Denialism Blog

Denialism Blog

  • Skeptics' Circle Number 85

    Andrea’s Buzzing about the latest skeptic’s circle.

    I’d point out in particular Blake Stacey’s discussion of the real expelled, scientists who challenge creationism.

    And I’d also recommend the Pap smear to Skepchic. It makes sense in context.

  • Vox Day's Crazy Dad Threatens Judge's Life

    Dude. If you thought Vox Day (the guy with the minge haircut) was crazy, check out what his crazy dad has been up too since he fast captured last year:

    The trial of millionaire tax protester Robert Beale turned bizarre even before jury selection began Monday as the prosecutor announced the arrest of four of Beale’s supporters for conspiring with Beale to disrupt the proceedings and intimidate the judge.

    “God … wants me to take the judge out, that’s what he wants me to do,” Beale allegedly told his common-law wife, according to a new criminal complaint filed against him and the four associates.

    …

    “Once I take down Ann Montgomery, no judge in the whole court will have anything to do with me,” Beale said in a tape-recorded phone call from jail.

    …

    Beale is a “member/leader” of what’s known among certain groups as an extra-judicial “Common Law Court” in Ramsey County. The lengthy title of this specific “court” indicates a religious undercurrent, including a reference to “a superior court for the People, original jurisdiction under Almighty Yahweh exclusive jurisdiction in and for confederation-government United States of America.”

    These are the guys behind world nut daily folks, just in case you were wondering why it’s such a source of insanity.

    And what’s with people not paying their taxes? Wesley Snipe fell for this nonsense conspiracy that the income tax is illegal as well. People, pay your taxes! I’ve heard about this nonsense before that the amendment was never ratified, yada yada. It’s constitutional, if you don’t pay your taxes you will go to jail, get over it.

    H/T Theresa.

  • Al Qaeda is apparently irritated by 9/11 conspiracy cranks too

    Here’s one of the more amusing news stories I’ve seen. Apparently Al Qaeda is irritated with Ahmadinejad’s 9/11 conspiracy theories. It turns out the people who committed the atrocity are quite proud of it, and don’t want people to forget it.

    Al-Qaida’s No. 2 leader issued a new audiotape Tuesday accusing Shiite Iran of spreading a conspiracy theory about who carried out the Sept. 11 attacks to discredit the power of the Sunni terrorist network.

    Ayman al-Zawahri, Osama bin Laden’s deputy, has stepped up his denunciations of Iran in recent messages in part to depict al-Qaida as the Arabs’ top defense against the Persian nation’s rising power in the Middle East.

    The increasing enmity toward Iran is a notable change of rhetoric from al-Zawahri, who in the past rarely mentioned the country — apparently in a hopes he would be able to forge some sort of understanding with Tehran based on their common rivalry with the United States. Iran has long sought to distance itself from al-Qaida.
    …

    One questioner asked about the theory that has circulated in the Middle East and elsewhere that Israel was behind the 2001 attacks on the World Trade Center and the Pentagon.

    Al-Zawahri accused Hezbollah’s Al-Manar television of starting the rumor. “The purpose of this lie is clear — (to suggest) that there are no heroes among the Sunnis who can hurt America as no else did in history. Iranian media snapped up this lie and repeated it,” he said.

    “Iran’s aim here is also clear — to cover up its involvement with America in invading the homes of Muslims in Afghanistan and Iraq,” he added. Iran cooperated with the United States in the 2001 U.S. assault on Afghanistan that toppled al-Qaida’s allies, the Taliban.

    Al-Qaida has previously claimed responsibility for the Sept. 11 attacks.

    Maybe next time we can ask them about what they think of the 9/11 troofer movement.

    Update – Life imitates parody:


    9/11 Conspiracy Theories ‘Ridiculous,’ Al Qaeda Says

    My favorite line is “Talking to you is like talking to a goat!”

    Thank’s SIS

  • Do I have clients or patients?

