If there's one thing that will annoy an antivaccinationist, it's to call her what she is: Antivaccine. While it's true, as I've pointed out on numerous occasions, that there are some antivaccinationists who are antivaccine and proud, unabashedly proclaiming themselves antivaccine and making no bones about it, the vast majority of antivaccinationists deny they are antivaccine. They frequently retort that they are "not antivaccine" but rather "pro-vaccine safety" or some such dodge. Most recently, we've seen this tack taken by Robert F. Kennedy, Jr. (and, of course, Bill Maher) himself, the man whose unhinged conspiracy mongering screed was my "gateway" to noticing and deconstructing antivaccine beliefs nearly a decade ago. it's a refrain I first noticed in a big way when the celebrity face of the antivaccine movement, Jenny McCarthy herself, started using it. Whenever I start hearing that "I'm not antivaccine" refrain, I like to dig up examples of rhetoric from the antivaccine movement to put the lie to that claim. Of course, "dig up" is probably the wrong term; I rarely have to look far, and so it was this time..

Mike Adams let it rip, possibly surpassing even what I thought to be the most vile analogy every made about vaccines. It was by an Marcella Piper-Terry, comparing vaccination to rape. True, it could be argued that comparisons to the Holocaust are worse, but let's just say it's a tossup. Not surprisingly, Mikey's latest rants are in response to California bill SB 277, which is a bill currently wending its way through the California Senate that would eliminate nonmedical exemptions to school vaccine mandates. Of course, any attempt to make exemptions to chool vaccine mandates harder to obtain causes the antivaccine movement to go into paroxysms of Holocaust analogies, complete with images of jackbooted fascists knocking on parents' doors in the middle of the night, syringes in hand, to throw the parents aside and vaccinate their children forcibly.

Coming back to the rape analogy, that's where Adams goes with a post entitled Progressive lawmakers in California violate women's rights with SB 277; children to be physically violated by government without parental consent and SB 277 will unleash "medical civil war" in California as parents demand doctors be arrested for felony assault. The level of paranoia in these screeds is truly beyond belief; that is, unless you've never encountered Adams before. Actually, the spin Adams tries to put on this is to make "vaccine choice" a matter of women's rights:

Seriously, this is stupid even by Mike Adams standards. Here's a taste of the written version, but to experience the full stupidity, you really need to watch the video:

California lawmakers pushing the mandatory vaccine initiative SB 277 are almost all Democrats. These are the same people who defiantly defend the right of "a woman's choice" to decide the issue of abortion. We are repeatedly told that abortion is the woman's choice alone, and that no government, no man and no doctor can force a woman to do something with her body against her will.

This also holds true with the issue of sexual encounters, where we are frequently reminded that NO means NO. If the woman doesn't consent, then it's called rape. So what do you call a forced medical intervention that physically violates a woman's body against her wishes? "Medical rape" doesn't seem quite appropriate. There must be a more poignant term for it.

Do you see the the problem with this analogy? It's incredibly obvious. SB 277 has nothing to do with forcing women to receive vaccinations they don't want. There's nothing in the bill that would do that, nor is there anything any pro-vaccine advocate proposes that would compel an adult woman (or man) to be vaccinated against her (or his) will. That's not what school vaccine mandates are about. None of this stops Adams from going full mental jacket antivax on the video, ranting about "toxins" and "formaldehyde" while referring to vaccines "maiming" children and implying that the government will require pregnant women to be vaccinated, thus causing all sorts of birth defects. His antivaccine dog whistles are whistling to the point that even mere humans can hear them behind Adams' cries of "choice," "human dignity," "civil rights," and "human freedom."

There's another aspect of Adams' truly silly analogy here that might not be obvious on the surface. Adams goes on and on about the supposed disconnect between what liberals believe about women when it comes to reproductive choice and giving consent to sex, as well as its anti-corporatism, to what he describes as their advocacy of giving corporations the power to "violate" women with "forced vaccination." Think about the assumption behind this whole line of "reasoning" (if you can call it that). The only assumption that makes this argument coherent (if you can call it that and even then it's still wrong on many other levels) is if you assume that the child is an extension of the woman's body. Thus, "violating" the child by "forced vaccination" is violating the woman. It's hard not to look at it any other way.

Indeed, Adams seems to be doing Rand Paul even one better. Remember how Rand Paul, interrupting a female reporter's question about his stance on school vaccine mandates, said, "The state doesn’t own the children. Parents own the children, and it is an issue of freedom.” Here, Adams seems to be saying that children aren't even property. They're just extension of the woman's body.

Either that, or Adams thinks his audience is too stupid not to discern the difference between forcing an adult woman to be vaccinated (which is not what is being considered, given that every adult has the right to refuse any medical intervention and no one—I mean, no one—is questioning that) and requiring a child to be vaccinated before she can attend school. It could easily be either—or both.

Adams tries to make hay out of claiming that "injection without consent is a violation of the American Medical Association's code of ethics:

A mandatory vaccination policy -- forced vaccination of unwilling recipients -- is, by definition, a medical intervention carried out without the consent of the patient or the patient's parents. This directly violates the very clear language in the Informed Consent section of the AMA Code of Medical Ethics which states:

The patient should make his or her own determination about treatment... Informed consent is a basic policy in both ethics and law that physicians must honor, unless the patient is unconscious or otherwise incapable of consenting and harm from failure to treat is imminent.

The AMA's Code of Medical Ethics statement is very clear: "physicians must honor" the policy of informed consent. In fact, the AMA describes this as "a basic policy in both ethics and law" and only makes exception if the patient "is unconscious" or if harm from failure to treat "is imminent."

Except that, again, this is not "forced" vaccination. Parents can still refuse to vaccinate their children. However, if they do so, then they must realize that there will be consequences flowing from that decision. Children attending school have a right to a safe school environment, and unvaccinated children endanger that environment by making outbreaks of vaccine-preventable disease more likely. Questions like this always boil down to a question of balancing individual rights versus the good of society. Also in the mix is the right of the child to proper medical care, particularly preventative care like vaccines, a right that people like Rand Paul and Mike Adams dismiss completely. To them, the child is nothing more than a possession or extension of the parents.

In any case, as Dorit Reiss explains, the doctrine of informed consent does not trump public health mandates and potential tort liability:

To repeat, the short answer is no. First, public health regulation always imposes some burden on the exercise of autonomy. Second, one may have both the private right to informed consent before vaccination and the public health obligation to be vaccinated. And the existence of the doctrine of informed consent does not mean there will be no other consequences to the informed decision that one makes.

Since the famous case of Jacobson v. Massachusetts, states have had wide powers to regulate for the public health – and, more particularly, impose immunization requirements – even at some cost to individual rights. Note that even Jacobson acknowledged that individual rights are not absolute. Laws passed by the states in this context must meet constitutional standards. For example, most scholars see Jacobson as constitutionally requiring that a state allow a medical exemption to immunization requirements.

But as long as they meet constitutional requirements, states may legislate or regulate to protect the public health. The requirements they put in place are not inconsistent with and do not violate informed consent. For example, quarantine laws are extremely coercive, imposing very strong limits on private autonomy – but they are constitutional, and no, they do not violate informed consent (pdf), either. Nor do school immunization requirements – even those without non-medical exemptions.

In other words, Adams' argument, as you might imagine, is a smokescreen without any basis in law or a compelling basis in ethics. Not that this stops Adams from predicting a "medical civil war" in which parents will demand that doctors be arrested for felony assault. Now, I'm not a lawyer, nor do I even play one in the blogosphere, but even I recognize Adams' legal reasoning as being—shall we say?—fantasy-based. He uses as part of his basis a law in Ohio that allows charging an HIV-positive person with "felonious assault" for having sex with someone without informing him or her of that positive HIV status, which makes me wonder why the same law doesn't include people with hepatitis B or C, both of which are also potentially deadly diseases and far more likely to be transmitted in a single act of sexual intercourse than HIV. Adams also cites federal law:

According to federal law enforcement, a needle is categorized as a "weapon" in the context of a physical assault. For example, if you were to acquire the blood of an HIV-positive person, fill a syringe with it, then assault someone with that needle, you would not only be charged with a felony assault, but an assault with a deadly weapon (the needle).

Under Ohio law, for example, it is explained as: "...causing or attempting to cause serious harm with a deadly weapon or a firearm -- referred to in the Ohio statutes as a 'dangerous ordnance.'"

When administered without consent, a vaccine injection is a physical violation of a human body. The substance contained in the vaccine is provably harmful and, in some cases, even deadly. Under Ohio sentencing guidelines, an individual forcing a vaccination upon someone without their consent would be committing a "felonious assault with dangerous ordnance."

Talk about some mental contortions! See Mikey shamelessly mix federal and state law (of a single state, yet) to come up with a new legal "theory" that lets him label vaccination as a "felonious assault with dangerous ordnance"! The rest of what flows from Adams' assumptions is simply too dumb to be real, except that I know it is real, because Mike Adams is capable of such depths. Read his rationale for how doctors committing "vaccine violence" against children would earn 41 months in federal prison (or more). But be prepared. Steel yourself. If you have any critical thinking skills, knowledge of vaccines, and even a rudimentary knowledge of the law on par with what many educated people do, you will have a headache from tightly clenched teeth, which will lose some enamel from grinding. It all depends upon Adams' considering needles on syringes containing vaccines as needles "containing a potentially dangerous substance" and such needles are considered a "dangerous weapon" by all law enforcement organizations. Based on this speculation, Adams cranks the crazy up to 11 and writes:

Under both federal and state law, parents who believe their children face the risk of imminent harm from a violent attack upon their bodies have every right to call 911 and request armed police officers come to their defense to stop the assault and arrest those attempting to commit those acts of violence.

I am now publicly predicting that, should SB 277 be signed into law, we will see a wave of California parents calling 911 to report their doctors while demanding the government press felony assault charges against medical personnel engaged in vaccine violence.

