Two examples of wokeness: cancer care and moccasins

September 3, 2023 • 9:30 am

CANCER CARE

This first link below was sent by my partner in crime Luana, and is from John Lucas’s Substack site “Bravo Blue”. (Lucas was any Army ranger who became an attorney.)

Lucas is decrying the “woke propaganda” to which he was exposed when he checked into the hospital for cancer care. Click below to read, and subscribe if you read often:

An excerpt:

I recently experienced my own personal encounter with this propaganda when filling out a pre-surgery questionnaire at my hospital. This is the story.

I am a cancer patient. Since last January I have been diagnosed with two types of cancer that have necessitated three surgeries so far. For my most recent surgery, I was referred to an oncological surgeon at the VCU Medical Center, which is associated with Virginia Commonwealth University.

At this point, I must add a personal advisory note: The VCU Medical Center enjoys a superb national reputation. Other members of my family have been treated there and have received superb care. Nothing I say here is intended to disparage any of the individual care-givers at the hospital in any way. All, from my surgeon to the kind lady who escorted me to my car after my overnight stay, were uniformly kind and professional. Any criticism I may have is directed at the government-sponsored infection of the medical system with the WOKE virus, not at any individual physician or other medical or support staff.

The forms:

When I checked in at the hospital for my pre-surgery consultation, because I was a new patient for them, they gave me the usual medical history form to complete. After completing it, I turned to a second two-page form. I printed my name at the top and, rather unthinkingly, began to fill it out. I was in a bit of a hurry to complete it before I was called back to see my surgeon, so at first I did not pay a great deal of attention to it. So, I dutifully answered the first question, which asked, “What is your “Sexual Orientation?” That should, however, have been an immediate red flag, causing me to wonder, “What on earth does this have to do with cancer surgery?” But out of habit and without thinking, I checked the block for “Straight (Not lesbian or gay).” Had I read it closer and given it a moment’s thought, I would have been nonplussed by the other answers on the menu: “Lesbian,” “Gay,” “Bisexual,” “Something else,” or “Don’t know.”

The first page:

The next question roused me out of my inattentiveness: “How do you describe your gender?” It then gave a menu of six possible answers: “Male,” “Female,” “Transgender male,” “Transgender female,” “Other” and – again – “Unknown.” Like the other questions it also included an option “not to disclose.” My surgeon’s notes from our consult include the notation that I was a “79 year old male.” In view of that rather obvious observation, how or why I was given an option to refuse to disclose my gender is unclear.

At that point I knew something was very wrong.

For me, the final straw was the third question: “What was your sex assigned at birth?” The options were “Male,” “Female,” “Unknown” (again), or “X. I was left to guess what “X” is; it was not defined.

The woke questions, avers Lucas, are irrelevant to cancer care, though they could have been relevant if, say, he was there for treatment in urology or gynecology. “Sex assigned at birth”, of course, is a phrase that really angers me, because it’s not accurate. Even if doctors use secondary sexual characteristics like genitalia to diagnose sex, sex is not “assigned at birth”, as if it were something arbitrary that doctors decide. It is observed at birth, even if what you really want to observe is whether a newborn has the biological equipment that evolved to make either small and mobile or large and immobile gametes. But genitalia show an almost perfect correlation with biological sex, so they’re a useful surrogate way to determine it.

But “sex assigned at birth” is becoming more frequent despite its inaccuracy. Why? Because it plays right into gender activism. One’s gender is, of course, often self-assigned, though the vast majority of people bear a social role of gender that corresponds to their biological sex. But you don’t have to distort the biological definition of sex to placate gender activists. And it also misleads people about science. The gender activists answer: “Forget the science; we’re making sex conform to gender.”

But I digress; here’s page 1 of the form:

But wait! There’s more!

The questions continued on a second page with more inanities.

It asked, for example, what pronouns I use, and – again – the option to say that I what pronouns I use is “unknown.” It occurred to me that a person who is unaware of what pronouns they use may belong in a hospital ward other than the cancer ward. A separate question inquired whether I “presently have” breasts, a vagina, a penis and “prostate/testes,” (They apparently think a man cannot have one without the other.) with instructions to check off all that you have. The most unintentionally hilarious part of the form was the instruction to “write in the space beside the organs listed if there is another word you would like your healthcare provider to use to refer to that body part.” Had I been thinking more clearly at the time, I could have had a lot of fun with that one.

I answered all the questions after the first one by only a single printed “I am a man.” Enough said.

Lucas found that these forms are widespread, and are apparently pushed by the government: the Centers for Disease Control:

Later when I had returned home to complete my recovery, I began to investigate the origins of this form. I quickly found that a very large number of hospitals and medical schools use this or a similar form. For example, the University of Utah health care system has a similar set of questions that it says it will ask each patient every six months.

After all, you may be genderfluid and your pronouns could change.

I discovered that this agenda is being pushed by the federal government. The CDC’s web site lists the questions that medical providers should ask. Its recommended questions are substantially the same as those on the VCU Medical’s questionnaire. However, there are some differences. In addition to the options provided by VCU Medical for “Gender identity,” the CDC recommends an option to specify “Genderqueer/gender nonconforming neither exclusively male nor female.” For “Sexual orientation” it adds, “Queer, pansexual, and/or questioning.” The CDC also suggests other possible pronouns such as “Ze,” “Zim,” and “Zirs.”

But they left out “leaf”!

**************************

MOCCASIN ACKNOWLEDGMENTS

Reader Gregory called my attention to this Eddie Bauer ad:

Here’s another view. These look just like the work boots that were de rigueur when I was in college, along with Army fatigue jackets and jeans. (It was the proletarian look.)

Although to me this looks like a conventional work boot, Eddie Bauer claims that it incorporates features of the moccasin, a form of Native American footwear. I swear I can’t see any resemblance (see below to compare) but Eddie Bauer apparently feels it has to acknowledge it to show its commitment to social justice.

The blue link in the box goes to this site, where Eddie Bauer promises to investigate which products have features that have been appropriated from indigenous peoples.

Here, however, are three pair of genuine Native American moccasins shown on Wikipedia. (They were often beaded.) They bear NO resemblance to the Eddie Bauer “Moc Toe boots,” even in the toes:

Osage:

Kiowa:

Cheyenne:

But why stop at Native Americans? I’m sure there are many products with features adopted from cultures throughout the world. Below is an Eddie Bauer woman’s dress that is clearly culturally appropriated from the culture of Rajasthan in India, known for its block prints very similar to the ones on this dress. This is blatant and unacknowledged appropriation from people of color:.

To be fair, the Eddie Bauer site also notes they’re starting a partnership with a Native American collective, which is great, but do they have to flaunt this? Of course they do, or they’ll get slammed on social media: the kiss of death for a company.

That said, at least the partnership accomplishes something.

Celebrities and influencers call on social media to remove anti-trans “hatred”

June 28, 2023 • 10:00 am

GLAAD was founded in 1985, with the acronym standing for Gay & Lesbian Alliance Against Defamation. As Wikipedia notes, the organization has now extended its coverage to transsexual and bisexual people. That’s presumably why the organization will remain “GLAAD” without the full name being used.

GLAAD (/ɡlæd/^[1]) is an American non-governmental media monitoring organization. Originally founded as a protest against defamatory coverage of gay and lesbian demographics and their portrayals in the media and entertainment industries, it has since included bisexual and transgender people.

Yesterday, a whole pile of celebrities and “influencers”, as well as “allies,” posted a demand on the GLAAD site for social media moguls (Zuckerberg, Musk, etc.) to stop allowing disinformation and “hate speech” against trans people on their sites. I wholeheartedly agree with nearly everything on the list of demands, which you can read by clicking below). But I have two significant objections. First, read the statement (you’ll be impressed by the list of supporters):

Here’s the content that the signers want censored by companies like Facebook and Twitter:

Content that spreads malicious lies and disinformation about medically necessary healthcare for transgender youth. As described above, such harmful content from high-follower hate-based accounts has resulted in extraordinary real-world harms.¹³ Specific mitigations on such disinformation must be developed (for instance akin to election and COVID-19 mitigations and rules).
Accounts and postings that perpetuate anti-LGBTQ extremist hate¹⁴ and disinformation,¹⁵ in violation of platform policies, and which target trans and LGBTQ people, including baseless and malicious disinformation of LGBTQ people being threats to children (e.g. the anti-LGBTQ “groomer” conspiracy theory¹⁶). Such harmful and dangerous lies must be more effectively moderated and mitigated.
Dehumanizing, hateful attacks on prominent transgender public figures and influencers. Online attacks against LGBTQ organizations and individuals are on the rise.¹⁷ A recent report from GLAAD, UltraViolet, Kairos, and the Women’s March shows that 60% of LGBTQ people feel harmed not only from direct harassment and hate, but from witnessing harassment against other LGBTQ community members such as celebrities and public figures.¹⁸ Directing hate against LGBTQ public figures is a common vehicle for expressing general anti-LGBTQ bigotry. When your companies maintain policy loopholes that allow such hate, this perpetuates harm against entire communities.
Anti-transgender hate speech, including targeted misgendering, deadnaming, and hate-driven tropes.¹⁹ For example, Media Matters, GLAAD and others have identified multiple YouTube videos — which have accumulated millions of views — that bully, harass, and misgender trans people. In each video, prominent anti-trans pundits use YouTube to demean, target, and misgender young people, their parents, and public figures²⁰ in videos saturated with blatant anti-trans rhetoric. These videos remain active despite these violations having been reported by Media Matters, GLAAD, and other organizations to YouTube.

