I certainly understand the criticisms of Vyazma using strong words in attacking the positions of others.  It’s quite fortunate that no one else here does that.

mckenzievmd - 18 October 2009 02:12 PM

As one of those healthcare professionals who VYAZMA would argue cannot be objective or look past my narrow self interests. . .

  Did he do that or are words being put in Vyazma’s mouth?

Medical error rates can always be improved, but they are hardly of the egregious or crisis proportions that the media, and critics of mainstream medicine would suggest.

See my earlier post.  “Egregious” - interesting word, but it depends on the importance of the activity.  Few would consider mis-shelving one out of a hundred books in a library egegious.  Iatrogenic harm to one patient every hundred visits or hospitalizations seems to me to be much closer to egregious. 

The question is not simply “How many people get hurt in hospitals,” as skeptic65 emphasized, but how many get hurt compared to those that get better.

Isn’t that the same argument that the National Rifle Association uses - Not how many bullets are fired that harm someone, but rather how many are fired without harming anyone?

No human endeavor is without error, but let’s not forget, in our quest to improve medicine, that we routinely solve medical problems that have caused untold death and suffering throughout human history and that there is no evidence a fundamental change, as opposed to incremental improvements, is needed in the system.

  I certainly agree with the first part of that statment, however, the fallacy here was “irrelevant conclusion” or “double tracking”.  The medical advances have been wonderful, but the failures in the management system, not the medical advances were the subject of criticism.

I generally prefer to argue facts rather than motives,  but I do think it is a bit disingenuous . . .

I agree that it’s better to argue by facts rather than by motives, however the rest of this paragraph seems to put that first clause into question.

Occam
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Occam - 18 October 2009 03:21 PM

Really, Doug, I admire your intelligence and rationality, however, the de minimus critical thinking fallacy deserves a response by analogy:  If one percent is so minor, then would you be willing to fly on an airline that had only one percent of its flights end up in a crash?  Or would you eat at a restaurant that assured you that only one person out of every, say, 110 patrons died of botulism? 

There are many areas in our lives what a one percent failure rate is completely unacceptable, and where their failure rate is less than one in a thousand. 

Many consumer advocates recommend that medical or hospital patients be sure to have at least one knowledgeable family member present to question each procedure to understand and check what’s going on.  This is a wise idea, especially if the failure rate is close to one percent.  Since, however, few people have enough scientific/medical knowledge most of them are at the mercy of the doctors, nurses and technicians.  That would seem to indicate that it is incumbant on the medical establishment maintain extreme care in preventing errors.

Occam, my issue with the one percent was whether or not it constituted an “extreme exception”. A rate of under 1% qualifies for that description. I never said that this was acceptable. Clearly, any negligence whatever is unacceptable.

As for Brennen’s post, if what you object to is strong criticism, why do you persist in engaging in it yourself? Brennen himself responded in a conciliatory fashion before your post, as did Vyazma.

I have to admit that Vyazma’s motives where suspect in my mind and part of the motivation for my post. His prior history of posting on medical issues and his clear distrust of the medical community is well documented in these forums. My other motivation was his comment about the persons suitability for the job, an oppinion formed entirley by looking at a picture. We have neither the ability nor the right to juudge someone base on such limited information. What exaclty tells you that this woman is unsuitable as an xray tech? Is it her obesity, her poor complexion, the deer in the headlights look in the photo ( loooked at your last DMV photo lately)?

macgyver - 18 October 2009 04:02 PM

I have to admit that Vyazma’s motives where suspect in my mind and part of the motivation for my post. His prior history of posting on medical issues and his clear distrust of the medical community is well documented in these forums. My other motivation was his comment about the persons suitability for the job, an oppinion formed entirley by looking at a picture. We have neither the ability nor the right to juudge someone base on such limited information. What exaclty tells you that this woman is unsuitable as an xray tech? Is it her obesity, her poor complexion, the deer in the headlights look in the photo ( loooked at your last DMV photo lately)?

I was taking into consideration the testimony of the Father who said that she talked rapidly and incessantly about her personal life while poisoning the child.
That being said, let’s drop EVERYTHING. I’m out. You win.
There are relevant posts above explaining my position.

Quoting Doug:

As for Brennen’s post, if what you object to is strong criticism, why do you persist in engaging in it yourself? Brennen himself responded in a conciliatory fashion before your post, as did Vyazma.

  Sorry, Doug.  I read from my first post on, since it had been only a few hours.  I responded as I read each post, and it’s always just too much fun for me as a wise-ass when I see critical thinking fallacies not to respond.  I did so then posted, and continued down the list.  That’s where I saw that they had both become more gentle.  Now, I had a problem.  I could go back and delete all my wonderful comments that I worked hard on, or just leave them.  I suppose, if I had been in a more reasonable mood instead of having just walked out of a stupid presentation at the local library, I would have done that.  So, sorry again.

Occam

Occam - 18 October 2009 04:18 PM

Sorry, Doug.  I read from my first post on, since it had been only a few hours.  I responded as I read each post, and it’s always just too much fun for me as a wise-ass when I see critical thinking fallacies not to respond.  I did so then posted, and continued down the list.  That’s where I saw that they had both become more gentle.  Now, I had a problem.  I could go back and delete all my wonderful comments that I worked hard on, or just leave them.  I suppose, if I had been in a more reasonable mood instead of having just walked out of a stupid presentation at the local library, I would have done that.  So, sorry again.

OK, no worries.

Occam,

Wow! Your “deconstruction” of my post gives every indication of being argumentative for its own sake, but I’m sure Doug feels better that you apologized to him for it.

As for the details-

There are many examples in past posts where VYAZMA has rejected points I and macgyver and asanta and others have made on the basis of our being members of the “Medical Industry” or apologists for the pharmaceutical industry or some such, so my reference to that line of thinking has some justification. Not to mention your own implication of the same thing, posted before my comment; “I can understand that, as a doctor, Macgyver would feel some need to protect those in his industry.”

Obviously we disagree about what constitues an acceptable error rate in medicine, but I think that doctors and nurses and other healthcare professionals deal with extremely difficult and complex problems remarkably well. Modern medicine is outstandingly successful at improving our quality and length of life. While it could certainly be better, I think it is biased and misleading to look at the harm done and not factor in the benefit when evaluating the system. Of course management and controls must be in place to protect patients from harm. Clearly in this case that system failed. The question is whether such systems in general in medicine are, as I suggest, generally very successful but in need of incremental improvement, or if the system is fundamentally flawed and needs to be scrapped or dramatically overhauled.

As Doug implied—no comment.

Occam