The sad thing is, I have no doubt that, should SB 277 pass (something that is still going to require a battle), there will be an antivaccinationist or two (or maybe even three) who will try what Adams suggests. My counter-prediction is that any police called for such a purpose will not take it seriously, to put it mildly. I can picture the 911 operator silently laughing and pointing at her headset, as if to say, "Get a load of this loon!" Even Adams seems to recognize that, predicting that the police won't arrest the doctor or nurse giving the vaccine, but still asserts that "parents will retain the right of CIVIL prosecution of those doctors for violating their civil rights." Yes, I'd love to see someone try that argument in front of a judge. The entertainment value would be enormous.

Meanwhile, the "not anti-vaccine" minion at the antivaccine crank blog Age of Autism, Ken Heckenlively, wonders when they'll "start shooting antivaxxers."

Coming back to the frequent clutching of pearls exhibited by antivaccinationists in response to being called "antivaccine," it's hard to take them seriously when, to them, seemingly vaccination is the Holocaust. It’s the Oklahoma City bombing. It’s Auschwitz (complete with Dr. Josef Mengele’s horrific experiments), before which antivaccinationists view themselves as much victims as Jews in Germany during the Nazi regime. It’s Stalin. It’s the Tuskegee syphilis experiment. It’s a tsunami washing away everything before it.

And now it's felonious assault, violence, an attack worthy of calling the police over. Adams might be what I like to colloquially call batshit crazy, but his rhetoric is useful because it tends to be the same as that of other antivaccinationists, just with the conspiracy mongering an crazy turned up to 11. If you look at others, you'll find echoes of the same sort of rhetoric. Rare is the case when I see anyone on the “antivaccine” side publicly call out rhetoric like this, even when someone like Mike Adams likens vaccines to the Holocaust, sexual assault, human trafficking, or felonious assault. It is worth repeating that the reason, I suspect, is because most antivaccinationists are at least sympathetic to such analogies but don’t use them publicly because they know how inflammatory and despicably ridiculous those not steeped in the false victimhood of the antivaccine cult find them. Perhaps next time I will provide more examples, this time from antivaccine physicians, some of whom we've met before. After all, even a seemingly "mainstream" (in the antivaccine movement) group like the Autism Media Channel refers to "vaccine violence."

the difference between forcing an adult woman to be vaccinated (which is not what is being considered, given that every adult has the right to refuse any medical intervention and no one—I mean, no one—is questioning that) and requiring a child to be vaccinated before she can attend school.

Actually, in both cases there is nothing to be forced against one's will. Well, aside from being forced to abide by the social contract. I mean, for some jobs, like in healthcare, employee vaccination is a requirement. Similarly, for school attendance, vaccination is required.

There is no ambush, it was told to people before they enlist. And if, on second thoughts, they don't want to be vaccinated, fine. The door out is this way.

Adams's argument is, as they say, fractally wrong. It starts out on a false premise (SB 277 does not mean forced vaccination) and just gets worse from there.

Except that, again, this is not “forced” vaccination. Parents can still refuse to vaccinate their children. However, if they do so, then they must realize that there will be consequences flowing from that decision.

I have no doubt that Mikey knows this because the reality is so mundane as to not make a rational person even blink he has to come up with this tosh to get attention. I believe that they do perceive this as forced vaccination because they are using the school system, in part, as daycare and do not see homeschooling as an option ergo they will be "forced" to vaccinate their special snowflakes in order to attend school.

The background is that the Australian Government is trying to make it harder for anti-vaxers to use conscientious objections to vaccination in order to gain benefits that are given to families that vaccinate their children. The anti-vaxers are complaining. They want the benefits, but don't want to vaccinate their children.

The AVsN has been given a right touching up by the press. http://www.news.com.au/national/australian-vaccination-skeptics-network…

"Health Minister Sussan Ley said vaccination did not equate to rape and to suggest otherwise was not only “repulsive”, but “off the planet”.

“This type of ill-informed and, frankly, disgusting campaign only serves to inform parents about the dangers of listening to these groups peddling anti-vaccine myths,” Ms Ley said."

And not even the state under discussion. Last I checked, Ohio and California were about 3000 km apart. It would be one thing to bring up Ohio law in a discussion of something happening in Ohio--probably wrong (IANAL, and neither is Mike Adams), but if the strategy is to throw a bunch of stuff against the wall and see what sticks (which seems to be Mike's MO), he might get lucky. Ohio law is of no relevance to the discussion of California. I have to wonder whether there is any such precedent in California, or if there is whether it is as unambiguous as Mike would want it to be.

My counter-prediction is that any police called for such a purpose will not take it seriously, to put it mildly. I can picture the 911 operator silently laughing and pointing at her headset, as if to say, “Get a load of this loon!”

I would not take either side of this bet. All it takes is for one 911 operator not to do this for big trouble to result. The operator need not even be anti-vax friendly, if she is in CYA mode and dispatches a police officer, just in case. At that point you would be counting on the intelligence of the police officer who responds, and judging from recent headlines, I get the impression that "police intelligence" is an even bigger oxymoron than "military intelligence".

Oh, I'm not saying that the dispatcher might not be obligated to dispatch an officer to investigate, but I doubt most dispatchers would take such a claim of "assault" that seriously themselves.

If SB 277 actually passes and is signed into law (and I wouldn't bet on it), it'll be interesting to see if Adams goes a step further to encourage violence against physicians (as he did with advocates for biotechnology). Or did he learn a lesson from the blowback after his GMO adventure?

If 911 in California starts to get calls related to vaccination, I'd be concerned that they'd relate to actions by antivax extremists, not physicians doing their jobs.

"...the difference between forcing an adult woman to be vaccinated (which is not what is being considered, given that every adult has the right to refuse any medical intervention and no one—I mean, no one—is questioning that)"

Once again, I suggest that fixing the issues with the practice of medicine would do more to promote well being than crazy ranting about crazy ranters.

Let's make vaccination of children a public health matter, carried out by the government. When the appropriate age comes, you go to the school building on designated days and have it done, for free.

If you want to opt out, you go there and opt out, and deal with the later consequences. But everyone is treated equally, and it is a community activity.

zebra, you appear to be suggesting that parents who refuse to have their children vaccinated might have them vaccinated against their will. That is certainly not what will happen.

The rape analogy has always struck me as particularly clumsy. No one can consent to sex on the child's behalf, but either the guardian or the state provides the required consent to medical treatments on the child's behalf. Even if there were forced vaccination, which there is not, it would still not be analogous to rape.

"Let’s make vaccination of children a public health matter, carried out by the government. When the appropriate age comes, you go to the school building on designated days and have it done, for free. "

Not a bad idea - we had something like it in the UK when I was a child in the 50s. 'vaccination days' were held at the local clinic and it was a genuine community event - I remember the queues were out of the door and down the street. However, in the 50s most mothers were able to stay at home with their kids; even the few who had to work and couldn't afford to take time off weren't short of neighbours who could take her child with theirs. These days, they'd have to accomadate working parents and hold vaccination days late into the evenings and at weekends, and it wouldn't really be so much of a community event.

Mikey disparages "loopy liberal logic"! At any rate, he's best described as a libertarian (loon) so why not?

Null has been caught in a similar rut: to him, criticising anti-vaxxers- who are mostlly women- makes whomever does so a misogynist. AND it also allows him to heap derision upon liberals ( the " corporate left") by mentioning well-known publications or commenters who support vaccination. His 'documentaries' feature anti-vaxxers who are predominantly women- including Drs Humphries, Bark, Banks and Tenpenny- as well as mothers. His own political affiliation is 'progressive libertarian" which basically means he wants the government to stay away from regulating his businesses and his pseudo-medical activities as well as from taxing his money.

In a recent video, RFK also noticed that those who first tried to inveigle him into supporting their cause ( when he opposed mercury from coal-burning power plants) were these incredibly intelligent and well-spoken WOMEN. The mothers who KNEW vaccines damaged their children.

The aforementioned pandering rabble rousers would probably say absolutely anything to get people to rally to support their dodgy cause as well as pad their gigantic egos. Like Andy, they learned long ago that here was a group of emotionally involved activists who immediately lauded anyone who agreed with their blindingly unrealistic theories- they find their audience ready and willing. What do you call someone who takes advantage of women as a business decision?

Just a question .... I've heard a few commenters- at the usual Kaffee Klatschs of iniquity- claim that their new born infants were vaccinated WITHOUT their consent- usually hep B but other vaccines have been mentioned. They claim that they gave orders against vaccination sometimes. They advise other mothers to keep the infant with them AT ALL TIMES. I've heard this at the Vaccine Machine facebook too.

@Helianthus "Actually, in both cases there is nothing to be forced against one’s will. Well, aside from being forced to abide by the social contract. I mean, for some jobs, like in healthcare, employee vaccination is a requirement. Similarly, for school attendance, vaccination is required."

Depending on the political leanings (i.e. anarchists, libertarians, ect.) of the person abiding by the social contract can actually be seen as a tyranny on par with Nazism and the USSR. This is especially true if policies infringe on a pet idea of theirs.

Sadly, it's not just Mike Adams that goes down the road of problematic analogies. In her testimony before the Judiciary Committee on Tuesday, Ms. Mary Holland compared the law to rape - earning a sharp rebuke from the committee chair, compared it to segregation in the pre-Brown days, and raised the specter of non-vaccinating parents being jailed (I know the idea has been raised in the media, but I don't think anyone supporting this bill actually supports it).

A. And re community event: some immunization coalitions actually organize local immunization clinics, to help those with access problems. Would that fit that? But remember that the anti-vaccine people express concern that their children will be force vaccinated if efforts are, for example, held in school.

B. @Denise Walter: it would be illegal. But: hospitals are encouraged to have high vaccination rates, and since most parents do vaccinate, a nurse may assume there's consent if she doesn't know differently. So not impossible. But I would treat any such story with caution, especially since the other side is prohibited from responding.

Our local elementary schools hold Flu vaccine clinics every year - both parents and students are encouraged to attend....

I’ve heard a few commenters- at the usual Kaffee Klatschs of iniquity- claim that their new born infants were vaccinated WITHOUT their consent- usually hep B but other vaccines have been mentioned. They claim that they gave orders against vaccination sometimes. They advise other mothers to keep the infant with them AT ALL TIMES. I’ve heard this at the Vaccine Machine facebook too.

When our son was born (1999) the Hep B vaccine recommendation for newborns was new and we declined to have him get it at that time. We even put a notice on the door of my hospital room that we didn't want any vaccines for our newborn.

