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“You're not allowed science any more”

nature.com

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Re: “You're not allowed science any more”

#41

Post by tormeh »

lotsofmangos wrote: post #13
sebular wrote: post #5

Earlier quoted context omitted.

The sarcastic metaphor and the exasperation that motivates it comes after centuries of scientists being ridiculed, persecuted, and even killed by ignorant people.

I know where it comes from, with my scientists hat on, I completely agree with the piece. But from a literary perspective, it is like being repeatedly bashed round the head by a moron with a length of 2x4. This conceit can be done well. Mitchell and Webb's little old lady job-justification hearings are a particularly good example. http://www.youtube.com/watch?v=UbXTBPN1HhA

Oh wow, that's pretty funny. These "gamblers" on the stock market do actually make the system work better and moves investment to places where it's likelier to have a good return. So they do help, although in a very abstract way and maybe not as much in practice as in theory but still. A better question than whether they help is how much and how much they should be rewarded for that help.

Re: “You're not allowed science any more”

#42

Post by waffle_ss »

spindritf wrote: post #3

I have spotted this totalitarian streak among some of my friends who went to med school. We should ban smoking, force everyone to do this or that. As bad as they can be, we're probably better off with lawyers in charge.

There are people who cannot be vaccinated (very young, very old, those with immune deficiencies) who rely purely on herd immunity to prevent getting certain illnesses. If all the healthy people who could suffer through the flu opted-out of the vaccine, most of them would get through it just fine, but the illness would pass through the population and kill off a lot of weaker people.

Smoking obviously causes lung cancer via secondhand smoke, but it also leaves a carcinogenic and heavy metal residue on walls and floors (thirdhand smoke). Kids, especially, get sick from this from crawling around the floor. They don't have the luxury of opting-out of smoking.

What are the solutions to these public health problems that aren't heavy-handed? I'm all for freedom and voluntarism but the libertarian solution of identifying the perpetrator and bringing them to civil court falls apart when the vector from perpetrator to victim is so diffuse that you can't trace it back.

Similar problem with people engorging themselves on unhealthy junk. I have no problem when it only affects themselves, but once their obesity-related maladies start costing other people via subsidized healthcare or extra-wide ambulances and whatnot, it's no longer just an individual choice.

Re: “You're not allowed science any more”

#44

Post by JumpCrisscross »

suprgeek wrote: post #36

I think we should be making a financial/societal incentive to do the right thing if the science is settled enough. The trouble with the view presented here is that sure the children get the vaccine due to this hypothetical rule. what happens when later the children get a severe cold (say) and the mom who remembers the previous visit thinks - bloody doctors I will just keep my kid home and pray for him to get better?…

> At school: "Sacha your kids are not vaccinated and we do not admit any students not vaccinated."

I thought this would perpetuate social stratification. But my hypothesis, that poor families are less likely to vaccinate their children than rich families, was incorrect. The National Network for Immunisation Information finds that "compared to fully immunized children, unvaccinated children were more likely to be non-Hispanic white and live in larger households. Educational levels, family income and other factors did not differ" [1].

Removing the philosophical exemption, at the federal level, seems a prudent first step. "States that allowed philosophical exemptions to immunization laws in schools had many more unvaccinated children than states that do not have philosophical exemptions."

[1] http://www.immunizationinfo.org/science/demographics-unvacci...

Re: “You're not allowed science any more”

#45

Post by DanBC »

suprgeek wrote: post #36

I think we should be making a financial/societal incentive to do the right thing if the science is settled enough. The trouble with the view presented here is that sure the children get the vaccine due to this hypothetical rule. what happens when later the children get a severe cold (say) and the mom who remembers the previous visit thinks - bloody doctors I will just keep my kid home and pray for him to get better?…

I would love it if schools and nurseries started to disallow children who were not vaccinated.