    One of my duties involves teaching nurse practitioner students. Nursing is quite different from medicine, and many of the linguistic markers of nursing differ significantly from medicine. As more physicians’ assistants and nurse practitioners enter the primary care world there will be a bit of a culture clash. For instance, my NP students often refer to a physical exam as an “assessment”, a misnomer which I do not allow them to use with me. Assessments come after you have spoken to and examined a patient. Another difference is in the common use of “client” in referring to patients. This debate seems to have originated in the late 80s or early 90s, and perhaps in psychiatry, but it spread rapidly. Its growth also coincided with the growth of HMOs and other managed care.

    Language means something beyond the words themselves, and what we call the people we care for matters.

    A patient is literally a “sufferer”, whereas a client is more literally a “customer” (although its roots in Latin refer to a much more specific relationship).

    There are some pretty serious implications to calling a patient a “client”. A patient is someone who is suffering, and to whom we have an obligation to help. We are expected to put their needs above our own as much as is possible.

    A client is a customer. We provide a service, they pay a fee.

    As paternalism receded in favor of autonomy as a medico-ethical value, many felt that “client” somehow empowered a patient—as they were paying for a service they were on more equal footing with the doctor. As a patient, a doctor is “acting” upon them, rather than partnering with them.

    What a load of bullshit.

    The first day of my pathology class, Dr. Alexander Templeton looked at us and asked, “Why does a patient come to see you? Come on, don’t be shy. Tell us. Why do they come to see you?” After a few answers taking jabs at common illnesses, he shouted, “No, no, no! They hurt and they want you to make them feel better!”

    If someone is a client, I have no obligation to make them feel better. If they come to me a gallbladder problem, my obligation is to order the correct tests, make the correct referrals, and collect my fee. If someone is my patient, I’m obliged to do all of that, plus try to make them feel better.

    There have been a few small studies that polled patient to find their preference, but I don’t think this helps—it isn’t a matter of democracy, but humanity.

    The authors of these studies listed some important disadvantages to “client”, some of which are:

    • Denial that the person has an illness or that certain
    treatments (e.g., drug therapy for schizophrenia) may
    be important in helping a sick person.
    • Denial of access to the sick role, from a failure to
    recognize that society allows sick people or patients
    certain rights to be cared for, and even denial of access
    to these rights.
    • Lack of protection (by the use of the term “client”
    per se) against the power and dependency that can
    exist in a doctor-patient relationship.
    • Lack of recognition of the importance of the doctor-
    patient relationship and its confidentiality.
    • Lack of the special elements of care and compassion
    implicit in the term “patient.”

    In this tug between paternalism, autonomy, and language, it is important to remember one fact: a patient comes to you for help, and as a doctor or a nurse, you are obliged to help them. Sure, you can’t (and shouldn’t) work for free, but between “client” and not working for free, there is a lot of ground. The most generous spin I can put on this is that a patient is a special subset of client, but that doesn’t work for me. There just isn’t the same compassion in a doctor-client relationship as their is in a doctor-patient relationship.

    I never see clients, only patients, and that’s the way I’m going to keep teaching it.

    __________
    Peter C. Wing, MB, ChB. Patient or client? If in doubt, ask. Canadian Medical Association Journal. 1997;157:287-9.

  • Domestic violence is bad for your health

    ResearchBlogging.orgA new study this month in The Lancet examined the health impact of domestic violence (of women by men). This was a very large WHO-funded study looking at multiple physical and mental health problems in abused vs. non-abused women. This is necessarily an observational study, but appears to be well done, and included a large and diverse sample of women.

    A few findings are worth a specific mention.

    First, intimate partner violence is very common across cultures, with numbers ranging from 15-71% of women who had ever been partnered with a man.

    Next, mental health problems, which were self-reported using standardized measures, were much more common in abused women.

    Finally, physical injury, including loss of consciousness, as a result of intimate partner violence was very common (about 22-80% of respondants).

    It is impossible to entirely prove causation rather than correlation in this type of study, but the authors have done a good job trying to parse this out in the discussion section.