My husband told me (I was sleeping a lot after the birth) that every time the nurses changed shift, one of them would come in and try to give our son that vaccination. Since my husband was always there, he would explain to the nurse that we didn't want it. She would accept that and then, after the next shift change, the scenario would be repeated. I can easily believe that had my dh not been there, my son might have been vaccinated while I was sleeping and without our permission. I don't know how common that would have been, but I do find it likely that it happened at times.

I've been pretty active in advocating for the bill -- been to three of the four hearings -- I'm guardedly optimistic. The "experts" the opposition has had testify have not been particularly impressive. I tremendously enjoyed hearing Senator Holly J. Mitchell put Bob Sears in his place. Senator Hannah-Beth Jackson stopped Mary Holland in her tracks several times for hyperbole and lack of legal grounding.

Yes, I know. I'm actually not pleased with my wording, because it's dragging in superfluous elements.

My meaning when using "contract" was more like: "I could employ you, but we will have to abide by my enterprise's standard policy: employees should get such and such vaccine" or: "Our school would gladly accept your children. Be warned that it will be required for them to be vaccinated against such and such diseases"

In short, a contract between two entities. No-one forced to do anything, but to pay for his side of the contract. I do hope that even the more hard-line libertarian/anarchist doesn't believe that he can just come in and grab whatever he wants. Actually, no, I don't hope this anymore, because a number of antivaxers did show a strong sense of personal entitlement.

Anyone care to ask Whole Foods corporation what they think about their trademarked logo being used in that manner?

I'd be willing to bet they say "Whoa there! Product placement not authorized!" and demand it get taken out of the video.

We can help them a bit by saying we buy fresh veggies etc. at Whole Foods but we're going to stop because they've authorized a product placement in a dastardly quack video that's more full of ---- than a manure trailer on an organic farm.

Adams uses a classic propaganda technique: Ask a bunch of rhetorical questions that everyone agrees about, to get the viewer answering each one "Yes!" Then the viewers are more likely to respond to your key propaganda questions with a "Yes!"

But I hope he manages to get that video seen by everyone in the CA legislature, because most of them are smart enough to recognize it for what it is. And once they see that, they are going to be more likely to write off Mikey's gang as a bunch of loons.

If I were him I'd be more concerned about the legislature expanding the criteria for a "51-50" involuntary three-day psychiatric hospitalization.

911 operators are selected for the job because they can keep a level head on their shoulders while dealing with people who are screaming and dying at the other end of the phone. They are not likely to play into this stuff.

And, they are also used to dealing with raving lunatics on the phone. Which is what they will think when someone calls them up to say "help!, police!, there's a doctor giving a kid a needle!"

It is difficult to allay fears when the fears are grounded in some reality. That's why I recommend people like Orac deal with beams before taking on the motes.

My suggestion was for parents to take their kids to be vaccinated, or show up, sans children, to sign a form declining. That way there is equal treatment, and a clear record; I understand from reading that the records can be a real issue.

Mike mentions that he shops at WF and in his bio says that you might see him at their market in Austin. Of course, it's much better to grow your own organic produce like HE does on his ranch.

He praises Dr Oz and now has rhapsodised about the brand new water filtration system he's tested in his 'forensic lab'.

There's a Nature "Futures" story that seems appropriate here. Too bad that it is still fiction. However, read and enjoy:

I do hope that even the more hard-line libertarian/anarchist doesn’t believe that he can just come in and grab whatever he wants. Actually, no, I don’t hope this anymore, because a number of antivaxers did show a strong sense of personal entitlement.

We've been over this before, but anarchism has no problems with having a social contract and enforcing it within a group, it just objects to the idea of top-down rule. Not that I'm saying it's a practical way to rule a society, but it's a bit different from how people imagine it, and actually more socially-oriented than yer typical libertarian philosophy.

In any case, you don't hear much about anti-vax anarchists, probably because anarchists would tend to be more concerned about actual assault by the state, like cops shooting unarmed people in the back, breaking their spines in custody, etc. Anti-vaxxers are just garden variety entitled babies.

If I were him I’d be more concerned about the legislature expanding the criteria for a “51-50″ involuntary three-day psychiatric hospitalization.

Did you even read that link? You can't honor a document you don't have, not to mention EMTs don't (legally can't) honor advance directives. And once the daughters arrived with the advanced directive the ICU physcian took him off life support. If anything it's a story about how doctors need to better prepare their patients for end of life. He really should have had a POLST to start with. Competely unrelated you your claim.

JP @ 25: "51-50" is the legal provision for civil commitment of persons found to be in a mental state that poses "a danger to self or others." Mikey is clearly delusional in a manner that poses a danger to others, as our recent measles outbreak demonstrates. QED.

My suggestion was for parents to take their kids to be vaccinated, or show up, sans children, to sign a form declining. That way there is equal treatment, and a clear record; I understand from reading that the records can be a real issue.

I'd imagine that there would be HIPPA issues. Show up without your kid and it's obvious he's not getting vaccinated. I'm pretty sure that's unacceptable protected health information leakage. Maybe Dorit can give some insight.

I know what the f*ck "51-50" is. I also know people who have been involuntarily held because they posed an immediate danger to themselves. I don't find the subject particularly amusing, and I don't appreciate your condescension on the matter, either.

- he spends a great deal of time manipulating people's emotions so that they'll buy his products - he made profits at several of his businesses - it appears he's managed to avoid breaking the law and being sued despite his writing - he has a rather large group of devoted followers who take his advice and spread his swill around the net - he knows enough about how people will feel and react to his work to say 'the right thing' to get what he wants

Of course, I wouldn't rule out a laundry list of other psychological problems and socially despicable actions that he habitually incorporates in his daily life but, SMI, no.

You do understand that requiring permission from a doctor to exercise your right to avoid treatment is oxymoronic, right?

Read the comments on that NYT piece; I know those are anecdotes but I don't think anyone would claim that there aren't serious obstacles to patients and families having their 'rights' respected.

Civil discourse from The Chronicle of Higher Education:http://chronicle.com/article/Universities-Aim-to/229787/?key=SDl7cwA3Yi…

Anti-vaccine people are an unfortunate reality of our society. I, in no way, want to make light of this situation, so please forgive my off-topic post. I just thought it worth your time, ORAC. Where i live, anti-vaxxers seem to be more of an internet only phenomenon, but that might just be my luck.

I am not suggesting a perp-walk for those people, just that they have to go to the school office at some point to sign a document in person. It's about everyone being treated equally.

Exactly what "reality" is Mike Adam's hysterical rhetoric about forced vaccination grounded in? The article you linked to was about the much more complex issue of end-of-life care: specifically, a case where the doctors weren't told the patient didn't want to be resuscitated or put on machines until after he was put on a respirator following a 911 call. In a situation like this, health care providers are obligated to do everything they can to keep the patient alive unless the family specifically instructs them not to.

Vaccination is not an analogous situation - people don't panic and call 911 to get their kids vaccinated and then forget to tell the EMTs that they don't actually want their kids vaccinated. To get a vaccine (at least the ones that are required for school) you have to take your kid to the doctor's office, sign a consent form, and hold the kid (or at least be present) while the doctor sticks the needle in. It's not the kind of thing that's going to happen by accident because of a lack of communication.

I find Beth's story more disturbing - what exactly do you mean by the nurses would "try" to give your baby the HepB vaccination? They had a syringe all ready to go and just walked over the the baby and to all appearances would have given the shot if your husband hadn't said anything? Or they repeatedly came in and asked to give the shot (or, instead of asking, they may have just said something like, "look's like you still need the HepB shot" - I remember being trained to do that as a nursing assistant because it still gave the patient a chance to refuse while avoiding a drawn out discussion. But then, I was working this elderly nursing home patients who were frequently confused, so I don't know if that's a standard nursing practice.) I don't have kids, but every time I've gotten a shot I had to sign a consent form - did the nurses bring a form with them? Or did you sign some sort of blanket consent to treatment when you went in for the birth? I'm not trying to nit-pick at you - I'm just trying to understand exactly what happened and whether this was a one-off thing or if it's some sort of wide-spread problem.

Doesn't anyone feel that Mike et al are deliberately targeting women and talking down to them by using this trope?

From a practical standpoint, I don't see why they would repeatedly walk in with the vaccine ready to go without prior approval for the shot. If nothing else, it's bad storage/handling procedure and could very well result in having to discard the vaccine.

Depending on the political leanings (i.e. anarchists, libertarians, ect.) of the person abiding by the social contract can actually be seen as a tyranny

This anarchist has no problem with the acceptance of certain standards as a requirement for membership of a particular group, given that vaccination is mutually beneficial and not in itself socially divisive.

This is exactly backwards. It is difficult to reason someone out of a position he did not reason himself into. Most anti-vax people, at least the ones profiled on this blog, did not arrive at, or maintain, that position through a process of reason.

There are people who fear flying, based on the facts that (1) planes do sometimes crash and (2) plane crashes frequently have fatal results for most or all people aboard. But there are businesses that cater to fearful flyers, and one can be taught to overcome that fear. Anti-vax sentiment does not work that way (at least not anymore): it's almost entirely based on things that do not happen: autism, mercury poisoning (thimerosal has not been a component of childhood vaccines for over a decade), etc.

The more likely assault theory would be a civil assault action against the parents of an unvaccinated child if it could be shown the child was the vector of an infectious disease from which the plaintiffs or their children suffered harm.

I think Dorit was suggesting that anti-vax parents would be concerned that their wishes wouldn't be honored in a "mass vaccination" setting if the kids were in school at the same time.

That's specifically what I was responding to, and my reference was to the fact that gosh, yes, stuff does happen, even when Trained Medical Professionals are involved.

I perceive the kind of defensiveness you exhibit as a big part of the problem. Any good propaganda relies on a germ of truth, and the truth is that there are valid reasons why people don't trust "the system".

It isn't about the 'reality' of vaccines causing autism; it is about the reality of big pharma or big ag or big energy or big medicine and so on having demonstrated that they can't be trusted.

It is about the reality that there's all this promotion of narcissistic magical thinking by advertising, and then you want to complain when a different business sells its product the same way.

You do understand that requiring permission from a doctor to exercise your right to avoid treatment is oxymoronic, right?

