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Defense of the PACE trial is based on argumentation fallacies

Messages
2,158
Wow, a second article by Steven Lubet. Great to get a legal ethicist academic to tear it to pieces. I look forward to reading this.

'the parade of horribles' is a wonderful phrase.

I have now read the article. It's truly excellent, well reasoned succinct and damning of those who pretend to have a valid defence of the PACE trial. Wonderful. Thank you Steven Lubet.
 
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Research 1st

Severe ME, POTS & MCAS.
Messages
768
The ethical doctors, scientists and academically minded people like Mr Lubet (patient) who speak up for the disabled patients against the appalling British PACE trial (by reading and following Scientific evidence on CFS), tend to not to be British. In contrast it seems if you are British and you dare to stand up for patients you are very quickly forced fed propaganda and told how to behave in the public eye or simply ignored.

That's what I like about Americans. They have an enviable right to free speech and remember their job is to defend patients at all times, irrespective of political decree, so use it without hesitation because they are brave.

In all my years talking to people online, it was only Americans who never forgot they were human, because their country allows you to think and say normal things without fear or reprisals.

Go team USA and down with communism that entraps social health care systems in nanny-state politics and policy.
 

sarah darwins

Senior Member
Messages
2,508
Location
Cornwall, UK
Great stuff. And (for the record) a reaction to the paper which spawned this long thread:

http://forums.phoenixrising.me/inde...-and-move-on-keith-petrie-john-weinman.50681/

It was pointed out somewhere in that thread that, as Steven Lubet writes, the authors of that paper have what are clearly paid positions with a company that sells a "belief-based behavior change approach", something they didn't think worth mentioning when declaring interests for their "Time to Move On" paper.
 

JaimeS

Senior Member
Messages
3,408
Location
Silicon Valley, CA
Great stuff. And (for the record) a reaction to the paper which spawned this long thread:

http://forums.phoenixrising.me/inde...-and-move-on-keith-petrie-john-weinman.50681/

It was pointed out somewhere in that thread that, as Steven Lubet writes, the authors of that paper have what are clearly paid positions with a company that sells a "belief-based behavior change approach", something they didn't think worth mentioning when declaring interests for their "Time to Move On" paper.

Yes, I also noted some of our arguments made their way into that paper... :)
 
it was only Americans who never forgot they were human, because their country allows you to think and say normal things without fear or reprisals.

Go team USA and down with communism that entraps social health care systems in nanny-state politics and policy.
Lol, what? :confused: Trump, the Republicans, the gun lobby as a few counter examples?? And free market health care just won't work when the healthy don't have to pay for the ill.

The US hardly has a wonderful record on dealing with ME now does it?
 

JaimeS

Senior Member
Messages
3,408
Location
Silicon Valley, CA
That's what I like about Americans. They have an enviable right to free speech and remember their job is to defend patients at all times

Lol, what? :confused: Trump, the Republicans, the gun lobby as a few counter examples?? And free market health care just won't work when the healthy don't have to pay for the ill.

....and I 'Liked' both of these... sigh. 'AMERICA' vs 'MURICA!!!!'
 

Large Donner

Senior Member
Messages
866
I don't think stupidity, greed, corruption, bribery, conspiracy, cover up etc has a border at which it stops, they are just some of the traits of humanity which for some reason always make it to the top of the pyramid. There is no perfect system.

There is however alot of self preservation, self censorship and self interest that allows something flawed to be maintained, and sometimes the original flaw is deliberate.

My personal belief is that once it is obvious there is a flaw in something all of those not bringing attention to it, who should be doing so in their position, are then guilty of making it deliberate.

Bad initial advice is one thing in terms of policy etc but once the genie is out of the bottle all too often the next stage is denial and narrative control.
 
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me/cfs 27931

Guest
Messages
1,294
I don't think stupidity, greed, corruption, bribery, conspiracy, cover up etc has a border at which it stops, they are just some of the traits of humanity which for some reason always make it to the top of the pyramid. There is no perfect system.

There is however alot of self preservation, self censorship and self interest that allows something flawed to be maintained, and sometimes the original flaw is deliberate.

My personal belief is that once it is obvious there is a flaw in something all of those not bringing attention to it, who should be doing so in their position, are then guilty of making it deliberate.

