How denying evolution can effect medical treatment
Friar Broccoli
following here:
http://scienceblogs.com/goodmath/2008/12/once_again_egnor_and_tautologi.php
[Note to El Cid; do a search for "Chris Lomont" and also click on his
name]
I think the note speaks for itself:
I've got a serious emotional stake in the effects of the way that
people like Egnor - a teacher at a medical school - deny the
importance of evolution in medical education.
My father died a year and a half ago. What finally killed him was
pneumonia. But what caused his death was the stupidity and ignorance
of an asshole doctor. My father died of an antibiotic resistant
infection. His doctor was, unfortunately, a fundamentalist christian,
but for some reason, my dad trusted him. This doctor watched as a
series of infections ravaged my father's body, and at pretty much
every step, he did the wrong damned thing. The reasoning behind his
errors relates directly to the kind of argument Egnor makes:
antibiotic resistance isn't the production of new traits; it's merely
the selection of existing traits in a population. So he prescribed
antibiotics in a way that anyone with a damned clue about how bacteria
evolve would have predicted would increase the antibiotic resistance
of the bacteria.
What's going to happen in you take a staph infection, and give it
penicillin? There's a good chance you'll kill the infection. What if
the penicillin doesn't? Then you know you're dealing with a resistant
infection. What's the right thing to do next? My dad's doctor gave him
more beta-lactam antibiotics with the addition of clavulanic acid,
which is an agent that defeats the most common mechanism of penicillin
resistance. When that didn't work, he gradually increased the dose of
clavulanic acid - the perfect thing to do to help the bacteria evolve
increased resistance. Then he put him into a room with a patient with
antibiotic resistant pneumonia. After all, they both had antibiotic
resistant infections.
The guy's pig-ignorance of how bacteria evolve led him to follow a
treatment plan that could almost have been designed to create deadly
strains of resistant bacteria. (And that same doctor prescribes
antibiotics like candy. Got a sniffle? Here, have some antibiotics.
They probably won't do anything, since it's probably a viral
infection, but what's the harm in being sure? Dumb bastard.)
It's incredibly important that doctors understand this stuff. Not just
understand that antibiotic resistance exists, but understand how it
develops, and how that development can be enabled by inappropriate
treatment decisions. Egnor argues vehemently that discussions of
evolution absolutely do not belong in medical education - that any
discussion of the process of evolution is, at best, a waste of time
for medical students. Attitudes like that cost lives. And to me, that
cost isn't abstract at all.
el cid
> While researching a completely different topic I ran across the
> following here:
>
Firstly of course, condolences. It's been 3 years but I recall making
many trips across the country watching my mother go from cancer,
though the C. Diff infections were as significant as the cancer.
One would need more information to fully judge the doctor you mention,
and I hate to pick nits over something that is so personal, but the
biggest mistake I see in the care you cite is placing your father in
the same room with someone who had drug resistant pneumonia.
The greatest risk to patients in hospitals is not that they develop
a new form of resistance, but that they are infected with a resistant
strain, particularly if the mode of resistance is transferable via a
plasmid or other vector. It is especially a problem in hospitals for
reasons that are all too familiar.
As to the clavulanic acid, it is one of the standard responses
to a beta-lactamase resistant infection and upping the dose
isn't really wrong. The best response is dependent on things
I don't know from the details you supplied. That should include
the hospital tracking the other resistant strains they have seen
over the last few months and the particular types of infections
your father had. And of course what cultures were done, if that
was possible, and what susceptibility spectrum they showed.
The thing that actually pisses me off a great deal is that the
most effective thing to do, that isn't done well, is to enforce
much stricter hand washing protocols in hospitals to limit
cross contamination between patients. And the problem
with doing so turns out to be doctors. You want to find a
good doctor, look for one that washes their hands coming
into and leaving a hospital room.
I'm not making a big deal of this to deny that resistance can
arise, it can and does, but it is important to know that the
greater acute risk to individuals is transfered resistance.
You might be interested in this site.
http://www.hospitalinfection.org/
Regards your link, I'm not sure what you want me to learn.
Egnor is a dangerous idiot. He makes a tautology claim
that demonstrates his ignorance. Do you want your faq
to specifically address him?
I googled the other guy (alone, plus "evolution" and plus
"tautology") but didn't see anything that struck me. What
was I supposed to find?
Steven L.
