disservice to all parties involved, and the schools know it. They exist to sweep these problems under the rug, and hide from site the ugly problems of violence, rape culture, privilege and racism from public view.

My experience with our campus judicial system started when I was a sophomore. I had just finished a summer internship working as a criminal investigator with the Public Defenders Office in Washington DC, a life-altering experience that involved investigating crimes, finding and interviewing witnesses, serving subpoenas, and testifying in court on behalf of juvenile offenders in one of our most violent cities. Ironically, within my first week back on campus I was falsely-accused of misconduct, after I reacted quite rudely to a RA who showed up at my door and, seemingly out of the blue, accused me of drinking in public and running from her when she called after me. I had been sitting in my room with several friends for the last hour so I reacted brusquely, called her an idiot, and slammed the door in her face. It turned out to be a case of mistaken identity, the person who had been seen had fled from her through our group apartment, in the back door and out the front, and I looked enough like him that the RA was understandably confused. My summer internship had prepared me incredibly well to deal with such officious authority figures, I wasn’t going to be hassled by some busybody who had no legal authority to harass me in my domicile. How naive I was.

As a result I got to experience the judicial board of my school first hand, first in a sit-down meeting with a dean at which I was threatened and bullied. I was told that I would face serious disciplinary action, calls to my parents etc, and a hearing in front of a judicial board at which I would receive no counsel and have to defend myself from my accuser in front of a group of faculty and peers. Or I could just make things easy and admit to drinking in public and running from the RA and face a minor disciplinary action which they would decide after I confessed! I refused. I told them I would do no such thing, I had already told my parents about the non-incident, had letters from multiple witnesses that proved I was not the guilty party and I wasn’t going to be bullied into telling a lie (my ace up my sleeve was the person who actually ran from the RA was willing to come forward if they called my bluff). Amazingly it worked. But my curiosity was piqued. What was this judicial system run within my university? Why did my dean make it sound like it was just a rubber stamp to punish those that refused to admit to any accusation from the administration? What crazy system of rules had we signed up for without a thought when we matriculated to this university?

It turns out that at most universities there are judicial systems, variably composed of faculty, administrators, and students who are responsible for hearing accusations of everything from academic violations such as cheating (which seems quite reasonable) to vandalism, drug crimes (woah), violent crimes, and yes, even sexual assault (insane). Using connections with friends on student government I got appointed to the judicial board of my school, with an eye for standing up for those, like me, who were falsely-accused and might be railroaded into falsely confessing. I was going to defend the innocent and be an obstruction to the rubber-stamp justice system of my school.

Instead my experience showed me that no one is safe from the biases inherent in serving on such panels, and there is no way for either the victims or the accusers to get justice from these fundamentally-flawed systems.

Take as an example, a student accused of smoking weed in their room. A complaint could be filed with as little as the detection of the odor of marijuana by an RA, without any physical evidence of possession, drug tests demonstrating intoxication, etc. A student could then end up in front of a dean, and after refusing to comply with whatever arbitrary discipline the dean suggests they end up in front of their pet rubber-stamp judicial committee. The committee is hand-picked by the dean and includes faculty members and students, if I recall correctly, faculty outnumbered the students on our boards. The hearing consists of a student, who may bring one person with them (who may not speak), in front of a board of their peers and faculty, and whoever accuses them of wrongdoing. The proceedings are loosely-based on court proceedings with the usual opening statements, testimony, presentation of any relevant evidence, cross by the accused, and closing statements. The evidence required to secure a disciplinary action is a “preponderance of evidence”, a lower-level of proof usually reserved for civil liability cases often being applied to criminal accusations with significant risk to the student as they may be expelled, lose their scholarships, student aid or even forfeit their tuition. Imagine an 18-year-old trying to defend himself from a flimsy accusation of drug use, in the face of that panel, with those risks, with no counsel, no knowledge of rules of evidence, facing their professors and accuser all alone in a room with no standardization of disciplinary action (expulsion was basically always on the table). It was absurd. It was unfair. It was, in the words of one of my favorite professors who was also a lawyer, a “kangaroo court”.