Bad initial advice is one thing in terms of policy etc but once the genie is out of the bottle all too often the next stage is denial and narrative control.
Apologies for a long slightly-offtopic post.

There are a few parallels between PACE and the Steady State Theory of cosmology. 60 years ago, there were two competing models for the universe: The Steady State Theory which purported that matter was continually being created in an expanding universe, and the Big Bang Theory which said that all the matter in the universe was created in one "Big Bang". Both theories make very testable observational predictions.

By the mid 1960s, observational evidence had disproven the Steady State Theory (in favor of the Big Bang). Yet the lead proponent of the Steady State Theory, Sir Fred Hoyle and his followers continued to (unsuccessfully) try to control the narrative and twist the data to support their model. In fact, Hoyle coined the term "Big Bang" as a derogatory label for the opposing theory.

Eventually the small group of "steady staters" were marginalized by the research community, but they never backed down on their belief. Hoyle died convinced his model of the universe was correct.

Strangely, while being steadfastly dead wrong in one area of science, Hoyle made major scientific contributions in other areas. In particular, he played a key role in correctly describing heavy element nucleosynthesis in the early universe.

How could such a first rate scientist like Hoyle not accept his theory was in conflict with the evidence?



In his book "Brilliant Blunders", Mario Livio writes (spacing mine for readability):
Mario Livio said:
Hoyle’s blunder was in his apparently pigheaded, almost infuriating refusal to acknowledge the theory’s demise even as it was being smothered by accumulating contradictory evidence, and in his use of asymmetrical criteria of judgment with respect to the big bang and steady state theories. What was it that caused this intransigent behavior?

A few statements made by Hoyle himself provide the best evidence. In Home Is Where the Wind Blows, he wrote the following striking paragraph:

The problem with the scientific establishment goes back to the small hunting parties of prehistory. It must then have been the case that, for a hunt to be successful, the entire party was needed. With the direction of prey uncertain, as the direction of the correct theory in science is initially uncertain, the party had to make a decision about which way to go, and then they all had to stick to the decision, even if it was merely made at random.

The dissident who argued that the correct direction was precisely opposite from the chosen direction had to be thrown out of the group, just as the scientist today who takes a view different from the consensus finds his papers rejected by journals and his applications for research grants summarily dismissed by state agencies.

Life must have been hard in pre-history, for the more a hunting party found no prey in its chosen direction, the more it had to continue in that direction, for to stop and argue would be to create uncertainty and to risk differences of opinion breaking out, with the group then splitting disastrously apart. This is why the first priority among scientists is not to be correct but for everybody to think the same way. It is this perhaps instinctive primitive motivation that creates the establishment.

One can hardly imagine a stronger advocacy for dissent from mainstream science. Hoyle echoes here the words of the influential second-century physician Galen of Pergamum: “From my very youth I despised the opinion of the multitude and longed for truth and knowledge, believing that there was for man no possession more noble or divine.”

However, as Martin Rees, Astronomer Royal for Britain, has pointed out, isolation has its price. Science progresses not in a straight line from A to B but in a zigzag path shaped by critical reevaluation and faultfinding interaction. The continuous evaluation provided by the scientific establishment that Hoyle so despised is what creates the checks and balances that keep scientists from straying too far in the wrong direction.

By imposing upon himself academic isolation, Hoyle denied himself these corrective forces.
While none of the researchers involved in PACE are remotely the scientific caliber of Hoyle, the self-imposed academic isolation seems to be a common perpetuating trait. And if this history is any guide, proponents of the BPS model of ME/CFS truly believe their theory is correct and will remain scientifically isolated while their model simply dies a slow death marginalized by the larger research community.

Edit: Up reflection, perhaps I missed the key point. A big puzzle of Hoyle is how he had the ability to hold two contradictory theories at the same same. While denying the Big Bang Theory, Hoyle simultaneously made significant science contributions to the very same Big Bang Theory he rejected. How Hoyle could maintain such contradiction remains a mystery to me.
 
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Solstice

Senior Member
Messages
641
Wow, a second article by Steven Lubet. Great to get a legal ethicist academic to tear it to pieces. I look forward to reading this.

'the parade of horribles' is a wonderful phrase.

