Free speech and forced jabs

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Our friend Jay Bhattacharya (ep. 175) is at the center of a major lawsuit claiming that the Biden administration has used the censoring power of big tech companies to get around the first amendment protection of free speech.

Documents released as part of the discovery process and through prior FOIA requests seem to confirm beyond any doubt a direct collusion between the feds and tech giants to muffle, silence, or deplatform critics of lockdowns, mask policies, and vaccine mandates (such as Bhattacharya, co-plaintiff Martin Kulldorff, journalist Alex Berenson, and others). The plaintiffs stand a good chance of winning, and a win would be a huge victory against public health tyranny.Continue reading “Free speech and forced jabs”

The empiricist has no clothes

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In the Spring of 2021, an Israeli doctor voiced a concern about cases of myocarditis that he was witnessing among young men who had received the Pfizer mRNA COVID vaccine. 

There was no apparent reason to doubt his testimony, and that should have been sufficient to alert physicians around the world to be on the lookout for similar occurrences. If confirmed in the experience of others, the Israeli doctor’s concern could be taken into prudent consideration for medical practice and public health worldwide.

But we live in the age of empiricism and “science-based” recommendations. In this age, the clinical judgment of physicians is not a fact until it has a number attached to it. Also, questions of right and wrong and of what to do can only be decided when “data” have been collected.

So a conflict of numerical facts was quickly entered into.Continue reading “The empiricist has no clothes”

Is myocarditis real?

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I highly recommend listening to our latest podcast with Dr. Vinay Prasad, an extremely intelligent, articulate, and courageous physician who has been absolutely phenomenal speaking out against the “unscientific” public health policies of the last 20 months. Vinay is an astoundingly prolific writer—publishing in academic journals and in the lay press—and now has an excellent YouTube channel that I turn to daily to get his analysis of the latest scientific and health policy news.

During our conversation with Vinay, and reflecting on some outlandish positions taken by the CDC on the incidence of COVID-induced myocarditis, Anish startled me by mentioning Michel Foucault and his notion of “regimes of truth,” the idea that the dominant political forces essentially set the framework under which a society comes to an understanding of things. “If knowledge is not power, but power is knowledge, then scientific objectivity may be a myth. What do you think about that!?” Anish challenged Vinay.Continue reading “Is myocarditis real?”

Realism for Joe Rogan

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Joe Rogan is notoriously difficulty to pigeonhole. He is pro-gun rights, anti-cancel culture, and voted for Libertarian candidates in 2012 and 2016, but he also holds progressive positions on many issues, supported Bernie Sanders in 2020, and is not necessarily opposed to big government programs.

I suspect that much of his appeal indeed comes from seeming “pragmatic” rather than ideological. But after listening to him on a recent excellent episode with guest Michael Shellenberger, it occurred to me that Rogan’s leanings may also be those of a philosophical realist

I’ve said and I repeat it…it’s a mantra, it’s part of my philosophy: You can’t be married to ideas. Ideas are just a thing that you examine. If you get married to an idea and you support it even though, like…like a corrupt district attorney would do…like you thought a guy was guilty and even though you had evidence that would exonerate him you keep prosecuting him…We all have ideas that we bounce around that are incorrect, and the only way you find out about that is if you’re confronted with better evidence…

(It seems fair to assume that he uses the word “evidence” here as a stand-in for reality, i.e., for things that are independent of how we think or feel about them.)Continue reading “Realism for Joe Rogan”

HCQ, Politics, and Professionalism

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By now, everyone and their mother has seen the censored Breitbart video of “America’s Frontline Doctors” standing in front of the Supreme Court and vaunting a hydroxychloroquine cocktail as “a cure” for COVID.  To many, the overtly political display seemed over-the-top and proof that the stuff could only be snake oil.  It also didn’t help that the doctor who promoted its benefit with the most swagger had apparently made prior claims about the demonic origin of certain diseases.

But I will take sides here and defend those who wish to prescribe that cocktail, that they may be able to do so without fear of ignominy.  If my arguments are taken to be political, so be it. 

Continue reading “HCQ, Politics, and Professionalism”

What’s a diagnosis about? COVID-19 and beyond

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Last month marked the 400th anniversary of the birth of John Graunt, commonly regarded as the father of epidemiology.  His major published work, Natural and Political Observations Made upon the Bills of Mortality, called attention to the death statistics published weekly in London beginning in the late 16th century.  Graunt was skeptical of how causes of death were ascribed, especially in times of plagues.  Evidently, 400 years of scientific advances have done little to lessen his doubts! 

