Category: Medical Ethics
Misleading Language: the Common Currency of “CAM” Characterizations Part II
Background I promised readers the “Advanced Course” for this week, which undoubtedly has you shaking in your boots. Fear not: you’ve already had a taste of advanced, subtle, misleading “CAM” language, and most of you probably “got” it. That was R. Barker Bausell’s analysis of how homeopathy is “hypothesized to work.” In the interest of civility, let me reiterate that I don’t...
Misleading Language: the Common Currency of “CAM” Characterizations. Part I
The Best Policy From time to time I have been reiterating that correct use of the language has much to do with logic; I should add that it entails also honesty. I use the word “honesty” in its broadest sense… Concision is honesty, honesty concision—that’s one thing you need to know. —John Simon. Paradigms Lost: Reflections on Literacy and its Decline. New York, NY:...
Ultrasound Screening: Misleading the Public
There is a new industry offering preventive health screening services direct to the public. A few years ago it was common to see ads for whole body CT scan screening at free-standing CT centers. That fad sort of faded away after numerous organizations pointed out that there was considerable radiation involved and the dangers outweighed any potential benefits. Now what I most commonly...
When the popularity of new surgical procedures outpaces science
In science- and evidence-based medicine, the evaluation of surgical procedures represents a unique challenge that is truly qualitatively different from the challenges in medical specialties. Perhaps the most daunting of these challenges is that it is often either ethically unacceptable or logistically impossible to do the gold-standard clinical trial, a double-blind, randomized placebo trial for an operation. After all, the “placebo” in...
Iraq civilian deaths II: Summing up
Call me naive, but I did not expect the volume or the emotional depth of the responses to the Iraqi civilian death post. I thought many would respond to the new NEJMed survey as I did; wondering about the validity of the previous surveys and recognizing that they have a validity problem. And, that there is a question about what is printed...
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February 21, 2008
Science by press release: A helmet to fight Alzheimer’s disease?
Recently, I’ve had a number of people bring to my attention a news story that has apparently been sweeping the wire services and showing up in all sorts of venues. It is, on its surface, a story of hope, hope for the millions of elderly (and even the not-so-elderly) who are or will be afflicted by that scourge of the mind, memory,...
Annals of Questionable Evidence: a new study reveals substantial publication bias in trials of anti-depressants
Part IV of the ongoing Homeopathy series will have to wait a day or two, because it is superceded by a recent, comment-worthy publication. Nevertheless, “H series” fans will find here a bit of grist for that mill, too. An important role for this blog is to discuss problems of interpreting data from clinical studies. Academic medicine has committed itself, on the...
The Ethics of Deception in Medicine
A recent study published in the Journal of General Internal Medicine and featured in a Time Magazine article, indicated that of 466 academic physicians in the Chicago area, 45% indicated that they have prescribed a placebo for a patient. This has sparked a discussion of the ethics of prescribing placebos in particular and deception in general in medicine. A placebo is a...