Now let us raise the stakes. After a year serving on this kangaroo court, engaging in as much juror nullification as I could when the charges were nonsense, or victimless, I was, amazingly, asked to serve on the sexual assault board. Again I was stunned to learn about yet another parallel judicial system within our university that had the audacity to sit in judgment of the most serious and devastating crimes imaginable. Forgive me, this was around 1997, the internet was in its infancy, we just weren’t as as savvy as we are now. This board was shrouded in even more secrecy. We had to swear on penalty of expulsion that we would not share details of the cases. The format of the board was similar with students and faculty deciding on guilt or innocence based upon a preponderance of evidence, but the mechanics were even more bizarre. The victim would tell their story, and the accused could respond. There was no cross-examination exactly. The accused could pass questions to the sexual assault board which would decide if they were appropriate to ask the accuser, with the goal of preventing a potential rapist from bullying or shaming his victim. Most of the rules were designed to make it as safe of a place as possible for the victim, and while admirable, made the process even more arbitrary.

I learned two things that year serving on this board. One, my university had a problem with rape. Two, my university was hiding it.

We were made aware rape was a problem on college campuses from day one, we were all introduced to it during orientation when the ugly statistics were presented to the entire freshman class. The stats seemed impossible to believe coming from high schools where everyone knew each other, often for our whole lives, that the same kind of people we grew up with would be the victims and perpetrators of such crimes at such a high rate. The studies agree, about 20% of women will be victims of sexual assault during their time at college. After a year in college I had a friend who was raped after a fraternity party (at another school). The women I was friends with at Bucknell would tell me about which fraternities on campus were the rape fraternities. In a small town in central Pennsylvania, in a formerly dry county, there is no alternative social scene aside from the fraternities, as a result, your choices were spending nights in doing laundry or going to whichever house was having a party that weekend. Before parties at these houses my friends made pacts not to let each other get separated. I took their word for it that it was a problem. It may have helped that I was as an independent, an outsider. At a school where over half the population was Greek, I had to forgo regular access to parties and alcohol, and I was clueless as to what happened at most of the houses other than the one house where a majority of my friends rushed, and even there I was only vaguely aware of some unpleasant hazing rituals as a requirement for entry. My whole life I have been constitutionally incapable of participating in mindless group activity, it makes me anxious. Our first week at school we were led around by mindlessly-cheerful “OAs”, or Orientation Advisors, who would lead us as a group in a series of chants involving singing and clapping. I ran away and hid until it was over.

From experiences like these it was clear to me from early on in my college career, rape was common. It was even known which houses were rape houses. How is it possible that we didn’t object? Why did we tolerate it? We were young. We didn’t know it could be any other way, and on a college campus with all of our peers tolerating it it was just normal. Hey, don’t be alone at that house, you’ll get raped. Gee whiz. And from the Rolling Stone article it looks like little has changed:

The women rattle off which one is known as the “roofie frat,” where supposedly four girls have been drugged and raped, and at which house a friend had a recent “bad experience,” the Wahoo euphemism for sexual assault. Studies have shown that fraternity men are three times as likely to commit rape, and a spate of recent high-profile cases illustrates the dangers that can lurk at frat parties, like a University of Wisconsin-Milwaukee frat accused of using color-coded hand stamps as a signal to roofie their guests, and this fall’s suspension of Brown University’s chapter of Phi Kappa Psi – of all fraternities – after a partygoer tested positive for the date-rape drug GHB. Presumably, the UVA freshmen wobbling around us are oblivious to any specific hazards along Rugby Road; having just arrived on campus, they can hardly tell one fraternity from another. As we pass another frat house, one of my guides offers, “I know a girl who got assaulted there.”

