Ann Gauger's latest salvo against Dennis Venema's arguments against an original pair of human beings


#438

What evidence demonstrates that the healing was done by God?


(GJDS) #439

What an odd response!


(GJDS) #440

What is your problem? The person who was healed stated that his prayer was answered. Why does this bother you?


#441

You stated that I was avoiding evidence. I am asking what evidence you think I am ignoring.

When people claim that I am ignoring evidence it does bother me a bit since I try to keep an open mind. It doesn’t bother me at all if people believe through faith that God healed them, as long as they aren’t preventing others from getting proper medical treatment because of their beliefs (but that is probably a discussion for another day).


(GJDS) #442

You questioned and sought to contradict the evidence presented regarding a healing that was attributed to God by the person healed. There was nothing in this account on avoiding seeking medical assistance - in fact, the data and information was provided by a doctor, and a patient who sought input from his doctor.

Thus your comments did not make sense to me, unless you avoided the evidence and information presented.


(Roberto L Hernandez) #443

Where did he or she question or contradict the evidence? He or she questioned the conclusion, not evidence.


#444

What I am pointing to is the Post hoc ergo propter hoc fallacy which questions the logic behind the conclusion, not the observations that have been given.

It is also a bit frustrating when you jump between “I have evidence” and “it’s based on faith”. Those seem to be contradictory positions.

Person A: I have evidence that God healed this person.

Person B: What evidence is that?

Person A: Why does it bother you that this person believes through faith that they were healed by God?

Person B: ++scratches their head++


(Jon Garvey) #445

Can’t resist getting my hands dirty with this. Remember that my friend’s recovery was presented in the context of different worldviews producing different explanations, and that has been demonstrated very nicley by your applying strict rules of evidence to it, and my (at the time) watching the test results on his behalf and being thankful to God.

Compare a similar story. Somebody tells me he went to the doctor with recurrent angina, was investigated and put on medication for it and has been fine ever since - he praises his doctor and his pills up to the heavens. And I reply, great (whilst basking in the reflected glory of my erstwile trade).

It simply wouldn’t cross my mind, unless I was involved in some retrospective trial of his particular drug, to even consider that given what I know of the literature, there’s a modest chance that the drug wasn’t the cause of his improvement in his case, but placebo effect, or that given the percentage who are known not to respond to it, the improvement might be purely coincidental.

The ideal evidential doctor might well insist on a withdrawal trial or two with double-blind substitution of placebo to exclude the post hoc ergo propter hoc fallacy… but it will never happen in practice, because the only person likely to doubt the obvious explanation that the drug worked is the crank whose worldview holds that all drugs are delusions of the devil.

It’s not that the everyday clinician is gullible in assuming his treatment was effective, but that his worldview sees no reason to treat it as a matter of evidence at all in such a case. Bear in mind I’m quite aware that much statistical research lies behind anti-anginals: the point is that this patient hasn’t had proper research, and might well be as much a unique case as my real friend - if one has some reason to think it problematic. Otherwise, the account given by the patient is sufficient.


#446

First off, that was a wonderful and enjoyable post.

I think you hit all of the points I have discussed and alluded to. I think we all realize that we are susceptible to confirmation bias and we need ways of double checking ourselves to make sure our conclusions are solid. That isn’t to say that something is false if there is a possibility of confirmation bias, only that we need solid methodologies and evidence in order to push past it.

An interesting study I cite once in a while dealt with arthoscopic knee surgery as a treatment for arthritic knee pain. The study was actually double blind where people in the control group received a mock surgery. As it turned out, the patients with the mock surgery reported reductions in knee pain equal to that of the group that received the real surgery. However, the reduction in pain wasn’t that huge in any of the groups, but it is interesting that there was still a reduction in knee pain in the mock surgery group. It is studies like these which remind us we may be making bad assumptions.


(Jon Garvey) #447

TA

Following a tangent, one of the bad assumptions my profession makes is to treat the placebo effect as a null hypothesis in trials and a distraction in practice, rather than one of the more significant tools at its disposal. There’s been far less research on it, I believe, than on the effects of surgery.

In one of my fields of interest, back pain, there was some relatively recent on the neurophysiology of chronic pain that suggest much of the benefit of time-honoured surgical procedures might have been because of the incidental stimulation of joint receptors.