My first qualification is about “hate speech.” My view is that, as far as possible, social-media outlets should adhere to the First Amendment principles of free speech, while recognizing that, as private companies, they don’t have to. But I’m in favor of the open discourse that the First Amendment provides.

Note, though, that the Amendment does not protect all speech: it disallows threats to people, speech intended to promote imminent lawless action , false advertising, fraud, and defamation. FIRE gives a list of exceptions, noting that “hate speech” and online “harassment” (but not harassment in the workplace) are protected categories of speech. I’m not sure why, if you take the First Amendment view, transgender people should be protected from legal speech while other groups like Jews, Muslims, or any minority, are not. (As a First-Amendment hard-liner, and a secular Jew, I am perfectly happy to have people make anti-Semitic remarks on social media, including denying the Holocaust or even, like the Scottish dog, raise their paw when the owner says “gas the Jews”.) But of course I reserve the right to answer that nonsense on the same social media.

Given the tremendous variation in what people think of as “hate speech” which is also legal speech, nobody should be immune on social media from “hate speech”—except the form that violates the First Amendment. For crying out loud, P. Z. Myers called me an “asshole” on his blog the other day, and I’m fine with that, though I won’t engage in the kind of puerile name-calling that occurs during his daily Two Minutes Hate.

But what worries me about this particular issue is that some justifiable discussion of trans matters might fall under the nature of “hate speech” or “disinformation about medically necessary healthcare for transgender youth”, and it this discussion should not be censored on the grounds that it engenders hate. I’m thinking in particular of criticism of “affirmative care”, which to me includes not just a therapeutic rush to confirm whatever gender identity a young person claims, but also the rush to give gender-dysphoric children puberty-blocking hormones. This is because the efficacy of “gender affirming therapy” (henceforth GAT), as contrasted with conventional therapy with an objective and empathic counselor has not been demonstrated, and GAT almost invariably leads to hormones: first blockers and then either testosterone or estrogen. (And sometimes surgery.) We know that most gender dysphoric children who aren’t given GAT will resolve their issues, most often either resuming their original gender or becoming gay. In both cases. the possibly damaging effects of hormone therapy and surgery are avoided. Of course some of those children will go on to become transgender, and assuming that they are of age (say 16 or 18) when they decide to take hormones, that is their decision.

But the manifesto above assumes that GAT is always the way to go. At least that’s what I take from the desire to ban “Content that spreads malicious lies and disinformation about medically necessary healthcare for transgender youth.” Who determines what is “medically necessary” for youth? The assumption here is that transgender youth (including those who are gender dysphoric and feel “trapped in the wrong body”) require medical healthcare. Yet there’s a lot of debate about that, and that debate should not be censored, even if you think social media needn’t adhere to the First Amendment. These issues are ongoing throughout the West, and Europe has dealt with them differently from the U.S., taking a more wait-and-see approach. Calling for caution about these matters until the data are is is not transphobia.

And there is this claim in the text leading up to the list of demands given above. The bolding is mine.

This disinformation and hate, inadequately moderated on your platforms, plays an outsized role in the sharp increase in real-world anti-transgender targeting and violence.⁹ As documented by the Human Rights Campaign Foundation in 2022,¹⁰ this is particularly the case when it comes to the online extremists leading proactive coordinated campaigns of hate and lies about gender affirming healthcare for trans youth.¹¹ Despite the fact that every leading medical and psychological association affirms the safety and necessity of gender affirming healthcare for trans people, including youth, inflammatory disinformation falsely asserting that this healthcare is dangerous is allowed to fester on your platforms because it drives clicks and profit. Trans youth and their families and care providers are being endangered by your negligence, causing many families to flee their homes.

It may well be that all the American associations assert that gender-affirming healthcare is “safe and necessary”, but there are many physicians who dissent. More important, entire European countries have not embraced that affirmation, but are worried about the hormonal aspects of GAT as possibly harmful in the long term, and are using things like puberty blockers only in clinical trials. This is now the case in the UK and Sweden, while puberty blockers are being strictly limited in places like Finland, Norway, and France. And just yesterday Ireland’s national health service board (the HSE) ordered a review of puberty blockers in children with gender dysphoria.

As the Atlantic noted,

But doctors do not agree [with American claims that GAT is necessary] , particularly in Europe, where no treatments have been banned but a genuine debate is unfurling in this field. In Finland, for example, new treatment guidelines put out in 2020 advised against the use of puberty-blocking drugs and other medical interventions as a first line of care for teens with adolescent-onset dysphoria. Sweden’s National Board of Health and Welfare followed suit in 2022, announcing that such treatments should be given only under exceptional circumstances or in a research context. Shortly after that, the National Academy of Medicine in France recommended la plus grande réserve in the use of puberty blockers. Just last month, a national investigatory board in Norway expressed concerns about the treatment. And the U.K.’s only national gender clinic for children, the Tavistock, has been ordered to close its doors after a government-commissioned report found, among other problems, that its Dutch-protocol-based approach to treatment lacked sufficient evidence.

Last November, the NYT reviewed the evidence for the harms vs. the value of puberty blockers, concluding that we just don’t have enough data to pronounce them safe and irreversible. Another NYT article by Emily Bazelon last June highlighted the “deep divisions” in America’s medical community about gender-affirming healthcare. Here’s an excerpt from Bazelon’s piece.

Taking puberty suppressants (or hormones) for gender affirmation is “off-label,” meaning this specific use of the medications is not approved by the Food and Drug Administration. Off-label prescriptions are common and don’t imply anything improper, but there may be less research about the drug’s effects. If young people continue on to hormone treatments, puberty suppressants “probably” compromise fertility, especially for trans girls, Stephen M. Rosenthal, a pediatric endocrinologist at the gender center at U.C.S.F. who is on the group for the SOC8 chapter on hormone treatments, explained in a review last year for Nature Reviews Endocrinology. The medication can also prevent bone density from increasing as it typically would, and while levels returned to normal in trans boys who went on to hormone therapy, they remained low in trans girls who did the same, according to a 2020 study from the Amsterdam clinic. Little is known about the impact on brain development. “The relative paucity of outcomes data raises notable concerns,” Rosenthal wrote in his review. But he has no hesitation about prescribing puberty suppressants to kids who are deemed ready for them at his clinic. “The observed benefits greatly outweigh the potential adverse effects,” he said.

The problem is that we don’t have a good handle on the “potential adverse effects.” That’s why they’re “potential.”

(See my post on her article and the ACLU’s enraged reaction to Bazelon’s piece).

I’ll draw to a close by saying that the two NYT pieces alone would be considered “hate speech” by the GLAAD manifesto above, yet they’re objective discussions of GAT, both affirming the need for more data before we start a widespread practice of prescribing hormones to kids with gender dysphoria. This is not transphobia, but a necessary and essential debate that has to take place, along with acquiring data, before making GAT any kind of gold standard or requirement for treating gender-dysphoric children. Calling for bans on such discussion is not only misguided, but potentially harmful.

Finally, Jesse Singal has tweeted his take on the manifesto above:

2/ If this policy were enacted, it would mean that users could get suspended or banned for e.g. publishing the Swedish health authority's view that "the risks of [youth gender medicine] currently outweigh the possible benefits[.]"

— Jesse Singal (@jessesingal) June 27, 2023

4/ When I tried to reach out to GLAAD to discuss some of this stuff, I was informed "GLAAD is not a medical organization or association" and was referred to Jack Turban as a trustworthy expert. pic.twitter.com/BBLHyXgh6v

— Jesse Singal (@jessesingal) June 27, 2023

In the response from GLAAD, two physicians are mentioned, and you might want to look up their records. They—especially Turban—are known for being wholehearted advocates of GAT.

Nature falls for one discredited aspect of autism: “facilitated communication”

May 17, 2023 • 10:30 am

As you know, autism runs the gamut between people who functional pretty normally to those who can barely function, require round-the-clock care, and cannot read, write, or speak. It’s often assumed that this is a “spectrum”: that is, a disorder with a unitary developmental/genetic cause that has various degrees of expression. Thus some groups that hope to ameliorate autism assume that the near-normal end of the spectrum require treatments similar in kind but not degree to those who show “profound” autism. Others think that the treatments needed are very different. The high-functioning people with autism can express what they want or need, but what about those who can’t express themselves?

This is the subject of the new Nature article shown in the second screenshot below. It’s also the subject of a critique of one part of the Nature article—a critique that appeared in Skeptical Inquirer (SI). SI is the well known magazine from the Committee for the Scientific Investigation of Claims of the Paranormal (CSICOP), itself an offshoot of The Center for Inquiry.

SI and SCICOP have devoted themselves to debunking woo, and their SI piece, written by psychologist Stuart Vyse, takes issue with one brand of woo historically involved with autism research: facilitated communication.

Facilitated communication was a method that, people thought, could allow profoundly autistic people who couldn’t read, write, or talk to communicate with others. The assumption was that with some assistance, the hidden verbal and mental abilities of profoundly autistic people could be revealed. This involved people helping the severely autistic people to “write” by using various devices. And lo, a trove of hidden thoughts were revealed. Sadly, it was eventually found that the “helpers” were actually prompting the autistic to communicate, and it was pretty much a scam, although perhaps an unwitting one. (It’s the equivalent of a Ouija board, where people think that they are not guiding the pointer but really are.) Here, let Wikipedia describe the method:

Facilitated communication (FC), or supported typing, is a scientifically discredited technique that attempts to aid communication by people with autism or other communication disabilities who are non-verbal. The facilitator guides the disabled person’s arm or hand and attempts to help them type on a keyboard or other device.