“I do too!” says her friend in mock-excitement. “That makes two! Yay!”

This is chillingly-familiar. Also familiar was the parallel justice of the Sexual Misconduct Board:

When Jackie finished talking, Eramo comforted her, then calmly laid out her options. If Jackie wished, she could file a criminal complaint with police. Or, if Jackie preferred to keep the matter within the university, she had two choices. She could file a complaint with the school’s Sexual Misconduct Board, to be decided in a “formal resolution” with a jury of students and faculty, and a dean as judge. Or Jackie could choose an “informal resolution,” in which Jackie could simply face her attackers in Eramo’s presence and tell them how she felt; Eramo could then issue a directive to the men, such as suggesting counseling. Eramo presented each option to Jackie neutrally, giving each equal weight. She assured Jackie there was no pressure – whatever happened next was entirely her choice.

Like many schools, UVA has taken to emphasizing that in matters of sexual assault, it caters to victim choice. “If students feel that we are forcing them into a criminal or disciplinary process that they don’t want to be part of, frankly, we’d be concerned that we would get fewer reports,” says associate VP for student affairs Susan Davis. Which in theory makes sense: Being forced into an unwanted choice is a sensitive point for the victims. But in practice, that utter lack of guidance can be counterproductive to a 19-year-old so traumatized as Jackie was that she was contemplating suicide. Setting aside for a moment the absurdity of a school offering to handle the investigation and adjudication of a felony sex crime – something Title IX requires, but which no university on Earth is equipped to do – the sheer menu of choices, paired with the reassurance that any choice is the right one, often has the end result of coddling the victim into doing nothing.

“This is an alarming trend that I’m seeing on campuses,” says Laura Dunn of the advocacy group SurvJustice. “Schools are assigning people to victims who are pretending, or even thinking, they’re on the victim’s side, when they’re actually discouraging and silencing them. Advocates who survivors love are part of the system that is failing to address sexual violence.”

This is exactly correct. As long as the schools have a mechanism to deal with these crimes internally, they will not encourage women to report their assailants to police and engage the courts where cases such as these belong. And indeed this was my experience at Bucknell. As long as schools can discourage reporting, and shroud their process in secrecy, the sources of rape on campus will be hidden and protected. And as I learned, the secrecy of these systems also can be used to silence criticism and dissent.

As a member of our parallel legal system I heard about each of the cases that was to be adjudicated before our system, once I had to recuse myself as I knew one of the parties, and as I gained more experience I also noticed something disturbing. Not one of the cases brought before the board involved a fraternity or a fraternity brother, despite the majority of our students being greek. All of the cases involved independent minority students, despite my university’s notoriously non-diverse campus. In other words, on a campus where my girlfriends would describe a frat house as “rapey”, the only cases I saw being adjudicated were against independent, minority students who represented < 5% of the population.

I had a small sample size, unfortunately. It was only my own personal experience. Maybe that year was a fluke? I can’t be sure.  I began to see the board as not just hopelessly flawed in dealing with what should be a criminal matter, but worse, implemented in such a way as to mask the criminality of the privileged students on campus.   The sexual assault board took the worst features of our criminal justice system, which often sees fit to punish minorities more frequently, and more harshly, and combined it with the worst rules of evidence from the civil justice system, all while shrouding the process in secrecy. But soon I was going to graduate, and move on, and fighting with the administration and board seemed pretty pointless as my next goal, getting into medical school, loomed larger, and fights with the administration would not help me on that path.

What should be the solution to this system that our schools have cobbled together from a tradition of internal disciplinary processes, mashed together with well-intentioned but obtuse quasi-legal processes? We know what the statistics are, 25% of women are sexually assaulted but only a tiny fraction bring legal action against their attacker. We know that men that rape will usually rape more than once. How can we say we are serving the interests of our students when we hide our own statistics, hide the locations and sources of rape, and then passively discourage reporting of rapists(who will rape again) with this paralysis of choice? It should be clear, university sexual assault boards do not serve the interests of victims of sexual assault, they serve the interests of the university. In doing so, they obscure the facts, they minimize rape by downgrading it from a felony to “misconduct”, and they create an alternative path of punishment that allows rapists to escape real criminal justice so they can victimize more women. They should be universally dismantled.

