3 ms·

I worry that something is going awry with the way this stuff is being approached. This is clearly criminal really but I wonder a bit about the medical and regul

I worry that something is going awry with the way this stuff is being approached. This is clearly criminal really but I wonder a bit about the medical and regulatory culture surrounding it and how it might be backfiring and fueling it further. Today I learned about a case where a local pediatrician was disciplined for discouraging childhood vaccinations (not just COVID but vaccinations in general, pre-COVID; https://www.startribune.com/minnesota-pediatrician-disciplined-for-discouraging-childhood-vaccines/600087021/ https://www.startribune.com/minnesota-pediatrician-disciplin...). I'm very pro-vaccine, and disagree strongly with the physician, but am also disturbed that a licensed physician can be threatened with losing their right to practice because they disagree with the field. As part of the settlement, for example, the pediatrician was ordered "to remove information from his website that was critical of vaccine safety research conducted by the Centers for Disease Control and Prevention." Even given his criticisms, 80% of his patients were still vaccinated. I'm mentioning it here because I sort of wonder if people like that nurse have an outlet to say "no, I don't feel comfortable administering this vaccine" as a matter of principle without being in danger of losing their job. The nurse might just have been on some kind of unhinged vigilante mission, but I feel like the sociopolitical dynamics around these issues are crossing into some territory I feel really uncomfortable with, on both sides. Again, am not defending the actions of this nurse at all, as they are really a different issue, but I worry somewhat that certain policies might encourage this kind of behavior more, or at least add fuel to the fire of the kinds of wild conspiracy theories that underlie antivax movements in general. At some level, I don't really think the COVID vaccine controversy is really about the COVID vaccines, it's about government control and regulation in general. I often feel like people are talking past each other and making things worse.

mleonhard 5y ago
If a medical professional believes there is a flaw in modern medical practice, they have many options: 1. They can correspond with medical researchers and try to convince them of the flaw. 2. They can analyze available literature and data, write papers, and submit them to medical journals. 3. They can transfer to an institution that performs research and then perform research on the flaw and collect and publish data on it. An institutional review board (IRB) checks and approves each experiment before the researcher performs it. 4. They can correspond with regulators and try to convince them of the flaw. When medical professionals are allowed to pick and choose from accepted medical practices, patients will suffer. As an extreme example, should a heart surgeon be allowed to omit one step of the standard procedure because they disagree with it?
- ttyprintk 5y ago
  Option 5 is that someone can become a “healer” or other “practitioner” and most societies are very receptive to them operating for private payment. The wider public is served better by paying for doctors, who follow science for the public good. I think your options are incomplete because they assume a board-certified worker who wants to avoid malpractice.
- derbOac 5y ago
  Coming from biomedical research, I take your point but am cynical about those options as well. Academics is rife with problems of their own and although I see "do research" as important, I'm skeptical that any given bit of research, especially one going against the status quo, will receive much more open consideration than what an authoritarian-minded licensing board would do. Peer review is broken. In any event, there's still the issue that if you have an expert who reads the research, and concludes that it is flawed, why shouldn't they be able to exercise their judgment at the level of recommendations? Why should they have to have their opinion peer reviewed? Does every perspective and act of free speech need a stamp of approval by an editorial board or governmental body to be deemed "legitimate"? I'm playing devil's advocate but I'm also very jaded by scientific-medical-academic-political authority at the moment. At the outbreak of the pandemic, this sort of authority via the CDC (the same one this pediatrican cannot criticize) bungled mass testing for at least a month, contributing to a sense of fear and helplessness about even knowing if you were infected. These same boards are currently somehow claiming that even if a booster shot has been shown to be effective and safe, you cannot get one unless they decide it's necessary? Why are they making a decision about what's necessary for me? Is the CDC and FDA now usurping my and my provider's ability to make healthcare decisions about a safe and effective treatment because it's in their best interest? What about discussions about the origins of SARS-CoV-2 to begin with? I guess what I'm saying is that even though I think it's absurd to steer children away from vaccines (isn't that what the CDC is doing now anyway?), if a pediatrician in their expert opinion comes to some "crazy" opinion, it seems dangerous to start policing it, as opposed to educating about it. I think there's some point where something becomes malpractice, but that isn't it imho. I guess I just believe this kind of authoritarian approach (such as by the licensing board or FDA) is fueling these conspiracies.
ttyprintk 5y ago
While the Hippocratic and other oaths, and the Nightengale pledge, are not legally binding, I think they explicitly promote prevention of disease among the public before individual treatment. What you’re seeing is a professional body enforcing its membership and the brand “doctor”.

mleonhard 5y ago

If a medical professional believes there is a flaw in modern medical practice, they have many options: 1. They can correspond with medical researchers and try to convince them of the flaw. 2. They can analyze available literature and data, write papers, and submit them to medical journals. 3. They can transfer to an institution that performs research and then perform research on the flaw and collect and publish data on it. An institutional review board (IRB) checks and approves each experiment before the researcher performs it. 4. They can correspond with regulators and try to convince them of the flaw. When medical professionals are allowed to pick and choose from accepted medical practices, patients will suffer. As an extreme example, should a heart surgeon be allowed to omit one step of the standard procedure because they disagree with it?

ttyprintk 5y ago
Option 5 is that someone can become a “healer” or other “practitioner” and most societies are very receptive to them operating for private payment. The wider public is served better by paying for doctors, who follow science for the public good. I think your options are incomplete because they assume a board-certified worker who wants to avoid malpractice.
derbOac 5y ago
Coming from biomedical research, I take your point but am cynical about those options as well. Academics is rife with problems of their own and although I see "do research" as important, I'm skeptical that any given bit of research, especially one going against the status quo, will receive much more open consideration than what an authoritarian-minded licensing board would do. Peer review is broken. In any event, there's still the issue that if you have an expert who reads the research, and concludes that it is flawed, why shouldn't they be able to exercise their judgment at the level of recommendations? Why should they have to have their opinion peer reviewed? Does every perspective and act of free speech need a stamp of approval by an editorial board or governmental body to be deemed "legitimate"? I'm playing devil's advocate but I'm also very jaded by scientific-medical-academic-political authority at the moment. At the outbreak of the pandemic, this sort of authority via the CDC (the same one this pediatrican cannot criticize) bungled mass testing for at least a month, contributing to a sense of fear and helplessness about even knowing if you were infected. These same boards are currently somehow claiming that even if a booster shot has been shown to be effective and safe, you cannot get one unless they decide it's necessary? Why are they making a decision about what's necessary for me? Is the CDC and FDA now usurping my and my provider's ability to make healthcare decisions about a safe and effective treatment because it's in their best interest? What about discussions about the origins of SARS-CoV-2 to begin with? I guess what I'm saying is that even though I think it's absurd to steer children away from vaccines (isn't that what the CDC is doing now anyway?), if a pediatrician in their expert opinion comes to some "crazy" opinion, it seems dangerous to start policing it, as opposed to educating about it. I think there's some point where something becomes malpractice, but that isn't it imho. I guess I just believe this kind of authoritarian approach (such as by the licensing board or FDA) is fueling these conspiracies.

ttyprintk 5y ago

While the Hippocratic and other oaths, and the Nightengale pledge, are not legally binding, I think they explicitly promote prevention of disease among the public before individual treatment. What you’re seeing is a professional body enforcing its membership and the brand “doctor”.