1 of 5
1
The SkeptVet vs Dr. Shawn—A Paradigmatic Kerfuffle
Posted: 26 January 2010 12:50 PM   [ Ignore ]
Moderator
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  4076
Joined  2006-11-28

Some of you have the masochistic bad taste to follow my blog, but for the rest of you I thought I’d mention a little exchange I recently had with a minor veterinary alternative medicine media personality. By itself it’s trivia since neither of us is all that important (his opinon of himself notwithstanding). But it seems to illustrate the difficulty in talking across the divide that separates faith-based medicine from skepticism and science-based medicine. I talk about facts and evidence, he talks about experience and miracles.

It particularly illustrates the reason why so often criticism of CAM is responded to with ad hominem attacks. If you base your belief i n what you do on your personal experience, then any challenge to the truth of your practices is by definition a personal attack to be responded to in kind. We in science-based medicine doubtless have egos at least as big as our CAM counterparts, but since we base our practices on the best currently available evidence, new evidence that invalidates them is an opportunity to change, not an attack on our intelligence or competence.

The links and a few quotes are below for anyone interested.

Dr. Shawn Messonier Disses the SkeptVet
Dr. Shawn Kerfuffle Update
CAM=Miracles, Science=Death?

Dr. Shawn:

:”Ultimately like many other skeptics, skeptvet will never be convinced that various therapies with which he does not agree may be helpful for people and pets. For those with an open mind, and the willingness to accept the time-honored tradition of clinical experience, a new world of healing awaits where true health can be obtained. An open mind is needed for change, and with change comes endless possibilities!”

SkeptVet:

“I am quite open-minded to any therapy that is demonstrated to work in a reliable scientific way. I submit I am more open-minded than you are since I acknowledge that my personal intuition and experiences may be mistaken, while you stick by your own beliefs regardless of what the research evidence says. Pick something specific I have said doesn’t work, show me real evidence it works, and I will be happy to admit my error for all the world to see… If I am opposed to alternative medicine it is only because I am opposed to gambling and experimenting on our patients. The problem is not with my closed-mindedness or prejudice, it is with your standards of what constitutes reliable proof…

Dr. Shawn:

“I’m still bewildered by the fact that many conventional veterinarians choose euthanasia as a solution for failure of their conventional treatments, rather than simply opening their minds to the healing power that exists when using clinically proven, time-honored natural therapies. My hope is that more owners will continue to seek doctors, for themselves and their pets, who are open-minded to doing what is in the best interest of the patient regardless of which therapy ultimately proves successful, or which one has been “proven” to work by artificially designed controlled studies.”

SkeptVet:

Note the use of “clinically proven” to mean “I think it works.” And the use of “proven” in scare quotes to denigrate the conclusions of scientific evidence. Then there’s the usual meaningless cliché “time-honored natural” to describe blind faith in tradition combined with the naturalistic fallacy. And finally we have the blithe dismissal of clinical trials as “artificially designed controlled studies.”

This is a portrait of a mind closed to any suggestion of its own fallibility and blind to the history of medicine in the last 200 years, which has seen progress in well-being unlike the previous total of human history thanks to the “artificial” methods of science.

 Signature 

The SkeptVet
The SkeptVet Blog
Militant Agnostic: I don’t know, and neither do you!

Profile
 
 
Posted: 26 January 2010 01:59 PM   [ Ignore ]   [ # 1 ]
Administrator
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  15362
Joined  2006-02-14

Good for you, Brennen!

 Signature 

Doug

-:- -:—:- -:—:- -:—:- -:—:- -:—:-

El sueño de la razón produce monstruos

Profile
 
 
Posted: 26 January 2010 09:16 PM   [ Ignore ]   [ # 2 ]
Sr. Member
RankRankRankRankRankRankRankRankRankRank
Total Posts:  2457
Joined  2008-06-03

I’m on team Brennen!  cheese

 Signature 

Some people can read War and Peace and come away thinking it’s a simple adventure story. Others can read the ingredients on a chewing gum wrapper and unlock the secrets of the universe.    - Lex Luthor

Profile
 
 
Posted: 26 January 2010 09:36 PM   [ Ignore ]   [ # 3 ]
Sr. Member
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  7665
Joined  2008-04-11