In terms of amusing surprises, I remember one study that showed that in rheumatoid arthritis (I think it was) hot water bottles significantly outperformed the most common anti-inflammatories in pain relief. Strangely enough, I never saw that cited in any of the reviews, nor were HWBs prescribed over NSAIDs in any centres I heard of. I strongly suspect a worldview, or at least a cultural reason for that preference for expensive patented drugs over cheap hardware from a corner shop!


#448

I think it is fair to use the placebo effect as a null hypothesis when you are talking about the mode of action for a specific drug.

As to a distraction in practice, that wing of the debate is starting to heat up. If something works, then why not use it? That seems to be the dangerous questions some scientists and doctors are starting to ask, especially when it comes to pain. Focusing more on results than mode of action is an interesting way of approaching medicine. On the flip side, giving out sugar pills as a treatment for sepsis is and should be malpractice.[quote=“Jon_Garvey, post:447, topic:36790”]
In terms of amusing surprises, I remember one study that showed that in rheumatoid arthritis (I think it was) hot water bottles significantly outperformed the most common anti-inflammatories in pain relief. Strangely enough, I never saw that cited in any of the reviews, nor were HWBs prescribed over NSAIDs in any centres I heard of. I strongly suspect a worldview, or at least a cultural reason for that preference for expensive patented drugs over cheap hardware from a corner shop!
[/quote]

Not so much of a worldview as a conflict of interest created by billions of dollars of profit. I am sure that you are more than familiar with this problem.


(Phil) #449

Certainly that is something I see a lot. Acupuncture for example seems to work for back pain, but when examined, is no better than sham acupuncture and acupuncture with the needle points being at random spots, rather than the traditional ones on the map. It is basically a strong placebo, as you might expect when you pay someone to stick needles in you. (though there may be some physiologic factors in play as well, as both needles and hot water bottles do affect neurotransmitters and such. No doubt knee surgery is the same.
What then is the harm? First of all, there are side effects and complications, then there are the economic factors of cost both individually and to society, as you alluded to. A doctor friend of mine refers to alt medicine as “God’s way of dealing with people who have too much money.”


(Richard Wright) #450

Phil,

I am a licensed acupuncturist (one of my 2 professional licenses), and I assure you that acupuncture, done properly, is much more than a placebo effect. The problem with those studies is that they are wholly dependent on the system of acupuncture used by and the competence of the practitioner. I’ve worked almost exclusively with pain patients over the last 10 years and I think I can say that I’m a bit of an expert in pain acupuncture. If one takes the time and effort to learn different systems, and one system doesn’t work for a patient but the next completely takes their pain away, then it can be said fairly confidently that the second treatment system of acupuncture worked to heal the patient in a real way.


#451

I have been successfully treated with acupuncture for neck pain. Thank heavens, because I can’t take any meds except Tylenol or controlled drugs for pain. Acupuncture is also being successfully used to treat animal pain, including at Cornell University Veterinary Specialists..


(GJDS) #452

I will try to end this exchange by showing you that the example I used was solely for the purpose of discussing what is commonly taken as evidence. The wider discussion on worldviews impacts on conclusions.

a) person was diagnosed with a medical condition = evidence
b) person stated he prayed for healing = evidence
c) person was healed = evidence
d) person attributes his healing to God as in b) = evidence

Those that do not believe in God would reject b) and d) - if they do so because they claim a-d is not evidence, they must, surely, contradict the clear evidence we are presented with.

Now I cannot see why anyone would scratch their head, or start some silly argument on what is presented. Other areas can be argued with those interested in such matters.


(Phil) #453

Well, far off subject, but not saying it doesn’t work, just not as the charts say and with a helping of placebo added. Sort of like back pain, medical, chiro, physical therapy etc does not seem to make a lot of difference, long term results are all pretty equal, so long as you avoid people with knives.


(Jon Garvey) #454

Well, there is an inherent worldview difference between “the bottom line is profit”, and “do not store up for yourselves treasures on earth”, but leave that to one side. The ethical questions of placebo effect are certainly important, but given the lack of knowledge of how conventional treatments for back pain work, and the fact that many explanations have had to be revised in the light of greater understanding of the complex physiology,“not knowing how it works” doesn’t seem to be the overriding issue in many cases, so much as a vague idea that the drug-receptor model (for example) is “OK”, whereas sugar pills having as great an effect is “woo”. And therefore the standards of evidence are applied differently.