"Friar Broccoli" <eli...@gmail.com> wrote in message
news:749df852-1cdd-4a6a...@30g2000yqm.googlegroups.com:
> The guy's pig-ignorance of how bacteria evolve led him to follow a
> treatment plan that could almost have been designed to create deadly
> strains of resistant bacteria. (And that same doctor prescribes
> antibiotics like candy. Got a sniffle? Here, have some antibiotics.
> They probably won't do anything, since it's probably a viral
> infection, but what's the harm in being sure? Dumb bastard.)
>
> It's incredibly important that doctors understand this stuff. Not just
> understand that antibiotic resistance exists, but understand how it
> develops, and how that development can be enabled by inappropriate
> treatment decisions. Egnor argues vehemently that discussions of
> evolution absolutely do not belong in medical education - that any
> discussion of the process of evolution is, at best, a waste of time
> for medical students. Attitudes like that cost lives. And to me, that
> cost isn't abstract at all.
The fact that we have such genetic similarities with guinea pigs and
hamsters (a consequence of common descent), makes it possible to use
those animals to conduct immunological studies whose results are
applicable to humans.
And modern veterinary medicine would be nearly impossible without common
descent.
Common descent enables veterinarians to capitalize on the similarities
across species (inherited from common ancestors), and then just focus on
the differences among species.
Recently, this enabled a dolphin at SeaWorld, sick with acute kidney
failure from kidney stones, to receive the same type of treatment that
humans in the same situation would receive: Dialysis to stabilize the
condition, followed by ultrasound to blast the kidney stones. In fact,
these treatments were administered to the dolphin by physicians who
normally treat human patients, since no veterinarians there had
experience with dialysis.
Common descent, in other words, "saves bandwidth." If every species
were unique, veterinary medicine would take a thousand times longer to
learn, as the student would have to learn about each species separately,
with no commonalities.
-- Steven L.
Friar Broccoli
Once again the link:
http://scienceblogs.com/goodmath/2008/12/once_again_egnor_and_tautologi.php
Sorry (and I think looking weak is just fine), I guess I was not clear
enough.
One of the replies #33 read as follows:
___________
"Mark, you really should look into a better definition of tautology if
you're basing your attack on Egnor's argument on a single word.
Although I agree he is off base, you are on (almost) equally incorrect
footing with your usage of tautology. Read the two wikipedia
definitions to start, as others have posted.
First of all, almost all equations in science are *not* tautologies
since they relate physically derived items up to our current level of
understanding. Wikipedia lists E=mc^2 as an example of an equation
that is *not* a tautology, since energy, mass, and speed of light are
defined elsewhere and this equation shows a relationship between them.
Similarly many equations in math are not merely tautologies - they
relate definitions. Different equations are true/false under different
axiom sets, so which are tautologies? Godel's Incompleteness theorems
make it clear you cannot axiomatize the integers - for any finite
axiom set there will always be a true statement not provable from the
axioms. So even in math claiming all equations are tautologies is
incorrect - each equation's truth depends on definitions and which
axiom set you start with.
If you're attacking someone's argument based on claimed misuse of a
word you should look up a precise definition of the word and
understand it first. Otherwise you're misleading others in the same
vein as Dr. Egnor."
_______________
The Poster "Chris Lomont" home page here
http://www.lomont.org/
Says he has a "PhD in math from Purdue" and is anyway obviously a
couple of orders of magnitude brighter than I am.
This is interesting for me because intelligent people are willing to
argue both sides of the question: "are mathematical equations
tautologies". (Another respondent makes a similar argument to his)
My interest here is that I cannot decide between competing positions
here, and I see no reason why I need to. I think I have come up with
wording that will satisfy you (and several others here who think math
statements are tautologies) if you will agree that the opposing
position is not irrational/insane.
I will eventually respond to your last comment in the FAQ thread.
el cid
> "Friar Broccoli" <elia...@gmail.com> wrote in message
The problem here is that there are drugs that are toxic in
guinea pigs and humans but not in rats and mice. If one
let evolution and common decent be a primary guide,
that would not make any sense at all. And if you are testing
a drug and find it isn't toxic in rats or mice, does this mean
you need to test it in guinea pigs? If it is toxic in guinea
pigs does that reliably predict it will be toxic in humans?
