One of the objections to the HPV vaccine was that it might encourage promiscuity, and so should not be administered.  There was a number of reasons why the objection failed. more…

If you look at the comments thread in the post about Kerrie Wooltorton, you’ll see that there’s been an interesting debate between me and someone who calls himself “Dr No”.  I don’t think that No and I will ever see eye-to-eye on quite a lot of stuff, but, then again, I don’t see eye-to-eye on a lot of things with the people whose offices are on the same corridor as mine, so there’s no surprise there.

Anyway - there’s a link to No’s own blog in one of the comments, and it, should you follow it, it’ll take you here.  You know the aphorism about pictures being able to represent a thousand words?  Here’s a picture: more…

This looks like it could be interesting…

Department of Philosophy, University of Bristol

This is an informal workshop on topics in the philosophy of medicine.

Everyone is welcome.

•09.45–11.00 Kevin Brosnan (Cambridge) “Does nothing in medicine make sense except in light of evolution?”
•11.15–12.30 Jeremy Howick (UCL) “Defining a role for mechanistic reasoning in EBM”
•13.30–14.45 Havi Carel (UWE) “Phenomenology and its application in clinical medicine”
•15.00–16.15 Alex Broadbent (Cambridge) “Inferring causation in epidemiology: mechanisms, black boxes, and contrasts”

The workshop will take place in the Common Room, Ground Floor, Department of Philosophy, 9 Woodland Road.

There is no need to register—it will be fine if you just turn up on the day. (If you do know that you are coming, it may be helpful to let us know, to ensure that we have a large enough room.) If you have any questions, please contact Alexander.Bird {AT} bristol.ac.uk.

This thought hit me over the weekend in Tesco’s car-park; I was still mulling over the reliability, or lack thereof, of science reporting in the media.  I was also thinking about the PCC and how powerless it is, largely because it’s simply a boys’ club for editors.

However, in my finding-a-trolley reverie, it occurred to me that there could be a solution.  There’s already a couple of papers that run debunk columns - the most high profile of these is obviously Ben Goldacre’s “Bad Science” in the The Guardian (with its corresponding blog, to which I’ve linked from here more than is absolutely healthy), but there’s also Tim Harford at the FT whose “Undercover Economist” pieces throw light onto often highly-spun news stories; he also presents Radio 4’s “More or Less”, which does its bit to look behind the headlines.  From the blogosphere, Lay Scientist, Ministry of Truth, and many, many others all provide sterling work evaluating science, the reporting of science, and the integration of science into policy.  (Peter Sinclair’s films on global warming, for example, are wonderful.)  There’s no shortage of people that care about accuracy.

What they have in passion, they lack in organisation.

So here’s the idea: its that there should be convened a panel of independent experts drawn from science, medicine and a few other fields: most importantly, statistics.  Every so often, this panel would meet and give news media a “reliability rating”.  In return for this, each member of the panel would be given a small honorarium - say a couple of grand a year - from a fund supported by the newspapers (rather as they fund the PCC).  Or maybe fewer members would be able to farm out consultancy work to academics.  Whatever - let’s not sweat the details yet.  Newspapers then would be able to print a little logo - say, a test-tube that’s more or less empty - next to their titles, to give readers a sense of the paper’s scientific trustworthiness.  The odd daft story would get through, but over the course of, say, a year, it’d be possible to build a picture of reliability.  The papers themselves would have an incentive to contribute to the scheme, and to be as reliable as possible, because they could use their trustworthiness as a selling point.  Papers that don’t participate in the scheme would, by omission, be flagging their own worthiness for scepticism.  Granted, there’re weaknesses in the picture: my guess is that people buy the Daily Fail for its scientific insight.  But they’d at least have an implicit warning that, if they were going to believe its on-occasion utterly daft health reporting, they’d only have themselves to blame.

There has to be a fatal flaw in this scheme (unless it is, so far, so sketchy right now that there’s nothing in which there could be a flaw).  Tell me what it is.

There’s an illuminating item that’s recently been posted on Enemies of Reason about the way that the press has been handling H1N1, and the way in which the distinction between deaths from and deaths with the illness has been blurred.  And it’s very easy to look at the newspaper stands and laugh at the manner in which they generate health scares from nothing - and the manner in which they then keep them going.  (Need one mention the MMR pseudo-controversy that just seems to keep on running?)

