Faith Healing in the WSJ

The WSJ brings us news of increasing opposition to laws that would protect faith healing. Or as I call it, negligence. As usual it has required the death of innocents before people will come to grips with common sense.

The recent death from untreated diabetes of an 11-year-old Wisconsin girl has invigorated opposition to obscure laws in many states that let parents rely on prayer, rather than medicine, to heal sick children.

Dale and Leilani Neumann of Weston, Wis., are facing charges of second-degree reckless homicide after their child, Madeline Kara Neumann, died on Easter after slipping into a coma. The death, likely preventable with insulin, has renewed calls for Wisconsin and dozens of other states to strike laws that protect parents who choose prayer alone in lieu of medical treatment.

I’ll take issue here. “Likely preventable with insulin” should actually be, “completely and totally, unquestionably, preventable with insulin.” In fact for type I diabetics, and critically in diabetic ketoacidosis, the choice really is insulin or death, with no middle ground. You need insulin to live. But I digress.

Lawyers nationwide say they are eager to see if the Neumann case sparks more changes in state laws. It raises a “national discourse as to whether children can be medically neglected legally,” says Marci Hamilton, a professor at the Benjamin N. Cardozo School of Law in New York who writes about children’s rights. In another recent case, a 15-month-old child in Oregon died in March from a form of pneumonia and a blood infection after her parents opted to try to heal her with prayer. Oregon law provides no defense for parents charged with causing the death of a child through neglect or maltreatment, and the couple has been charged with second-degree manslaughter and criminal mistreatment.

There’s been a small, steady pushback against state provisions protecting spiritual healing. A Massachusetts bill that would have protected parents who used prayer in lieu of medical treatment stalled in committee last year, despite the measure’s broad sponsorship by 33 lawmakers.

In Maryland, lawmakers in 2005 repealed part of a law that had protected parents from losing custody if they withheld medical treatment because of religious belief. And in Maine that year, legislators amended several laws regarding religious treatment, and repealed part of its family law that stated that children couldn’t automatically be considered abused solely because they were treated “by spiritual means by an accredited practitioner.” Evert Fowle, the district attorney in Augusta, Maine, said the amendments would now allow him to bring charges against guardians should a child be harmed after being treated with prayer alone.

And here is the question for my readers, although to me it isn’t much of a question at all. Do parents have a duty to their children to protect their health using the best information available? Or does freedom of choice dictate the ability of parents to decide whether their children can live or die based upon unethical human experimentation with prayer or quack therapies? Because that’s what you call it when you take an unproven modality and try it out on someone to see if they get better – experimentation. Did I load that question heavily enough?

More below the fold:

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Deus ex machina

Many of you were too busy trying to ace organic chemistry to know what a deus ex machina is. For those of you who managed to squeeze in a classics course, please stick with me anyway.

Deus ex machina (“god from the machine”) is a literary device. In ancient Greek literature, a complicated dilemma was sometimes solved by having one of the gods literally pluck the unfortunate protagonist off the stage from the arm of a crane. It’s sort the ancient version of the Superman gambit—don’t like the ending? Just turn back time by reversing the rotation of the Earth. In either scenario, an impossible dilemma is circumvented by an improbable escape.

I bring this up because the machina is also used in debates. A valid logical argument (OK, philosophers, please hold your horses…this is the 101 course) requires true premises and a conclusion that must follow. For example:

All humans are mortal

I am human

Therefore, I am mortal

The premises are very likely to be true, and the argument as constructed is valid. The conclusion is very likely true.

Mercury is toxic

Vaccines contain mercury

Therefore, vaccines are toxic

This argument is a properly constructed, superficially valid syllogism. If the premises are true, the conclusion is true.
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Think of it as a poll crash…

A new blogger out there stepped on the third rail. He’s a senior law student, blogging about social justice, progressive politics, etc., and he found out that David Kirby, the Minister of Propaganda for the mercury militia, is coming to speak at his school.

This nascent lawyer had the temerity to call him out, and ZOMG! Kirby took the bait and brought his addled-minded friends.

There seem to be a whole lot of folks over there in need of some larnin’. I s’pose it couldn’t hurt to see what’s getting Kirby all hot and bothered.

Thanks for playing

First, thank you for all the wonderful comments on yesterday’s post. I never really know which posts are going to rake in the comments—my favorites are usually the quietest, and some of my quickies bring ’em in by the dozen. According to my uber-seekrit data, I’ve had two unique visitors to my naturopath post. As erv would say, “UR DOING IT RONG!11!!”