Therapies that work across species do so due to shared
biochemistry. When they don't cross over well, it is because
of differential biochemistry. Evolution provides a very
good model for how the shared biochemistry got there
but it isn't a fine enough tool to provide high quality
predictions of cross-species pharmacological effects.
Veterinary science does try, and with some success,
but also with significant failures. Human toxicology
yields some spectacular failures in moving from animal
models to humans. The failures are not due to errors
in evolutionary theory but that doesn't stop them from
being failures.
I've listened for decades to enthusiasts who claim we
are on the cusp of a revolution in medicine where we
will be able to predict biology, to design drugs, to
unravel disease mechanisms from first principles.
But the revolution is slow in coming. The truth is that
we are getting better at rationalizing effects but not
really getting much better at predicting them.
This isn't to throw cold water on the effort, but to put
some reality back into the rhetoric. Trial, and sadly
error, is still the main driving force in medical discoveries.
Observation still trumps theory.
Intellectually, this is very unsatisfying. And without
defending those who would argue against advancing
the theoretical framework behind a medical education,
including evolutionary theory, it is important to understand
the pragmatic basis of that position. The religious
opposition is another matter.
Every bit of the cross-species inference you cite
is as valid from simple observation as it is from a
theoretical framework. The proper use of antibiotics
is determined as well, or better, from observation
as from theory. I'll spare you more about the difference
between engineering and science.
el cid
> On Sep 29, 2:51 pm, el cid <elcidbi...@gmail.com> wrote:
>
> > On Sep 29, 12:55 pm, Friar Broccoli <elia...@gmail.com> wrote:
> > I googled the other guy (alone, plus "evolution" and plus
> > "tautology") but didn't see anything that struck me. What
> > was I supposed to find?
>
>
> Says he has a "PhD in math from Purdue" and is anyway obviously a
> couple of orders of magnitude brighter than I am.
>
> This is interesting for me because intelligent people are willing to
> argue both sides of the question: "are mathematical equations
> tautologies". (Another respondent makes a similar argument to his)
> My interest here is that I cannot decide between competing positions
> here, and I see no reason why I need to. I think I have come up with
> wording that will satisfy you (and several others here who think math
> statements are tautologies) if you will agree that the opposing
> position is not irrational/insane.
>
> I will eventually respond to your last comment in the FAQ thread.
Despite how I've come off at time, I don't consider myself
a special authority on what is and isn't a tautology. However,
it's clear that one can find (as you note) authoritative sources
who will say a definition is one, and those who say it isn't.
What puzzles me more is the sentiment from informed
sources that tautologies are bad. The challenge as I see
it is to show that, if you define tautology in such a way that
definitions are tautologies, then tautologies aren't bad.
And that is the only sense in which the statement defining
fitness qualifies as a tautology, so no harm done. There's
also the angle of showing that the attack is specific to
the definition of fitness which itself is only part of the
logical presentation of natural selection. Logical propositions
that contain tautologies are not rendered invalid.
chris thompson
> following here:
>
Nominated. A heartbreaking story, but one we really need to listen to.
My condolences.
Chris
Friar Broccoli
wrote:
That post was COPIED from the linked site.
My dad died of kidney failure under the care of a very good doctor.
chris thompson
My apologies. It still deserves to be read, and maybe we can
incorporate El Cid's response into the PotM, but by all means let it
read that it was taken from another site.
And still, condolences on the passing of your dad. It took a long time
for me to forgive my father for things, and even on his death bed he
said things that pissed me off, but I miss him now.
Chris
bpuharic
<eli...@gmail.com> wrote:
>While researching a completely different topic I ran across the
>following here:
>
>http://scienceblogs.com/goodmath/2008/12/once_again_egnor_and_tautologi.php
>[Note to El Cid; do a search for "Chris Lomont" and also click on his
>name]
>
>I think the note speaks for itself:
nashton, a fundie who posts here, will ignore this.
cassandra
The puzzle you mention disappears for me when I keep in mind there are
at least two senses of the word. My understanding is there are no
invalid uses of a logical tautology. Some tautological expressions
may be circular, but they are invalid because of their circularity,
not because they are tautologies. Other logical tautologies may be
obvious ex. A=A, but what is obvious is subjective and relative to
personal experience and so is not a logical criticism.
My impression is definitions are true either by consensus or
constrained to a specified context, and so are not necessarily true,
and so are not tautologies.
