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Wed, 13 Nov 2002 09:33:28 EST

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In a message dated 11/12/2002 12:27:58 PM Eastern Standard Time, 
Matthew.Dunn@swh.nhs.uk writes:

> While I don't subscribe entirely to the argument that the burden of proof
> lies with the person proposing use of a medication (or the other argument
> that it lies with the person proposing a change to practice), 

Hmmmm..
Do you subscribe to that concept called "science"?
I have been cutting off the left ear of patients for the past 10 years--I 
have done it on 150 patients without a single mortality, and one wound 
infection.  Who could argue with how safe this is?  If you disagree with 
this, show me data to refute my results!  Do you know of any data against 
cutting off the left ear of patients?  If not, then I am perfectly justified 
in doing it.

Now--can you see the very basic flaw of this line of logic? And--the analogy 
to the most fundamental concepts of science--that one imposing risk on a 
patient has the burden of FIRST proving there is some benefit to it--NEXT, 
after there is some benefit shown, comes proof of safety--NOT the other way 
around!  It is NOT appropriate to just impose an unproven intervention 
carrying known risk and/or cost on a patient, without testing it for 
efficacy, then dare everyone else to prove it wrong.  This was the basic 
problem with the explosion of laparoscopic surgery a decade aga, and we are 
still suffering from its industry- and money-driven effects.  What is 
science, after all, when compared to economics, and what we just HAVE to 
believe no matter what?
John Hunter, Robert Koch, Louis Pasteur, Galileo--please restrain yourselves 
form turning in your graves!  This perversion of your tenets cannot really be 
that widespread--can they?
ERF

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<HTML>In a message dated 11/12/2002 12:27:58 PM Eastern Standard Time, Matthew.Dunn@swh.nhs.uk writes: 
 
<BLOCKQUOTE TYPE=CITE style="BORDER-LEFT: #0000ff 2px solid; MARGIN-LEFT: 5px; MARGIN-RIGHT: 0px; PADDING-LEFT: 5px">While I don't subscribe entirely to the argument that the burden of proof 
lies with the person proposing use of a medication (or the other argument 
that it lies with the person proposing a change to practice), </BLOCKQUOTE> 
 
Hmmmm.. 
Do you subscribe to that concept called "science"? 
I have been cutting off the left ear of patients for the past 10 years--I have done it on 150 patients without a single mortality, and one wound infection.&nbsp; Who could argue with how safe this is?&nbsp; If you disagree with this, show me data to refute my results!&nbsp; Do you know of any data against cutting off the left ear of patients?&nbsp; If not, then I am perfectly justified in doing it. 
 
Now--can you see the very basic flaw of this line of logic? And--the analogy to the most fundamental concepts of science--that one imposing risk on a patient has the burden of FIRST proving there is some benefit to it--NEXT, after there is some benefit shown, comes proof of safety--NOT the other way around!&nbsp; It is NOT appropriate to just impose an unproven intervention carrying known risk and/or cost on a patient, without testing it for efficacy, then dare everyone else to prove it wrong.&nbsp; This was the basic problem with the explosion of laparoscopic surgery a decade aga, and we are still suffering from its industry- and money-driven effects.&nbsp; What is science, after all, when compared to economics, and what we just HAVE to believe no matter what? 
John Hunter, Robert Koch, Louis Pasteur, Galileo--please restrain yourselves form turning in your graves!&nbsp; This perversion of your tenets cannot really be that widespread--can they? 
ERF</HTML>

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