Resistance is futile? Hell, no! (A call to arms)

Well, I won’t back down No, I won’t back down You can stand me up at the gates of hell But I won’t back down Gonna stand my ground Won’t be turned around And I’ll keep this world from draggin’ me down Gonna stand my ground And I won’t back down From “I Won’t Back Down” by Tom Petty, 1989 This week,...

/ July 21, 2008

Science, Reason, Ethics, and Modern Medicine, Part 2: the Tortured Logic of David Katz

In Part 1 of this series* I asserted that a physician’s primary ethical responsibility is to honesty and integrity, which in turn must be largely based on science and reason (I apologize if that sounded preachy; if there had been more time I might have couched it in more congenial terms). I mentioned the fallacious reasoning whereby proponents of implausible medical claims (IMC) point to real and...

/ July 18, 2008

Chiropractic and Stroke: Evaluation of One Paper

Do not trust the cheering, for those persons would shout as much if you or I were going to be hanged.” ~ Oliver Cromwell In the blogosphere, the proponents of chiropractic often quote the following paper, with the abstract: Risk of Vertebrobasilar Stroke and Chiropractic Care Results of a Population-Based Case-Control and Case-Crossover Study Spine. 2008 Feb 15;33(4 Suppl):S176-83. by Cassidy JD,...

/ July 17, 2008

A Guide for Confronting Patients

I sometimes lecture on science-based medicine to my colleagues and one of the most common questions I get is how to deal with a patient who expresses belief in unscientific treatments. The dilemma for the physician is that professionalism requires that we do not confront patients regarding their personal beliefs. We are there to inform and advise, not preach. And yet proper...

/ July 16, 2008

Should I Take a Multivitamin?

I’ll start with a confession. I used to do something irrational. I used to take a daily multivitamin, not because I thought there was good scientific evidence to support the practice, but for psychotherapy. I tried to eat a healthy diet and worried about it. By taking a pill, I could stop worrying. Then I found out that higher intake of vitamin...

/ July 15, 2008

When “investigative reporting” becomes anti-vaccine propaganda

Introduction: The following is the text of a letter that I mailed to Bob Sliva, General Manager of WXYZ-TV in Detroit in response to arguably the most biased and incompetent “investigative report” about mercury, vaccines, or autism that I have ever seen. I sent the letter by snail mail, because I was always taught that that gets a station manager’s attention far...

/ July 14, 2008

Science, Reason, Ethics, and Modern Medicine Part 1: Tu Quoque and History

Several weeks ago I argued here that a physician’s primary ethical obligation is to science and truth. In retrospect I probably should have put it a slightly different way: a physician’s primary ethical obligation is the same as everyone else’s. It is to honesty and integrity. For physicians, however, that means being true to real medical knowledge, among other things, and real medical...

/ July 11, 2008

Cavalcade of Quackery: A Pantomine Horse

Last week I received the news release below that Steve Zeitzew, an orthopedic surgeon at VA Hospital Los Angeles and UCLA, sent to the Healthfraud list. It was sent to me by our colleague Liz Woeckner, President of the nonprofit research protection advocacy organization Citizens for Responsible Care in Research (CIRCARE) http://www.circare.org/ Ms. Woeckner sent it on with a cryptic comment, wondering...

/ July 10, 2008

Should We Study Chelation for Autism?

The National Institute of Mental Health (NIMH) supports doing a study on the effects of oral chelation therapy in autism. The proposal is highly controversial, is drawing criticism from many scientists, but has popular support among parents who believe this type of therapy might help their children with autism. The proposal raises many questions about the ethics of biomedical research. Chelation and...

/ July 9, 2008

Are Cardiologists Ordering Too Many CT Angiograms?

A really snazzy new invention allows doctors to see inside their patients’ hearts as never before: the CT angiogram. It produces gorgeous 3-D video images of the beating heart in action. It allows us to see the blood flow through the heart’s chambers and it shows any plaque in the coronary arteries. Cardiologists are understandably excited about this new tool. Too excited....

/ July 8, 2008