Pretty tough to exercise your rights when your dead. Absent documentation healthcare providers need to operate under implied consent, legally and ethically. Simply having a family member say that he said no machines isn't good enough, how can you know it was actually the patient's will? And it's not requiring permission, it's verification. POLSTs are there to ensure that a patient's wishes are respected when they can no longer make/communicate decisions themselves. Or is your argument that implied consent itself is the problem and we should no longer help people who can't, for whatever reason, give consent?

There certainly issues with end of life care but they mostly stem from doctors failing to adequately explain and prepare the family and/or improper forms. I legagally can't honor invalid DNR/POLSTs, documentation I don't have, advance directives, or family requests (except if it's the POA, with documentation, after getting an order). No one is going to not honor a valid DNR in hand and if they do that is absolutely assault. Yes there's issues and they make my job a nasty mess at times but they are not the ones you think they are.

I am not suggesting a perp-walk for those people, just that they have to go to the school office at some point to sign a document in person. It’s about everyone being treated equally.

@Ditz-Name sounds right......pretty funny see Pan squirming like a animal when called out. When u have an injured child from a vaccine, then u should talk and understand the other side. its easy to say vaccine for all when u don't have an injured child. Home school is not option when/if u are single parent or dual income home. Pan is puppet and all for this as you have seen barely stand in line are med folk$ following $

I think Dorit was suggesting that anti-vax parents would be concerned that their wishes wouldn’t be honored in a “mass vaccination” setting if the kids were in school at the same time.

That’s specifically what I was responding to, and my reference was to the fact that gosh, yes, stuff does happen, even when Trained Medical Professionals are involved.

You can't act on information you don't have and once they doctors got the relevant documentation they did respect the patient's wish. In the case of vaccination tbey would need signed consent before giving it. Since it's not life saving measures implied consent never comes into play. Per your isual MO you conflating two things in a way that seems reasonable but to anyone with knowledge of how they actually work is patently absurd.

I perceive the kind of defensiveness you exhibit as a big part of the problem. Any good propaganda relies on a germ of truth, and the truth is that there are valid reasons why people don’t trust “the system”.

Verification of what? What makes the note signed by the doctor magical? How do you know I didn't change my mind since I got it?

As to the vax thing-- read my other comments; everyone gets vaccinated at the school, not by individual doctors.

Actually there are two types of anarchism that I can think of that despises all types of social organizations. They are post-left anarchism and egoist anarchism. On the libertarian side their is a movement called the sovereign citizen movement. I should have provided these examples in my first post.

Not to defend the Health Danger, but I feel citizens should have the right to coerce vaccination. That's not saying it's a good idea to do so for our current set of diseases, nor am I saying proposed law is that coercive. However, if I make penalties that are steep enough, it might not be forcing people, but it can be as coercive on less wealthy people as almost anything else I could do.

rork, There was just an article posted this week (I wish i could remember where) that talked about an approach similar o what you are suggesting. A Utah county was concerned with below ideal vaccination rates. They swapped the costs from $0 for an exemption and $25 for a vaccination to the opposite. That small difference restored the county's herd immunity status to desired levels.

I Verification of what? What makes the note signed by the doctor magical? How do you know I didn’t change my mind since I got it?

Verification that you discussed you discussed it with your doctor, you decided you don't want resuscitation yourself, and someone witnessed it. If you change you mind you just have to tear it up. What should we be doing instead, assume everyone who is unconcious doesn't want treatment and require those who do to have Do Resuscitate orders? Seems backwards.

As to the vax thing– read my other comments; everyone gets vaccinated at the school, not by individual doctors.

Free vaccination at schools is indeed a fine idea and as Lawrence said in #17 some schools already do this. But it doesn't address the problem of antivaxxers and as Dorit pointed out it may make things worse. Currently you either provide documentation that your child os vaccinated or sign an exemption. In your plan you either get vaccinated at school or sign an exemption. I do think that offering free vaccination to all children is a great idea but parents who are going to get an exemption are still going to get an exemption. Free school based vaccinations could be done alongside something removing nonmedical exemptions. Make it easier for parents who want to to vaccinate AND give the parents who don't want a little push while still leaving them options if they refuse (home/private school).

They had a syringe all ready to go and just walked over the the baby and to all appearances would have given the shot if your husband hadn’t said anything? Or they repeatedly came in and asked to give the shot (or, instead of asking, they may have just said something like, “look’s like you still need the HepB shot”

I can't answer your questions as I wasn't the one telling the nurses 'no thank you'. My dh was letting me sleep. However, it was nearly 16 years ago, so I don't know how relevant that would be w.r.t. today's procedures. My point was that I can believe the claim that some newborns received it without getting permission from the parents first.

Actually, what I was responding to was zebra's contention that "It is difficult to allay fears when the fears are grounded in some reality," which seems to imply that zebra is arguing that fears of forced vaccination are reasonable. As evidence she offers an article dealing with end-of-life care, which, as I pointed out, is a very different situation and not relevant to the plausibility of school vaccine mandates morphing into forced vaccination campaigns.

Is that seriously your only response? Sh!t happens so literally any fear is reasonable? Just to refresh your memory and make sure we're talking about the same thing here, the topic of the post was Mike Adams (not that he's the only one) alleging that a bill seeking to eliminate nonmedical exemptions to school vaccine mandates is equivalent to and/or will lead to forced vaccination (which, in turn, is equivalent to rape and/or felonious assault.) Do you think that that's a reasonable interpretation of the situation? If so, why? If not, then we have nothing to argue about. I'm certainly not making the argument that the health care system is perfect - I am arguing that its not as bad as Mike Adams (among others) claims.

You do understand that requiring permission from a doctor to exercise your right to avoid treatment is oxymoronic, right?

Putting aside the fact that that's not what the word "oxymoron" means, you don't have to get a doctor's permission to avoid treatment, you just have to not go to the doctor. Its not like doctors are going door-to-door looking for sick people to harass - you have to go to them, and when you do so you are initiating a therapeutic relationship, not (solely) a business transaction. You can call it paternalistic if you want, but doctors are not sales clerks, and medicine doesn't (or shouldn't) work on the principle of "the customer is always right." Like it or not, the plain fact is that the doctor has knowledge and training that you don't, which entails on them a responsibility to provide a certain standard of care - unless you actively refuse it. And if you do refuse, they have a responsibility to do the best they can to make sure you understand the likely consequences of that refusal.

I grew up in New Zealand, and received a number of vaccinations at school (I recall injectable polio, TB - test and immunization, oral polio, there may have been more). Since this was 1950s/60s, it may have been that these vaccines were at the time new and there was a government plan to get them out to as many children as possible as fast as possible: I just don't know. It seemed like a good idea to me. In the early 1970s, as a research student in Japan, I got my annual Japanese encephalitis vaccination at the university. I don't even think there were forms, we just lined up if we wanted the shot: it was done with one of those jet injectors that are no longer used. Derek Lowe, at "In the Pipeline", has an article today on the elimination of rubella from the Americas, http://pipeline.corante.com/archives/2015/04/30/a_vaccination_salute.php. The New York Times and a number of other sites do too, with the NYT reporting including the tragic story of Gene Tierney's daughter, born severely damaged when Gene caught rubella at an event where she was performing - and that one of the attendees had slipped out of a rubella quarantine to attend the event.

Sarah A@51 As is typical, following zebra's comments get very difficult, very fast. Originally he said that everyone should be vaccinated at school. Dorit responded this could cause more fear in AV parents. To that zebra replied that some fears are justified. Which makes no sense in context. zebra advanced both the idea that all vaccines should be done at school and that some fears about that idea had a basis in reality. zebra does this predictably. Make one reasonable point and then slip some nonsense in. It gives the illusion that she's reasonable and the resulting misdirection makes the thread harder to follow.

First point: Why do I have to discuss it with 'my doctor'? Why can't I use a notarized advanced directive? Or medical POA? It's my body, right?

Second point: I explained that I conjectured that making vaccination a community thing might be helpful. Some people seem to agree; if you don't that's fine.

On both points, you appear to be more comfortable with authoritarian solutions. Which again makes my point that it isn't unreasonable for people to have concerns about surrendering their autonomy.

Denice #12: I think a lot of those are cases where parents say "no vaccinations" and then the parents learn that Special Snowflake got a Vitamin K shot. IOW, what the parents actually wanted was "no needles" but they expressed it as "no vaccines" and, naturally and reasonably, the medical staff failed to read their minds and went on what the parents actually said rather than what they thought they were saying.

Yes, I can call it paternalistic, and authoritarian. No means no. It doesn't matter how much training you have, you don't own my body.

That you guys can't hold two nuanced thoughts simultaneously is remarkable, since you give the impression that you are TMP.

First point: Why do I have to discuss it with ‘my doctor’? Why can’t I use a notarized advanced directive? Or medical POA? It’s my body, right? As I said a medical POA is fine as long as there's documentation. As far as advance directives, from your link:

Emergency workers like E.M.T.s and paramedics are legally required to prolong the lives of dying patients unless they have a specific order from a doctor, which an advance directive is not. When called to the side of a dying patient, they do not have the time, the training, or the medical knowledge to try to parse the details of a patient’s case. It is understandable that health care personnel on the front lines — E.M.T.s, paramedics and even physicians like myself — err on the side of prolonging life in patients whom we don’t know.

Second point: I explained that I conjectured that making vaccination a community thing might be helpful. Some people seem to agree; if you don’t that’s fine.

I did agree that was a good idea. It's also not mutaully exclusive with getting rid of nonmedical exemptions. What both myself and Sarah A disagree with is that "It is difficult to allay fears when the fears are grounded in some reality" or that your link about end of life care has anything to do with the topic at hand. By the way, pointing back to your original reasonable point when people actually have issues with your subsequent nonsense is exactly what I meant by misdirection.

On both points, you appear to be more comfortable with authoritarian solutions. Which again makes my point that it isn’t unreasonable for people to have concerns about surrendering their autonomy.

I think POLSTs are great because they leave no room for interpretation the way advance directives or POAs do. In that sense they are actually the best at preserving automony. Vaccine mandates for school are also not authoritarian. Freedom, even health freedom, does not include freedom from consequences.