    In their own words:

    …violence is not only a substantial health problem by virtue of its direct effects, such as injury and mortality, but also…might contribute to the overall burden of disease as a risk factor for several other serious health problems. The extent to which the associations between partner violence and reported ill health in women are consistent across sites both within and between countries in striking. This observation suggests that experiences of physical or sexual violence, or both, by a partner are associated with increased odds of reports of poor physical and mental health, irrespective of where a woman might live, her cultural or racial background, or the extent to which violence might be tolerated or accepted in her society or by herself. In addition to being a breach of human rights, the high prevalence of partner violence and its associations with poor health–including implied costs in terms of health expenditures and human suffering–highlight the urgent need to address partner violence in national and global health-sector policies and programmes.

    This is not the first study done on domestic violence, but the size and quality of the study are a damning. One of the biggest public health problems in the world is domestic violence. They correctly frame this as a human rights issue. If half the human population is suffering mental and physical ill health due to preventable actions by members of the other half, we are doing something terribly wrong.

    Despite the lessons of the holocaust, genocides continue. But we recognize them as genocides, and sometimes we actually do the right thing. This study screams out for action. The health and welfare of half the human population is at risk due to violence in their own home. Even if we can’t eradicate domestic violence, we can elevate it to the level of malaria, AIDS, and genocide as one the world’s most urgent public health problems.
    _______________
    Ellsberg, M., Jansen, H., et al, . (2008). Intimate partner violence and women\’s physical and mental health in the WHO multi-country study on women\’s health and domestic violence: an observational study. The Lancet, 371(9619), 1165-1172.

  • Expelled as Holocaust denial

    I’ve been reluctant to write about Expelled from the perspective of their abuse of the memory of the Holocaust. Ever since I learned that they were going to recycle the ludicrous Darwin-caused-Hitler argument I’ve been sending out emails to asking other experts their take on whether or not it constitutes a serious affront. Now reading Orac’s coverage of Art Caplan’s review of Expelled I think it’s something that needs to be discussed.

    Let’s start with very clear statements of fact that are at issue here.

    1) The Holocaust was a direct result of racism and anti-Semitic hatred that existed througout Europe for centuries. This was the motivation, this is clear and obvious to non-Holocaust denier.

    2) The statement that the Holocaust sprung from the scientific theory of natural selection is absurd, Orac again does the best job of tearing this one apart. Hitler never once mentioned Darwin, rather Koch and Pasteur seemed his scientists of choice in his rhetoric against the Jewish people.

    Previously the ADL has attacked those who have made this comparison. Why they have been quiet this time is inexplicable. I’ve sent them multiple missives asking for a similar reply to Expelled but no reply has been forthcoming. This is unfortunate. But I think their previous argument abotu D. James Kennedy’s use of the Holocaust to attack Darwin stands:

    :”This is an outrageous and shoddy attempt by D. James Kennedy to trivialize the horrors of the Holocaust. Hitler did not need Darwin to devise his heinous plan to exterminate the Jewish people. Trivializing the Holocaust comes from either ignorance at best or, at worst, a mendacious attempt to score political points in the culture war on the backs of six million Jewish victims and others who died at the hands of the Nazis.

    So I’m left with the following observations. Stein and the makers of this film have ignored the factual inaccuracy of their claims about Hitler and the Holocaust to present a false-history of how these events happened. They have attempted to score political points against science by shifting the blame for the Holocaust from the racism of the Nazis to an English scientist.

    Does this constitute Holocaust denial? It certainly is denialism – it is the promotion of false history to attack science. It also includes the denial of a specific and important facet of the history of the Holocaust – that European racism is what facilitated the Nazi campaign of extermination against the Jews. While it doesn’t minimize the number of victims, or deny the actual events like more classic Holocaust denial, what does one call it when one lies about the reason for the Holocaust? Without the specific anti-Semitic intent I’m not entirely sure this qualifies.

    I don’t know. We should ask experts like Deborah Lipstadt what they think. I do know one thing for sure. It is despicable.

  • Is injecting yourself with a human pregnancy hormone a good idea?

    Certainly not! But unfortunately we need to look a little more closely.

