[FRIAM] anthropological observations

Mon Apr 13 22:41:44 EDT 2020

I think in the caes of doctors there are additional traditions, working over or alongside those that attend generic public actors or advisors.

Specifically: the Hippocratic oath.  I probably don’t know the true wording, but the version I always hear is “First, do no harm”.  That is an uncommonly strong version of the precautionary principle, kind of like Popper’s dictum of falsifiability is a a limiting form of the asymmetry between support and dissent that both exist in Bayes’s theorem.

There are probably also considerations of the asymmetric dynamics of reputation.  Hard to earn, easy to lose, then even harder to restore.  Enough cases are known of heart irregularities within responsibly-performed trials of hydroxychloroquine, as I understand newspaper articles I read (I think there was one in NYT thisAM), that if a public agency gave positive approval for its use on people who are high-risk anyway, there would with probability approaching one be some people who died as a consequence of that authorization.  Even if they were fewer than those who might have been saved by the treatment and who otherwise would have died (a harder statistic to estimate), the loss of a reputation for guarding safety is probably believed to do more harm than a marginal gain in efficacy.  (I probably agree with that belief.)

The term “off-label” seems to be common enough among medical practitioners that I guess there is a fairly conventional cohort of “compassionate care” cases (if I remember the right term) for which either death or misery are believed to be certain, and deviating from label exclusions can’t be very much worse, so it happens with some frequency and doesn’t get sued out of existence.  But there probably is a real question about whether one wants to shift that from an informal filter of litigation risk (is this dire enough that I am unlikely to get sued?) to an institutionalized or statutory filter (the agency will encode such-and-such compassionate-care exceptions).  There is probably more room for nuance in case-by-case litigation than in the coarser grain of statute or institutional bylaws.  For medicine even moreso because of the Hippocratic tradition.

In addition to the attitudes about the legitimacy of law that you mention below, which I also tend to agree are active.

Eric

> On Apr 14, 2020, at 5:24 AM, <thompnickson2 at gmail.com> <thompnickson2 at gmail.com> wrote:
> 
> Friammers,
>  
> Allow me some ill-informed maunderings about the chlor-whatitsface controversy:  It seems to me the controversy has to do with our ambivalence with respect to the law.  Do we wait for a green light on a deserted street at 3 am or do we drive right through because we KNOW that basic purpose of that light system is to prevent accidents and that  there is NO possibility of an accident under present circumstances.  When do we take the law into our own hands?
>  
> Now the Health Expert Community Knowledge (hereafter, HECK) tells us that chlor-whatitsface might help some people and might harm some others, and so we should not use it on a single patient until we can guarantee to that patient that it will do more good than harm.  Meanwhile we hear of doctors writing themselves prescriptions for themselves and their families, just in case.  "Aw, HECK, let's just try it."
>  
> So to what extent, I am wondering, is not pushing out chlor-whatitsface to every hospital in the country a case of stopping at the red light at the wilderness intersection in the middle of the night?  
>  
> And why DO we do that?  I think we do it because respect for the law is a thing itself and has benefits.  Socrates did have a reason to drink the hemlock.  Well-designed laws have benefits for the vast majority of citizens in the vast majority of circumstances, and laws, even well designed ones, do not survive long in a society of citizens who pick and choose among them.   But Socrates also had reasons not to drink  the hemlock.  And it's quite possible that, contrary to his final reasoning, we would all be better off, now, if he hadn't.  
>  
> Nick 
>  
> Nicholas Thompson
> Emeritus Professor of Ethology and Psychology
> Clark University
> ThompNickSon2 at gmail.com <mailto:ThompNickSon2 at gmail.com>
> https://wordpress.clarku.edu/nthompson/ <https://wordpress.clarku.edu/nthompson/>
>  
>  
> -----Original Message-----
> From: Friam <friam-bounces at redfish.com <mailto:friam-bounces at redfish.com>> On Behalf Of u?l? ?
> Sent: Monday, April 13, 2020 1:53 PM
> To: FriAM <friam at redfish.com <mailto:friam at redfish.com>>
> Subject: Re: [FRIAM] anthropological observations
>  
> I presume it's this one: 
>  
> Die geheimen Gene: Das Geheimnis der Kirche und die soziale DNA https://books.google.com/books?id=lpqUDwAAQBAJ&newbks=0&printsec=frontcover&dq=inauthor:%22Jochen+Fromm%22&hl=en&source=newbks_fb <https://books.google.com/books?id=lpqUDwAAQBAJ&newbks=0&printsec=frontcover&dq=inauthor:%22Jochen+Fromm%22&hl=en&source=newbks_fb>
>  
> No copies seem to be available. I also assume propaganda plays a prominent role in your explanation. I keep wondering why Trump's sycophants like Navarro keep claiming the Spanish Flue happened in 1917 instead of 1918. E.g. in this clip: https://youtu.be/nSx704KK_Ik <https://youtu.be/nSx704KK_Ik>
>  
> #5 and #6 from this list seem plausible to me:
> https://theweek.com/articles/832990/6-theories-trumps-pointless-lies <https://theweek.com/articles/832990/6-theories-trumps-pointless-lies>
>  
> When Trump hears Navarro say "1917", it's a signal of loyalty, even if everyone knows it's the wrong year, that he uses that year, helps confirm his loyalty. Knowing to use "1917" instead will help me code-switch if I find myself in a conversation with these people. If you use "1918", they'll know you're out-group. Hypothesis #6 is only plausible if you think Trump is an idiot. But I buy the argument put forth here:
>  
> Tony Norman: Who are you going to believe — POTUS or an actual expert?
> https://www.post-gazette.com/opinion/tony-norman/2020/04/07/1917-Donald-Trump-truth-George-Orwell-Anthony-Fauci-Peter-Navarro-hydroxychloroquine/stories/202004070017 <https://www.post-gazette.com/opinion/tony-norman/2020/04/07/1917-Donald-Trump-truth-George-Orwell-Anthony-Fauci-Peter-Navarro-hydroxychloroquine/stories/202004070017>
>  
> Maybe it's a perverse mix of the expression of power, loyalty, and getting the audience used to fudging the details ... encouraging the cult members to impute the nomothetic even though it fails to fit the idiographic.
>  
>  
> On 4/13/20 11:04 AM, uǝlƃ ☣ wrote:
> > Link! I should buy the German version and see if I can read some of it. The last time I tried that was with Faust after my German II semester in college ... terrible failure.
>  
>  
> --
> ☣ uǝlƃ
>  
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