4 ms·

I am not downlaying the article at all. I made it quite clear I believed it was likely the procedure was being abused. The anecdote of the asthmatic woman is pa

I am not downlaying the article at all. I made it quite clear I believed it was likely the procedure was being abused. The anecdote of the asthmatic woman is particularly concerning. > But how often have ended up in danger from people who were both handcuffed and secured to the stretcher? Multiple times (I don't have a specific number). A stretcher is not intended to be used as an anchor for restraints. It's very difficult to keep someone restrained to a stretcher if they are continuing to fight. There is also a significant risk they will injure themselves. Finally, in some cases it is necessary to sedate a patient to provide treatment. The point of my comment is that it would be very easy for the article to omit details to make situations seem far less appropriate than they actually may have been (or that the abuse was more widespread than it actually was). EDIT: As your comment is starting to gray out, I think it's important to say that while I disagree with you, I think your comment is thoughtful and contributes meaningfully to the conversation (and certainly shouldn't be downvoted)

eesmith 8y ago
Thank you for your support. I tried to highlight the specific reasons why it felt like downplaying. Another way to phrase my view would be, if someone did want to downplay the report, how would it come across? An outright rejection doesn't work. It's too easily dismissed. For example - and I make this comparison only to provide a well-known example - if you look at the anti-vaxxers, they don't outright reject vaccination. Instead, they argue that it should be examined more closely, there are uncertainties, and it's best to be cautious. No one can argue with those general statements. It's when you come down to specific things like "should all 6 month old babies (excepting medical reasons) be vaccinated for X" where the opposition comes into play. The opposition strategy is to take it back to the more abstract level, or bring up specific examples where vaccination might have caused a problem. I felt like your comment followed a similar pattern of switching to abstract principles that no one disagrees with. Someone who wanted to downplay the report would do that, to establish credential as being a reasonable person, and then use that credential to argue that things are more grey and nuanced than it appears. A third way to phrase my view would be as a complaint about switching to abstractions, which seems to minimize the concrete abuses of the actual people described.
- JshWright 8y ago
  I think where my comment differs from an anti-vaxxer's position is that I am an (admittedly self-described) content area expert. I am not attempting to discredit established science, I am providing more context that a layperson reading this article would otherwise lack. My concern with the article is that uses the same sort of vague and general statements that you're concerned with to argue against the use of sedation. For instance: "The police encounters that led to EMS using ketamine ranged from cases of obstruction of justice to jaywalking, according to the report. One man was dosed with ketamine while strapped to a stretcher and wearing a spit hood." To someone without the context of what these sorts of scenarios often look like, that sounds awful. As someone with a decade+ of EMS experience, I can think of a dozen calls that could be simplified into that paragraph. In every one of those cases in my personal experience I feel I acted in the best interest of the patient, while protecting my own safety and the safety of my crew. These are not decisions that are undertaken lightly, and even in cases where I'm 100% sure I made the right call, these are still the decisions I dwell on for the next couple days. You are absolutely right that my point is to argue that things are more grey and nuanced. Because they _are_. When I read this article, I think about all the time I've sedated someone, and the ways in which those scenarios could be simplified and twisted into a case where I "obviously" did the wrong thing. I'm not sure how you expect me to discuss this without using abstractions. I don't have specific knowledge of the cases involved, and it would be inappropriate for me to share all but the broadest details of the situations where I have personal experience.
  - eesmith 8y ago
    I bring up anti-vaxxers as a clear example. There are any number of other examples I could bring up, including from content area experts. For examples, the current medical experiment ethics are in place because of a history of experts more interested in the research results than in people. Eugenics, infamously, was part of established science, but more recently we have found many cases where there have been innumerable wrong convictions based the false science of bite marks, flame patterns, etc., all made by content area experts. There are also innumerable cases where people - domain experts - react to protect their institution over protecting people. Just look at the reaction of the forensics field to those who have identified major structural problems in forensics. Or look at how universities protect researchers over the many students who have filed sexual harassment claims. Or look to how co-workers often shun whistle blowers who highlight real problems. As an historical example, a century ago more than 30 Brooklyn physicians opposed the Bureau of Child Health because "If we’re going to save the lives of all the women and children at public expense, what incentive will there be for a young man to go into medicine?” - http://www.harvardsquarelibrary.org/biographies/sara-josephine-baker/ http://www.harvardsquarelibrary.org/biographies/sara-josephi... . So I don't mean specifically that this argument style is only used to discredit established science, but rather to give an example of how downplaying might look. As for how to discuss this without using abstractions, that isn't quite my point. Abstractions are fine. What I didn't like was how your abstractions moved the topic away from the concrete details of what appears to be horrible treatment, and into a region where there is no real controversy - abstractions which the article itself used as the baseline for judging what might be unacceptable. Personally speaking, and here I switch to an abstraction, after reading the many articles where police justify a shooting because they were worried about being attacked - at rates far higher than elsewhere in the world, and with department policies which seem to be biased towards an aggressive style - and stories of police using forced medical exams, and the stories of supposed 'content area experts' in forensics using false science for decades to reinforce police power, my presumption has become more that there is a systemic bias towards the use of power to enforce a level of compliance which is inhumane. For perhaps the starkest contrast in prison treatment, https://www.youtube.com/watch?v=HfEsz812Q1I https://www.youtube.com/watch?v=HfEsz812Q1I . (Haldane is likely the most extreme example of a humane prison, and not typical of European prisons, so this isn't quite fair.) Do you have an idea of what people in your position do in other countries, like those in Western Europe? We rarely hear about British police throwing flash grenades by accident into a baby's occupied crib. On the same lines, do you think your European counterparts would be doing the same things you do?