I have to read and savor the articles, then I’ll comment! grin
...Okay, I read the blogs, including the good doctor’s straw men. He should change his name to Dr ‘Messiah’, I love how he presents himself as a savior. Miraculously curing pets on their deathbed who have been cruelly abandoned by ‘conventional’ medicine. Just makes me want to swoon! (barf)

[ Edited: 26 January 2010 11:08 PM by asanta ]
 Signature 

Church; where sheep congregate to worship a zombie on a stick that turns into a cracker on Sundays…

Profile
 
 
Posted: 28 January 2010 05:29 PM   [ Ignore ]   [ # 4 ]
Jr. Member
Rank
Total Posts:  14
Joined  2010-01-26

I just finished reading the blogs.  I have to say I do question some of the “natural remedies”, but I also know that to find new “scientifically proven” treatments, someone needs to take the chance on different treatments.  For example: 10 years the standard of care for a person with severe trauma was to apply MAST trousers and inflate them to push the blood from the lower periphery to the core.  Over the last 2-3 years as a first responder this has changed, showing that shunting the blood to the core was not helpful and was possibly harmful by forcing lactic acid to the core and/or putting overpressure on the heart, lungs, ect….  Another example, when a person with cardiac arrest was revived, or a faced multiple system trauma patient re-warming them was the standard of care (warm IV fluids, warm compresses to the axillary groin).  In March, we will be one of few EMS providers in the United States to implement hypothermic treatment for these patients (cold IV fluids, cold compresses to the groin and axillary).  The science with this treatment is solid, by cooling the body to a low temperature you will slow the heart rate, breathing, metabolic functioning and muscle contraction of the patient.  By doing this it places less stress on all of the systems until the patient is at a facility where the patient will receive more definitive care, ie. surgery.  We have been met with a lot of criticism from physicians, nurses, and hospital administration around the area stating “We do not think this will be beneficial and may be harmful.  We will warm the patient as soon as you bring them to our facility.”  This closed mindedness is the type of behaviors that slows or stops positive progress in medicine and science.  Sometimes a different approach is not a faulty one.  Many times new treatments that one is uncomfortable with or unfamiliar with is treated as “crazy” or unacceptable.  I am not saying that this is the same situation in which you are dealing with, but just because a treatment is new or different does not mean it is wrong.  Sometimes we must look past “time honored” treatments to new innovative treatments for the advancements in medicine and science.  Unfortunately, there is no way of “scientifically” proving treatments without study groups using people and/or animals as “experiments”.  We test the theories, look at the pro’s and con’s, ask for input from others, but eventually someone has to implement these “theories” as treatments. 

I do have a couple question for you.  What is the harm in checking titers for diseases prior to vaccinating the pet or, even for that matter a person before vaccinating it?  Is it feasible that some of the resistances for diseases could be passed from one generation to the next and show up with a titer test?  If this is the case could we not save millions of dollars with not vaccinating pets or people with positive titers?  Could this save some people or pets from suffering from possible side effects from vaccinations?  I do understand that those suffering from the side effects are rare and I do believe in vaccinations, just curious.  Some people even with vaccinations do not show positive titers for immunity, for example I have received my Hep B vaccination 3 times because my titer is always negative.  What is your thought on getting re vaccinated in these cases?  Just curious of your thoughts on these questions.

Profile
 
 
Posted: 28 January 2010 06:32 PM   [ Ignore ]   [ # 5 ]
Jr. Member
Avatar
RankRankRank
Total Posts:  63
Joined  2009-12-24

SkeptVet:

“I am quite open-minded to any therapy that is demonstrated to work in a reliable scientific way. I submit I am more open-minded than you are since I acknowledge that my personal intuition and experiences may be mistaken, while you stick by your own beliefs regardless of what the research evidence says. Pick something specific I have said doesn’t work, show me real evidence it works, and I will be happy to admit my error for all the world to see… If I am opposed to alternative medicine it is only because I am opposed to gambling and experimenting on our patients. The problem is not with my closed-mindedness or prejudice, it is with your standards of what constitutes reliable proof…

Love it! Kudos to you SkeptVet.