There is widespread agreement within the scientific community and among disability advocacy organizations that FC is a pseudoscience. Research indicates that the facilitator is the source of the messages obtained through FC, rather than the disabled person. The facilitator may believe they are not the source of the messages due to the ideomotor effect, which is the same effect that guides a Ouija board. Studies have consistently found that FC is unable to provide the correct response to even simple questions when the facilitator does not know the answers to the questions (e.g., showing the patient but not the facilitator an object). In addition, in numerous cases disabled persons have been assumed by facilitators to be typing a coherent message while the patient’s eyes were closed or while they were looking away from or showing no particular interest in the letter board.

Facilitated communication has been called “the single most scientifically discredited intervention in all of developmental disabilities”. Some promoters of the technique have claimed that FC cannot be clearly disproven because a testing environment might cause the subject to lose confidence. However, there is a scientific consensus that facilitated communication is not a valid communication technique, and its use is strongly discouraged by most speech and language disability professional organizations. There have been a large number of false abuse allegations made through facilitated communication.

The article is remarkably strong for Wikipedia, and has a long section on documenting the flaws of facilitated communication.

At present, though, the method is still used, and is an important part of the Nature paper. Now it’s often done with the “facilitator” holding up an alphabet board and having the autistic person point to letters that, they say, give a message. The thing is that the boards are always held up by a facilitator, who can move them around, and the autistic person can look at the “facilitator” for approval. They never do it with the alphabet board flat on a table and the facilitator out of view of the subject. Look at this video using the kind of facilitated communication touted in the Nature article, and you’ll see the issues. The facilitator moves the board around, and the subject looks at times at the facilitator, seemingly seeking approval. And it’s hardly credible that someone who cannot either write, read, or speak could nevertheless convey complex messages this way. But you don’t have to guess: experiments have debunked the whole method.

In the article below (click to read), psychologist Stuart Vyse calls out Nature not for its whole article (for parts of it are enlightening and reasonable), but for buying into facilitated communication. Here’s the premise of the Nature article involving facilitated communication, as stated by Vyse:

This renewed controversy over communication methods has emerged in the context of a larger political fight within the autism community. The Nature story was about efforts on the part of some autism advocates to have people with autism more involved in the planning and execution of autism research. In theory this sounds like a good idea, but this effort has been largely dominated by verbal advocates on the higher functioning end of the autism spectrum. As it is now defined, autism spectrum disorder (ASD) has a remarkably wide range that can include both highly verbal Harvard graduates and nonspeaking people who engage in repetitive and self-injurious behaviors. It includes both people who will be fine and may even thrive living independently and people who will never be able to live independently without substantial support.

Parents of children on the severe end of the spectrum argue that the needs of their children are substantially different than those of the verbal self-advocates on the other end of the spectrum. Furthermore, if the research agenda is driven by people on the less severe end of the spectrum, the approximately thirty percent of children with autism who will never develop speech will be left behind.

That’s why Nature is touting facilitated communication as a way of finding out how the severely autistic want to give input into their worldviews, their problems, and their therapy.

SI article:

The quote given in the Nature piece below (click to read) is taken from a severely autistic person pointing at a letterboard. And the entire quote, from Rachel Kripke-Ludwig, “a non-speaking autistic advocate and student based in Menlo Park, California” is even more complex (I’ve put the “communication” in bold below):

In the conventional approach, several researchers “are mostly working off the wrong set of assumptions”, writes Rachel Kripke-Ludwig, a non-speaking autistic advocate and student based in Menlo Park, California. “The best way to get it right is to listen to us.”

Here’s a photo of Kripke-Ludwig from Nature shown using the letter board:

(from Nature): Rachel Kripke-Ludwig helps to ensure that autism research is relevant to autistic people.

Why does somebody always hold the letter board? It would be dead easy to see if people like Rachel could communicate without the help of a facilitator, but they won’t let scientists test that hypothesis, which would be dead simple to do. As Vyse says,

The new variants of facilitated communication involve the nonspeaking person pointing at a letter board with a finger or a pencil; however, rather than simply placing the letter board on a table, a “communication partner” holds the letter board in the air. It is not clear why this is necessary, but it is clear that the involvement of another person muddies the question of who is authoring the communication. Does the finger touch the letter board, or does the letter board touch the finger? Publicly available videos often show the letter boards bobbing around in the air while the nonspeaking person looks somewhere else. Furthermore, perhaps having learned a lesson from the 1990s, the purveyors of these letter board techniques have assiduously avoided participating in research that would definitively show who the author of the messages is.

Now testing this hypothesis is not a James Randi “million-dollar-challenge” issue—a simple debunking of woo. It is vitally important to know if profoundly autistic people can really communicate on their own. If they can, then it would overturn both the theories and treatment of autism, and also enable us to take advantage of their own ideas of what they need, which is the point Nature is trying to make. That is why this ability to communicate needs to be tested.

Nature takes it for granted that this is real communication. Click to read.

Not only does the article neglect the decades of work showing that facilitated communication is bogus, but presents statements by people like Kripke-Ludwig as if they really come from the subject and not the facilitator, and endorses the method (my emphasis):

Many autistic people see that as a step back to labels that they have rejected. “I am profoundly gifted, not profoundly low-functioning,” writes Payam, a non-speaking autistic advocate who is based in Atlanta, Georgia. Payam is not an exception, says his mother, Parisa Khosravi. “We need to presume competence and listen to our non-speakers,” she explains, “rather than assume intellectual disability.”

Many other autistic people who are non-speaking or have intellectual disabilities have found ways to speak up for themselves, says Zoe Gross, director of advocacy for the Autistic Self Advocacy Network in Washington DC. “It is completely inaccurate to say that as a group, autistic people with intellectual disabilities, or nonspeaking autistic people, can’t advocate for themselves,” she wrote in an e-mail. “Not all autistic people have access to a communication method that works for them, and for some people, the currently available communication methods may just not work.”

If they could write for themselves, or even point at a static letterboard without guidance, we might accept these statements, which could lead to profound advances in treating autism. But, since the facilitated communicators won’t let their method be tested, we’ll never know. This is one example of what is likely to be woo, or a quasi-scam, impeding science. Nature is not behaving scientifically here, and in fact may be impeding the treatment of people with severe autism. Will different “facilitators” give different answers? How do we know they’re not in cahoots, making stuff up? They might mean well, or even believe that they are bringing out hidden words to help people, but we won’t know that without scientific testing of the methodology. As I said, such tests are not rocket science, and, when used on other means of facilitated communication, invariably show it’s a sham.

As Vyse notes:

Finally, in an odd alliance, some parents of nonspeaking individuals who believe in facilitated communication or one of its variants have been recruited to this fight by the advocates on the higher functioning end of the spectrum. Thus, you have the peculiar situation of an article in the scientific journal Nature, whose title is drawn from a quote that the American Speech-Language-Hearing Association says “should not be assumed to be the communication of the person with a disability.” We have no evidence that the person being quoted said those words, and yet she is being put forth as the poster child for a highly politicized movement. In my view, this is the real travesty. This person has achieved remarkable visibility, including quotes and a photograph in a widely read science journal, yet the available scientific evidence suggests that rather than speaking out for herself she has been silenced and someone else has substituted their voice for hers. All of this may have happened with the best of intentions, but if I am right, it is a substantial injustice nonetheless. And the journal Nature, which ought to know better, is complicit in making it happen.

To learn more about the perils of facilitated communication, visit facilitatedcommunication.org.

Frankly, this is a serious misstep on the part of Nature. Even if facilitated communication eventually did prove to work in some cases, Nature should, at the least, point out the serious issues with it.

UPDATE: This Frontline Video, “Prisoners of Silence”, was noted by a reader in the comments; it shows how the method works (it’s always “facilitated”) and how it was debunked. The power of confirmation bias was strong; in fact, there was no evidence that facilitated communication worked. My one question is this: if the facilitators were sending the messages unconsciously through the subjects, why did so many of them produce messages that the subject was sexually abused?

The decline and fall of America’s medical schools

February 25, 2023 • 11:30 am

A reader this morning used ChatGPI write me an email saying that he didn’t like the “excessive” amount of antiwoke stuff on this website, and wondered if I had heard this from other readers. (Answer: almost never, though people may vote with their feet). Although I informed him that I write about what interests me, and that right now in academia (and elsewhere in America) we’re in the midst of a “racial reckoning” that could completely change the nature of the country, I still felt bad—as I always do when someone tells me I write “too much” about this and that. And that’s despite Rool #6, which says this:

6. Please do not tell me how to run my site. That is, comments about “too many cats,” “too many boots,” “not enough biology,” “too much religion,” etc., are not welcome. I provide content free of charge, and if you don’t like the mix of posts, you’re free to go elsewhere. By all means take issue with what I say, but don’t argue about the balance of topics.

So, especially today, don’t leave comments agreeing with the reader (i.e., please abide by rule #6).

I’m disturbed enough that although I present this Tablet article, which is antiwoke (its theme is the ruination of America’s medical schools via DEI initiatives), I’m not going to say much about it. It’s free and you can read it for yourself by clicking on the screenshot. There’s a reason to be more concerned with the quality of doctors that is being turned out than with, say, experts on English literature or evolution, for a poorly trained doctor can do a lot of damage to people’s lives and health.

I will give a few excerpts below.

Most of this is about UCSF, a terrific medical school, which has implemented a stringent new DEI policy:

These race-first imperatives have now come to influence the research priorities of major institutions. Perhaps no better case study exists than that of the University of California, San Francisco (UCSF), an institution devoted exclusively to the medical sciences, and one of the top recipients of federal grants from the National Institutes of Health. Last May, UCSF took the unprecedented step of creating a separate Task Force on Equity and Anti-Racism in Research, which proceeded to make dozens of recommendations.

