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Defense of the PACE trial is based on argumentation fallacies

Discussion in 'Latest ME/CFS Research' started by Tom Kindlon, Jun 14, 2017.

  1. Tom Kindlon

    Tom Kindlon Senior Member

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  2. trishrhymes

    trishrhymes Senior Member

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    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.
     
    Last edited: Jun 14, 2017
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  3. Research 1st

    Research 1st Severe ME, POTS & MCAS.

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    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.
     
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  4. sarah darwins

    sarah darwins I told you I was ill

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    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.
     
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  5. JaimeS

    JaimeS Senior Member

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    Yes, I also noted some of our arguments made their way into that paper... :)
     
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  6. AndyPR

    AndyPR Senior Member

    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?
     
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  7. JaimeS

    JaimeS Senior Member

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

    Demepivo Dolores Abernathy

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    MURICA! Hooray for WWE, monster truck rallies,Type 2 diabetes & millions without health cover....
     
  9. JaimeS

    JaimeS Senior Member

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  10. Large Donner

    Large Donner Senior Member

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    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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  11. Webdog

    Webdog Senior Member

    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):
    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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  12. Solstice

    Solstice Senior Member

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    No holding back anymore, apparently. I like it.
     
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  13. A.B.

    A.B. Senior Member

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    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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  14. Large Donner

    Large Donner Senior Member

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    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. ;)
     
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  15. Barry53

    Barry53 Senior Member

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    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.
     
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  16. NelliePledge

    NelliePledge plodder

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    :bang-head:
     
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  17. Esther12

    Esther12 Senior Member

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    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?:

    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!
     
  18. JaimeS

    JaimeS Senior Member

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

    There is the premise.

    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.
     
  19. JaimeS

    JaimeS Senior Member

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

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

    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.
     
  20. Esther12

    Esther12 Senior Member

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    But doesn't Lubet go on to himself support this P&W point:

    ...by saying this?:

    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!

    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.
     
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