 Signature 

“Authenticity involves living your life as if you’re actually interested in it.” ~Charles D. Hayes

Profile
 
 
Posted: 28 January 2010 09:07 PM   [ Ignore ]   [ # 6 ]
Sr. Member
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  7665
Joined  2008-04-11
rbess71 - 28 January 2010 05:29 PM

I do have a couple question for you.  What is the harm in checking titers for diseases prior to vaccinating the pet or, even for that matter a person before vaccinating it?  Is it feasible that some of the resistances for diseases could be passed from one generation to the next and show up with a titer test?  If this is the case could we not save millions of dollars with not vaccinating pets or people with positive titers?  Could this save some people or pets from suffering from possible side effects from vaccinations?  I do understand that those suffering from the side effects are rare and I do believe in vaccinations, just curious.  Some people even with vaccinations do not show positive titers for immunity, for example I have received my Hep B vaccination 3 times because my titer is always negative.  What is your thought on getting re vaccinated in these cases?  Just curious of your thoughts on these questions.

I am a long practicing Registered Nurse who worked for a long time in an ICU at a Level 4 trauma center. We do a LOT of research. When the research shows that a new treatment is more efficacious or an old treatment is not working. We change our practice. My dogs are vaccinated against distemper. Distemper is a VERY obvious disease which kills most dogs affected. It would be like withholding a Pertussis vaccination from an infant until you did titers. When an infant gets Pertussis, you know it. Also, rabies is a public health issue…that kills the dogs affected, but puts him in a position to cause harm to humans. Yes, some people do not get adequate titer response to Hep B, or other vaccinations. That is why herd immunity is so important. No it is not feasible to think that resistance to these diseases are passed on from one generation to another. Certainly populations who have been exposed over millennia to diseases such as measles or chicken pox are less likely to die of it, but people DO die. Native Americans who have only had a 400 year exposure to these diseases die at a much higher rate. I have had dogs who died of distemper before the vaccinations became availiable. It is a MISERABLE death. One of my siblings had to go through rabies vaccination after being exposed to a rabid dog when we were children. I was lucky not to have tried to play with the dog, and we were lucky that someone was able to identify us after finding that the dog had rabies. My brother would have most likely died. As I have stated before, I have cared for infants who have died from Whooping cough, despite all of the high tech and treatments our University Hospital (which is one of the best in the country) can throw at them. Same for infantile haemophilus influenzae type b, which routinely devastated infants before a vaccine was developed.

 Signature 

Church; where sheep congregate to worship a zombie on a stick that turns into a cracker on Sundays…

Profile
 
 
Posted: 29 January 2010 06:05 AM   [ Ignore ]   [ # 7 ]
Jr. Member
Rank
Total Posts:  14
Joined  2010-01-26

Thanks for the response asanta, I agree with what you have said.  I was just wandering what some of the opinions were, or if there were studies that have shown resistance passed from one generation to another.  Thanks again for your info.

Profile
 
 
Posted: 29 January 2010 10:10 AM   [ Ignore ]   [ # 8 ]
Moderator
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  4076
Joined  2006-11-28

rbess71,

Thanks for taking the time to read my blog and comment. I certainly agree that new ideas have to be investigated or there is no progress in medicine, and scientific medicine is all about progress and change, often more so than the forms of alternative medicine which rely on “ancient wisdom” for their validation. I certainly hope I didn’t give the impression that I’m opposed to trying new things, because that would absolutely be inaccurate.

My problem with much of CAM is not that the ideas are new. It is simply a question of how one approaches investigating and implementing new ideas. I agree we cannot always wait for extensive large scale clinical trial evidence. A plausible idea, consistent with established knowledge of basic biological principles with some promising in vitro or animal model evidence to support it is perfectly appropriate for implementing in a controlled, limited way to assess how it performs in the real world, or for use in those cases where the urgency to act and the inadequacy of current methods are so clear that they outweigh the risks of using an incompletely validated approach. My only cautions are against practices which I see in CAM more often than in mainstream medicine, though they occur in both areas: 1) implementation of ideas which are fundamentally inconsisteent with established knowledge and so vanishingly unlikely to work (homeopathy, energy therapies, etc), 2) widespread use of practices justified solely on the basis of anecdotes and clinical experience without any effort to formally evaluate them in a controlled way or even after controlled evidence has shown them to be unsafe or ineffective (most use of chiropractic and acupuncture, most herbal medicine, etc).

I remember when the MAST trousers were introduced, when they were the new idea, and they’re a good example of how the process works. They represent a plausible idea implemented before definitive evidence could be had since such evidence required their use in a field situation, and an idea eventually discarded when the evidence accumulated to sufficient mass to suggest lack of expected benefit. Sure, there is always resistence from individuals to change, whether adoption of a new idea or the discarding of an established practice, but science as a process is bigger than inividuals, and it works because it compensates for the biases and errors all of us are prone to. The main difference between CAM and science-based medicine is the CAM tendancy to make faith a virtue and doubt a sin.