That task force builds on layers of prior DEI bureaucratic expansion, spanning nearly a decade. This programming includes the “UCSF Anti-Racism Initiative,” started after the summer of 2020, which established dozens of new institutional policies throughout the university, such as “evaluating contributions to diversity statements in faculty advancement portfolios.” The School of Medicine, meanwhile, has published its own Timeline of DEI and Anti-Racism Efforts, which documents such steps as adding a “social justice pillar” to the school’s curriculum and creating an anti-racist curriculum advisory committee.

The policies often promote an idiosyncratic and controversial understanding of concepts like diversity and racism. Through its Difference Matters initiative, the medical school created a document titled “Anti-Racism and Race Literacy: A Primer and Toolkit for Medical Educators”—which is filled with eyebrow-raising assertions. Racism, the guide asserts, “refers to the prioritization of the people who are considered white and the devaluation, exploitation, and exclusion of people racialized as non-white.” Anti-racism, meanwhile, involves directly shifting power from those who are white to those who are Black. “Anti-racism examines and disrupts the power imbalances between racialized and non-racialized people (white people), to shift power away from those who have been historically over-advantaged and towards people of color, especially Black people.” Of course, when applied to the allocation of lifesaving medical care, these ideals can carry weighty consequences. During the height of the COVID pandemic, New York, Minnesota, and Utah issued guidance for allocating monoclonal antibodies that heavily prioritized racial and ethnic minorities.

But race isn’t the only issue for which these initiatives demand action:

Some of these initiatives create obvious issues of academic freedom. In 2020, the UNC School of Medicine created a “Task Force for Integrating Social Justice Into the Curriculum,” issuing a report with dozens of recommendations. One called for faculty to adhere to “core concepts of anti-racism,” listing several of these required “concepts,” including “race is not a set biological category” and “specific organs and cells do not belong to specific genders.” The task force also called for students to “be trained in core advocacy skills”—even listing a number of political causes that it deemed important for students to embrace. These causes, which the report labeled “health realms,” included “restoring U.S. leadership to reverse climate change,” and “achieving radical reform of the US criminal justice system.” The school initially listed every recommendation as “On Time” on an online implementation tracker, though it eventually walked back some of the more controversial requirements.

Finally, UCSF’s (non)response to criticism:

By the time it published the report, the UCSF task force was aware of all of these issues. Each had been brought up by UCSF employees during the comment period. The comments were published in the report’s appendixes, which make up perhaps the most telling part of the whole publication.

One commenter repeated the same line in every answer: “I fundamentally do not feel or have ever felt that UCSF is a racist place. These are grossly misdirected funds and efforts.” Several cautioned against embracing discriminatory policies in the name of anti-racism. “All of the above sounds to me like trying to fight racism with more racism,” one noted. Still others urge the task force not to distract from UCSF’s focus on scientific research. As one commenter put it, “UCSF is a medical and life science campus. Its strength lies in its objective data-driven experimental approach. Qualitative and sociological research has no place at UCSF and no place in scientific medical research and will undermine UCSF’s reputation.”

Yet rather than addressing the concerns of the school’s employees, the report attacks them while presenting its authors as the real victims.

It is important to note that while many of the comments received were constructive and helpful, task force members were traumatized by a striking number of comments that denied the existence of inequities and racism, and others that minimized the burden that racism has imposed, particularly on Black Americans at UCSF.

The forward to the report quotes one of the task force co-chairs, Sun Yu Cotter, who adds:

It is extremely important to acknowledge the magnitude of the emotional labor and trauma that many of the Task Force members endured in doing this work, particularly during the public comment period. Not only are many of the Task Force members, especially our Black colleagues, encountering and navigating racism on a daily basis at work and outside of work, we are also volunteering our very limited time to dive into grueling work (the minority tax is real!). Then to be gaslit by some members of our very own UCSF community was very painful.

Take note. This is the future of American medicine.

I have no comment but to add that for obvious reasons we really need to worry about the politicization of medical schools, and also about the extreme lowering of standards that has gone with it.

h/t: Adam

Medical revision: You probably don’t need to drink 8 cups of water per day (and you can eat more cheese)

January 3, 2023 • 9:15 am

Now I’m not a doctor (I just play one in academia), so I’m not going to tell you to stop drinking so much water. After all, some people need to. But the upshot of this new article from The Washington Post (click on screenshot below) is that most people don’t have to act like camels, swigging and guzzling from their fancy water bottles that they tote everywhere. They even guzzle in public! If you drink only when you’re thirsty, most people will be fine. Read on:

I have to say that, as a curmudgeon who been this way for decades, I always feel a bit snarky when I see full-grown adults toting water bottles everywhere with them, and swigging at random. Surely much of this comes from the medical “wisdom” that you need to drink 8 cups of water (roughly 64 ounces, or half a gallon) per day. And, of course, there’s water available everywhere in America, so you don’t need your own personal bottle.

I see much of this as an infantile behavior: adults needing, like infants, to suck on a bottle full of liquid. It’s just like adult cats “kneading” as a leftover behavior from their kittenhood. (Of course, I do carry a water bottle if I’m out for the day in a foreign land (many places don’t share the American habit of having water fountains widely available), or in places where the local water isn’t safe to drink (e.g., India).

But otherwise, I just don’t like drinking water. It has no flavor, and I drink it only when I’m thirsty. Usually that’s in the morning before coffee, and then with dinner (along with wine). I seem to do fine on about 20 ounces per day, and have never been dehydrated. Even worse: the medically-inspired advice to drink lots of water has even boosted the most useless industry ever: bottled water, which is no better than tap water and has the byproduct of producing plastic refuse:

Now I know what some readers will say. “I LIKE drinking water!” If so, more power to you, but I take that statement with the same grain of salt I do when someone tells me “I LIKE eating broccoli” or “I don’t eat desserts because I don’t like sweets.” But this news, from last month’s Washington Post, heartened me. No longer do I—or you—have to feel like if you’re not sucking on the adult version of a baby bottle, you’re doing something wrong.

Here’s the news, and look at where that medical dictum comes from! (My bolding):

We’ve all heard the age-old advice to drink eight cups of water a day. But if you fall short, don’t worry: That advice is probably wrong anyway.

That’s according to new research, published in the journal Science, which found that for most healthy adults, drinking eight cups of water a day is completely unnecessary. The advice is misguided in part because it doesn’t take into account all the water that we get from our food and from other beverages like coffee and tea. The research found that our water needs vary from one person to next and depend on factors like your age, sex, size, physical activity levels and the climate that you live in.

The authors of the study say that for healthy adults, there is no real benefit to drinking eight cups of water a day. Nor is it dangerous: Your body will just excrete the extra water you consume in your urine.

“If you drink eight cups of water a day, you’ll be fine — you’re just going to be spending a lot more time in the bathroom,” said Herman Pontzer, a professor of evolutionary anthropology and global health at Duke University and a co-author of the study.

The advice to drink eight cups of water a day stems from a 1945 recommendation from the Food and Nutrition Board of the National Research Council, which encouraged adults to consume about 64 ounces of water daily. The recommendation referred to a person’s total daily intake of water, including from all their foods and beverages, but it was widely misinterpreted to mean that people should drink eight 8-ounce glasses of water every day.

Some experts have argued that the widely held belief was not rooted in science. One study of 883 elderly adults for example found that there was no evidence of dehydration among the 227 people in the study who routinely drank less than six glasses of water daily.

“Until we have more evidence-based documentation that fluid intake of eight glasses per day improves some aspect of an elderly person’s health,” the researchers concluded, “encouraging a fluid intake above a level that is comfortable for the individual seems to serve little useful purpose.”

Nevertheless, the advice is so widely ingrained that many companies use it to market products. You can buy 64-ounce water bottles designed to motivate you to drink the equivalent of eight cups of water daily, and water-bottle sensors that will track your water intake and remind you to “hydrate” every 30 to 40 minutes.

SENSORS THAT REMIND YOU TO HYDRATE EVERY 30-40 MINUTES! WHAT A WORLD!

“We have guidelines telling people how much water to drink,” said Pontzer, who wrote a book on metabolism called “Burn.” “But the reality is that people have been kind of making it up.”

Indeed. I am comfortable with two or three medium sizes glasses a day, on top of wine, coffee, and other beverages. I estimate that I drink about 24 ounces of pure water per day—less than half the recommendation.

I wonder if any reader will be heartened by this, or will most people get defensive and say they like water (what’s to like? it’s flavorless), or that there’s nothing to lose by swilling the stuff (yes there is: hours in the bathroom). Many of my male friends (women won’t share this information) tell me that they get up several times per night to urinate. I never have to do that, and I’m fine.

Here’s what the article recommends (my bolding again):

So how much water should you drink? The answer is simple: Drink when you’re thirsty. Prioritize water, and try to avoid sugary drinks, which can cause metabolic problems. Coffee and tea are fine as well.

Get that? (I bet you were going to inform me that coffee is a diuretic.) It seems that, all along, I’ve been doing what’s recommended. The final advice:

While the caffeine they contain can increase urination, they will still be hydrating so long as you consume less than 400 milligrams of caffeine, Rosinger said. Keep in mind that you get water from your food as well. Some water-rich foods are fruits, vegetables, beans, yogurt, brown rice, and soups.

“If you’re paying attention to your body and drinking when you feel like you need to, then you should be fine,” Pontzer said.

And here’s the Science paper, which reports that a lot of normal water intake (up to 50%) comes from food, and 85% from food and other liquids, including coffee and juice). Water generated by your metabolism constitutes about 10% of your daily water usage. Drink 8 glasses per day? Fuggedaboutit!