Unfortunately there are enough parents to make "no vaccinated children allowed" (you are not allowed in if you've been vaccinated) schools viable. See "Measles parties" and the sending of items infected with chicken pox through the post for examples.

Re: “You're not allowed science any more”

#46

Post by kstenerud »

falcolas wrote: post #23
kstenerud wrote: post #15

This is so telling. The sheer arrogance is plainly visible, as is the doctor's complete lack of empathy. There are plenty of ways to motivate people, and this is most certainly not a good one. You don't get a mule to move by pushing it.

Arrogance, which I'd call exasperance in this case, in the face of repeated ignorance of reality, is justified. You can only deal with willingly ignorant people for so long before giving up on the human race. And the doctor in the tale did try and educate the mother before she was cut off. She just didn't want to listen.

It's fine to feel exasperated. It's not fine to treat people in such a condescending manner. People are rational, and want to understand, but unless you make the information properly accessible in the UX sense, your exasperation is due to your own fault.

The doctor did not try to educate the mother. He tried to lecture her. He offered her a bad user experience, which she naturally rejected. People are not machines. You don't just feed the same information format in and expect the same result from everyone.

Re: “You're not allowed science any more”

#47

Post by Zigurd »

kstenerud wrote: post #15

This is so telling. The sheer arrogance is plainly visible, as is the doctor's complete lack of empathy. There are plenty of ways to motivate people, and this is most certainly not a good one. You don't get a mule to move by pushing it.

At no point in this very long parable did the patient actually get information about the nature of risk, the odds of bad reactions, the nature and severity of bad reactions, treatments for reactions, etc. If an MD is actually going to talk that much to a patient, the information content could be a lot higher.

Re: “You're not allowed science any more”

#48

Post by untothebreach »

sbhere wrote: post #21
wmeredith wrote: post #6

Earlier quoted context omitted.

You're being reductive, The refusal to read the pamplet while demanding impossible assurances is symbolic of the willfull idiocy of the scientific illiterate making impossible demands on society.

The mother in the narrative is requesting to be informed. A pamphlet does not inform, although it may. Face-to-face conversation has the opportunity for an asker to ask questions for an authority on the matter to answer. However, more to the point: is this pamphlet science or marketing? Many such pamphlets about medicine blur that line quite well...

The mother in the narrative is not asking to be informed, she is asking for a specific guarantee that the doctor cannot give. It would be like a client saying, "give me a guarantee of 100% uptime or I'm going with someone else," and refusing to read your literature about how many "9s" you can provide.

Re: “You're not allowed science any more”

#49

Post by 0xdeadbeefbabe »

vonklaus wrote: post #29

If only there was a way to outsource all decision making to an over-arching centralized authority to make all decisions for us. That entity would have all our best interests at heart and make the tough decisions for us. It would be auch a weight off my shoulders of I didn't have to think anymore. I would even be willing to pay 20-30 percent of my paycheck to it, just so it could help me stay safe. What would we call…

A bad religion?

Re: “You're not allowed science any more”

#50

Post by micro_cam »

Things like this makes me ashamed to have my name on papers in Nature.

First, lets set aside the hypocrisy of a non open access journal publishing this[1]. (What happens if Sacha wants to inform her self by reading a few old nature papers?)

I am pro vaccine but far too many doctors have this fantasy that they should have unlimited control and articles like this just serve to validate that view point.

Medicine is an inexact and continually evolving science and a good doctor should always be willing to talk over the options with you and engage with you on a level beyond just parroting the current recommendations. As someone who is one of the people contributing to the body of often-vague statistics we call medicine it is continuously annoying to have to get doctors to explain their (often subjective) judgment calls they are making and actually present their reasoning analytically.

Additionally, many doctors choose to forgo recommended treatments themselves due to side effects [2].

[1] In fact you can pay extra to make your nature paper open access but it is by no means fully open access. [2] http://www.nytimes.com/2013/11/20/your-money/how-doctors-die...

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