Friar Broccoli
> On Wed, 29 Sep 2010 09:55:44 -0700 (PDT), Friar Broccoli
>
> >While researching a completely different topic I ran across the
> >following here:
>
> >[Note to El Cid; do a search for "Chris Lomont" and also click on his
> >name]
>
> >I think the note speaks for itself:
.
> nashton, a fundie who posts here, will ignore this.
Ignore the fact that I used "effect" as a verb?
I think not.
el cid
I believe there is an implied syllogism:
premise 1 Tautologies are bad.
premise 2 Evolution is a tautology
alt premise 2 Evolution includes a tautology.
conclusion Evolution is bad.
I dispute premise 1.
Of course, that doesn't mean tautologies are "good" or
especially virtuous. However, some people really like
to see things as very black and white, either good or
bad, and this tendency is pronounced in many creationists.
A simplification of the syllogism is guilt by association.
That represents its own logical fallacy but it nevertheless
has a significant emotional appeal.
The result is that 'the tautology argument' is very
effective when parlayed toward a sympathetic mob.
This then presents an interesting challenge that
fairly well sums up my interest in talk.origins.
You know the right answer, you understand the
nature of the wrong answer. How to you actually mount
an effective counter argument? Not just what is the
right counter argument, what is both right and
effective?
el cid
The title could make sense with either affect or effect, though
you likely meant affect. For evolution to effect medical treatment,
you would want to do something like train (evolve) a population
of killer t-cells to attack cancer cells.
William Morse
I am glad there are others who disagree that tautologies are bad. I
would argue that evolution is in fact a tautology (depending on your
definition of tautology), by which I simply mean that if you have excess
reproduction and heritable variation you will get change. This is a
simple consequence of the math. Whether this change will produce the
appearance of design depends on natural selection. Natural selection
occurs when the fittest survive. This is what we expect, but there are
many circumstances - rapid environmental change is one - in which the
fittest don't survive. And under stable conditions differential fitness
is often so low that most change occurs due to drift.
But there is also the problem that biological systems are sufficiently
complex that our expectations about what should be most fit are
frequently wrong. Thus we often do define fitness retroactively, as that
which did survive.
That may make "survival of the fittest" a tautology in some cases, and
again I agree that doesn't make it bad. In sports, we assume that the
best team will win. How do we define the best team? Oh, it was the team
that won. Does that make sports bad?
William Morse
I have to admit that in my Respond Only To The Thread Title mode I was
tempted to ask how strongly and in what forums I would have to deny
evolution in order to implement the treatment, and on which conditions
it might be effective. So when you brought it up I couldn't resist :-)
cassandra
You can say you mean the logical definition of tautology, but if your
target audience hears the rhetorical perjoratives, your message is
lost. This is a similar problem as with evolutionary "theory".
Walter Bushell
<50a0eef8-3140-4418...@l6g2000yqb.googlegroups.com>,
chris thompson <chris.li...@gmail.com> wrote:
But would a knowledge of evolution change how doctors practice medicine?
I doubt it. It's really hard to turn down a demand to prescribe
antibiotic when you lose the customer and you have $300K of student
loans to repay.
--
The Chinese pretend their goods are good and we pretend our money
is good, or is it the reverse?
Friar Broccoli
> In article
> <50a0eef8-3140-4418-8a99-53a2991b5...@l6g2000yqb.googlegroups.com>,
.
> But would a knowledge of evolution change how doctors practice medicine?
> I doubt it. It's really hard to turn down a demand to prescribe
> antibiotic when you lose the customer and you have $300K of student
> loans to repay.
Reply #24 to the blog supports your doubt without assuming any bad
faith. All the adaptive behavior of bacteria could be considered by
a creationist doctor as micro-evolution within kinds. Other possible
explanations include an older doctor (creationist or not) who never
took the time to understand how resistant bacteria behave. Or the
doctor was limited by other constraints that the blogger did not know
about, so the blogger went ahead and constructed a sequence of
inferred imaginary motives for the doctors behaviour.
We don't have anywhere near enough information to know what actually
happened.
el cid
You don't even need to invoke an ignorance of evolution. There are
two significant factors to consider. Firstly, and likely most
important,
as human beings who like to care for people, doctors are subject
to the wishes of the patients. This includes the very basic aspect
of care giving which is doctors doing something tangible to show
they care, sadly often taking the form of giving a pill so that in the
fine tradition of the witch doctor the patient thinks something is
being done. It isn't necessarily mercenary.