I have more good news too, also from the Post. Click to read:

An excerpt:

. . .when people talk about their fondness for cheese, it’s often in a guilty way, as in, “Cheese is my weakness.”

“Cheese is packed with nutrients like protein, calcium and phosphorus, and can serve a healthy purpose in the diet,” says Lisa Young, an adjunct professor of nutrition at New York University. Research shows that even full-fat cheese won’t necessarily make you gain weight or give you a heart attack. It seems that cheese doesn’t raise or reduce your risk for chronic diseases, such as heart disease and Type 2 diabetes, and some studies show it might even be protective.

Don’t sue me if you stop drinking water, chow down on cheese, and then get sick. I am just the messenger here!

National Health Service ends “gender-affirming care,” replaces with “holistic and appropriate” care

October 25, 2022 • 9:45 am

The NHS has come to its senses and issued a whole new set of protocols for treating gender dysphoric youth. Previously, the Tavistock Clinic in London was the go-to place for these children, whose numbers have risen rapidly in the past few years, especially for females (graph below from here):

But there were complaints from patients, and a commissioned report on the Clinic by Dr. Hilary Cass damned the form of care practiced at Tavistock: “affirmative care,” which in practice meant affirming a child’s wishes about changing sex, which led to buttressing their wishes by giving puberty blockers to prepubescent youth, and ultimately adding hormone therapy and referring children for surgery to remove breasts and remodel genitals (the NHS never covered gender-transition surgery).

The problem was that many youth with gender dysphoria have mental problems or are simply distressed about their sexuality, and that lots of these difficulties resolve themselves without changing gender—often by becoming gay, which involves no drugs or surgery.

It was this rush to judgment and treatment, combined with a spate of pending lawsuits by former patients, that led to Tavistock’s downfall. Its functions will not only be farmed out to other centers, but the whole notion of “affirmative care” is being abandoned in favor of what I see as more sensible approach, which the article below calls “a holistic view of identity development in children and adolescents. Preliminary assessment will include “nonaffirmative” but supportive therapists, and there will be no “rush to hormones”; puberty blockers (whose long-term effects are still largely unknown) and hormones like testosterone administered only in clinical trials. The whole National Health Service protocol has been revised, and those who evade it by, say, ordering their own hormones, will not be further supported by the NHS.

These changes, following protocols already implemented in Sweden and Finland, are described in the article below from the Society for Evidence Based Gender Medicine (click to read):

Here’s what the article says about why the Tavistock protocols were abandoned.

The reasons for the restructuring of gender services for minors in England are 4-fold. They include (1) a significant and sharp rise in referrals; (2) poorly-understood marked changes in the types of patients referred; (3) scarce and inconclusive evidence to support clinical decision-making, and (4) operational failures of the single gender clinic model, as evidenced by long wait times for initial assessment, and overall concern with the clinical approach.

And a bit about the new program:

The new NHS guidance recognizes social transition as a form of psychosocial intervention and not a neutral act, as it may have significant effects on psychological functioning. The NHS strongly discourages social transition in children, and clarifies that social transition in adolescents should only be pursued in order to alleviate or prevent clinically-significant distress or significant impairment in social functioning, and following an explicit informed consent process. . .

The new NHS guidelines represent a repudiation of the past decade’s approach to management of gender dysphoric minors. The “gender-affirming” approach, endorsed by WPATH and characterized by the conceptualization of gender-dysphoric minors as “transgender children” has been replaced with a holistic view of identity development in children and adolescents. In addition, there is a new recognition that many gender-dysphoric adolescents suffer from mental illness and neurocognitive difficulties, which make it hard to predict the course of their gender identity development.

“Social transition” comprises the acts of medical professionals facing children with gender with gender dysphoria and helping them change gender with puberty blockers and hormones.

There are ten highlights (i.e., changes from the Tavistock protocols) in the NHS’s new system. They’re described in the article, and I’ll put them below with one or two aspects of each intervention (there are more in the article). All extracts from the article are indented; my own comments are flush left.

1. Eliminates the “gender clinic” model of care and does away with “affirmation”

“Affirmation” has been largely eliminated from the language and the approach. What remains is the guidance to ensure that “assessments should be respectful of the experience of the child or young person and be developmentally informed.”
Medical transition services will only be available through a centralized specialty Service, established for higher-risk cases. However, not all referred cases to the Service will be accepted, and not all accepted cases will be cleared for medical transition.

2. Classifies social gender transition as an active intervention eligible for informed consent

The NHS is strongly discouraging social gender transition in prepubertal children.

They outline the criteria needed to address gender transition, which include “persistent and consistent gender dysphoria” and “a clear and full understanding of the implications of social transition.”

3. Establishes psychotherapy and psychoeducation as the first and primary line of treatment

All gender dysphoric youth will first be treated with developmentally-informed psychotherapy and psychoeducation by their local treatment teams.

This is one of the main ways the Tavistock model failed: it didn’t use therapists who would assess the patient objectively rather than push them into changing genders.

4. Sharply curbs medical interventions and confines puberty blockers to research-only settings

The NHS guidance states that the risks of puberty blockers are unknown and that they can only be administered in formal research settings. The eligibility for research settings is yet to be articulated.
The NHS guidance leaves open that similar limitations will be imposed on cross-sex hormones due to uncertainty surrounding their use, but makes no immediate statements about restriction in cross-sex hormones use outside of formal research protocols.

This is an important change because the long-term effects of puberty blockers, especially used in combination with hormones like estrogen or testosterone, are not known.

5. Establishes new research protocols

All children and young people being considered for hormone treatment will be prospectively enrolled into a research study.
The goal of the research study to learn more about the effects of hormonal interventions, and to make a major international contribution of the evidence based in this area of medicine.

These studies will be continued into adulthood, as they should be. It’s important to know whether there are delayed injurious effects of hormones, as well as psychological “desisting”, or regret for changing gender.

6. Reinstates the importance of “biological sex”

The NHS guidance defines “gender incongruence” as a misalignment between the individual’s experience of their gender identity and their biological sex.

This change and the others implicitly assume that there is such a thing as biological sex and that it’s not a social construct. They don’t say there are only two biological sexes, but I think that’s assumed.

7. Reaffirms the preeminence of the DSM-5 diagnosis of “gender dysphoria” for treatment decisions

The NHS guidance differentiates between the ICD-11 diagnosis of “gender incongruence,” which is not necessarily associated with distress, and the DSM-5 diagnosis of “gender dysphoria,” which is characterized by significant distress and/or functional impairments related to “gender incongruence.”

The DSM-5 is the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition—the latest set of criteria used to diagnose mental illness. The addition of distress is important because without distress the panoply of treatments outlined for gender dysphoria aren’t used.

This is one of the most important changes, advocating a variety of expertise brought to bear on gender dysphoria, none of it dedicated to affirming the patient’s wishes:

8. Clarifies the meaning of “multidisciplinary teams” as consisting of a wide range of clinicians with relevant expertise, rather than only “gender dysphoria” specialists

The NHS guidance clarifies that a true multidisciplinary team is comprised not only of “gender dysphoria specialists,” but also of experts in pediatrics, autism, neurodisability and mental health, to enable holistic support and appropriate care for gender dysphoric youth.
Such multidisciplinary teams will be the hallmark of the new Service, into which challenging and risky cases may be referred. In addition to specific expertise in gender identity development and incongruence, the clinical leadership teams of the newly-established Service will include strong, “consultant level” expertise in a wide range of relevant areas:
- neurodevelopmental disorders such as autistic spectrum conditions
- mental health disorders including depressive conditions, anxiety and trauma
- endocrine conditions including disorders of sexual development pharmacology in the context of gender dysphoria
- risky behaviors such as deliberate self-harm and substance use
- complex family contexts including adoptions and guardianships

9. Establishes primary outcome measures of “distress” and “social functioning”

The rationale for medical interventions for gender-dysphoric minors has been a moving target, ranging from resolution of gender dysphoria to treatment satisfaction. The NHS has articulated two main outcome measures of treatment: clinically significant distress and social functioning.

These criteria are used for specifying treatment for other illnesses like depression.

10. Asserts that those who choose to bypass the newly-established protocol will not be supported by the NHS

Families and youth planning to obtain hormones directly from online or another external non-NHS source will be strongly advised about the risks.

The NHS will not support further treatment of those who obtain and take hormones outside of the NHS’s protocols.

Can anybody argue that these are not more sensible protocols than the ones used previously? Since most gender dysphoric children turn out to be either cis or gay if not given hormones and surgery, shouldn’t one take these kinds of precautions before injecting or cutting such people?

The premise, of course, is that many children who are dysphoric don’t need “affirmation” (especially if there’s social pressure to change their gender), but compassionate therapy to see how serious their problem is and how strongly they wish to change identity. If you can’t vote until you’re 18, why should you be able to start changing your hormones and body parts before then? 18 is just a subjective age, of course, but the protocol is based on not immediately accepting the views of children—or their parents, who can pressure kids destined to be gay into seeing themselves as transsexuals—that they’re in the wrong body. You don’t just affirm that right off the bat, but ascertain it with intensive therapy.

Of course there will be many objections to these protocols by trans activists who are of the “affirmative care” stripe, but I think that in twenty years we’ll look back on the present as a time when many children were harmed by improper medical and psychological care. That’s the basis of the more than 1,000 lawsuits likely to be filed against Tavistock.

