Please create an account to participate in the Slashdot moderation system

 



Forgot your password?
typodupeerror

Comment: Re:Goes to show. (Score 1) 467

by neoshmengi (#27457227) Attached to: Believing In Medical Treatments That Don't Work

The vast majority of people who don't immunize aren't doing it for religious reasons. There's a growing segment of 'educated' people who have 'researched' the issue and have decided that the risks outweigh the benefits.

Unfortunately there are 'professionals' within the health care system that spout this idiocy, including nurses and chiropractors.

Comment: Re:My only problem with Dawkins is.. (Score 1) 1161

by neoshmengi (#27101553) Attached to: Oklahoma, Vatican Take Opposite Tacks On Evolution

He is saying that teaching a religious doctrine is child abuse. That is just not reasonable.

You may not think it is reasonable, but we have pulled children out of homes before.

Saying that some religious teachings or philosophies are bad is no different than saying that some non religious philosophies are bad

True.

I think a non religious environment can be potentially abusive too. So what?
OK, why? At least Dawkins has a rational.

You're misunderstanding me.

The reason children 'get pulled out of homes' in your example is not because the parents are religious, but because the state believes that harm is being done. The focus is on the act (or lack of action) by the parents, not on the fact that the parents are teaching religion to their child.

Dawkins is not advocating against the specific things that can lead to harm, but rather that religion itself is harmful and tantamount to abuse in and of itself. That is unreasonable.

I think a non religious environment can be potentially abusive too. So what?
OK, why?

I suspect you think I am saying that a non religious environment is conducive to abuse (compared to a religious one). I am not. I think any environment has a potential for abuse and the religion aspect is a non issue.

Comment: Re:My only problem with Dawkins is.. (Score 1) 1161

by neoshmengi (#27101429) Attached to: Oklahoma, Vatican Take Opposite Tacks On Evolution

You honestly believe that religious people are all abusing their children?

I think a religious environment is potentially abusive, and instilling superstitious beliefs as truth in children is not a good thing.

You think that concept is 'reasonable'? It's staggering that you got modded up.

What about "christian scientists" that deny critical care to their children? What about muslims who teach terrorism. What about "abstenence only" education?

I'm not saying that fundamentalists weren't responsible for the twin towers. I'm saying that painting them as representatives for all religion is offensive. But that is his intent after all...

It is the seeming rational moderate "enablers" that give comfort to the extremists. Religion is nonsense. If you can believe absurdities you can perpetrate atrocities.

It's fine to look at a *specific* act or ideology and debate its merits. He is not. He is not saying 'potentially abusive', or 'more likely to be abusive'. He is saying that teaching a religious doctrine is child abuse. That is just not reasonable.

Saying that some religious teachings or philosophies are bad is no different than saying that some non religious philosophies are bad

I think a non religious environment can be potentially abusive too. So what?

There are plenty of non religious people who perpetrate atrocities. Would it be reasonable to paint Pol Pot or Stalin as model atheists?

Comment: Re:My only problem with Dawkins is.. (Score 1) 1161

by neoshmengi (#27101267) Attached to: Oklahoma, Vatican Take Opposite Tacks On Evolution

He's said that people who teach their kids religion are child abusers.

No, he said that labeling children is close to child abuse.

He ends one of his lectures by saying how religious fundamentalists crashed into the twin towers, and therefore it's time to stop being so respectful of religion.

No he doesn't. You are lying about what he's saying, just like with the child abuse argument he made.

Those are pretty offensive comments to me...

And I find it offensive that you are actively lying about what Dawkins is saying. Pathetic.

And I quote,

"How did September the 11th change you? Well here's how it changed me. Let's all stopped being so damned respectful."

This is from the atheist's call to arms from Tedtalks 2002.

Now who's lying to promote their own agenda?

Comment: Re:My only problem with Dawkins is.. (Score 1) 1161

by neoshmengi (#27101173) Attached to: Oklahoma, Vatican Take Opposite Tacks On Evolution

He's said that people who teach their kids religion are child abusers.

From a logical perspective, that is not unreasonable or unheard of. We remove children from "christian scientists" when they refuse critical care.

He ends one of his lectures by saying how religious fundamentalists crashed into the twin towers, and therefore it's time to stop being so respectful of religion.

Religious fundamentalists *DID* crash into the twin towers.

Those are pretty offensive comments to me...

Truth is often offensive to those who refuse to accept it.