Yes, I can call it paternalistic, and authoritarian. No means no. It doesn’t matter how much training you have, you don’t own my body.

This is hugely disingenuous. No one is forcing vaccines. Say no and you don't get one, but you will have to deal with the cknsequences of that choice. As far as saying no to resuscitation, when you're dead or unconcious you can't say no, the DNR/POLST actually protects the decision you previously made. Of course, you can also just choose not to call 911 or go to a hospital and no paramedic thugs are going to break down your door and resuscitate you.

I would suspect, and I would like someone who really knows to verify, that a notarized document would be fine.

The problem I see is that the medicos would need to know the document exits, so unless you walk around with it stapled to your chest, some ER doc isn't going to know, and if you're at a hospital you have no previous relationship with (with the documentation in their files), they won't have a way to know.

"Doesn’t anyone feel that Mike et al are deliberately targeting women and talking down to them by using this trope?"

That seems to be one of the main tactics of the leaders of the antivaccine movement.See what Robert F. Kennedy Jr. says at the end of this article.

To some degree, this approach seems to be modeled on this article: https://leviquackenboss.wordpress.com/2015/04/26/lowly-womens-work/

I'm trying to understand something that shouldn't be difficult: I'm not talking about paramedics or EMT, but if you are a physician, why is my directive, notarized, as in a will, somehow 'less' than something that has a physician's signature? How is it 'less simple'? I don't want to be hooked up to machines; what is it you don't understand?

why is my directive, notarized, as in a will, somehow ‘less’ than something that has a physician’s signature? How is it ‘less simple’?

A notarized directive does not guarantee the patient's competence to make such a decision, nor does it rule out pressure from relatives to make such a directive. That's the point of having a doctor sign a POLST or DNR.

I had never heard of Dr. Richard Pan before SB277,and I am willing to wager most people outside California did not either,but if you look at his background on his 2014 campaign web site,you can see he knows quite a bit about child health and development.

I have been very impressed by Dr. Pan when I have heard him speak on these issues,and I am aware some of the money for his campaign has come from pharmaceutical companies.

People like Kevin Kim don't seem to get it that drug companies make little,or no money from most vaccines.especially the older ones.

I have read some of the hate filled messages that have been posted on Dr. Pan's Facebook pages.The usual poorly written Nazi comparisons,with pictures of Hitler and such.There is also a posted video from the ABC News affiliate in San Diego,of a "vaccine injured" child,whose family was awarded money from the vaccine court.I must say,I have rarely seen a more classic case of PANS,or Pediatric Acute-onset Neuropsychiatric Syndrome,which often includes autism.

PANDAS and PANS may be more common than people think,and too few pediatricians seem to be aware of it.These diseases have a very strong genetic basis,with long family histories of autoimmune and psychiatric disorders.A few examples are found in this chart.

These diseases can be triggered by any insult to the immune system,be they wild infection or vaccines.I believe these diseases account for a major portion of the "vaccine induced autism" we see.I think the big problem here,is most doctors have never heard of PANDAS or PANS,and never think of asking parents about family medical histories before kids are vaccinated,or running tests for autoimmune function.These are kids who have a serious inherited autoimmune disorder.and might benefit from an altered vaccine schedule,maybe modeled after the one suggested for lupus.

In reference to Beth's comments about her newborn and the Hep B vaccine. I worked as a pediatric RN with frequent floating to the newborn nursery between 1999 - 2007, so my experience might be in that 16 year window. Vitamin K was given immediately after delivery, before the baby was even brought to the newborn nursery. And the first of the HepB series was typically given on the morning of discharge, after making sure that informed parental consent was documented. Different hospitals may likely have had different procedures, but our practice was definitely different from her experience.

As a woman, who is more likely to be raped at some point in my life than is, say, the pond scum pretending to be human and calling itself Mike Adams, I find his vaccine analogy vile and appalling. Which is pretty much how I feel about most of his statements, so at least he is consistent.

I’m trying to understand something that shouldn’t be difficult: I’m not talking about paramedics or EMT, but if you are a physician, why is my directive, notarized, as in a will, somehow ‘less’ than something that has a physician’s signature? How is it ‘less simple’? I don’t want to be hooked up to machines; what is it you don’t understand?

I am a paramedic. I don't think you've ever seen a POLST or a living will. POLSTs are very simple and standardized. I know where to look to make sure it's valid and if it is I know that it means no CPR, no intubation. Living wills can be pages long and are not standardized. Still, as your own reference demonstrates, doctors will honor them. It just takes time and training to figure them out and because of that they are not nearly as ironclad as POLSTs are.

Now I understand. Doctors are infallible judges of someone's competence. But, we do not require doctors to declare that I "am of sound mind and body" when I make a will involving tens of millions of dollars (yes, in my dreams).

So, if I have a notarized advanced directive in my wallet (next to my insurance card) that says I don't want CPR or intubation, you have to go through a long legal process to validate it, but if it is signed by a 'doctor' you don't.

As usual zebra resorts to personal attacks as soon as his ignorance and lack of reasoning skills are exposed.

@Denice: in my years as a RN - newborn nursery, postpartum, labor and deliver, and as a midwife: I never saw a baby get the Hep b shot without a signed consent from the parent(s) on the chart. Vitamin K, yes, that was given routinely unless the parents specifically had documented no Vitamin K. But I never ever, in my 20 years, saw a vaccine without a consent, nor did I ever hear of it happening. Even the women with + Hep B screens had to sign a consent for the baby to get the vaccine.

(And yes, I am aware this is anectdote that it was never given without consent. But I also worked in hospitals in 3 states, before and after the vaccine).

Sarah: Nurses may have come in each shift to ask about consent for the vaccine (though that's pretty poor nursing care - the first nurse should have noted no Hep B to be given and it should have been passed on at every report). They never should have walked in to give the injection without a signed consent.

So, if I have a notarized advanced directive in my wallet (next to my insurance card) that says I don’t want CPR or intubation, you have to go through a long legal process to validate it, but if it is signed by a ‘doctor’ you don’t.

If you have an notarized advanced directive I legally cannot honor it. There's no verification to go through, I simply cannot terminate resuscitation without a physician order. If it was very simple I would do CPR (as I am legally required to) and contact medical control to see if I could honor it before intubating. Almost every time though they will tell us to work you. As a side note keeping that in your pocket is a poor choice. No one is going to rifle through your pockets before starting care, especially in a full arrest.

And you could certainly refuse them. Though if you didn't I can assure you that you would get the same standard of care as all my patients despite my personal distaste for you.

Saying "you're wrong' is not a personal attack, despite what creationists and other authoritarians like yourself think.

Saying “you’re wrong’ is not a personal attack, despite what creationists and other authoritarians like yourself think.

As disingenuous as ever I see. Simply saying "you're wrong" is not a personal attack. This however, is:

Yes, capnkrunch, I understand that you don't get to make decisions on your own. But that's the point here. We don't get from what is to what ought, at least to all the moral philosophers for quite a while now. Why don't you try thinking for yourself, if you want to argue here on the wonderful internet? Stop complaining that "zebra asks hard questions", and try answering some on your own volition.

@Denice #12: re vaccinations of babies. I think the claim is a load of crap. You have to document signed formed consent, and the mother is the only one allowed to sign anywhere I've every worked for newborns. Dad is actually not the Dad until the birth certificate is filed. The nursery only stocks the Hep B because as we all know, the MMR is not given to newborns for the very good reason it won't take.

You can file for criminal or civil charges in such a case (giving medical treatment without consent would be considered battery), and since I've never heard of it happening, it is highly unlikely as a scenario.

@zebra: You are comparing apples to oranges. In the case of EOL care, the ADULT patient is unable to speak for himself. Therefore the family must do it. In the article you cite, the wife (the legal POA) panicked and did the opposite of what the patient stated he wanted. Unfortunately, advanced directives have little legal authority in an emergency situation, which is why getting the POLST form is so important. It tells the EMTs what to do.

This has no relationshiop to vaccination, which is NOT an emergency and where PARENTS have total control over what happens.

@Sarah #34: It depends on whether or not treatments are done in Mom's room or not. So a nurse might have brought it along. But I find that scenario very unlikely, because Hep B must be refrigerated.

I do think the nurse could have come around to try and talk to the parents on more than one occasion, to comply with hospital policies or state rules demanding high vaccination rates. But the nurse would only be overzealous in trying to convince the parent to give informed consent. That consent must be documented, so I really question whether Beth misinterpreted what the nursing staff was really trying to do.

@Kevin Kim: Vaccine injured? If the child is really injured by a vaccine, no further vaccinations are required and your kid can go to school. If you mean the crazy autism claim, the injury does not exist and therefore your kid must be vaccinated to go to school. Sorry about your luck.

Thanks. I thought that these stories seemed unlikely or mis-remembered to represent a current belief about vaccines.

So, if I have a notarized advanced directive in my wallet (next to my insurance card) that says I don’t want CPR

This is going off on a bit of a tangent, but I have to say, as a Red Cross volunteer trained in CPR and 1st Aid, I'm not going to stop and check someone's wallet before I start CPR.

I’m not going to stop and check someone’s wallet before I start CPR. ---------------------------------------------- Moriarty: For the benefit of people without television... He's fainted.

The one having trouble with nuanced concepts is you. Nothing I or anyone else on this thread has said could even remotely be interpreted as denying that a competent adult has the right to refuse medical treatment. You keep trying to conflate the subject at hand (whether school vaccine mandates = forced vaccination = rape/felonious assault) with the far more complex ethical issues surrounding end-of-life care - a situation in which doctors are morally and legally obligated to err on the side of life if there's the slightest doubt about the patient's wishes because, to put it crassly, you can always die later, but once you're dead there's no re-do. The fact that doctors are reluctant to let their patients die unless they're really, really sure that's what they would have wanted is not evidence that the medical establishment doesn't respect patient autonomy.

Sixteen years ago, Beth was asleep at the time: http://scienceblogs.com/insolence/2015/04/30/the-annals-of-im-not-antiv…

When our son was born (1999) the Hep B vaccine recommendation for newborns was new and we declined to have him get it at that time. . . My husband told me (I was sleeping a lot after the birth) that every time the nurses changed shift, one of them would come in and try to give our son that vaccination.