eesmith 8y ago

Thank you for your support. I tried to highlight the specific reasons why it felt like downplaying. Another way to phrase my view would be, if someone did want to downplay the report, how would it come across? An outright rejection doesn't work. It's too easily dismissed. For example - and I make this comparison only to provide a well-known example - if you look at the anti-vaxxers, they don't outright reject vaccination. Instead, they argue that it should be examined more closely, there are uncertainties, and it's best to be cautious. No one can argue with those general statements. It's when you come down to specific things like "should all 6 month old babies (excepting medical reasons) be vaccinated for X" where the opposition comes into play. The opposition strategy is to take it back to the more abstract level, or bring up specific examples where vaccination might have caused a problem. I felt like your comment followed a similar pattern of switching to abstract principles that no one disagrees with. Someone who wanted to downplay the report would do that, to establish credential as being a reasonable person, and then use that credential to argue that things are more grey and nuanced than it appears. A third way to phrase my view would be as a complaint about switching to abstractions, which seems to minimize the concrete abuses of the actual people described.

JshWright 8y ago
I think where my comment differs from an anti-vaxxer's position is that I am an (admittedly self-described) content area expert. I am not attempting to discredit established science, I am providing more context that a layperson reading this article would otherwise lack. My concern with the article is that uses the same sort of vague and general statements that you're concerned with to argue against the use of sedation. For instance: "The police encounters that led to EMS using ketamine ranged from cases of obstruction of justice to jaywalking, according to the report. One man was dosed with ketamine while strapped to a stretcher and wearing a spit hood." To someone without the context of what these sorts of scenarios often look like, that sounds awful. As someone with a decade+ of EMS experience, I can think of a dozen calls that could be simplified into that paragraph. In every one of those cases in my personal experience I feel I acted in the best interest of the patient, while protecting my own safety and the safety of my crew. These are not decisions that are undertaken lightly, and even in cases where I'm 100% sure I made the right call, these are still the decisions I dwell on for the next couple days. You are absolutely right that my point is to argue that things are more grey and nuanced. Because they _are_. When I read this article, I think about all the time I've sedated someone, and the ways in which those scenarios could be simplified and twisted into a case where I "obviously" did the wrong thing. I'm not sure how you expect me to discuss this without using abstractions. I don't have specific knowledge of the cases involved, and it would be inappropriate for me to share all but the broadest details of the situations where I have personal experience.
- eesmith 8y ago
  I bring up anti-vaxxers as a clear example. There are any number of other examples I could bring up, including from content area experts. For examples, the current medical experiment ethics are in place because of a history of experts more interested in the research results than in people. Eugenics, infamously, was part of established science, but more recently we have found many cases where there have been innumerable wrong convictions based the false science of bite marks, flame patterns, etc., all made by content area experts. There are also innumerable cases where people - domain experts - react to protect their institution over protecting people. Just look at the reaction of the forensics field to those who have identified major structural problems in forensics. Or look at how universities protect researchers over the many students who have filed sexual harassment claims. Or look to how co-workers often shun whistle blowers who highlight real problems. As an historical example, a century ago more than 30 Brooklyn physicians opposed the Bureau of Child Health because "If we’re going to save the lives of all the women and children at public expense, what incentive will there be for a young man to go into medicine?” - http://www.harvardsquarelibrary.org/biographies/sara-josephine-baker/ http://www.harvardsquarelibrary.org/biographies/sara-josephi... . So I don't mean specifically that this argument style is only used to discredit established science, but rather to give an example of how downplaying might look. As for how to discuss this without using abstractions, that isn't quite my point. Abstractions are fine. What I didn't like was how your abstractions moved the topic away from the concrete details of what appears to be horrible treatment, and into a region where there is no real controversy - abstractions which the article itself used as the baseline for judging what might be unacceptable. Personally speaking, and here I switch to an abstraction, after reading the many articles where police justify a shooting because they were worried about being attacked - at rates far higher than elsewhere in the world, and with department policies which seem to be biased towards an aggressive style - and stories of police using forced medical exams, and the stories of supposed 'content area experts' in forensics using false science for decades to reinforce police power, my presumption has become more that there is a systemic bias towards the use of power to enforce a level of compliance which is inhumane. For perhaps the starkest contrast in prison treatment, https://www.youtube.com/watch?v=HfEsz812Q1I https://www.youtube.com/watch?v=HfEsz812Q1I . (Haldane is likely the most extreme example of a humane prison, and not typical of European prisons, so this isn't quite fair.) Do you have an idea of what people in your position do in other countries, like those in Western Europe? We rarely hear about British police throwing flash grenades by accident into a baby's occupied crib. On the same lines, do you think your European counterparts would be doing the same things you do?