    It’s been a while since I’ve posted on hard-core woo, and I miss it, so here’s a little tip for you: if a diet sounds too good to be true, then it is. Weight loss is very hard, unless you are very sick. In fact, a colleague of mine ran into a friend who had lost a lot of weight and said, “You’re OK, aren’t you?” As an internist, when I see dramatic weight loss, my first thought is cancer, not a wildly successful new diet. But all of us overweight types wish there were an easy way.

    There isn’t. A friend of mine heard about a diet that involves extreme calorie restriction along with injections of human chorionic gonadotrophic hormone (hCG). My first thought was if you restrict yourself to 500-800 calories per day, it doesn’t matter what you inject—you’re going to lose weight. But as is the usual pattern with woo, each time you try to rebut it, there is a new claim. For example, when you point out that starvation diets will always make you lose weight, they say that this one makes you not hungry. When you say that it sounds dubious, they say that it not only makes you not hungry, it causes you to somehow lose weight where you want it, and keep it where you like it.

    So what experts are behind this revolutionary diet? Well, the biggest proponent appears to be Kevin Trudeau, the infomercial guy who keeps going to jail for fraud. What kind of claims is he making?
    (more…)

  • There is no pro-science political party

    With the news that in addition to John McCain both Clinton and Obama have now pandered to anti-vaccine denialism I think it’s time to reiterate there isn’t a political party in this country that has a truly sound grasp on sound science. And in this instance it is clear that both sides are more than happy to pander to the denialists.

    The fact is that there is no link between vaccines and autism. As time has gone on the denialists move the goalposts further and further back as the evidence for a link becomes increasingly unlikely. First it was thimerosal, and now 6 years after its removal from childhood vaccines we continue to see an increase in autism diagnoses. And what about that epidemic? It’s not really an epidemic.

    This is one of the problems of medicine that occurs time and again with denialists. As our diagnostic criteria change, as our tests become more sensitive, as our screening becomes more rigorous, the appearance of many diseases and disorders tends to increase. Cranks routinely latch onto this as evidence we’re getting sicker, or are being poisoned by fluoride, or vaccines, or alien lizards running Monsanto, but the fact is when these public health interventions are rigorously studied, the link simply is not there. Autism is no exception. As the diagnostic criteria were widened, the stigma of diagnosis decreased (the damn Freudians decided to blame it on bad mothers so it wasn’t exactly a diagnosis that was sought out), and more social services and money were addressed to the disorder the population of children diagnosed with the disorder has widened. All attempts to link the autism with vaccines scientifically have failed, and the methods used by the anti-vaccine crowd to spread this myth are denialist to the last drop. They allege outrageous conspiracies implicating everyone from the CDC to the FDA to the average family doc. They cherry pick the scientific literature for every tiny little scrap they can twist to fit their position and ignore the rigorous international studies demonstrating no link. They put their faith in fake experts like the Geiers and crank journalists like David Kirby. They are the kings of moving the goalposts as exemplified in their unwillingness to admit that thimerosal had nothing to do with autism or their recent pathetic attempt to link mitochondrial disorders to autism in light of the Hannah Poling case. Logical fallacies are their bread and butter.

    Vaccines are arguably the most effective life saver that evidence-based medicine has ever developed. Fear of vaccines in parents is natural. Utilizing a technology that puts your child at risk, even the astronomically small risk associated with vaccination, to prevent an illness they may never get interferes with the basic primal instincts of parents to protect their children from any harm. That and shots are scary. They make kids scared and upset.

    Rational people realize that the benefits outweigh the risks, that the ride to the doctor is probably more risky than the jab, and vaccination is the responsible decision for a parent to make. And while I sympathize with the parents of autistic children who think vaccines are to blame the science is simply not on their side. The anti-vaccine cranks exploit this completely understandable but irrational fear in normal parents of harming their children, and in doing so are actively harming public health. The science-based medicine denialists then typically offer any number of unproven crank cures with which, for a price, you can experiment on your children. Testimonials abound, scientific evidence of their efficacy or a physiologic basis for the intervention is nowhere to be seen.