Anyway, I would like to thank my commenters on that post. Even those of you who I think are terribly wrong were at least civil.

I’d love to address all of the issues raised in the comments but I’m far too lazy busy at the moment, but I’d like to focus on a few issues.

First, I still haven’t found an over-arching authority over naturopathic education and practice equivalent to real doctors. Second, much of what I’ve read so far follows an new and interesting path—a large number of very intelligent, very well-educated, very well-intentioned shamans.

Anyway, let’s examine some of the misconceptions raised in the comments.
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Can’t get into med school? Legislate your own doctorate!

I guess it’s not just doctors watching this one—an alert reader and a fellow SciBling both picked up on this one. Apparently, in my neighboring state of Minnesota (really, check the map), home to Greg Laden, PZ Myers, and lutefisk, doctor wannabes have legislated themselves into “doctorhood”. You see, there is this entity called a “naturopath”, or “naturopathic doctor”, which is some sort of shaman that likes to think that if you study woo long enough, it becomes science.
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On being a doctor—humility and confidence

The practice of medicine requires a careful mix of humility and confidence. Finding this balance is very tricky, as humility can become halting indecision and confidence can become reckless arrogance. Teaching these traits is a combination of drawing out a young doctor’s natural strengths, tamping down their weaknesses, and tossing in some didactic knowledge. I supervise residents—they make the decisions, but it’s my name and my ass on the line, so I keep a close eye on things. Some teaching physicians dictate every decision on patients, some do nothing at all. I try to keep toward the end of the spectrum that allows for resident autonomy. When I’m presented with a case, and asked what I would do, I cry foul:

You are the doctor,” I say. “Tell me what you’re planning. I’ll tell you if I disagree, and I’ll let you know if I disagree enough to override your decision.”

This technique must, like all others, be tailored to the individual learner, but I want them to worry—I want them to think, “if I don’t do this right, no one else will, and a patient will be hurt,” because that is what the rest of their careers will be—being awakened in the middle of the night out of a sound sleep, having to make a quick assessment, and being reasonably sure that you’re right.

Except I’ve got their backs.

Of course, that confidence can lead to arrogance. It’s an occupational hazard. If it’s simply a personality quirk then it’s annoying. If it includes a lack of humility, a lack of knowing what you don’t know, then it is as dangerous as indecisiveness.

It takes years of training to develop the decision-making skills that go into being an effective attending physician.

This is one place where we part ways with the cranks and quacks.
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Adventures in staffing—a new physician

When a resident of student presents a patient with me and I help them formulate a plan, we call it “staffing” the case. Recently while I was staffing, I was presented with a patient who speaks little English, but speaks another language fluently. Unfortunately for us, this language wasn’t Urdu, Spanish, French, Romanian, or Hindi (languages spoken by the people immediately within my reach). The medical instructions we needed to give were fairly complex—too complex for Pidgin English, so I paged one of my interns.

“Hey, S.,” I said, “how well do you speak (insert little-known language here)?”

“Quite well, why?”

“Well, I have a nice older woman who speaks it as well, and her resident happens to be graduating. She could really use your care, both for your medical skills and your language skills.”

“You can put her in my schedule as soon as you need to. If there aren’t any openings soon, tell her to come right at 1pm and I’ll just see her before I start my clinic.”

Wow.

It takes a lot to make a doctor. I’ve talked about teaching medicine: how to give bad news, how to help patients with difficult diseases, and I’ll probably write a lot more.

But some things aren’t taught—you just know them. My resident just knew the right thing to do. Despite her hellish schedule, she offered time to a patient in need. This behavior is not a given. It is the mark of a true physician.

Food dye—a new bugaboo

If you’re around my age, you remember the disappearance of the red M&M. One day, they were just…gone. Apparently, folks worried that a red food dye not even used in M&M’s caused cancer.

Well, the red ones came back, but food dyes are back in the news. The Center for Science in the Public Interest is concerned about a possible link between certain food dyes and (presumably bad) child behavior.

Now I don’t really care what color my food is (unless my lettuce is brown and my meat is green), but these dyes are used ubiquitously to make food appear appealing, appetizing, and profitable. Given that these dyes don’t contribute nutritionally, there really is no health reason to use them, but food producers like them because they work; they help sell food.

What’s the claim, and what’s the science?
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