It’s not only in respect of health that journalism gets things wrong or sensationalises the trivial, of course - it happens all the time in science journalism more generally.  There is, the wisdom goes, a terrible lack of understanding about science among journalists and - worse - a perception that they don’t care that they don’t understand.  Ben Goldacre keeps returning to this theme: in the last few days, he has picked up on this particularly egregious example - the same story was noted and demolished by EoR (among others) a little while ago - and PZ Meyers has highlighted another in the recent past.  And, of course, bad science journalism and bad medical journalism come together, since it’s in respect of health that much scientific reserch gets into the papers to begin with.  (It’s either health, dinosaurs or global warming…)

So we can construct an argument about bad journalism.  It’d go something along the lines that lazy or incompetent writing is misleading, and thereby puts people’s health and welbeing in danger.  Parents are not getting their children vaccinated because of HPV and MMR stories that are simply not true, and that’s generating a serious health threat.  Others are making other decisions that have effects ranging from unnecessary anxiety to threats to life based on the way that health stories get reported.  Perhaps this might not be quite so worrisome when we’re talking about the way the mainstream press covers a story about, say, the expression of a gene in zebrafish (assuming that it got any coverage at all), since noone sane is going to change their life on the basis of how that gets reported.  But in respect of matters of health… well, that’s potentially a bit different.  And by “a bit”, I mean “very”.

Or we could construct a rather less consequentialist argument, and say that journalism that distorts the facts is blameable without any appeal to the outcomes at all - it’d still be blameable if it made people do optimific things.

A secondary charge is that the press treats “balance” as demanding equal time for all sides - which means allowing vaccination cranks as much space as people who know of what they speak.  (On which topic, Dara O’Briain is worth a watch…)  Again, this is misleading, and perhaps culpably so.

I’m beginning to wonder whether this is correct, though - or, at least, whether there might be at least a limited case for the defence.  With no small trepidation, here goes… more…

At least the Trolley Problem has been solved.  (Hat-tip to Brian Leiter for the pointer.)

Doubtless many of you will have heard by now of Kerrie Wooltorton, who, apparently depressed by her fertility problems, drank anti-freeze, called an ambulance, and handed a living will to staff at A&E. Her story is reported by the Telegraph under the headline “Suicide woman allowed to die because doctors feared saving her would be assault” more…

Cambridge: Cambridge UP, 2009; 538+xv pp

£40, pb

A couple of months ago, Cambridge UP tried to post a cheeky advert for this book in the comments to one of the posts on this site.  I sabotaged the link, but offered to restore it in return for a freebie, which CUP asked me to review.  I’ve restored the link to the book’s webpage; but is it worth following? more…

In the wake of the DPP’s publication on Wednesday of guidance about assisted suicide, the Telegraph is reporting that the Christian Legal Centre is considering launching legal action to halt the implementation of that guidance.  The nub of their claim is that Lord Phillips, who had ruled in the summer that clearer guidance ought to be provided, showed in a newspaper interview in September that he was unsuitable to preside - he’d said that he felt “enormous sympathy” for terminally ill people who wanted to end their lives.  Thus the CLC’s claim is that:

these remarks showed that Lord Phillips had allowed his personal views to colour his judgement in the Purdy case.

This, the CLC insists, is in violation of Article 6 of the ECHR, which guarantees a fair trial.

There’s a range of things that the CLC has not noticed.  The first is that the human right to a fair trial is designed to protect… er… humans.  It’s not entirely clear to me that anyone’s rights were infringed, not least because it’s not clear that there’s anyone involved in the Purdy ruling who was in a position to have had any rights infringed to begin with.  Second, there’s no reason at all why being sympathetic to people in Purdy’s position would have to make any difference to a judge’s ability to interpret and apply the law, any more than why sympathy for a victim of mugging makes it less possible to try a suspect fairly.  His comments certainly do not show that his judgement was clouded; they don’t even give a reason to worry that they might have been clouded.  Note that Phillips didn’t say that he was sympathetic or well-disposed to Purdy’s suit; he said he felt sympathy for her and people in her position.  That’s very different, and you’d have to be quite a monomaniac to miss that point.

Oh, wait.  This is the CLC.  Hmmm.

Third, Andrea Williams, director of the CLC, says that

[j]ustice must be seen to be done. He [Lord Phillips] should be showing a clear lack of impartiality. These are fundamental issues that affect life. They are a matter of life and death.

I suspect the idea that judges should be showing a lack of impartiality is a typo, but it’s quite an amusing one.  Now, that justice should be seen to be done is is a long-standing principle of law: not only is it important that everyone has access to justice, but it’s also important that the justice system be transparent.  Impoprtantly, the DPP’s guidlines contribute to this clarificatory process.  My slight worry, though, is that the CLC has interpreted “seen to be done” as meaning that a criterion of justice is that it accord with expectations, which is simply not the case.

It’s also striking that a Christian group - hell, any reasonably decent person at all - should object to a judge because he’s expressed sympathy for people in difficult circumstances.  If your objection to a judge’s ruling is that he has elsewhere proved himself to have human feelings, then it’s not really much of an objection.

(Have a look at the CLC’s website.  It’s quite odd - note how, when the CLC wins a case, they thank God for it.  I’m willing to guess that they don’t blame him when they lose, though, which seems a bit unfair…)

The Director of Public Prosecutions has today published interim guidelines on prosecutions for assisted suicide in England and Wales - they’re available here (and Northern Ireland will get its own consultation process).  I’ve not had time to consider them in full, but there’s a number of things that stand out to me as worthy of comment. more…