And second, the issue of over-prescribing antibiotics isn't that
significant to specific patients. A brand new mode of resistance
is very rare within individual patients so if the focus is on the
individual, the potential harm is actually minimal. For society,
the potential harm is high but as a matter of ethics it is not such
a simple thing to decide if the doctor is supposed to serve the
patient in front of them or should worry about the world at large.
The equation has shifted now that resistant strains are so
prevalent but there is still significant good done for individual
patients when they get antibiotics even when they might not
really need them though the good is reduced every year.
It's much like the story with vaccinations. Big picture medicine
can be at odds with the best care of the individual. Should a
doctor treat the patient or the species? Smart medicine seeks
a balance but it is often not black and white.
Bob Casanova
in talk.origins, posted by Walter Bushell <pr...@panix.com>:
Perhaps, but IIRC a prime tenet of the Hippocratic Oath is
"First do no harm". One could make a case that unneeded
drugs and improper treatment regimens do the opposite, both
for the patient and for society in general. Do you believe
it would be impossible or undesirable to require that
doctors "do it right", with severe penalties, including
license revocation, for those who put their finances ahead
of the welfare of their patients?
--
Bob C.
"Evidence confirming an observation is
evidence that the observation is wrong."
- McNameless
backspace
The logical proposition (A or not-A) can't be refuted or rendered
invalid but neither can it be verified. Same with "what happens,
happens" and "7=7". But the sentence "7=7 and therefore my mommy had
long teeth and a tail" is a fallacy , the conclusion is a non-sequitur
and is called a "rhetorical tautology". All tautologies reside under
the rubric "semantic tautology" but not all tautologies are
fallacious. Some tautologies are logical validity's while others
involve an argumentation scheme where the conclusion doesn't follow
logically.
You are equivocating between different concepts in different
contexts,they use the same semantic description but the concepts
aren't the same. Why is this so difficult to understand?
backspace
Circular reasoning isn't the same thing as a tautology as explained by
Dr. Wilkins.
el cid
The tautology has nothing to do with it. It is simply a non-sequitur.
The sky is blue, therefore your mommy had long teeth is likewise
a non-sequitur. The essence of the non-sequitur does not change
if you substitute as the blue sky is blue..
>All tautologies reside under
> the rubric "semantic tautology" but not all tautologies are
> fallacious. Some tautologies are logical validity's while others
> involve an argumentation scheme where the conclusion doesn't follow
> logically.
The validity of a syllogism is not effected by the presence of a
tautology among the premises. Therefore, referencing the
tautology as the source of the faulty reasoning is an error.
> You are equivocating between different concepts in different
> contexts,they use the same semantic description but the concepts
> aren't the same. Why is this so difficult to understand?
I wasn't and it isn't.
backspace
> That may make "survival of the fittest" a tautology in some cases, and
> again I agree that doesn't make it bad. In sports, we assume that the
> best team will win. How do we define the best team? Oh, it was the team
> that won. Does that make sports bad?
The *asserting* fact that the best team won is a logical validity or
type Tautology1 as defined under
http://scratchpad.wikia.com/wiki/Naming_Conventions
The *proposition* that the best team won and therefore 20mil years ago
our common daddy swung by his tail while fondling his nuts is a
rhetorical tautology, the conclusion doesn't follow logically.
Bill
.
>
> It's incredibly important that doctors understand this stuff. Not just
> understand that antibiotic resistance exists, but understand how it
> develops, and how that development can be enabled by inappropriate
> treatment decisions. Egnor argues vehemently that discussions of
> evolution absolutely do not belong in medical education - that any
> discussion of the process of evolution is, at best, a waste of time
> for medical students. Attitudes like that cost lives. And to me, that
> cost isn't abstract at all.
This was a sad story. Unfortunately, Creationist doctors have no
monopoly on the inappropriate or ineffective use of antibiotics.
Burkhard
It is not a tautology under any description, it is simply an invalid
inference. You could argue that "-(7=7) and therefore my mommy had
long teeth" is a "rhetorical tautology" (whatever that is supposed to
be), since it is a valid inference (ex falso sequitur quodlibet), and
a fallacy (lack of relevance, which is also why it would not be valid
in non-classical systems of relevance logic)
>All tautologies reside under
> the rubric "semantic tautology" but not all tautologies are
> fallacious. Some tautologies are logical validity's
All tautologies are.