I have now read the article. It's truly excellent, well reasoned succinct and damning of those who pretend to have a valid defence of the PACE trial. Wonderful. Thank you Steven Lubet.

No holding back anymore, apparently. I like it.
 

A.B.

Senior Member
Messages
3,780
Well done Steven Lubet. I enjoyed reading this article. I don't think we can claim that criticism of PACE led to increased interest in biomedical research though. One can point out that since 2011 the number of ME/CFS papers published has been increasing every year (with the rate also increasingly a little), so at least there are no signs of researchers choosing to abandon the field.

It does seem obvious that funding bodies are unlikely to invest in biomedical research if they believe that CBT/GET are effective treatments and even solutions.
 
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Large Donner

Senior Member
Messages
866
Apologies for a long slightly-offtopic post.

There are a few parallels between PACE and the Steady State Theory of cosmology. 60 years ago, there were two competing models for the universe: The Steady State Theory which purported that matter was continually being created in an expanding universe, and the Big Bang Theory which said that all the matter in the universe was created in one "Big Bang". Both theories make very testable observational predictions.

By the mid 1960s, observational evidence had disproven the Steady State Theory (in favor of the Big Bang).

Well its good to know they got it all worked out exactly what happened 13.7 billions years ago and where the universe ends and exactly when it started and how a big bang just appeared out of nothing.

All you have to do is find supporting evidence to disprove another theory and by default that proves your own theory.

Aern't scientific THEORIES wonderful. ;)
 
Messages
2,391
Location
UK
OK guys, remember the thread topic... lolol: "
Defense of the PACE trial is based on argumentation fallacies"

I just don't understand why the author left so many great ones out.
But it just might turn into a series?

A thought that crosses my mind. Steven Lubet has clearly got an excellent grasp of logical fallacies and psychological subterfuges used/abused in debate, and no doubt in all manner of legal cases. I don't doubt that this sort of mental chicanery is common practice among those trying to wriggle past the justice system (and Professors of Law will be pretty wise to that). So it's really rather interesting and revealing that these psychologists are exhibiting these sleight of mind conjuring tricks, in a large number of published papers, that they may one day find themselves in some formal (maybe even legal) enquiry trying to deny they ever do such things.

I think intelligence must come in many different variants, and that multiple variants can coexist within a single person. In some people the different sorts seem to vary massively. How can such intelligent people be so stupid.
 

NelliePledge

Senior Member
Messages
807
The ethical doctors, scientists and academically minded people like Mr Lubet (patient) who speak up for the disabled patients against the appalling British PACE trial (by reading and following Scientific evidence on CFS), tend to not to be British. In contrast it seems if you are British and you dare to stand up for patients you are very quickly forced fed propaganda and told how to behave in the public eye or simply ignored.

That's what I like about Americans. They have an enviable right to free speech and remember their job is to defend patients at all times, irrespective of political decree, so use it without hesitation because they are brave.

In all my years talking to people online, it was only Americans who never forgot they were human, because their country allows you to think and say normal things without fear or reprisals.

Go team USA and down with communism that entraps social health care systems in nanny-state politics and policy.
:bang-head:
 
Messages
13,774
I thought that most of this was really good, but there were two sections I was not keen on.

I didn't really like that 'Circularity' section, and thought it seemed to misread some of the piece it was responding to.

Maybe this was at the heart of the problem?:

The very point of contention regarding the PACE trial, however, is whether or not myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) symptoms are the product of patients’ “unhelpful” or “dysfunctional” illness beliefs.

But PACE was intended to assess the efficacy of treatments, not determine the cause of patient's symptoms. Doesn't Lubet's point here actually seems to support the claim made by Petrie and Weinman (that I disagree with) about what is at the heart of the controversy around PACE? I felt confused by exactly the point that was being made in this section.

The 'Bait and switch' section seemed like a 'bait and switch' itself, moving from P&W's claims about treating 'cancer-related fatigue' to talking about curing cancer. I thoght P&W's point was BS, but this didn't seem a great response.

I should probably re-read the paper before posting this, but it's late and if I've misunderstood something I'm sure someone here will let me know!
 