Minnesota medical students take ideological oath including, among other things, to “honor all indigenous ways of healing”

October 14, 2022 • 9:30 am

In the last several decades, the “white coat ceremony” has become a tradition at medical schools, with the entering students receiving their doctor’s coats and then reciting the Hippocratic Oath. There are many variants of this ancient oath, and often students write their own version to supplement the traditional one. As you can imagine, some of these go beyond the doctor’s pledge, adding pledges of social justice, ideological belief, and so on. I’ve seen several versions of these white coat oaths; the FIRE article below mentions them at Harvard, Columbia, WashU, Pitt Med, and the Icahn School of Medicine. But perhaps the one most distressing to scientists and advocates of science-based medicine is this one, recited at the University of Minnesota’s white coat ceremony on August 19.

According to the Foundation for Individual Rights and Expression (FIRE), the speaker is Robert Englander, Associate Dean for Undergraduate Education for the Medical School, who leads the students in what is both a pledge and a prayer. (Curiously, Englander’s university bio has disappeared from its website.)

Now this oath wasn’t written by the administration itself, but, according to FIRE and the agenda of the ceremony, by a committee of fifteen incoming medical students on the “Oath Writing Committee.” These students may, of course, not represent the beliefs of their class as a whole; in fact, it’s likely that, as usual, it’s the activists who seek the loudest megaphone. Click on screenshot below to see the article, and I’ve put the video of the recitation below that.

Here’s the two-minute video of the oath:

Here’s the oath’s text reproduced from FIRE’s letter sent yesterday to the medical school deam (I’ve bolded the sentence that bothers me the most.)

With gratitude, we, the students of the University of Minnesota Twin Cities Medical School Class of 2026, stand here today among our friends, families, peer, mentors, and communities who have supported us in reaching this milestone. Our institution is located on Dakota land. Today, many Indigenous people from throughout the state, including Dakota and Ojibwe (ooj-jib-way), call the Twin Cities home; we also recognize this acknowledgment is not enough.

We commit to uprooting the legacy and perpetuation of structural violence deeply embedded within the healthcare system. We recognize inequities built by past and present traumas rooted in white supremacy, colonialism, the gender binary, ableism, and all forms of oppression. As we enter this profession with opportunity for growth, we commit to promoting a culture of anti-racism, listening, and amplifying voices for positive change. We pledge to honor all Indigenous ways of healing that have been historically marginalized by Western medicine. Knowing that health is intimately connected to our environment, we commit to healing our planet and communities.

We vow to embrace our role as community members and strive to embody cultural humility. We promise to continue restoring trust in the medical system and fulfilling our responsibilities as educators and advocates. We commit to collaborating with social, political, and additional systems to advance health equity. We will learn from the scientific innovations made before us and pledge to advance and share this knowledge with peers and neighbors. We recognize the importance of being in community with and advocating for those we serve.

There are the usual arguable claims, which should not be professed or vowed by the students or foisted on them by the dean and fifteen vocal students. The claims include these:

The implication that the original owners of the school’s land was the Dakota people. (Note that the oath says that acknowledgement is “not enough,” but what else will they do for the Dakota people? Will they give the land back, or compensate the original owners? There is no vow to do either.)
Inequities in medicine are not just rooted in past forms of oppression, but are ongoing, and reflect white supremacy as well as other forms of bigotry.
There is “structural violence deeply embedded in the healthcare system”. What, exactly, do they mean by “structural violence”?
There is a “gender binary” that causes further traumas. I think they’re referring to the “sex binary”, which is real. Few people assert that there is a “gender” binary when “gender” is construed as a person’s sociosexual role.
The students will “honor all Indigenous ways of healing that have been historically marginalized by Western medicine.” ALL OF THEM? There are a million of them if you count all forms of indigenous healing overtaken by Western medicine. Yes, a few of these treatments may be efficacious, but almost none have been subject to scientific testing using the gold standard of double-blind treatment. “Honoring” a form of pre-scientific healing simply because it’s was practiced by indigenous people is ludicrous. Certainly you shouldn’t disparage the people themselves who use such healing, as the treatments were developed outside of science, but you shouldn’t honor all the ways of healing themselves. Most of them don’t accomplish anything; what kind of “honor” does that deserve?
The rest of the oath is boilerplate social-justice jargon, and there’s nothing wrong with that, but this is an ideological/political pledge, not a medical-school pledge. As FIRE notes in its article, this is a form of compelled speech that many of the students might not agree with, but are nevertheless force to give fealty to.

Now many of you can say—and this is likely true—that the social-justice aspects of this pledge are meaningless, and the students don’t have to live up to them. Nor do the students have to consider shamanism, chanting, herbs, and so on as worthy of “honor.” (These, by the way, were not historically “marginalized” by Western medicine, but were replaced by scientifically-based treatments because those treatments work.)

If, as the students also pledged, they will “restore trust in the medical system,” they can begin by refusing to honor traditional treatments that don’t work. It is no dishonor to indigenous people to reject methods they developed in the absence of science. I suspect it is the “progressiveness” of this oath that has led to widespread ridicule against it and perhaps to the disappearance of Robert Englander’s bio.

Now on to FIRE, which has legal objections to this oath. Their main objection is that this is not only compelled speech—making students swear to something that they disagree with and is not a requirement of the profession—but also that, in the future, students could be punished for failing to adhere to what they’ve sworn. This is not a fanciful scenario:

From the FIRE article:

FIRE respects students’ rights to express their views. But because only a small committee of all new students penned the statement, some of the other several-hundred students may have been compelled to express that handful of classmates’ opinions as their own. (It’s unclear whether any students dissented and, if so, whether they could opt out.)

We’re also concerned that these subjectively squishy commitments could become de facto professionalism requirements, and that students could be punished for failing to uphold them. For example, what must a medical student do to adequately practice “anti-racism”? And whatever that may be, if she does not (as UMMS understands that term), could she be dismissed for violating her oath? What if she refuses to take the oath in the first place?

FIRE has certainly seen administrators of professional programs in medicine, dentistry, law — even mortuary science — who deployed ambiguous “professionalism” standards to punish students for otherwise protected speech.

. . .More than 10% of the campus-related cases in which FIRE intervenes now concern requirements that students and faculty demonstrate their DEI commitments or contributions, or personally make land acknowledgements.

Again, while universities, students, and faculty are free to encourage or promote DEI-type values, forcing others to say they believe in these concepts is not only contrary to many universities’ legal obligations — but violates their moral obligations, too.

Consider: Even students or faculty who broadly agree with a university’s stance on DEI may believe, for example, that land acknowledgements are merely performative. Or a faculty member who studies race and gender may have highly nuanced views on DEI not reflected by the university’s stance. Students, likewise, may disagree with other aspects of a given DEI pledge.

Medical students possibly being made to read verbatim from ideological pledges if they wish to become physicians would be a new low.

I’d add that surely a lot of the students forced to say that they’ll honor all indigenous methods of healing “historically marginalized by Western medicine” certainly don’t believe that, but are nevertheless forces to vow it. How many of those reciting students accept the curative powers of, say, shamanic rituals?

Here is the summary of the objections in the letter written by Zachary Greenberg, FIRE’s Senior Program Officer for Campus Rights Advocacy, went to Jakub Tolar, the Dean of the Medical School, as well as to the school’s President and General Counsel:

While UMMS may encourage students to adopt these views, the First Amendment bars the university from requiring them to do so. The First Amendment protects not only the right to speak, but the right to refrain from speaking. Requiring new students to “vow” or “commit” to contested political viewpoints violates students’ clear expressive rights, is inconsistent with the role of the university as a bastion of free inquiry, and cannot be enforced at a public institution.

UMMS can require students to adhere to established medical standards, but this authority cannot be abused to demand allegiance to prescribed ideological views—even ones that some students do indeed hold. Specifically, UMMS may not compel students to recite a land acknowledgment, commit to “uprooting the legacy and perpetuation of structural violence deeply embedded within the healthcare system,” or “promote[e] a culture of anti-racism.” Nor may it force students to express a commitment to “embody cultural humility,” or “advance health equity.” Even if written by a group of students, UMMS may not subsequently require all students adhere to these views.

Because students may reasonably perceive recitation of this oath as mandatory, FIRE calls on UMMS to make clear that students may refuse to say it without penalty, and that students will not have to affirm any political viewpoints as a condition of their continued education at the school.

We request receipt of a response to this letter no later than the close of business on October 20, 2022.

My prediction? UMMS will not reply. Will there then be a lawsuit? I don’t think so—unless they find medical students injured by professing what they don’t believe, and what medical student would be plaintiff to such a suit? But I do think that in future years the school will refrain from such over-the-top vows.

Should you get that bivalent booster shot?

October 4, 2022 • 12:00 pm

My primary-care physician, Dr. Alex Lickerman, discusses the question everyone’s asking: should you get that bivalent booster? (For most people it would be their third booster and the fifth Covid shot). You can access Alex’s post by clicking on the screenshot below. (Be sure to look at the graphs and read it all.)

Alex always looks at the science before he decides what’s to recommend, and by that I mean the primary literature. When I first asked him about whether to get a booster, he said he didn’t know because the data hadn’t been published, and all the existing studies were on antibody levels in mice. Now he looks at more data. I’ll give his conclusion below but do have a look at his post.

My own decision was to get the booster simply because I’m traveling tomorrow, but, as always, consult your own doctor or decide from the data themselves. People tend to get covid on airplanes these days (a friend who just returned from Boston said only 5% of the passengers on her Southwest flight wore masks), and Alex said that it couldn’t hurt me to get one before traveling—but it might not help me much, either.