Nice appeal to emotion this thread. You really need a smokescreen that big? Jeez the thought of you lot, like a coven of aardvarks, all polishing the helmet over this latest creation............I see shares in Kleenex going up.

Until the comparative studies between non vaccinated and vaccinated demonstrate some value in vaccination - there is no evidence that vaccination has a positive contribution to make to health care. Disallowing dissent by effectively banning children from school unless they 'believe' is a bit archaic. In fact creating a generation of home schooled kids might actually turn the economy around so keep up the good work.

The more kids you can help not have to swear allegiance to the flag every goddam day is a plus for free thinking.

I know you have all colluded in that marvelous weasel tool called the 'medical peer review' but the scientologists also have a book with 'how it is' too.

Paying for studies and then claiming the 'tablets of stone', as facts, isn't good enough. If the public need to demonstrate for protection then so be it.

You are the deluded ones that believe in the scriptures of the CDC. Why on earth would any sane person think that directives by that bunch of crooks was in the best interest of anyone's health? Who has the patent on Ebola - the good old CDC.

What was it called - swine flu? LOL. What was that tune by the Monkeys? Swine flu believer...............

"As to the vax thing– read my other comments; everyone gets vaccinated at the school, not by individual doctors." zebra

I suppose that makes sense, if you are going to coerce kids somewhere, might as well do it where you are brainwashing them - it's a no brainer really.

Bit like they do in those countries run by military Juntas. In fact let's adopt those North Korean ways of doing things and have done with it.

Philip Hills also asserts that there is no evidence that influenza is contagious ("playground lurgy"). I'm too tired to dig up where I quoted from A.T. Still a little while ago, but anything that Phildo manages to emit relating to basic medicine since 1910 ultimately devolves to this.

You do understand that requiring permission from a doctor to exercise your right to avoid treatment is oxymoronic, right?

If you want to opt out, you go there and opt out, and deal with the later consequences. But everyone is treated equally, and it is a community activity.

Is it "oxymoronic" that the idea is that one has to go to school to exercise the right to be excluded from school?

Playground lurgy? That must have been that germ theory denier Johnny Labile. Same as it ever was. Nothing ever changes with Mr. Hills.

I'm not conflating different things, and you are indeed having a problem with nuance if you think so. I've very simply and clearly pointed out that people's mistrust-- about vaccines, however misplaced it is-- does not exist in a vacuum.

So, my original reference was specifically in response to Orac's statement about refusing treatment, because humans don't carefully compartmentalize their fears-- "you can't always trust the system on x, but you can always trust it on y".

You can keep saying "well, I know medicine isn't perfect, but gosh, look how wacky those people are" if it makes you feel better, but the wacky people are acting out their wackiness within the context/ status quo that you are defending.

Having communal vaccination is something that changes the context, and so perhaps changes behavior. Having a more communal health-care system in general changes the context. Not having creepy pharma advertising on TV changes the context. Having standardized advanced directives one can download and have notarized changes the context.

Perhaps you can't see the connections, because you are inside the system, but to me the human behavior looks pretty much the same on the conventional side and on the woo side. Beam/mote, as I said.

As usual? I have repeatedly exposed your ignorance and poor reasoning skills here. Remember the gambler's fallacy, your claims that TCM isn't taught to medical students, your assertion that serious poisons could not be traditional medicines, your argument that prescribing ginger tea would stop the prescription of antibiotics for viral infections, your jaw-droppingly ignorant arguments about normal distributions and probability? I could go on. It seems you are still butthurt at having embarrassed yourself here so many times; that's your problem, not mine.

Here you seem to be arguing that the fact that medical professionals will do their best to keep a patient alive, unless they have good reason to believe that the patient doesn't want this, has resulted in a lack of trust that doctors will not administer vaccines without consent. That is a ridiculous claim.

1. That the patient was competent to make an informed decision about their EOL care, for example that they did not make this decision while suffering from a temporary bout of depression. A lawyer notarizing a document is not qualified to make such an assessment, any more than a doctor is qualified to make decisions about the law.

2. That the patient made an informed decision about their EOL care i.e. that they understood the implications of signing a POLST or DNR. This isn't an academic point, as one of the comments on the article you linked to makes clear:

I can't count the number of times I have met with a patient with a DNR order presenting with a serious but curable illness like pneumonia, facing "life support". When I ask "are you sure you would not want to be on a breathing machine for a few days if that's what it takes for a good chance of going home again" they look absolutely stunned, and reply along the lines of "I thought this form referred to being unconscious and on life support for decades, like Terri Schiavo or Nancy Cruzan".

Is a lawyer notarizing a document going to explain the implications? Whenever I have had a document notarized the lawyer hasn't taken the slightest interest in what the document contained, just in verifying my identity and getting his fee.

3. That the patient has not been coerced or conned into signing a POLST or DNR. There have been cases where this has happened, particularly cases where elderly abuse is occurring. For all a doctor knows, the notarized document found in the patient's wallet (in the unlikely event that this should happen before treatment is started) might have been planted by a relative fed up with caring for their sick, elderly patient.

Even raising this issue in the context of vaccination demonstrates your inability to make a coherent argument.

Saying “you’re wrong’ is not a personal attack, despite what creationists and other authoritarians like yourself think.

As capnkrunch pointed out, it is accusing me of having "a pathetically weak input" to the comments here, and defaming capnkrunch's professional abilities* that are personal attacks.

Incidentally, that's the first time I have ever been accused of being authoritarian. Someone here is full of sh!t, to the brim, and I'm pretty sure it isn't me.

* Perhaps you should make up your mind if capnkruch is too good at keeping people alive, or not good enough.

I’m not conflating different things, and you are indeed having a problem with nuance if you think so. I’ve very simply and clearly pointed out that people’s mistrust– about vaccines, however misplaced it is– does not exist in a vacuum.

Nope. You are very much conflating things if you think that source about EOL care has anything to do with the topic at hand. Even if EOL care did, you misrepresented the source you provided because they did not have the paperwork and were not informed about his wishes.

So, my original reference was specifically in response to Orac’s statement about refusing treatment, because humans don’t carefully compartmentalize their fears– “you can’t always trust the system on x, but you can always trust it on y”.

And as I said at least twice already, in that reference they didn't have the paperwork and the wife didn't inform them about it. Once they did the man's wishes were honored. Your logic only makes sense of you think that the default mode of healthcare providers should be do not resuscitate which is ridiculous.

Having communal vaccination is something that changes the context, and so perhaps changes behavior. Having a more communal health-care system in general changes the context. Not having creepy pharma advertising on TV changes the context. Having standardized advanced directives one can download and have notarized changes the context.

No one ever said these were bad ideas. People have a problen with you saying that AV fears are justified and using something unrelated as proof. You've also failed to respond to two critiques of your original idea. Dorit Reiss said that having commuinty vaccinations at school could look much scarier to AV parents to which you replied that the fear would be justified. I said there might be HIPPA issues to which you replied they just need to go the office to fill out a form at some point; which is suspiciously similar to tbe current system. And I'm the one who has trouble answering tough questions.

Perhaps you can’t see the connections, because you are inside the system, but to me the human behavior looks pretty much the same on the conventional side and on the woo side. Beam/mote, as I said.

Perhaps she can't see the connections because they aren't there. You don't get to make the absurd claims that you do, fail to make substantive replies to criticisms of them and then play the unbiased third party.

like a coven of aardvarks I rejoice in pointing out that the proper term for a group of aardvarks is in fact an 'armoury'. Such are the benefits of a good education.

" humans don’t carefully compartmentalize their fears" does not translate to "AV fears are justified".

If you think my reasoning about human behavior is wrong, then explain why. And note that I suggested reading the comments on the NYT article as well as the article.

As for the school vaccinations, same thing. I don't know why people would be afraid of vaccinations taking place in a clinic-type setting if they don't bring their kids to it. And I don't see how going to the office to sign a document is the same as mailing or faxing a form; again, that's my take on human psychology, with which you are free to disagree. I can't "answer" if you don't ask a question.

@ ZEBRA You can keep saying “well, I know medicine isn’t perfect, but gosh, look how wacky those people are” if it makes you feel better, but the wacky people are acting out their wackiness within the context/ status quo that you are defending.

Vaccines are proven safe but we need protection from lawsuits because they are safe. go shoot yourself

Thimerosal was put into vaccines because it is safe and it has been removed (except in the flu shot) because it is potentially dangerous, but it is also safe. get the noose

One size fits all medicine. We all know that makes no sense, some people are caffeine sensitive and flip out when they have it. But Vaccines are safe for everyone. Some children are genetically susceptible to injury.

@johnny You are the deluded ones that believe in the scriptures of the CDC. Why on earth would any sane person think that directives by that bunch of crooks was in the best interest of anyone’s health? Who has the patent on Ebola – the good old CDC.

Its very clear we are debating with a bunch of trained medical professionals,staff, Nurses doctors etc. Your entire belief system is founded on a Pharmaceutical Religion that you were indoctrinated in from school. That is really sad.

So as soon as cracks in the foundation appear and vaccines are criticized they fear monger hospital administrators and started forcing vaccines. like a time out for your child. They are losing control of the information. They MUST keep the soldiers on the front lines compliant perpetuating the scheme. Thats not good enough now every child must be vaccinated to go to school. Whats next getting on an airplane for all adults?

So, my original reference was specifically in response to Orac’s statement about refusing treatment,

because humans don’t carefully compartmentalize their fears– “you can’t always trust the system on x, but you can always trust it on y”.

You can keep saying “well, I know medicine isn’t perfect, but gosh, look how wacky those people are if it makes you feel better”

but the wacky people are acting out their wackiness within the context/ status quo that you are defending.

The context/status quo being defended is one in which people have the right to refuse medical intervention and have that refusal respected -- as demonstrated by the example in your reference -- which no one is questioning or challenging.

I'm not 100% sure why you think child sacrifice is socially acceptable. I am 100% sure it's not linked to my wife's excellent cooking.

One size fits all medicine. We all know that makes no sense, some people are caffeine sensitive and flip out when they have it.

Please go lift a recent printed copy of the Physician's Desk Reference and then tell me about how medicine is so one-size-fits-all.