But given the known genuine benefits of placebo, the current medical ethic of explaining everything, including the failure rates of treatment, even if it jeopardizes recovery, could be seen as a little odd. Though in one fascinating example I saw a physician explained to his patients carefully that he was going to use a placebo for their condition, and still got good results - I’ve forgotten the condition, but it was a clearly physical one.

Acupuncture was available from one of my friendly pain consultants when I ran a back clinic. My own impression of its results overall wasn’t that great, but that was one practitioner in one condition. To counter Phil’s general (and frequently made) charge about placebo effect in relation to paying a sympathetic practioner, I can say that those it did help had it administered by the same friendly practioners who had usually already tested the placebo effect of drugs, injections, physiotherapy and so on - and only the placebo effect of the acupuncture helped. So the placebo effect appears to be as detail specific as individual drug treatments.

Beyond that, I endorse Richard Wright’s skepticism about the results, and perhaps even the good faith, of many studies on such things, and endorse beaglelady’s testimony. I myself was only needled one as a demonstration by an acupuncturist on a back pain course I was running.

I gained my own interest in back pain when I did a course in spinal manipulation early in my GP career, partly from the feeling that I was only trained as a delivery system for drug companies, and would be utterly useless to people if I were stranded on a desert island.

Learning to use my hands diagnostically and therapeutically changed the lives of literally thousands of my patients over three decades, and the more I was able to refine and target its use, the more effective it became, including sharpening up my diagnosis of serious conditions missed by others. Since it was not regarded as a proper medical treatment, it’s the one thing I’ve occasionally offered to friends and family since I retired, and has won me a good number of pints of ale amongst musicians restored, to their surprise, to comfortable playing.

And yet the journals carried a regular stream of articles claiming it was shown to be no better than placebo, and so on. In most cases one could work out the design errors of the trials, but it often boiled down to the researchers setting out to demonstrate the inefficacy of something outside their own model - which is where I came in with my friend the heart patient (to whom I could have added maybe half a dozen other instances in my experience, including those who accepted prayer utterly convinced it would not help).

Incidentally, my hypothetical understanding of how manipulation works shifted over the years, a paradigm shift occurring when I started to work with experts in the physiology of chronic pain. At no stage did I resort to “Goddidit” as the default explanation, though at every stage I gave him as much thanks as I did for my daily bread.


(Jon Garvey) #455

Phil - I address this one as a postscript to my previous post. Since the long term results of most back pain are that it gets better eventually, it’s a little misleading to compare treatment of acute episodes on that basis.

A better thing to examine is time spent off work, or time taken for recovery, or reduction of chronicity - which is how most comparable conditions and therapies are judged. Anecdotally (in literally hundreds of instances) that could be expressed in my habit of asking patients I happened to see how their pain was after the n weeks/months/years since I saw them, and getting the reply, “Do you know, I haven’t had a twinge since I walked out of your office that day.”


(Phil) #456

Certainly, symptomatic relief is important, even if long term results are not different. As alluded to however, we are all victims of confirmation bias, whether it be in theology or medicine. We tend to hear what we want to hear, and accept those results that confirm our preconceptions and support our position. With back pain, those patients who do not respond to our treatments, go elsewhere and we tend to not see the treatment failures as often. In Christianity, we see those who we fail go elsewhere as well. If we let it, it keeps us humble.


#457

I do not believe in God, and I do not reject b) and d). I fully accept that the person prayed and that the person believed they were healed by God. I also see no evidence that would reject God as a possible reason for the healing. What I am looking for is positive evidence that God actually did the healing and what has been presented doesn’t rise to that level from a scientific point of view.

The post hoc ergo propter hoc fallacy is one that scientists are very aware of and very sensitive to. It is more commonly known as the “correlation does not prove causation”. In addition to the person being prayed for they also probably rode in a car, ate a specific food, or did any long list of activities. Why single out the prayer as the only event that could result in the observed outcome? On top of that, you have an n of 1 which is not conducive to any real scientific investigation.

The reason we may be talking past one another is in how we define evidence. Evidence is a group of observations, but not all observations are evidence, and it is this difference which may be causing us to cross our wires. As I see it, evidence is a set of observations that allows us to determine if something is true or false within the limits of reasonable doubt. The observations you have given don’t meet that requirement in my estimation. Perhaps those observations do meet your requirements for evidence.

As to why some are left scratching their heads, you freely move between claiming to have evidence and believing through faith. In my view, faith is a belief held in the absence of evidence. An evidence based conclusion and a faith based belief are opposite things that don’t allow you to move freely from one to the other.