    I am incredibly disappointed with both candidates for failing so thoroughly to stand up for science in this instance. I think it’s an excellent example of why ScienceDebate2008 is such an important objective. Science is not conservative or liberal, Democratic or Republican. And if we are interested in the voice of science wielding influence on public policy we have to realize that we have to act as an independent voice of reason. Citizens who think science is important and should inform public policy must become their own constituency. Having a presidential debate on science will make it clear that there is a large body of people in this country that value science and what it offers to society, and we demand to be listened to by both political parties.

  • Repeat after me: "Correlation does not imply causation"

    The post hoc ergo propter hoc fallacy is one of the great weapons in the arsenal of denialists. The reason it works so well is it makes sense. As my readers know, my daughter is dealing with a nasty respiratory virus. One of the doctors told my wife, who is not a medical professional, that kids with this virus go on to develop asthma. My wife was not pleased to hear this. What the doc didn’t tell my wife was whether or not there is a causal relationship between the infection and asthma. It is also true that kids who get RSV end up going to school.

    Asthma is a common illness. RSV is more common. Some prospective studies have followed children who have had RSV and looked at the rates of asthma, and found them to be rather high. The problem is, most children get RSV. It is very difficult to prove that a ubiquitous virus has a causal role in a common respiratory disease. The best study would follow similar children with and without RSV, but where do you find kids without RSV? How do you know that kids who don’t have clinically apparent RSV infections aren’t just resistant to respiratory disease in general? That being said, there is a fascinating literature on the effect of RSV on the lungs and the immune system. I’m actually becoming a living laboratory as we speak.

    Human beings can’t help being susceptible to the causation/correlation fallacy. It’s probably hard-wired. But we can watch out for it and maintain a skeptical eye on claims of causation.

  • Open letter to Douglas M. Steenland, president and CEO, Northwest Airlines

    Dear Mr. Steenland,
    I would contact you using more conventional means, but getting through to even a minor lackey at your company is next to impossible. Thank you in advance for reading this.

    I hate your company. They are perhaps the most difficult company I have ever dealt with as a consumer, and I won’t be sorry to see them go, although I doubt it will change anything.

    Let me give you a little background.

    In December, my in-laws planned a family trip for their 50th anniversary. I’ll spare you some of the details, but let me give you the basics—an elderly couple, and two young couples with children show up early for their flight to meet the cruise ship. Airplane breaks, new airplane is called in, with time to spare to meet ship. Once on new plane, NW realizes that the cabin crew has “timed out” and we need a new one. They finally arrive, and then NW realizes that flight crew has timed out. After waiting for new flight crew, we get in line for de-icing. We arrive in San Juan just in time to see our boat leave without us. Northwest’s response was as expected—horrible. They did try to put us up in a hotel, but it didn’t accept kids, so we couldn’t stay there. There are more details, but I’ll spare you. The level of incompetence to allow such a thing to happen is hard to fathom. If I sent a patient to surgery, and after getting on the table, the nurses found they were off the clock, and then after finding new ones, the surgeons had to leave, until the surgery was finally postponed…well, you can follow the analogy.

    So, my wife and I decided to take a vacation alone together—no children. Just before we were to leave, my daughter got a terribly contagious respiratory illness and was hospitalized. I called Northwest and I was informed that we cannot have a refund. I tried to explain that given our situation and the amount of planning for work and child care, we are unlikely to be able to use the tickets in the next year. I was passed to a supervisor twice, and chided like a child for being annoyed that I was asked to listen to the same script multiple times. I was given the direct number for customer care, which isn’t accepting calls. I was told I have to email, and when the supervisor gave me the email address, it started with “www.”. When I explained that that is a web address, not an email address, she discontinued the conversation with this angry doctor-blogger.

    Clearly, Northwest doesn’t care a bit about their customers. I’m shocked, shocked to find a large American company only cares about taking customers’ money, and not about pleasing and retaining them. Shocked.

    I would appreciate, but of couse do not expect, a response.

    Sincerely, but angrily,

    Peter A. Lipson, M.D.

    P.S. Please buy something nice with my 2000 bucks. I hope it looks good on you.