>while others
> involve an argumentation scheme where the conclusion doesn't follow
> logically.
Then the argumeentation scheme is simply a fallacy.
> You are equivocating between different concepts in different
> contexts,they use the same semantic description but the concepts
> aren't the same. Why is this so difficult to understand?
Because you made up the term "rhetorcial tautology" and aassume that
people not only understand it, but understand it on your terms taht
you never explained?
Walter Bushell
<bc4bfc0d-a482-457b...@j24g2000yqa.googlegroups.com>,
Friar Broccoli <eli...@gmail.com> wrote:
It's hard to accept an idea that conflict with one's livelihood and it
does not in fact need to be conscious, rather a weighing of evidence on
a preconscious level. It just doesn't let itself be thought.
Walter Bushell
<5cc0512a-ecbc-432a...@q2g2000vbk.googlegroups.com>,
el cid <elcid...@gmail.com> wrote:
> The equation has shifted now that resistant strains are so
> prevalent but there is still significant good done for individual
> patients when they get antibiotics even when they might not
> really need them though the good is reduced every year.
One might treat before the tests come back for a condition of unknown
origin, such as a suspicion of scarlet fever, yes. If the doctor has
abstained from treating such a patient and said patient comes turn out
to have scarlet fever then the physic pressure on the doc is large.
William Morse
> On Sep 30, 5:11 am, William Morse<wdNOSPAMMo...@verizon.net> wrote:
>> That may make "survival of the fittest" a tautology in some cases, and
>> again I agree that doesn't make it bad. In sports, we assume that the
>> best team will win. How do we define the best team? Oh, it was the team
>> that won. Does that make sports bad?
>
> The *asserting* fact that the best team won is a logical validity or
> type Tautology1 as defined under
> http://scratchpad.wikia.com/wiki/Naming_Conventions
Wrong. Do you really believe that the winner is always the best team? If
the 1998 NFC championship game was replayed ten times, how often do you
think Atlanta would win? If the best team invariably won, why would we
have the expression "may the best team win"?
> The *proposition* that the best team won and therefore 20mil years ago
> our common daddy swung by his tail while fondling his nuts is a
> rhetorical tautology, the conclusion doesn't follow logically.
>
> Why is this so difficult to understand?
>
What is difficult to understand? Please explain how excess reproduction
and heritable variation can result in anything other than evolution,
other than by maintaining that best teams consistently lose.
Mike Painter
Evolution has neveer been about the survival of the fittest. It has always
been about the survival of the just barely good enough.
John S. Wilkins
Evolution *by natural selection* has always been about, not only the
survival, but the long term reproductive success, of the more adequate.
Other kinds of evolution are about the chance retention of some
varieties over others, or the constraints of history on change by deeply
entrenched developmental processes.
--
John S. Wilkins, Philosophy, Bond University
http://evolvingthoughts.net
But al be that he was a philosophre,
Yet hadde he but litel gold in cofre
cassandra
If I understand you correctly, you make at least two important
points. One is there is more than one way to change gene frequencies
in a population. The other is that survival is based on relative
factors. As the joke goes, you don't have to be faster than the bear,
just faster than your companions.
> John S. Wilkins, Philosophy, Bond Universityhttp://evolvingthoughts.net
> But al be that he was a philosophre,
> Yet hadde he but litel gold in cofre- Hide quoted text -
>
> - Show quoted text -
Friar Broccoli
.
I'm not certain, but I don't think that is his point. I see two
separate points:
- Selection due to drift (chance).
- The evolutionary history of a species limits possible future
evolutionary options, for example flying insects can never develop
large brains due to the weight problem.
John S. Wilkins
Ayup. And that selection is not merely survival (which is the opposite
to the bear point). Not only must you outrun the bear, you must also
outrun competitors for mates, and ensure that your progeny survive to
mate also. If you are in the right circumstances, you might also have to
ensure that their progeny survive by leaving them resources and a
constructed environment.
--
Bob Casanova
in talk.origins, posted by Bob Casanova <nos...@buzz.off>:
>On Thu, 30 Sep 2010 09:41:53 -0400, the following appeared
>in talk.origins, posted by Walter Bushell <pr...@panix.com>:
<snip>
>>...would a knowledge of evolution change how doctors practice medicine?