CONCLUSION: Should you get the bivalent booster? In the absence of human trial data, we might think about this question as follows: We can be reasonably certain that the bivalent booster will produce a level of neutralizing antibodies that diminishes the risk of infection from COVID. We don’t know how long that protection will last, but a fair guess would be from 3 to 6 months. If there is some reason you feel the need to reduce your risk over the next 3 to 6 months, say, for travel, getting the bivalent booster would seem reasonable. On the other hand, if in addition to being vaccinated, you’ve had COVID recently (meaning you’ve been infected with an Omicron variant), likely the same level of protection accrues, obviating the need for the bivalent booster. If your main concern is dying from COVID and you’ve already received the primary series and one or two boosters, your risk is so low that getting another shot would seem superfluous. If you are at high risk for dying from COVID, while there is no data to suggest the bivalent booster might further reduce your risk beyond levels afforded by the primary series and one or two boosters, there is also likely little risk of getting it. In the absence of data to guide us, this would then be a personal decision.

Often Alex answers questions in the comments, so if you have any, put them below. I’ll tell him that he might look at the comments.

Is this a valid exception to protected free speech?

September 4, 2022 • 11:20 am

Here’s a case where one might want to suppress speech in apparent violation of the First Amendment. But after due pondering, I don’t think it’s a good idea. But I waver, as you’ll see, and even though I come down against the bill, as it may be a bad precedent, I am not sure of my stand.

This has to do with a new California law (not yet signed by Gavin Newsom) that punishes physicians who contradict conventional wisdom about Covid-19, with some of that wisdom specified by law. It applies to words, not to actions.

I found this bill through note and links sent by reader Gary, who said this:

I’ve seen very little discussion of California Assembly Bill 2098. The intention of the bill is good, as are many attacks on free speech, but I, and perhaps you, feel that curbing free speech is generally not the best solution. Under AB-2098, passed in the California Assembly and Senate, but not yet signed by the governor, physicians and surgeons would face disciplinary action if they voiced an opinion contrary to certain facts about COVID-19 and the associated vaccines as determined by the legislature. The disciplinary action could include revoking their license to practice. I despise misinformation and disinformation, but the solution in my opinion, is not punishing those who disagree with the scientific consensus. The solution is the spread of solid information, not the attempted squelching of misinformation.

I think that this bill is going to the governor’s desk with very little discussion or notice. He has three weeks to sign the bill, but hasn’t made his position public. If you think it’s important, you may want to include it in your website.

I’ve put the meat of the bill below. It calls for licensing boards, which are arms of the government, to take action against doctors who “disseminate misinformation or disinformation related to COVID-19, including false or misleading information regarding the nature and risks of the virus, its prevention and treatment; and the development, safety, and effectiveness of COVID-19 vaccines.” In other words, this involves the government suppressing speech, an apparent violation of the First Amendment. But does it fall under the few court-allowed forms of speech that are NOT protected by that Amendment?

The seven points leading to this Diktat are below. These are pretty well established, but they are not absolute facts, as no scientific assertion is beyond questioning. For example, the statement in (c) about the safety and efficacy of COVID-19 vaccines is the best guess we have, but do we know the long-term effects of the vaccines? No, as they’ve been around for only two years. And remember that our knowledge about this disease and about the vaccines, changes almost week by week. Yes, it’s an attempt to protect the health of the public by squelching speech, just as “hate speech” laws are attempts to protect the feelings of the people.

But have a look at the text of the bill from the link above:

LEGISLATIVE COUNSEL’S DIGEST

AB 2098, Low. Physicians and surgeons: unprofessional conduct.

Existing law provides for the licensure and regulation of physicians and surgeons by the Medical Board of California and the Osteopathic Medical Board of California. Existing law requires the applicable board to take action against any licensed physician and surgeon who is charged with unprofessional conduct, as provided.

This bill would designate the dissemination of misinformation or disinformation related to the SARS-CoV-2 coronavirus, or “COVID-19,” as unprofessional conduct. The bill would also make findings and declarations in this regard.

THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

SECTION 1.

The Legislature finds and declares all of the following:

(a) The global spread of the SARS-CoV-2 coronavirus, or COVID-19, has claimed the lives of over 6,000,000 people worldwide, including nearly 90,000 Californians.

(b) Data from the federal Centers for Disease Control and Prevention (CDC) shows that unvaccinated individuals are at a risk of dying from COVID-19 that is 11 times greater than those who are fully vaccinated.

(c) The safety and efficacy of COVID-19 vaccines have been confirmed through evaluation by the federal Food and Drug Administration (FDA) and the vaccines continue to undergo intensive safety monitoring by the CDC.

(d) The spread of misinformation and disinformation about COVID-19 vaccines has weakened public confidence and placed lives at serious risk.

(e) Major news outlets have reported that some of the most dangerous propagators of inaccurate information regarding the COVID-19 vaccines are licensed health care professionals.

(f) The Federation of State Medical Boards has released a statement warning that physicians who engage in the dissemination of COVID-19 vaccine misinformation or disinformation risk losing their medical license, and that physicians have a duty to provide their patients with accurate, science-based information.

(g) In House Resolution No. 74 of the 2021–22 Regular Session, the California State Assembly declared health misinformation to be a public health crisis, and urged the State of California to commit to appropriately combating health misinformation and curbing the spread of falsehoods that threaten the health and safety of Californians.

I’ve put in bold below the two definitions that make me waver about opposing this bill.

SEC. 2.

Section 2270 is added to the Business and Professions Code, to read:

(a) It shall constitute unprofessional conduct for a physician and surgeon to disseminate misinformation or disinformation related to COVID-19, including false or misleading information regarding the nature and risks of the virus, its prevention and treatment; and the development, safety, and effectiveness of COVID-19 vaccines.

(b) For purposes of this section, the following definitions shall apply:

(1) “Board” means the Medical Board of California or the Osteopathic Medical Board of California, as applicable.

(2) “Disinformation” means misinformation that the licensee deliberately disseminated with malicious intent or an intent to mislead.

(3) “Disseminate” means the conveyance of information from the licensee to a patient under the licensee’s care in the form of treatment or advice.

(4) “Misinformation” means false information that is contradicted by contemporary scientific consensus contrary to the standard of care.

(5) “Physician and surgeon” means a person licensed by the Medical Board of California or the Osteopathic Medical Board of California under Chapter 5 (commencing with Section 2000).

This is what I wrote back to Gary:

I’ll have a look, but remember that the scientific consensus changes rapidly, and who is the legislature to determine what the correct “facts” are? And will they then punish doctors for giving out information about diet, etc. that contradicts the legislature? There’s no end to this, and I’m a bit wary of legislating what information is “absolute truth that cannot be contradicted”.

And I stand by my claim that the government should not be in the business of what doctors say about COVID-19, even if it goes against a world of conventional wisdom. This is freedom of speech, even if emitted by a doctor. Or are they allowed only to pronounce on items not related to medicine, or parrot the latest consensus?

It’s a different matter, however, if a doctor acts in a reckless way, violating professional standards like injecting patients with some Trumpian nostrum to cure COVID-19. In that case it is action, not talk, that causes harm, and boards should have the write to examine a doctor’s conduct and, if necessary, punish them or take away their licenses. Likewise, hospitals should be able to fire them. False advertising, too, is illegal, so a doctor is liable to sanction if he or she advertises cures that are known or demonstrated to be bogus. But advertising is not the same as a doctor simply making a pronouncement. Advertising is luring in patients under false pretenses.

Now I am sort of on the fence about this one, for “disseminating information to patients that you know is false, and doing so with malicious intent”, is indeed malpractice. But that’s already covered by the law. How can you prove that a doctor is doing this with “malicious intent or an intent to mislead”?

This is the same distinction that we see between saying hurtful and “harmful” words like “gas the Jews” or “Jews are acquisitive and in a conspiracy to dominate the world”, which is harmful but legal speech, and causing actual physical harm by hitting someone or inciting predictable and immediate violence against them. The one difference is that patients tend to take their doctor’s advice. But sometimes doctors give bad advice, which is why we urge second opinions on serious matters. A doctor may give bad advice, like “you’d be better off having three stents put in now,” but to me that’s not illegal unless the doctor means it maliciously. The doctor must intend to do harm, and carry that out by treating the patient. And intention is what is nearly impossible to prove in this bill.

To me this bill seems good on the face of it, but creates a precedent where the legislature decides what medical facts are acceptable, and what opinions cannot be uttered. Just remember how advice on diet (and smoking) has changed just in my lifetime. Let’s leave this to the consensus of doctors and their professional organizations, and let it apply only to actions, not to words.

I’m sure some readers will disagree with me, and that’s fine. Have your say below. As I said, I’m of two minds about this bill.

The New Zealand government subsidizes spiritually based “traditional” healing, with no evidence that it works

September 2, 2022 • 9:30 am

I have nothing in general against “traditional medicine” so long as it’s efficacious. But that’s the rub, for, as the old Q&A goes: “What do you call traditional medicine that works? Medicine.” Thus, if something is being touted, especially by the government, as a useful form of medicine, it should have been scientifically tested to ensure that it does what it does.

Many of our modern drugs do indeed come from plants, but not all of those were used in traditional or “indigenous” medicine: some were found simply by surveying plants by medical scientists looking for useful effects. And of course without testing—with the gold standard being double-blind testing—you can’t tell whether a plant-based drug is better than a placebo.

This lack of testing appears to be characteristic of Rongoā Māori (“RM”), the traditional healing used by Māori in New Zealand, as reported by the article from the University of Auckland shown first below. And that lack of hard evidence for efficacy, while it shouldn’t lead to the banning of Rongoā Māori, shouldn’t lead to its declaration as being equal to modern medicine, nor should it lead to the government’s funding of untested remedies. But it’s already too late.

Since this is New Zealand, testing of Māori claims isn’t needed: tradition and anecdotal health claims are enough. Indeed, criticism of such claims is seen as racist.