As for antibody titers, they are sometimes recommended as an alternative to vaccination. This is a complex subject, and it is not possible to make definitive, universal recommendations about when titer testing is helpful. For some diseases, such as canine parvovirus, rabies, and feline panleukopenia, high antibody titer levels have been shown to reliably predict resistance to infection. However, due to other elements of the immune system which titers do not measure, animals with low titers to these diseases may still be protected from infection.

For other diseases, titers do not reliably predict whether the patient is resistant to the disease or not. And the predictive value of antibody levels also depends on how common the disease is in the population, so for an uncommon disease a negative titer is more likely to be an error, which makes deciding which individuals need vaccination based on their titer unreliable. Titers are useful in certain circumstances, but they are not appropriate as a routine alternative to vaccination for the general population. Given the low risk of vaccination, the unpredictability of individual response and duration of immunity, the sometimes poor correlation between titer level and protection from disease, and other complicating factors, it does not seem rational to replace vaccination with titers routinely.

Most of the folks who recommend this are simply opposed to vaccination on principle, subscibing to the idea that vaccines are full of “toxins” and wildly exaggerate the risks of vaccination. They may claim to be willing to vaccinate on the basis of titer results, but then they often go on to suggest that nutrition, homeopathic nosodes, or herbal concoctions are just as effective against disease and safer than vaccines, and so the titer question is a bit of a stalking horse for a larger anti-vaccine agenda. I do often use titer testing in practice, especially for rabies, but I don’t think the CAM folks are talking about it accurately or honestly.

 Signature 

The SkeptVet
The SkeptVet Blog
Militant Agnostic: I don’t know, and neither do you!

Profile
 
 
Posted: 30 January 2010 07:18 AM   [ Ignore ]   [ # 9 ]
Jr. Member
Rank
Total Posts:  14
Joined  2010-01-26

Thanks for the response and explanation.  I think you are correct in most of your opinions on CAM.  I do think that acupuncture and/or chiropractic treatments may be of use for some.  I personally do not use either of them, well I went to a chiropractor once and I thought he was going to kill me and afterward I wish he had.  I do see some people benefit from these treatments, but question if this is not a placebo effect.  My sister swears by the chiropractor… I do not understand and have discussed this with her, but in her mind this helps so she goes to him once a month.  Probably a waste of money, but if it gives her piece of mind, makes her feel better, capable of doing more, and alleviates pain, what is the harm?  If a person with chronic pain has acupuncture done and in his/her mind it works and they are no longer using narcotics then I think it may be beneficial.  I do not pretend to know the answers to these questions, but think if people can find alternative treatments that avoid chemicals in our bodies then what is the harm?  The best treatment is to find the problem and correct the issue, but sometimes the problem is never identified.  As I said, I do not pretend to know all the answers, but attempt to keep an open mind as to what works for individuals.

Profile
 
 
Posted: 30 January 2010 11:15 AM   [ Ignore ]   [ # 10 ]
Moderator
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  4076
Joined  2006-11-28

I have no doubt acupuncture and ciropractic relieve suffering. I am certain they do so not by changing subluxations or chi, and I am fairly confident they have only very mild and non-specific physilogic effects. However, pain and nausea are real and meanigful forms of discomfort that have a heavy psychological component, and these treatments can sometimes relieve those kinds of discomfort by changing the patient’s perceptions. This is “real” in the sense that they actually feel better, it’s just not real in the sense that their underlying disease, if any, has been changed. The only problem with such approaches is that they require some degree of belief in them to work, and this so easily leads to a general set of erroneous beliefs about physiology and how therapies should be validated that it becomes a danger. People find relief from such a practice and begin to suspect scientific medicine is a crock and that wacky alternative theories of health and disease are correct, and this leads to very serious mistakes, such as avoiding appropriate diagnostics, therapeutics, and preventative interventions that really do work.

And, of course, in my field the psychological component to subjective discomfort is harder to interpret or manipulate, so I worry that such methods as chiropractic and acupuncture treat owners’ perceptions of their pets discomfort while leaving the pet still suffering.

