Archive for the ‘medicine’ Category.

Free Philosophical Discussions 2010-07-12 13:59:00

Fear of Science Will Kill Us

Not again…

Take a second to read this article. It's good to see someone finaly give a skeptical report of facilitated comunication. FC is a cruel farce that just will not go away. In test after test after test it has been shown that the patient cannot answer simple questions when the facilitator does not know the answers. Show a patient a card with a word and a picture on it and even spell out the word for them and they can re-type the word with the facilitator’s assistance. Then take the facilitator out of the room, when another card is shown and the word spelled. Bring the facilitator back in and the patient cannot spell the word. The only reasonable conclusion here is the most obvious one, the facilitator is just using the patient’s hand like a Ouija board pointer and typing the word herself, not the patient. Since she didn’t see or hear the word she can’t answer the question.

This is a particular thorn in my side because as I’ve said before, my brother-in-law is severely autistic and primarily non-verbal. No single medical breakthrough would trill me more than the ability to sit down with him and have a meaningful conversation. Unfortunately, FC is not that breakthrough. I believe that most facilitators are self-deceived, but some of them know full well it is a scam and are selling parent’s false hope in order to make a buck. It really chaps my hide to see once again some idiot reporter give a totally credulous report of a non-medical breakthrough. An eight year old can look at what is going on here and see right past it, but somehow reporters at MSNBC who call themselves "Dr" are completely taken in.

Why We Make Mistakes

For years I've been fascinated with the concept of human decision making. I've enjoyed reading books that explore this concept. I'm also intrigued about the strategies that people use to justify their mistakes and the cognitive dissonance required to make your actual decisions jive with what you know is right.
Why We Make Mistakes: How We Look Without Seeing, Forget Things in Seconds, and Are All Pretty Sure We Are Way Above Average by Joseph Hallinan is my latest read on this subject. In the opening chapter of the book Hallinan describes a commercial airliner simply flying into the ground because they got too hung up on a small light that was burned out ans ignored the fact that the plane was slowly loosing altitude. I felt that this one simple metaphor described the rest of the book. We do lose focus of the things that are truly important. And all too frequently our focus was shifted by relatively trivial details.
Hallinan skillfully points out how uncommon common sense really is. But rather than just blame the decision maker he talks about how we can put ourselves into positions that will help to make better decisions. sometimes it takes a design difference so that, for instance, clockwise is off on all the knobs. Things like always putting the hot on the left and the cold on the right, etc. Sure it sounds like a simple design issue but he gave some frightening mortality statistic from an anesthesia machine that was clockwise for off on on drug and counter-clockwise for another.
Hallinan compared the airline industry to operating room. In the past few decades accident rates in the airline industry have dramatically dropped and there has been an increase in the operating rooms. Hallinan points to the main cause of this as the changes that have been made to the authority system in on and not in the other.
In the airline industry anybody the cockpit is virtually free of authority struggles. Many decisions are not based on rank or position. A 20 year old air traffic controller tells the pilot where to land and the pilot obeys and doesn't pretend that he knows better just because she's been doing flying since the controller was a kid. In the cockpit as well the co-pilot and even attendants are valuable resources and their input is encouraged.
Conversely, this authority system seems to be trending the other direction in the operating room. Doctors all too frequently are seen as unquestionable. Even in situations where nurses have spoken up to prevent the error Hallinan sights instances of flipped x-rays and the wrong limb being removed.
A few years ago my youngest daughter had to have a tooth pulled. We went to see the specialist with the x-ray from our dentist. She'd taken a fall on the driveway and one of her teeth was a starting to go gray. The x-ray seemed to confirm that the root on the graying tooth was dying. When we went to get her tooth pulled the nurse questioned the x-rays. She thought we we looking at it backwards. The dentist did not question her and called to have another x-ray taken just to be sure. She was absolutely right. In spite of the fact that one tooth was starting to turn gray it was the tooth on the other side that had the dead root. The dentist went ahead and pulled the dying tooth and the gray tooth eventually regained its color. Had that nurse not spoken up and, more importantly, had the dentist not accepted her advice Eve would have had to go back and have the correct tooth pulled later and they'd have had a very upset father on their hands. I'm very grateful to have had a dentist who was willing to admit that he could make mistakes and ultimate prevent them.
I enjoyed this book and would recommend it to anybody who is aware that they can make mistakes. I also think it should be force feed to anybody who thinks that they can't.