Reporting of rape does not have to disclose details of the victim to be effective. Details of the crime and the victim can be protected while appropriately reporting, collecting data, and informing and protecting the public from this crime. Let’s take an example from medicine. There are events in medicine that we refer to as “never events.” These are events that should never happen, yet they do, because of human error, systems errors, and sometimes by terrible luck. But if appropriate systems and protections are in place we believe we can make them vanishingly rare. They include things like operating on the wrong patient, or the wrong body part, transfusing the wrong blood type, or switching an infant. Interestingly, the list of never events includes sexual victimization of patients under a hospital’s care. When a never event occurs, hospitals are required to report it, and an investigation will occur to determine exactly where the system broke down, and where the error occurred so that it may never happen again.  Yes it’s embarrassing to the hospital when such things occur, but it’s actually reassuring to the public to see that when they do occur the response is serious, and there is accountability and change in practice as a result.

If we were as serious about rape as we are about not leaving a sponge behind in a patient, when such an event as this occurred it would result in an immediate report to an independent auditor who would collect data on these events. Without disclosing details of the victim, just as we do not need to disclose details of the patient, the report would be public with regard to the location and type of incident and non-identifying details. Disclosing the assault to the police could still be at the discretion of the victim, but we must standardize the advice to victims so that parties with conflicts of interest – like school administrators – can’t protect their institution by discouraging criminal prosecution or public disclosure. An attempt at a system like this was made once with the Clery Act, however cases are obviously slipping through the cracks. If students don’t file an official report, or are discouraged from reporting, the numbers will always appear far lower than the reality. Here is Bucknell’s report for the last 3 years. In that time about 32 forcible sexual assaults are recorded and the data only really narrows it down to “on campus” or “off campus”. How is that helpful? Given the known rates of sexual assault how can we even consider this to be remotely accurate? We would expect well over 100 assaults to occur per year, this suggests less than 10% are being reported, and in the vaguest way possible, as “on campus” includes fraternities for Bucknell.  UVA’S Clery act reporting is even more pathetic with as many as 20,000 undergrad and grad students on campus they report 32 rapes last year.  Clery Act reporting is a joke. There should be a map, with a point showing where each assault is reported to have occurred. If assaults cluster in an area, such as a particular house it should be shut down.

The only people that fear data collection and study are crooks and cranks. Just look at how the NRA tries to suppress research into gun violence, or how Republicans try prevent agencies like the DOD or EPA from performing or benefiting from scientific research into climate change. Their motives are obvious, they know the data are damning. If you believe, like Gawker that frats should be shut down, this is unlikely to happen and will likely just result in mindless push-back. A more modest proposal is to force the collection of high quality data, requiring colleges to record and report all allegations of rape, whether or not they result in police reports or criminal prosecution so they can’t use internal mechanisms to avoid Clery act reporting. Reports should be specific and tied to geographical presentation of the data about sources of sexual assault on and off campus. If your frat is the rape hotspot on campus it gets investigated by external auditors, and if it’s negligent or complicit it gets shut down. The goal will be to identify the sources of rape on campus. Rape will likely never be as rare as “never events” given the complexity of the crime but we don’t act as a society as though we’re truly interested in solving the problem. We won’t be able to reduce the frequency of rapes on campus as long as our process for dealing with it only exists to protect the institutional reputation and ignores the interests of victims.  What “never events” have taught us in medicine is that being transparent about events that we are embarrassed by isn’t as bad for the institution as sweeping such incidents under the rug.  Until we study exactly how, where, why it happens, and make that data public no one will be empowered to enact the changes necessary reduce the frequency of rape on college campuses.