I certianly agree, no one has all the answers, and we all need to keep an open mind. I don’t think that “open mind” means, though, that we can never make judgments or come to conclusions, which is how the phrase is sometimes used. Knowledge, however imperfect, is sometimes possible, and being open-minded shouldn’t be a cover for ignoring what we do know.

 Signature 

The SkeptVet
The SkeptVet Blog
Militant Agnostic: I don’t know, and neither do you!

Profile
 
 
Posted: 30 January 2010 11:33 AM   [ Ignore ]   [ # 11 ]
Jr. Member
Avatar
RankRankRank
Total Posts:  63
Joined  2009-12-24
rbess71 - 30 January 2010 07:18 AM

Probably a waste of money, but if it gives her piece of mind, makes her feel better, capable of doing more, and alleviates pain, what is the harm?  .

In my opinion the harm is similar to the harm caused by other types of lying and deceit (religion, junk science, pyramid scams, ufo sightings, bigfoot, etc.).  If a person is duped into believing something to be true or workable, and is selling the idea to others in the way of testimony, it is much easier for the hucksters to get their cash.  Also, the duped are less likely to be open to effective means of treatment putting themselves and (depending on the ailment) others at risk.  It always amazes me that millions of dollars are spent on care and suppliments that can’t survive the scientific method. 

See asanta’s post entitled “nurses and woo.”  One of her co-workers (a registered nurse I’m assuming) believes that her sinuses were cleared by the manipulation of her neck.  A woman who took the same physiology and anatomy classes required of other RN’s.  Just because something makes someone feel better doesn’t render it harmless, and it doesn’t give license to the believer to sell it as true.

 Signature 

“Authenticity involves living your life as if you’re actually interested in it.” ~Charles D. Hayes

Profile
 
 
Posted: 30 January 2010 01:20 PM   [ Ignore ]   [ # 12 ]
Jr. Member
Rank
Total Posts:  14
Joined  2010-01-26
rcrase - 30 January 2010 11:33 AM

In my opinion the harm is similar to the harm caused by other types of lying and deceit (religion, junk science, pyramid scams, ufo sightings, bigfoot, etc.). 

You mean I can’t make millions on pyramid scams and buy my way into heaven…  There is no such thing as UFO’s and bigfoot does not exist…. Huh…. all of these years.  No wander I have not made a million, my ship does not fly and I have yet to find some one with more hair than uncle Buck…  LOL

I agree that there needs to be scientific proof of a treatment.  I also think that people use interventions which mask the true diseases or if used instead of seeking medical interventions lead to worsening conditions.  As I stated I am not an advocate to these treatments.  If it appeared as if I were advocating for these treatments it was not my intention.

Profile
 
 
Posted: 31 January 2010 08:04 AM   [ Ignore ]   [ # 13 ]
Jr. Member
Avatar
RankRankRank
Total Posts:  63
Joined  2009-12-24
rbess71 - 30 January 2010 01:20 PM
rcrase - 30 January 2010 11:33 AM

  As I stated I am not an advocate to these treatments.  If it appeared as if I were advocating for these treatments it was not my intention.

I don’t think you’re an advocate, you asked “what is the harm?” I was just stating what I think the harm is.

 Signature 

“Authenticity involves living your life as if you’re actually interested in it.” ~Charles D. Hayes

Profile
 
 
Posted: 15 February 2010 12:58 AM   [ Ignore ]   [ # 14 ]
Jr. Member
Rank
Total Posts:  4
Joined  2010-02-11

Perhaps Dr. Messioner should be careful-it seems his mid is so open his brain is in danger of falling out. This is a very interesting blog man, i like the part “natural remedies”... For sure i’ll be watching this blog!

[ Edited: 16 February 2010 11:35 PM by Ronaldo10 ]
Profile
 
 
Posted: 15 February 2010 10:26 AM   [ Ignore ]   [ # 15 ]
Sr. Member
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  441
Joined  2009-12-17

I get so tired of sceptics who feel a religious kind of zeal to attack and do away with alternative medicines, almost all of which have absolutely no potential harmful effects. The word of the month (if not longer, I have only been here a while) is ad-hominem… I see it thrown around all over the place by people trying to show off their vocabulary. The truth is that almost all of the abuse comes from sceptics who have this zeal and don’t understand perspective and the fact that there is a world outside science. Also what the hell is CAM ?

Profile
 
 
   
1 of 5
1