You honestly believe that religious people are all abusing their children? You think that concept is 'reasonable'? It's staggering that you got modded up.

I'm not saying that fundamentalists weren't responsible for the twin towers. I'm saying that painting them as representatives for all religion is offensive. But that is his intent after all...

Comment: Re:My only problem with Dawkins is.. (Score 1) 1161

by neoshmengi (#27096271) Attached to: Oklahoma, Vatican Take Opposite Tacks On Evolution

I find a lot of the time he can be callously disrespectful and religiously atheist.

Having seen him many times, the only offense he may have committed is *not* entertaining the rediculous notion that a god exists without any proof.

He's said that people who teach their kids religion are child abusers.

He ends one of his lectures by saying how religious fundamentalists crashed into the twin towers, and therefore it's time to stop being so respectful of religion.

Those are pretty offensive comments to me...

Comment: Re:Oklahoma? (Score 1) 1161

by neoshmengi (#27096155) Attached to: Oklahoma, Vatican Take Opposite Tacks On Evolution

Dawkins holds that to be an intelligent scientific thinker you must hold to both strict naturalism and evolution apriori, which is not so subtly implying that all of the other 53-ish percent of humans living in the United states are basically drooling morons.

Perhaps Dawkins is not implying that these people are unintelligent, but that they are unscientific.

Actually in many of his lectures he implies that religious people are less intelligent. He delights in in the studies that have shown this kind of correlation.

Comment: Re:Evidence-based medicine (Score 4, Interesting) 1064

by neoshmengi (#27037489) Attached to: Why Doctors Hate Science

Unfortunately this is severely mitigated by two groups - lawyers and patients.

The original article could equally be titled 'why lawyers hate science' - as the parent says, many judgements against doctors are based on whether something could have been done, not whether there was evidence to support doing it, or even whether it would have been effective.

That is sheer and utter nonsense.

I wish it were nonsense. There was a US case about a patient who had an acute spinal cord injury. There is a controversy about whether or not to give steroids in these cases to reduce swelling and decrease subsequent injury. So far the consensus is that it doesn't help. The ER attending physician therefore did not give steroids. The patient had a bad outcome. The ER attending was found guilty (not sure what the correct term is) because the prosecution found an expert witness who said that it might have helped.

The only "imperative" imposed by the courts is that "reasonable care" be applied? Why is that so terrible? Why is that so onerous? Most medical care is far, far above that relatively low standard.

The difficulty is in defining reasonable. It seems that some lawyers are very good at skewing this definition.

Most physicians practice 'defensive medicine'. That means they do things that are medically unnecessary, solely to protect themselves from frivolous lawsuits. Good medicine alone unfortunately won't protect you from malicious (or vulnerable and wounded) people, looking for someone to blame.

I can tell you a number of cases where the physician was found guilty and they did nothing wrong. The jury just didn't like how things turned out for the patient.

(Big fan of yours by the way!)

Comment: Re:Evidence-based medicine (Score 2, Informative) 1064

by neoshmengi (#27037327) Attached to: Why Doctors Hate Science

US emergency medicine guidelines, for example, are extremely aggressive and notorious for over investigating. The priority is protecting practitioners from litigation rather than appropriately treating the patient.

Actually one of the big reasons that EM diagnostic evaluation is more aggressive than usual is that (shock) patients actually do have a hint of what is important. That is, if you take a random person who goes to his family doc with chest pain versus one who goes to the ER the former is less likely to have significant coronary artery disease. So its not surprising that if you compare ER with primary care, it is good medicine to be more aggressive with diagnostic evaluations in the ER.

That said, hell yeah as an ER doctor I sometimes practice defensive medicine. If you place me in an environment where people can effectively sue me for what I might make full time in 20 years for a bad outcome that happens despite me practicing medicine that meets the standard of care in my practice environment I sure as hell am going to practice defensive medicine. The fact that I don't always do aggressive diagnostics in every patient is either me being a Pollyanna or perhaps taking my patient's best interests at heart. I'm willing to put my neck on the line somewhat to avoid a CT in a toddler who just has overprotective parents, but your fat, diabetic, smoking, sedentary, litigious ass is just not cute enough to get the my sympathy.

I'm comparing US emergency medicine guidelines with Canadian emergency guidelines. A lot of the US based CME will even directly admit in their lectures that their recommendation is based more on protecting against potential litigation.