Vaccines and the Boanthropy Risk

I’m reading Jeffrey Kacirk’s delightful Forgotten English, which includes this anecdote concerning boanthropy, a condition where a person believes himself to be a cow or ox:

In 1792, Edward Jenner successfully developed a vaccine for smallpox by injecting a boy with closely related cowpox germs. He did this despite his medical critics’ attempts to scuttle his project by circulating boanthropy scare-stores. The critics alleged that those inoculated would develop bovine appetites, make cowlike sounds, and go about on four legs butting people with their horns…

Samuel Hopkins Adams, Articles on the Nostrum Evil and Quackery

As part of related research into consumer protection, I recently scanned in a copy of Samuel Hopkins Adams’ seminal articles on the patent medicine industry. These articles, which appeared in Collier’s magazine starting in 1905, helped build the record for the 1906 Pure Food and Drugs Act, and for amendments to that law in 1912.

There are fourteen articles in the series and in them you will see how little has changed in the world of quackery. Adams focused much of his attention on the relationship between publishers and quacks, a problem that exists to this day (publishers are one of the most reliable opponents of consumer protection laws). Here, he points out the idea that publishers will lose their contracts with patent medicine quacks if “hostile legislation” is passed.

In this first article, Denialism readers will recognize two key strategies used by today’s nutritional supplement sellers: claims of universalism/universal cures, and the idea that doctors are suppressing remedies in order to protect their professional racket. Enjoy. Uncorrected OCR follows.

introduction_1_Page_3

4

5

6

7

8

9

10

page11

INTRODUCTION
This is the introductory article to a series which will contain a full explanation and expire of patent-medicine methods, and the harm done to the public by this industry, founded mainly on fraud and poison.  Results of the publicity given to these methods can already be seen in the steps recently taken by the National Government, some State Governments and a few of the more reputable newspapers.  The object of the series is to make the situation so familiar and thoroughly understood that there will be a speedy end to the worst aspect of the evil.

Gullible .America will spend this year some seventy-five millions of dollars in the purchase of patent medicines. In consideration of this sum it will swallow huge quantities of alcohol, an appalling amount of opiates and narcotics, a wide assortment of varied drugs ranging from powerful and dangerous heart depressants to insidious liver simulauts; and, far in excess of all other ingredients, undiluted fraud. For fraud exploited by the skillfulest of advertising bunco men, is the basis of the trade. Should the newspapers, the magazines and the medical journal refuse their pages to this class of advertisements, the patent medicine business in five years would be as scandalously historic as the South Sea Bubble, and the nation would be richer not only in lives and money, but in drunkards and drug.fiends saved.
“Don’t make the mistake of lumping all proprietary medicines in one
indiscriminate denunciation,” came warning from all sides when this series
was announced. But the honest attempt to separate the sheep from the
goats develops a lamentable lack of qualified candidates for the sheepfold.
External remedies there may be which are at once honest in their claims
and effective for their purposes; they are not to be found among the
mu~h-advertised ointments or applications which :fill the public prints.
~ut!cura may be a useful preparation, but in extravagance of advertising
1t nvala the most clamorous cure-all. Pond’s Extract, one would naturally
suppose, could afford to restrict itself to decent methods, but in the recent
ep~demic scare in New York it traded on the public alarm by putting forth
“~1aplay:• advertisements headed, in heavy black type, “Meningitis,” a
d1aease In which witch-hazel is about as effective as molasses. ~his is
fairly comparable to Peruna’s gh9ulish exploitation, for profit, of the yellow.
fever. scourge in New Orleans,· aided by various southern newspapers of
tan~mg, which published as news an “interview” with Dr. Hartman,
president of the Peruna Company.