And so, as the article below reports, the Kiwi government is funding a $100,000 program to “support injury recovery through Rongoā Māori. The program is funded through the “ACC” (Accident Compensation Corporation), a government body established in the 1970s to oversee the provision of support, treatment and rehabilitation for people involved in accidents. What we have, then, is government support for traditional medicine used to heal accidents.

But this is only the camel’s nose, for as the article below implies, this is just the first step in insinuating traditional healing into regular medical practice guaranteed to all Kiwis by their government.

In fact, in several ways Rongoā Māori is similar to Mātauranga Māori, traditiional “ways of knowing” that I’ve written about at length. Both systems contain a mixture of theology, spirituality, and practical knowledge, both are imbued with fact claims that can’t be tested, and both are touted by their practitioners as deserving equal treatment with modern science.

It is the “equal treatment” that worries me, as neither MM or RM are coequal with science. Parts of MM can be considered empirical truths—”practical knowledge” like how to grow plants or catch eels—but I have no idea whether RM is efficacious in healing, at least beyond having a placebo effect. Finally, both MM and RM involve the ubiquitous valorization of the ways of indigenous people. Traditional customs should of course be taught as aspects of anthropology and sociology, important parts of New Zealand’s history, but shouldn’t be valorized to the point where they’re considered coequal to science or medicine.

What is involved in Rongoā Māori? The two articles below (click on screenshots), as well as the short video, give you an idea.

A shorter explanation of RM is here.

Here are the major components of RM, considered “holistic healing” with a big dollop of spirituality. This list comes from the two articles above and a few others.

a.) Traditional plant remedies. The second article above gives a list of which plants are used and for what ailments. They must be used in a proper way—not just in their preparation, but ensuring that they’re gathered in traditional ways. Here’s what the second article says

The use of plant remedies does not require regulatory approval as long as they do not contain a scheduled medicine. However, as some pharmaceuticals are derived from plants, it is possible that Rongoā may contain active ingredients. As long as these pharmaceuticals are not purposely added to a remedy no restrictions apply to the use of such plants. Note that some plants, for example St Johns wort, can interact with conventional medicines.

Appropriate tikanga (customs and rites) must be observed during the collection, preparation and storage of Rongoā.
Plant material must be correctly identified, gathered from non-polluted areas and prepared safely and hygienically.
Plants are usually crushed or dried and mixed with water or ethyl alcohol.
Plant remedies should only be prescribed and dispensed by Tohunga [traditional healers] to individual patients. Tohunga will advise on appropriate use.
Plant remedies should not be labelled with therapeutic claims. Labels should contain the ingredient(s), instructions for use, date of preparation, expiry date and who the remedy is prescribed for.

But if they cannot make therapeutic claims, why is the government paying for them? The important question is whether all or any of the drugs are useful in healing the ailments they’re prescribed for. Before you say “they must be, as they’re based on tradition,” be aware that a lot of spiritually-based traditional medicines tested in the U.S. have been shown to be bunk.

I have found no mention of testing for any of these plants. While some of the traditional herbal medicines may be efficacious, I see no sign that they’ve been tested or compared to modern pharmaceuticals that must be and have been tested.

b.) Massage. Massage can be useful in temporary relief, and even chiropractic can be useful for back problems, but the idea of adjusting the body because it’s diseased or out of whack, as evidenced in the articles and the video above, is dubious (I’d say “bunk,” but I’m being kind here.) Look at the video and watch them adjusting the feet of a man with a lower back problem. This is called romiromi, or “body alignment”.

c.) Lunar calendar relationality (maramatka). I don’t know how this is implemented, but it’s a big red flag.

d.) Meditation. Your mileage may very, but I haven’t been prescribed meditation for any accidents I’ve had.

e.) Spirituality. This site at Health Navigator New Zealand explains that the spiritual side of RM is its most important aspect. A quote:

The most fundamental part of rongoā Māori is the traditional spiritual teachings, which can be seen as the basis of all traditional medicine. For Māori, rongoā is a part of the Māori culture from Tāne (God of the forest) who retrieved the three baskets of knowledge from Io (God) with the knowledge and teachings to guide us in this world.

As Māori, we believe we are part of the children of Tāne, along with the creatures of the forest such as the birds, trees and plants and, therefore, we have a strong connection to rongoā rākau. To learn rongoā, people have to become apart of the world of Tāne. They become connected and immersed in the forest, learning about a relationship far beyond the physical elements of the trees and plants. To utilise Te Oo Mai Reia, the healer must become immersed in ancient spiritual teachings while becoming a vessel to achieve the healing through Io alongside the use of physical touch to create balance and shift energies.

This is a form of shamanism.

Now this is all well and good, and if people want to use RM for diseases or healing from accidents, that’s their prerogative. I wouldn’t, but that’s my choice. But what I dislike is the insistence of these articles and practitioners that RM is just as good as modern medicine and should be offered coequally by the government. Here are two quotes from the University of Auckland article:

Located in Dance Studies in the Faculty of Creative Arts and industries, Ngākau Oho will provide a personalised recovery programme for 20 ACC clients and their whānau. In the process, the programme aims to reclaim and normalise rongoā Māori as a viable and everyday healthcare practice.

Recent efforts to address Māori health inequities across the health sector have focused on increasing the number of Māori health professionals and Māori access to culturally relevant rehabilitation services, says Dr Reihana.

Why is this in a dance studio? But wait—there’s more, and this is the worrisome part (my emphasis):

The programme will provide ACC with evidence-based insight on how rongoā Māori would be embedded within established healthcare services.

“We believe the approach we develop will be an innovation that can be used within the health system, and importantly, by Māori health practitioners, providers and whānau, helping ensure that rongoā Māori practices can be a real and easily accessed option for Māori in wellbeing and recovery,” says Dr Reihana.

This implies that RM will indeed become part of the government-funded healthcare system of New Zealand. But what is the “evidence-based insight” that is forthcoming, since there is no mention of controls?

Finally, Donna Kerridge, the RM practitioner shown in the video above, says this:

“I think the Western health and healing system is awesome; it’s not better, it’s not worse.”

This is the insistence on absolute equality that is ubiquitous in both MM and RM, and it’s just wrong. If you have diabetes, do you want traditional herbal medicine or insulin? If you have an infection, do you want plants or antibiotics? Now many Māori do avail themselves of modern medicine instead of or alongside RM, and those people are the savvy ones. But it seems risible to say that RM is exactly as good as modern medicine. It can’t be, because its “testing” is based on anecdotes instead of scientific studies with controls.

I want to add one bit about “alternative medicine” in the U.S. In 1991, the government established the National Center for Complementary and Integrative Health as part of the National Institutes of Health. Its goal was to scientifically study “alternative medicine”, using the kind of controls that all science-based medicine uses. As Wikipedia notes:

NCCAM’s mission statement declared that it is “dedicated to exploring complementary and alternative healing practices in the context of rigorous science; training complementary and alternative medicine researchers; and disseminating authoritative information to the public and professionals.” As NCCIH, the mission statement is “to define, through rigorous scientific investigation, the usefulness and safety of complementary and alternative medicine interventions and their roles in improving health and health care.”

Since the NCCAM’s founding, over two billion dollars have been spent testing stuff like coffee enemas, intercessory prayer, magnet therapy, and so on. Not one “alternative treatment has worked. You’ll be amused at the examples given in the article about the treatments tested and their outcomes. A screenshot is below (click to enlarge). NOT ONE WORKED! And for the others, no results were ever reported, which means that they didn’t work, either.

Two quotes from the article:

In 2012, the Journal of the American Medical Association (JAMA) published a criticism that NCCAM had funded study after study, but had “failed to prove that complementary or alternative therapies are anything more than placebos.” The JAMA criticism pointed to large wasting of research money on testing scientifically implausible treatments, citing “NCCAM officials spending $374,000 to find that inhaling lemon and lavender scents does not promote wound healing; $750,000 to find that prayer does not cure AIDS or hasten recovery from breast-reconstruction surgery; $390,000 to find that ancient Indian remedies do not control type 2 diabetes; $700,000 to find that magnets do not treat arthritis, carpal tunnel syndrome, or migraine headaches; and $406,000 to find that coffee enemas do not cure pancreatic cancer.” It was pointed out that the public generally ignored negative results from testing, that people continue to “believe what they want to believe, arguing that it does not matter what the data show: They know what works for them.” Continued increasing use of CAM products was also blamed on the lack of FDA ability to regulate alternative products, where negative studies do not result in FDA warnings or FDA-mandated changes on labeling, whereby few consumers are aware that many claims of many supplements were found not to be supported.

I’ll take my coffee in the other end, thank you.

And here’s a skeptical take (there are other criticisms given of NCCAM by doctors and scientists):

A 2012 study published in the Skeptical Inquirer examined the grants and awards funded by NCCIH from 2000 to 2011, which totaled $1.3 billion. The study found no discoveries in complementary and alternative medicine that would justify the existence of this center. The authors argued that after 20 years and an expenditure of $2 billion, the failure of NCCIH was evidenced by the lack of publications and the failure to report clinical trials in peer-reviewed medical journals. They recommended that NCCIH be defunded or abolished and the concept of funding alternative medicine be discontinued.

That money hasn’t been completely wasted, for it’s debunked therapies that people insisted would work. And those therapies won’t be approved by the FDA or used by rational doctors. Still, therapies are usually tested clinically when there’s some preliminary evidence that it might work. The tests above were simply based on “folk claims.”

All I’m asking is that Rongoā Māori be tested the same way as the NCCAM tested its putative remedies. If RM treatments aren’t (and they surely aren’t), Kiwi taxpayers should be protesting loudly about wasting their money on subsidizing spiritually-based medicine

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