” humans don’t carefully compartmentalize their fears” does not translate to “AV fears are justified”.

If you think my reasoning about human behavior is wrong, then explain why. And note that I suggested reading the comments on the NYT article as well as the article.

I did read the comments. There were some unfortunate circumstances but all of them stemmed from similar issues. I saw one that might have been a situation where it was full on ignored but even that was rssolved. Regardless, this is not what we are taking issue with. It is that you said that AV fears have basis in reality.

As for the school vaccinations, same thing. I don’t know why people would be afraid of vaccinations taking place in a clinic-type setting if they don’t bring their kids to it.

It's the fact that it is a government funded program that takes place at school. It looks much closer to the force mass vaccinations that AVers are so scared of.

And I don’t see how going to the office to sign a document is the same as mailing or faxing a form; again, that’s my take on human psychology, with which you are free to disagree.

I do disagree. Regardless your idea is all about community. If it is only the people who would be getting vaccines who would go to get the vaccines and AVers can come in whenever to fill out a form you've targeted the demographic that was already going to vaccinate.

That's certainly a simplistic view. It is in fact possible to pose concerns as statements and answer them appropriately.

At #31, I suggest reading the comments thread on the NYT article-- should have said that in my original comment.

Unless you think all those people are secret anti-vax conspirators, it indicates that some have had bad experiences and some see the doctor's writing as self-serving. So, as I said, there is mistrust of "the system" that is based on experience.

And I still don't see how, if I have to get a doctor's permission to refuse treatment by a doctor, as in Krebiozen's model, that counts as autonomy.

It is difficult to allay fears when the fears are grounded in some reality. That’s why I recommend people like Orac deal with beams before taking on the motes."

Clearly referencing the anecdotes, not saying vax fears are grounded in reality. But you already knew that. This is your idea of a serious debate?

zebra@104 You are a lair. Not that we didn't know that already but this example is a pretty clear and nicely contained within one thread and only a handful of posts.

It is difficult to allay fears when the fears are grounded in some reality. That’s why I recommend people like Orac deal with beams before taking on the motes.

But remember that the anti-vaccine people express concern that their children will be force vaccinated if efforts are, for example, held in school.

In your response to Dorit Reiss comment about concerns over forced vaccination you said "It is difficult to allay fears when the fears are grounded in some reality." Now you are saying:

Responding to your particular brand of trolling is more tiring than entertaining. I'm not going to respond anymore and you are more than welcome to claim I ran away from your "hard questions." I wonder if others will agree.

And I still don’t see how, if I have to get a doctor’s permission to refuse treatment by a doctor, as in Krebiozen’s model, that counts as autonomy.

As capnkruch noted, you are being dishonest, yet again. You don't have to get a doctor's permission to refuse treatment by a doctor, as you know very well. Assuming you are a competent adult you can simply refuse to sign a consent form and that will be the end of it. Even if you are unconscious and unable to consent, if you have made your wishes clear through whatever counts as legal documentation in that jurisdiction, doctors are legally obliged to respect it.

As usual you have argued yourself into an untenable position and are simply too pig-headed to admit it.

"Even if you are unconscious and unable to consent, if you have made your wishes clear through whatever counts as legal documentation in that jurisdiction, doctors are legally obliged to respect it."

1. That the patient was competent to make an informed decision about their EOL care, for example that they did not make this decision while suffering from a temporary bout of depression. A lawyer notarizing a document is not qualified to make such an assessment, any more than a doctor is qualified to make decisions about the law."

So, if "what counts as a legal document" can only be signed by a doctor, I need a doctor's permission to refuse treatment if I am unconscious.

Thimerosal was put into vaccines because it is safe and it has been removed (except in the flu shot) because it is potentially dangerous, but it is also safe.

I'll repeat the relevant phrase: potentially dangerous. Thimerosal was suspected of causing harm and removed as a precaution. Then, when the investigations were done, it was determined that it wasn't harmful. But by then the manufacturers had changed their processes. Organisations that supported the removal now say that had they known then what they know now, they would never have pressed for its removal.

The fact that we aren't certain precisely what causes autism doesn't mean that we can't exclude things. The supposed link between vaccines and autism has been investigated in great depth. If a meta-analysis of all the studies looking at this question would occur, it would look at literally millions of people. No link was found in the properly designed studies. So yes, we can say that vaccines do not cause autism.

Perhaps I'm being naive, but I'm always perplexed when people try to retcon their arguments on the internet. You do know your original words are there for everyone to see, right? Several other commenters have already pointed out

So, if “what counts as a legal document” can only be signed by a doctor, I need a doctor’s permission to refuse treatment if I am unconscious. Exactly what I said.

That's not at all what you said. The doctor's signature is confirmation that the patient was competent, informed and acting out of his/her free will when signing the POLST, DNR or whatever. It doesn't grant the patient permission, any more than a lawyer witnessing a will gives a person permission to leave their possessions to whoever they want.

A doctor cannot refuse to sign a valid POLST unless s/he has good reason to doubt that the patient is competent, informed and has not been coerced, which any reasonable person would surely agree is a good thing.

I suppose discovering that you don't understand the meaning of yet another simple English word, in this case "permission", shouldn't surprise me. I'll add it, and 'oxymoron' to the list.

@johnny You are the deluded ones that believe in the scriptures of the CDC. Why on earth would any sane person think that directives by that bunch of crooks was in the best interest of anyone’s health? Who has the patent on Ebola – the good old CDC.

Oops, must have accidentally hit submit. As I was saying, several commenters have already pointed out the inconsistencies in your attempts to re-write history, so I'll confine myself to observing that back at comment #51 I explicitly stated that my arguments were based on the interpretation of your statement "It is difficult to allay fears when the fears are grounded in some reality" as an argument that Mike Adams' fear-mongering about "forced vaccination" was reasonable in light of the current state of the medical system in the US, as exemplified in the article you linked to. I specifically asked if that was indeed your view; if it wasn't, you could have clarified back then rather than waiting until you'd lost the argument to try and pretend you never said it.

Having communal vaccination is something that changes the context, and so perhaps changes behavior. Having a more communal health-care system in general changes the context. Not having creepy pharma advertising on TV changes the context. Having standardized advanced directives one can download and have notarized changes the context.

I'd love it if the US had universal health care and outlawed advertising prescription medications. But its ridiculous to imply that antivax sentiment arises from these things; the UK has nationalized health care and doesn't allow pharmaceutical companies to advertise, but it was the UK antivax organization JABS that funded Wakefield and launched the antivax movement into the public consciousness.

Perhaps you can’t see the connections, because you are inside the system, but to me the human behavior looks pretty much the same on the conventional side and on the woo side. Beam/mote, as I said.

Really? So alt-med practitioners have evidence-based standards treatments have to meet before they're used on patients? Treatments that don't work or have unacceptable side effects are abandoned? They have organizations that actively work to identify failures in the system and come up with solutions? Alt-med clinics are subjected to surprise inspections to ensure they are conforming to best practices? They have governing bodies that strip practitioners of their right to practice if they fail to provide a commonly accepted standard of care? (Hint: these are rhetorical questions; the answer is no.)

I never understood any of this automatic distrust of the CDC. No one there gets any compensation from vaccine-producers. They aren't elected officials so they have no contributors to kowtow to, and they don't have to wheedle grant money out of big corporations so they aren't beholden to them. Yet somehow, we're supposed to believe that CDC is kissing the ass of (scary music) Big Pharma !!!1! and that CDC, NIH and FDA are all secretly in the pocket of Teh Big Pharms! 1!! Um, except nobody has ever shown any such collusion or corruption exists. The biggest thing anyone has come up with is bizarre "Six Degrees of Seperation" -like nonsense. Hey I know, let's see how many steps it is between Dr. Tom Frieden and Kevin Bacon.

"The doctor’s signature is confirmation that the patient was competent, informed and acting out of his/her free will when signing the POLST, DNR or whatever. It doesn’t grant the patient permission, any more than a lawyer witnessing a will gives a person permission to leave their possessions to whoever they want. "

permission: "the right or ability to do something that is given by someone who has the power to decide if it will be allowed or permitted"

Ummm... if doctors are the only ones with the power to decide that I can have a DNR, I only have the ability if the doctor so decides.

Not only that, but besides the higher level executives and researchers at the CDC, the actual grunt work is done by the over 14,000 regular old employees, who are responsible for studies directly or have oversight responsibilities.

So, there is enough money being thrown around to bribe over 14,000 people (and how much would be enough? $100,000 per person - which works out to $1.4 Billion dollars just for the CDC) - how exactly do you hide that kind of money?

Then you multiple that by the tens of thousands of other medical professionals - which means that "Big Pharma" is spending more money in "supposed bribes" than they even make in overall revenue from all the vaccines sold.

@ Justthestats I have no idea which genes or what circumstances permit injury from vaccines but it happens all around the world. In case you missed this story regarding Gardasil. MORE EVIDENCE of vaccines doing damage. This happened in Denmark and was publicized on national television. Stark contrast to the censorship going on in this country.

A lot more than we know actually. not just immunocompromised. There should be screening to find out. The science is not settled on Autism/vaccines no matter how hard they try., Especially when this is circulating around.

Anyway, you are avoiding or intentionally misunderstanding my point, which I've now repeated and can't make any clearer-- I am talking about the psychology of the public, not whether alt med is sufficiently regulated.

I'm pointing out some areas where there seems to be overlap, by which I mean there are similar motivational factors. Having faith in doctors and having faith in faith healers is still having faith. Looking for a pill to lose weight isn't a different type of laziness if the pill comes from pharma or Dr Oz's herbs.

I can go on but I doubt you are interested in actually discussing this when you have your woo is woo argument to repeat, over and over.

The pharmaceutical industry portrays itself as an industry fighting to prevent and eliminate diseases but, behind the pretext of this noble cause, it is extorting billions of dollars in subsidies from dozens of governments and is demanding blind obedience from hundreds of millions of patients. The drug industry is trying to establish a global monopoly as the sole “purveyor of health.”

In fact, the pharmaceutical drug industry is not a health industry at all, it is an investment business. While pretending to deliver health to the world, its entire existence is based on promoting diseases as multi-billion dollar markets for patented drugs.