>>I doubt it. It's really hard to turn down a demand to prescribe
>>antibiotic when you lose the customer and you have $300K of student
>>loans to repay.
>Perhaps, but IIRC a prime tenet of the Hippocratic Oath is
>"First do no harm". One could make a case that unneeded
>drugs and improper treatment regimens do the opposite, both
>for the patient and for society in general. Do you believe
>it would be impossible or undesirable to require that
>doctors "do it right", with severe penalties, including
>license revocation, for those who put their finances ahead
>of the welfare of their patients?
Well?
el cid
> On Thu, 30 Sep 2010 10:38:00 -0700, the following appeared
> in talk.origins, posted by Bob Casanova <nos...@buzz.off>:
>
> >On Thu, 30 Sep 2010 09:41:53 -0400, the following appeared
> >in talk.origins, posted by Walter Bushell <pr...@panix.com>:
>
> <snip>
>
> >>...would a knowledge of evolution change how doctors practice medicine?
> >>I doubt it. It's really hard to turn down a demand to prescribe
> >>antibiotic when you lose the customer and you have $300K of student
> >>loans to repay.
> >Perhaps, but IIRC a prime tenet of the Hippocratic Oath is
> >"First do no harm". One could make a case that unneeded
> >drugs and improper treatment regimens do the opposite, both
> >for the patient and for society in general. Do you believe
> >it would be impossible or undesirable to require that
> >doctors "do it right", with severe penalties, including
> >license revocation, for those who put their finances ahead
> >of the welfare of their patients?
>
> Well?
The premise that MDs profit by prescribing drugs is rather
dubious. MDs who own testing labs and send their patients
for unnecessary tests at those labs have been sanctioned
but that's not your point.
Dick C.
news:71beb981-040d-4e1c...@z25g2000vbn.googlegroups.com:
From time to time it comes out that some docs get kick backs from
some pharmacies. The kickbacks generally do not include over
prescribing, or prescribing unneeded drugs, but the pharmacy pays
the doctor a bit per prescription filled.
I also recall a scandal where a doctor that did radiation treatment
in his office also had interest in another site that did radiation
treatment, but a somewhat different type. He was sending cancer
patients there even though his radiation treatment was all that was
needed. I may have been part of that group, as I received both types
of radiation.
On the other hand, I became cancer free, and have not had it return.
Although I no longer need to use lights after dark. :)
--
Dick #1349
"They that can give up essential liberty to obtain a little temporary
safety
deserve neither liberty nor safety."
~Benjamin Franklin
Home Page: dickcr.iwarp.com
email: dic...@gmail.com
Walter Bushell
Bob Casanova <nos...@buzz.off> wrote:
> On Thu, 30 Sep 2010 10:38:00 -0700, the following appeared
> in talk.origins, posted by Bob Casanova <nos...@buzz.off>:
>
> >On Thu, 30 Sep 2010 09:41:53 -0400, the following appeared
> >in talk.origins, posted by Walter Bushell <pr...@panix.com>:
>
> <snip>
>
> >>...would a knowledge of evolution change how doctors practice medicine?
> >>I doubt it. It's really hard to turn down a demand to prescribe
> >>antibiotic when you lose the customer and you have $300K of student
> >>loans to repay.
>
> >Perhaps, but IIRC a prime tenet of the Hippocratic Oath is
> >"First do no harm". One could make a case that unneeded
> >drugs and improper treatment regimens do the opposite, both
> >for the patient and for society in general. Do you believe
> >it would be impossible or undesirable to require that
> >doctors "do it right", with severe penalties, including
> >license revocation, for those who put their finances ahead
> >of the welfare of their patients?
>
> Well?
Damn that would be hard to prove. Likely this is down without conscious
thought. Beside we might end up with no doctors.
Bob Casanova
appeared in talk.origins, posted by el cid
<elcid...@gmail.com>:
>On Oct 3, 12:54 pm, Bob Casanova <nos...@buzz.off> wrote:
>> On Thu, 30 Sep 2010 10:38:00 -0700, the following appeared
>> in talk.origins, posted by Bob Casanova <nos...@buzz.off>:
>>
>> >On Thu, 30 Sep 2010 09:41:53 -0400, the following appeared
>> >in talk.origins, posted by Walter Bushell <pr...@panix.com>:
>>
>> <snip>
>>
>> >>...would a knowledge of evolution change how doctors practice medicine?