6
prominent Chicago newspaper and spread before its advertising manager a full-page advertisement, with blank spaces in the center. “We want some good, strong testimonials to fill out with,” he said. “You can get all of those you want, can’t you Y” asked the newspaper
manager. “Can youf” returned the other. “Show me four or five strong ones from
local politicians and you get the ad.”
Fake Testimonials That day reporters were assigned to secure testimonials with photo.graphs which subsequently appeared in the full-page advertisement as

——–· —–·-······—······-·····–··-··· …… ———.
! ~–~~H~N£Y M;:l~
Xa:n•B of I’a.p•>:. ··-··’····-·······-‘-·–‘-‘········—-··-/
l’ \/rtlt \
” r ‘ ><
er ‘v\.i.-.. -·-···-· —–o~ua.nater.
A CONTRACT €0NTA·I-NING THE RED CI:.AUSE ‘l’he “Red Clause” is shown in heavy type, beginning with the words “It Is mutually agreed . • .” The Gazette bus recently decided to exclude all
patent-medicine advertising from its columns.
promised. As for the men who permitted the use of their names for this purpose, several of them afterward admitted that they had never tasted the “Compound,” but that they were willing to sign the testimonials for the joy of appearing in print as “prominent citizens.” Another Chicago news.
7

A WINDOW EXHIBIT IN A CHICAGO DUUG STORE.
8
paper compelled its political editor to tout for fake indorsements of n nostrum. A man with an inside knowledge of the patent-medicine business made some investigations into this phase of the matter, and he declares that such procurement of testimonials became so established as to have the force of a system, only two Chicago papers being free from it. To·day, he adds, a similar “deal” could be made with half a dozen of that city’s dailies. It is disheartening to note that in the case of one important and high·class daily, the Pittsburg Gazette, a trial rejection of all patent. medicine advertising received absolutely no support or encouragement from the public; so the paper reverted to its old policy.
One might expect from the medical press freedom from such influences. The control is as complete, though exercised by a class of nostrums some· what differently exploited, but essentially the same. Only “ethical” prepa.rations are permitted in the representative medical press, that is, articles not advertised in the lay press. Yet this distinction is not strictly adhered to. “Syrup of Figs,” for instance, which makes widespread pretense in the dailies to be an extract of the fig, advertises in the medical journals for what it is, a preparation of senna. Antikamnia, an “ethical” proprietary compound, for a long time exploited itself to the profession by a campaign of ridiculous extravagance, and is to·day by the extent of its reckless use on the part of ignorant laymen a public menace. Recently an artie!~ announcing a startling new drug discovery and signed by a physician was offered to a standard medical journal, which declined it on learning thnt the drug was a proprietary preparation. The contribution was returned to the editor with an offer of payment at advertising rates if it were printed as editorial reading matter, only to be reject~d on the new basis. Subse.quently it appeared simultaneously in more than twenty medical publica.tions as rending matter. There are to-day very few medical publica.tions which do not carry advertisements conceived in the same spirit and making much the snme exhaustive claims ns the ordinary quack “ads” of the daily press, and still fewer that are free from promises to “cure” diseases which are incurable by any medicine. Thus the medical press is as strongly enmeshed by the “ethical” druggers as the lay press is by Paine, “Dr.” Kilmer, Lydia Pinkham, Dr. Hartman, “Hall” of the “red clause,” and the rest of the edifying band of life-savers, leaving no agency to refute the megaphone exploitation of the fraud. What opposition there is would naturally arise in the medical profession, but this is discounted by the proprietary interests.
The Doctors Are Investigating
“You attack us because we cure your patients,” is their charge. They assume always that the public has no grievance against them, or rather, they calmly ignore the public in the matter. In his address at the last convention of the Proprietary Association, the retiring president, W. A. Tal.bot of Piso’s Consumption Cure, turning his guns on the medical profession, delivered this astonishing sentiment:
“No argument favoring the publication of our formulas was ever uttered which does not apply with equal force to your prescriptions. It is pardon.able in you to want to know these formulas, for they are good. But you must not ask us to reveal these valuable secrets, to do what you would not do yourselves. The public and our law-makers do not want your secrets nor ours, and it would be a damage to them to ha1Je them.”
The physicians seem to have awakened, somewhat tardily, indeed, to counter-attack. The American Medical Association has organized a Coun.cil on Pharmacy and Chemistry to investigate and pass on the “ethi~l” preparations advertised to physicians, with a view to listing those wb1ch
9
are founrl to     be reputable and useful TJ1at tl · · d d
-. · us Is regar e as a directIt t)
assau on 1e propnetary mterests is suggested b tJ t ts
the verge of frenzy in some cases, emanatincr fro~ t~eo;ro es ‘ e oq~ent to ~an~facturers control. . Alre~dy the council has issued s:ru~r~:~:f~~~~c;r::~ 1ep01 ts on products of Imposmgly scientific nomenclature. and rno y t
follow.     ‘ re are o
What One Druggist Is Doing
Largely f~r trade reason~ a few druggists have been fightin the nos.trums, but without any considerable effect Indeed •t · · ~
tb t 1 d . · , I IS surpnsmg to see
~ peop e are ~o eep!y Impressed with the advertising claims put forth duly as to be Impervious to warnings even from -t A t
· 1     exper B. cu -ratet th E
s ore, e cononuca Drug Company of Chicago st rt d ·
and displayed a sign in the winuow readincr · ‘ a e on a campaign
o ·
PLEASE DO NOT ASK US
ANY OLD
What is
PATENT
Worth?
MEDICINE
/<’01· you embarrass us, as our honest ans1cer must be that
IT IS WORTHLESS
1( you mean     to as7e at what price we sell it that is an entirely different proposition. ‘
When sick, consult a !J.OOd physician. It is the onl ro er course. A:zd pou ~ll find it cheaper in the enJ fha! self-medtcatton 1vtth worthless “patent” nostrums.