A few days ago, Fox News reported that Colorado governor Jared Polis had “pushed back against recent coronavirus death counts, including those conducted by the Centers for Disease Control and Prevention.”  The Centennial State had previously reported a COVID death count of 1,150 but then revised that number down to 878.  That is but one of many reports raising questions about what counts as a COVID case or a COVID death.  Beyond the raw numbers, many controversies also rage about derivative statistics such as “case fatality rates” and “infection fatality rates,” not just among the general public but between academics as well.  

Of course, a large part of the wrangling is due not only to our unfamiliarity with this new disease but also to profound disagreements about how epidemics should be confronted.  I don’t want to get into the weeds of those disputes here.  Instead, I’d like to call attention to another problem, namely, the somewhat confused way in which we think about medical diagnosis in general, not just COVID diagnoses.Continue reading “What’s a diagnosis about? COVID-19 and beyond”

It’s not about tradeoffs

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It is tempting to oppose the harmful effects of COVID-related lockdown orders with arguments couched in terms of trade-offs. 

We may contend that when public authorities promote the benefits of “flattening the curve,” they fail to properly take into account the actual costs of imposing business closures and of forced social distancing: The coming economic depression will lead to mass unemployment, rising poverty, suicides, domestic abuse, alcoholism, and myriad other potential causes of death and suffering which could be considerably worse than the harms of the pandemic itself, especially if we consider the spontaneous mitigation that people normally apply under the circumstances.

While I have no doubt that lockdown policies can and will have very serious negative consequences, I believe that the emphasis on trade-offs is misguided and counterproductive.  It immediately invites a utilitarian calculus: How many deaths and how much suffering will be caused by lockdowns?  How many deaths and how much suffering will occur without the lockdowns? How exactly are we to measure the total harm?  What time frame should we consider when we ponder the costs of one option versus the other?Continue reading “It’s not about tradeoffs”

When scientists know the answer ahead of the experiment

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On the day that we taped our podcast episode with Brian Nosek about the replication crisis, the renowned statistician Andrew Gelman published an essay in the New York Times on precisely that topic.

Gelman echoes some of the remarks made by Nosek.  In particular, he draws attention to the point we discussed regarding what to believe when the results of an experiment are contrary to what is expected.  Commenting on a recent study (co-authored by Nosek) in which statisticians were asked to predict, ahead of a replication experiment, whether the findings of the original study would be replicated or not, Gelman says:

Here’s where it gets really weird. The lack of replication was predicted ahead of time by a panel of experts using a “prediction market,” in which experts were allowed to bet on which experiments were more or less likely to — well, be real.

We tried to press Brian on that point.  Do certain subjects impose essential limitations on empirical science?  It seems to me that certain questions regarding human behavior are essentially answered by human judgment rather than by “mindless” data analysis, despite the fact that human minds can be prone to bias.  Brian agreed but also brought up some counterpoints.  Don’t miss listening to that episode.

When scientists discover new body parts

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Soon after publishing our second podcast episode on brain death, this article from Newsweek came into my Twitter feed: “Endorestiform Nucleus: Scientist Just Discovered a New Part of the Human Brain.”

According to the article, an Australian researcher may have discovered an island of neurons heretofore undescribed and which may be involved in important motor activities.

The same article also mentions the “discovery” early this year of a new organ to be called the interstitium.  As in the case of the endorestiform nucleus, the claim for the interstitium is not that scientists have discovered a new material part of the body so far unknown, but that a known part of the body that previously did not attract the attention of physiologists is now found to have a function that is capturing their attention.

These “discoveries” illustrate nicely a philosophical point about body parts.  Continue reading “When scientists discover new body parts”

The case against shared decision-making – part 3

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(Part 1 and part 2)

To conclude this 3-part series, I will discuss the relationship between shared decision-making (SDM) and evidence-based medicine (EBM), as the two are intimately connected.

As I indicated in part 1, SDM did not attract the attention of academics until the late 1990s.  It is only then that publications on SDM began to appear routinely in the medical literature, and their numbers have exploded since the early 2010s (see chart).  Yet shared decision-making was proposed by the Presidential Commission’s ethicists as far back as 1982.  What accounts for the delay in interest?

The simple answer is that the development of SDM had to wait for the appearance of the evidence-based medicine movement on the healthcare scene in the early 1990s.  And it makes perfect sense that SDM would require EBM to flourish, since EBM was proposed precisely as a scientific and objective antidote to “eminence-based medicine,” which is one expression of the culture of medical paternalism that SDM was supposed to be countering.Continue reading “The case against shared decision-making – part 3”