>> >>I doubt it. It's really hard to turn down a demand to prescribe
>> >>antibiotic when you lose the customer and you have $300K of student
>> >>loans to repay.
>> >Perhaps, but IIRC a prime tenet of the Hippocratic Oath is
>> >"First do no harm". One could make a case that unneeded
>> >drugs and improper treatment regimens do the opposite, both
>> >for the patient and for society in general. Do you believe
>> >it would be impossible or undesirable to require that
>> >doctors "do it right", with severe penalties, including
>> >license revocation, for those who put their finances ahead
>> >of the welfare of their patients?
>>
>> Well?
>
>The premise that MDs profit by prescribing drugs is rather
>dubious.
Assuming you mean "profit directly", I agree. Nor did I make
such a claim.
> MDs who own testing labs and send their patients
>for unnecessary tests at those labs have been sanctioned
>but that's not your point.
No, it wasn't. Nor was it that MDs directly profit from
dispensing drugs. Perhaps you should re-read what I wrote,
taking into account the post to which it was a response.
Bob Casanova
in talk.origins, posted by Walter Bushell <pr...@panix.com>:
>In article <v8dha6pqvh5cbrq5c...@4ax.com>,
> Bob Casanova <nos...@buzz.off> wrote:
>
>> On Thu, 30 Sep 2010 10:38:00 -0700, the following appeared
>> in talk.origins, posted by Bob Casanova <nos...@buzz.off>:
>>
>> >On Thu, 30 Sep 2010 09:41:53 -0400, the following appeared
>> >in talk.origins, posted by Walter Bushell <pr...@panix.com>:
>>
>> <snip>
>>
>> >>...would a knowledge of evolution change how doctors practice medicine?
>> >>I doubt it. It's really hard to turn down a demand to prescribe
>> >>antibiotic when you lose the customer and you have $300K of student
>> >>loans to repay.
>>
>> >Perhaps, but IIRC a prime tenet of the Hippocratic Oath is
>> >"First do no harm". One could make a case that unneeded
>> >drugs and improper treatment regimens do the opposite, both
>> >for the patient and for society in general. Do you believe
>> >it would be impossible or undesirable to require that
>> >doctors "do it right", with severe penalties, including
>> >license revocation, for those who put their finances ahead
>> >of the welfare of their patients?
>>
>> Well?
>
>Damn that would be hard to prove.
Undoubtedly, although circumstantial evidence should abound.
For example, if a doctor prescribed antibiotics for a
*known" viral infection - i.e., your earlier example.
> Likely this is down without conscious
>thought.
Somehow that is *not* reassuring... "I wasn't really
thinking about what I was doing when I prescribed your
meds." (Or "removed the wrong kidney", or "left my scalpel
sticking in your spleen")
> Beside we might end up with no doctors.
Already on the way, given increasing governmental and
insurance restrictions (which don't address the above
concerns, but only "fairness" and cost), and the antics of
tort lawyers. And I don't blame the doctors at all.
Walter Bushell
Bob Casanova <nos...@buzz.off> wrote:
On the whole it might improve the health of the population, as hard as
it might be on some individuals. People might wake up and start being
responsible for their own health, rather than just taking some pills.
Anyway the race needs a weeding.
chris thompson
This was a breaking story today:
"The race for emerging market domination may be even more competitive
than we thought. U.S. federal investigators are looking into whether a
host of Big Pharma companies have bribed foreign official in order to
increase their performance in new markets. The Wall Street Journal
obtained a letter which said the government is looking for four types
of violations: "bribing government-employed doctors to purchase drugs;
paying company sales agents commissions that are passed along to
government doctors; paying hospital committees to approve drug
purchases; and paying regulators to win drug approvals." The Foreign
Corrupt Practices Act of 1977 prevents companies on U.S. stock
exchanges from bribery in other countries. Questionable transactions
in Brazil, China, Germany, Italy, Poland, Russia and Saudi Arabia are
being probed."
http://www.fiercepharma.com/story/u-s-investigates-pharma-bribes-emerging-markets/2010-10-05
When my father had a private practice (30+ years ago)...well I cannot
say for sure he got kickbacks from any pharm sales rep, but he sure
got plenty of gifts and things. They were all over the house. We grew
up thinking it was normal.
Chris
Chris