This was followed up by th , . f .
prominent nostrums that they ~::1esme: 8 In ormmg all applicants for the
was unable to get rid of ite wa: I~g m~!l~Y· Yet, with all this that trums comprise one· third f . s . pa en .-me Icme trade, and to-day nos.thirds of that of the averaoge~:~enlltnte busmess. They comprise about two.
. 1 ti . a s ore.
I.egJs a on IS the most b · -d .
Jlt’Deral public or the aw k o ~Ious/~~e .Y’ pen~ID~ the e~lightenment of the lion proceeds slow! a enmg o . 1e JOUrnalistic conscience. But legisla.lu practical termsya:n~2~~vo6oso~~amtst ~p:osition, which may be measured e last report of the Pro ;ie ‘ a s.a .e ~n the other side. I note in statement that “th P h tal!’ AssoCiations annual meeting the signifi.Most of the I . ~ t•eaviest expenses were incurred in legislative eg~s a Ion must be done by states, and we have seen
,
10
in the case of the Hall Catarrh cure contract how readily this may be con· trolled. .
Two government agencies, at least, lend themselves to the purposes of the patent-medicine makers. The Patent Office issues to them trade-mark registration (generally speaking, the convenient term “patent medicine” is a misnomer, as very few are patented) without inquiry into the nature of the article thus safeguarded against imitation. The Post-Office Depart· ment permits them the use of the mails. Except one particular line, the disgraceful “Weak Manhood” remedies, where excellent work has been done in throwing them out of the mails for fraud, the department bas done nothing in the matter of patent remedies, and has no present intention of doing anything; yet I believe that such action, powerful as would be the opposition developed, would be upheld by the courts on the same grounds that sustained the Post Office’s position in the recent case of “Robusto,” namely:
That the advertising and circular statements circulated through the mails were materially and substantially false, with the result of cheating and defrauding those into whose hands the statements come;
That, while the remedies did possess medicinal properties, these were not such as to carry out the cures promised;
That the advertiser knew he was deceiving;
That in the sale and distribution of his medicines .the complainant made no inquiry into the specific character of the disease in any individual case, but supplied the same remedies and prescribed the same mode of treatment to all alike.
Should the department apply these principles to the patent-medicine field generally, a number of conspicuous nostrums would cease to be patrons of Uncle Sam’s mail service.
Some states have made a good start in the matter of legislation, among them Michigan, which does not, however, enforce its recent strong law. Massachusetts, which has done more, through the admirable work of its State Board of Health, than any other agency to educate the public on the patent-medicine question, is unable to get a law restricting this trade. In New Hampshire, too, the proprietary interests have proven too strong, and the Mallonee bill was destroyed by the almost united opposition of a “red-clause” press. North Dakota proved more independent. .After Jan. I, 1906, all medicines sold in that state, except on physician’s prescriptions, which contain chloral, ergot, morphin, opium, cocain, bromin, iodin or any _ of their compounds or derivatives, or more than 5 per cent. of alcohol, .must so state on the label. When this bill became a law, the Proprietary Association of .America proceeded to blight the state by resolving that its members should offer no goods for sale there.
Boards of health in various parts of the country are doing valuable edu·
cational work, the North Dakota board having led in the legislation. The
Massachusetts, Connecticut and North Carolina boards have been active.
The New York State board has kept its hands off patent medicines, but the
Board of Pharmacy has made a cautious but promising beginning by
compelling all makers of powders containing cocain to put a poison label
on their goods; and it proposes to extend this ruling gradually to other
dangerous compositions.
Health Boards and .Analyses
It is somewhat surprising to find the Health Department of New York
City, in many respects the foremost in the country, making no use of care
fully and rather expensively acquired knowledge which would serve to pr11·