I'm not criticizing defensive medicine either. 98% of my charting is done solely to protect myself in case of a law suit. Very little of it is clinically helpful.

I practice mostly in primary care, but I do ER work as well. Most of my EM CME is US based. My comment is not intended as a slam at all, just a realization that we practice medicine in different environments.

(and thanks to my EM training I picked up two subtle acute coronary syndromes recently that my partners missed. Direct admit from clinic to the ICU baby! Sometimes it pays to be aggressive)

Comment: Re:Evidence based medicine is extremely frustratin (Score 1) 1064

by neoshmengi (#27037277) Attached to: Why Doctors Hate Science

I was referring specifically to acute (new onset) back pain. I'm not advocating never investigating back pain.

I think that medicine and physiology is still in its infancy relatively speaking. When I get someone in your situation, I tell them that the tests look normal. That it's good news because it rules out a lot of bad things, but it still doesn't explain the problem. There is a vast range of human experience that we just don't understand or have a good solution for.

Comment: Re:is there some way to find EBM doctors? (Score 1) 1064

by neoshmengi (#27036973) Attached to: Why Doctors Hate Science

There's no good answer to this. There aren't really EBM vs non EBM schools of medicine. The difference is the amount of time you spend keeping up, and how willing you are to change your practice. Newer docs tend to be more up to date than the older ones. EBM is very new phenomenon.

The other problems is that evidence is very often in the eye of the beholder. Many physicians lack the time and ability to evaluate evidence for themselves. They rely on drug reps (shudder) to get their 'evidence'.

Good evidence in medicine is hard to find. Once something is standard of care, it's hard to test it because ethically you can't not offer someone effective treatment to compare. The best studies are placebo controlled, double blind, randomized, controlled trials which are extremely expensive and often sponsored/biased by Big Pharma. Often there are even contradictory studies. A lot of the newest clinical care guidelines boil down to expert opinion.

Comment: Re:Evidence based medicine is extremely frustratin (Score 2, Interesting) 1064

by neoshmengi (#27036897) Attached to: Why Doctors Hate Science

I guess I do sometimes prescribe and perform treatments that have little evidence behind them. The problem is that the placebo effect is not necessarily statistically significant. Is it worth taking the gravol to have one less barf over the course of the illness? Maybe...

It's hard for me to recommend anything that has potential to harm, unless I firmly believe that the benefits outweigh the harms. That's the crux of the issue for me.

Many people I see take a number of medications, prescription and non that I may not even know about. There are potential dangerous interactions there that I don't/can't/won't know about. Even non dangerous side effects can be problematic. There is also the fact that medications cost money. I don't want people to waste their money on a treatment that is no better than placebo.

I do prescribe things that are of nebulous benefit, when people are desperate to try something, or to cling to their experience that it works.

It's just not my style to prescribe unnecessarily (in my opinion). If you see me for your cold. I will tell you to rest, take some advil or tylenol, suggest a decongestant and give you a note for work if you need it. If you see my partner, you will get a prescription for cough syrup (most do nothing), painkillers and decongestants. He also has a very low threshold for prescribing antibiotics. The net result is that his patients are extremely satisfied and his visits are quicker. My patients leave somewhat disappointed, often come back (I'm STILL sick!!!) and I have to spend a lot more time educating my patients. The patient populations self select over time and the pill poppers go to him, and the pill averse come to me.

Comment: Re:Evidence based medicine is extremely frustratin (Score 4, Insightful) 1064

by neoshmengi (#27036383) Attached to: Why Doctors Hate Science

When people bring their kids in to get some gravol for their viral gastroenteritis, I tell them that it has been shown to be no better than placebo, so I don't offer it.

Have you considered that, although it's no better than placebo, it might be better than nothing? Saying it's no better than placebo doesn't actually mean that they won't see a difference if you don't prescribe anything. It's why they use placebos in trials.

I have considered it. I also consider the fact that every medicine I prescribe carries risks, even if those risks are low. If I don't know whether the risk outweigh the benefits, I don't prescribe, particularly for 'nuisance' illnesses.

I know many physicians who prescribe placebo treatments and tests. I have trouble doing this even though patients find it very satisfying. What I sometimes do instead is tell people what the evidence is and let them decide. I struggle with the ethics of prescribing a placebo.

Thus spake the master programmer: "Time for you to leave." -- Geoffrey James, "The Tao of Programming"

Working...