JaimeS

Senior Member
Messages
3,408
Location
Silicon Valley, CA
Doesn't Lubet's point here actually seems to support the claim made by Petrie and Weinman (that I disagree with) about what is at the heart of the controversy around PACE? I felt confused by exactly the point that was being made in this section.

I agree that this part could have been clearer. Here is the original text, bold and breaking-up-of-large-paragraphs mine:

A circular argument assumes or incorporates the desired answer in the premise of the question itself. Petrie and Weinman engage in circular reasoning when they begin with the statement that “differing beliefs about the causes of chronic fatigue syndrome (CFS) still influence how scientific studies in this area are accepted and evaluated.

There is the premise.

They offer no proof for this assertion, although they revert to it repeatedly throughout the paper, claiming, for example, that “this is really the key issue behind the criticisms of the PACE study” and “causal beliefs are an important factor in the way patients understand their illness” (citing only themselves for the latter proposition).

The premise as per the authors: that patients' 'unhelpful' beliefs perpetuate their illness

and

this is why patients refuse to accept a theory that states that their unhelpful beliefs perpetuate their illness
.

In other words, patients' illness beliefs make them unable to accept papers about illness beliefs.

In other words,

Conclusion A because of also Conclusion A,
where you have made no independent, successful attempt to show that A exists or is the case
.

I hope that's clear but very unsure. Circular reasoning by its very nature is very confusing to describe, and I'm having an awful brain fog day.
 

JaimeS

Senior Member
Messages
3,408
Location
Silicon Valley, CA
The 'Bait and switch' section seemed like a 'bait and switch' itself, moving from P&W's claims about treating 'cancer-related fatigue' to talking about curing cancer.

The bait-and-switch that Lubeck is discussing is this very thing.

In my own words on a discussion on this very paper,

We talked on another thread about how these people are not exactly self-analyzers. But you seriously do see articles claiming that CBT helps everything from cancer to diabetes. The thing is, CBT practitioners who see cancer patients would never, never claim they can cure cancer. Instead, they'd say something like, "I teach my patients coping skills" or "I help my patients through positive thinking". They may believe it affects the course of their illness to a certain degree, or they may feel that talking things through and learning coping skills just makes the patient feel more comfortable in a difficult situation. I'm sure there are lunatics who believe they can cure cancer through the power of their words alone, but my impression is that they are outliers.

Therefore, when the authors of the original paper are saying "see? We use CBT even in cancer, and you don't hear any cancer patients complaining!" they are comparing apples and oranges. Clinicians who use CBT in cancer do not make any claims that the therapy is curative, whereas BPS CBT practitioners for ME/CFS do so.

Therefore, comparing the opinions of cancer patients who receive CBT versus ME/CFS patients who receive a very different treatment with very different expectations is a bait-and-switch.
 
Messages
13,774
But doesn't Lubet go on to himself support this P&W point:

Petrie and Weinman engage in circular reasoning when they begin with the statement that “differing beliefs about the causes of chronic fatigue syndrome (CFS) still influence how scientific studies in this area are accepted and evaluated.

...by saying this?:

The very point of contention regarding the PACE trial, however, is whether or not myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) symptoms are the product of patients’ “unhelpful” or “dysfunctional” illness beliefs.

At points I thought Lubet was arguing that P&W misleadingly exaggerated the importance of beliefs about the cause of symptoms in the disputes surrounding PACE (something that annoyed me about their paper), but then he seemed to go on to say that this is the very point of contention. Maybe I'm still missing something.. off to bed now!

The bait-and-switch that Lubeck is discussing is this very thing.
...

Therefore, when the authors of the original paper are saying "see? We use CBT even in cancer, and you don't hear any cancer patients complaining!" they are comparing apples and oranges. Clinicians who use CBT in cancer do not make any claims that the therapy is curative, whereas BPS CBT practitioners for ME/CFS do so.

Therefore, comparing the opinions of cancer patients who receive CBT versus ME/CFS patients who receive a very different treatment with very different expectations is a bait-and-switch.

I thought that Lubet dealt well with that part in his 'Blaming the Victim' section, but the 'bait and switch' section is specifically on the claim about effectively treating 'cancer related fatigue', not 'cancer'. It wouldn't amaze me if some would claim cancer related fatigue could be reversed through psychotherapy and exercise.