11
teet the public. More than two years ago analyses were made by the chemists of the department which showed dangerous quantities of cocain in a number of catarrh powders. These analyses have never been printed. Even the general nature of the information has been withheld. Should any citizen of New York going to the Health Department, have asked: “My wife is taking Birney’s Catarrh Powder; is it true that it’s a bad fhing?” the officials, with the knowledge at hand that the drug in question is a maker of cocain fiends, would have blandly emulated the Sphinx. Outside criticism of an overworked, undermanned and generally efficient department is liable to error through ignorance of the problems involved in its admin.istration; yet one cannot but believe that some form of warning against what is wisely admittedly a public menace would have been a wiser form of procedure than that which has heretofore been discovered by the formula, “policy of the department.”
Policies ·change and broaden under pressure of conditions. The Health Commissioner is now formulating a plan which, with the work of the chem.ists as a basis, shall check the trade in public poisons more or less con.cealed behind proprietary names. .
It is impossible, even in a series of articles, to attempt more than an exemplary treatment of the patent-medicine frauds. The most degraded and degrading, the “lost vitality” and “blood disease” cures, reeking of terroriza.tion and blackmail, cannot from their very nature be treated of in a lay journal. Many dangerous and health-destroying compounds will escape through sheer inconspicuousness. I can touch on only a few of those which may be regarded as typical: the alcohol stimulators, as represented by J:’eruna, Paine’s Celery Compound and Duffy’s Pure Malt Whiskey ( adver.tised as an exclusively medical preparation) ; the catarrh powders, which breed cocain slaves, and the opium-containing soothing syrups which stunt or kill helpless infants; the consumption cures, perhaps the most devilish of all, in that they destroy hope where hope is struggling against bitter odds for existence; the headache powders, which enslave so insidiously that the victim is ignorant of his own fate; the comparatively harmless fake as typified by that marvelous product of advertising effrontery, Liquozone; and, finally, the system of exploitation and testimonials on which the whole vast system of bunco rests, as on a flimsy but cunningly constructed foundation.