Anyone can easily see that the entire business model of the pharmaceutical industry is based on fraud and deception. The elimination of diseases, the very goal the drug industry pretends to serve, is actually being vigorously fought against by this industry, for an obvious reason: the disappearance of diseases would destroy the global drug market based upon which they are based and ultimately the drug industry itself.

To continue this “largest fraud in the history of mankind” against growing resistance, the drug industry is using major portions of its billions in profits to finance political stakeholders, to bribe health professionals and to buy the media. In 1997 Dr. Rath described the drug industry as the “biggest obstacle to world health” and since then, numerous books have been published describing the devastating impact that this organized fraud has on people and societies around the world. selection of those books:

THEO@118 I was going to say something about plagiarism again but given that your post is directed at johnny and I understand you want to emulate his "skill" I suppose that's meaningless. In the future please try to use lowercase for crazy johnny (or just call him by his real name, Phillip Hills) because I'd hate for anyone to mistake that you are referring to sane Johnny.

THEO, you can't even get my name right. As for your two cites, the first one is from "Health Impact News", a name that just screams "quackery ahead". Your second one is a link to a scribd page about documents that supposedly support the vaccine autism link. I've seen that list, and I've seen it refuted. As for your comment in #118, Matthias Rath is an AIDS denialist and quack who managed to bend the ear of Thabo Mbeki, South African president from 1999 to 2008 when he was forced out of office. For all of his intelligence, Mbeki was an arrogant, supercilious and obnoxious man who ignored evidence that contradicted his idees fixee, and resorted to ad hominem attacks on anyone who disagreed, challenged or criticised him. Try again.

I don't have time to read all of the comments right now but to respond @Denice Walter - when my son was born we had to fill out forms to have him vaccinated. Meaning, they came in with all of the information for the vaccine recommended (Hep B) fact sheet, etc. and then we had to read the consent form and sign it before he was vaccinated. I would be very doubtful that an infant was vaccinated without that signed consent form. They may have been confusing the Vit K shot, which I don't believe (although I was a bit fuzzy right after he was born mostly due to blood loss) they give them pretty immediately after birth. The Hep B vaccine occurred probably a couple of hours after he was born when the rounding pediatrician came in to look him over and also to ask whether or not we wanted to have him circumcised as well as conducting an examination. They also did the heel stick at that time as well (to fill out the screening card for genetic testing), so all of the unpleasantness could all be done in one go. They messed up his first heel stick or dropped the blood or something and had to do it again (with profuse apologies). He got his revenge though, peed all over the nurse.

If you can't understand my comment #51 I really don't know how to make it any clearer to you. And no, you didn't respond - that was my whole point. I'm beginning to think capnkrunch is right and this is a deliberate strategy on your part: maintain two separate and unrelated lines of argument so that whenever you're at a loss to respond to a criticism of one argument you can ignore it and focus on the other.

And once again you're trying to change your stance and pretend that's what you were saying all along. Of course the motivations of the patients who seek out SBM or alt-med are the same - they want to get well! But your admonition for SBM to take the beam out of its own eye before looking for motes in alt-med's only makes sense if your statement that "to me the human behavior looks pretty much the same on the conventional side and on the woo side" was referring to the behavior of the practitioners of the respective systems, which, as I pointed out, is certainly not the same. The difference between SBM and woo is that real doctors don't ask for "faith" - they don't need to, because they have evidence.

Teho, when a list of 86 papers opens with an abstract from a conference poster session where the author (Verstaeten)presented preliminary results from an incomplete two phase study, but does not also include Verstaeten's peer-reviewed juornal publication presenting the full results following the completion the study;ssecond phase where the initial appearance of an association between thimerosal and neurologic development disorders was found to represent a false positive, there's really no reason to read further--is there? Whoever compiled the list obviously has no interest in honestly assessing the available evidence.

Since THEO is here at the moment, perhaps he can spare a moment from the sycophancy to explain what he meant by "Spenglerians" and "Bushmen" abstaining from vaccination.

You are beginning to sound a little paranoid wacky yourself here-- what "only makes sense" to you is not necessarily what "only makes sense" to me, and not every comment is part of some devious strategy. I'm not bound by your misinterpretations- or do you think you too are infallible?

Do you disagree that the mainstream establishment is clearly responsible for how people think about health care?

Like the expectation that they can take a pill to effortlessly solve their problem? That there's this authority figure with special wisdom who can heal them and save their lives if they get sick?

Sounds like faith to me. The vast majority of people have zero knowledge of, or ability to evaluate, or even the inclination, to look at the "evidence". And traditionally, that suits the establishment just fine.

permission: “the right or ability to do something that is given by someone who has the power to decide if it will be allowed or permitted” Ummm… if doctors are the only ones with the power to decide that I can have a DNR, I only have the ability if the doctor so decides. Why is it relevant what criteria she uses to do so?

They don't have the power to decide whether or not you can have a DNR, they sign the form to say that you were competent, informed and were not coerced at the time you signed the form. It is your decision and yours alone. If you are really unable to see the difference I can't help you, but I suspect you are just desperately trying to dig your way out of the hole you are in. Again.

For example, the California POLST form (PDF) has boxes to tick to indicate whether it was discussed with the patient and that the patient has capacity, or it was discussed with a legally recognized decisionmaker if the patient lacks capacity.

My signature below indicates to the best of my knowledge that these orders are consistent with the patient’s medical condition and preferences

Studies have shown that among patients with POLST forms treatment preferences were respected 98% of the time, and no one received unwanted CPR, intubations, intensive care or feeding tubes.

There doesn't seem to be a problem here, certainly not one that is responsible for eroding public trust in vaccines, as you seem to be suggesting. Or do you have evidence that doctors are arbitrarily refusing to sign DNRs and POLSTs?

You cannot really believe it is OK for people to make life-ending decisions when they lack the capacity to understand what they are deciding, are misinformed or have been coerced. Do you seriously think that a lawyer is capable of explaining the implications of a DNR or a POLST, and assessing a person's competence? Who else but a physician is qualified to do this?

Seriously, are you insane? If they don't sign, you can't have the DNR. How is that not the power to decide whether or not you can have the DNR?

@Julian sorry you dont like independent reporting from that website but its here to stay. Focus on the the story not the source. There is a video embedded you can view. I am sure you can find another outlet that you trust that has the story about Vaccine injured girls in Denmark. I am sorry this truth is hard to take. but its what we are SCREAMING about in the Antivax community and no-one is listening. Thus the need for independent news coverage to get the message out. GRASSROOTS

Since THEO is here at the moment, perhaps he can spare a moment from the (sycophancy<--------- new word for me thanks) to explain what he meant by “Spenglerians” and “Bushmen” abstaining from vaccination.

That was cited by Age of Autism. I have no idea what that meant. Sorry. it sounded funny didn't it? hehe

Matthias Rath is an AIDS denialist and quack. That piece about pharma is completely accurate no matter who wrote it. Corroborated by many other sources. documentaries etc. I was impressed how it well it was written and succinct.

How about this hot off the presses dated today. And you want us to trust the studies and establishment? No effing way Face palm SMH.

The peer review process – long considered the gold standard of quality scientific research – is a “sacred cow” that should be slaughtered, the former editor of one of the country’s leading medical journals has said. WOW!

Richard Smith, who edited the British Medical Journal for more than a decade, said there was no evidence that peer review was a good method of detecting errors and claimed that “most of what is published in journals is just plain wrong or nonsense”.

The editor of the second of the country’s two leading medical journals, Dr Richard Horton of The Lancet, wrote in an editorial earlier this month that “much of the scientific literature, perhaps half, may simply be untrue”, blaming, among other things, studies with small sample sizes, researchers’ conflicts of interest and “an obsession” among scientists for pursuing fashionable trends of dubious importance”. Are you serious? Add to it Marcia Angell's comments from JAMA and you have a check-mate scenario developing.

@THEO Everyone who works with scientific research for a living knows that prepublication peer review is the first step towards scientific acceptance, not the end-all-be-all stamp of scientific acceptance. What does it say about your pet theories that they can't even make the low bar of passing peer review?

At #31, I suggest reading the comments thread on the NYT article– should have said that in my original comment.

Unless you think all those people are secret anti-vax conspirators, it indicates that some have had bad experiences and some see the doctor’s writing as self-serving. So, as I said, there is mistrust of “the system” that is based on experience.

The fact that there's a handful of strangers on the internet complaining about something else entirely in entirely other terms doesn't actually demonstrate the truth of that proposition .

And I still don’t see how, if I have to get a doctor’s permission to refuse treatment by a doctor, as in Krebiozen’s model, that counts as autonomy.

Since THEO is here at the moment, perhaps he can spare a moment from the (sycophancy<——— new word for me thanks) to explain what he meant by “Spenglerians” and “Bushmen” abstaining from vaccination.

That was cited by Age of Autism. I have no idea what that meant. Sorry. it sounded funny didn't it? hehe

That was cited by Age of Autism. I have no idea what that meant. Sorry. it sounded funny didn't it? hehe

Second point: I explained that I conjectured that making vaccination a community thing might be helpful. Some people seem to agree; if you don’t that’s fine.

Let’s make vaccination of children a public health matter, carried out by the government. When the appropriate age comes, you go to the school building on designated days and have it done, for free.

If you want to opt out, you go there and opt out, and deal with the later consequences. But everyone is treated equally, and it is a community activity.

I'm still waiting to hear how having to go to school to opt out of going to school is any different from this DNR/autonomy dog-and-pony distraction (much less the status quo).

The underlying dynamic doesn't seem that mysterious though: you people are all stupid for talking about the subject of the post at all, because Z. has "a better solution."

@ johnny #87: No demonstrated benefit? How do you explain away the disappearance of smallpox, polio, native cases of measles (all current outbreaks were brought from overseas), and now mumps?

And I think you have been told that the study you demand is highly unethical and would never get IRB approval: see the Tuskegee Experiment for the reasons why.

@zebra #94: Please get out a legal dictionary and look up the differences between an advanced directive and a POLST form. You are indeed conflating that issue with informed consent for vaccines. Very nicely phrased ad hominem attack, by the way.

@Theo #116: No moving the goal posts. The weak evidence that Gardasil caused harm in some patients has nothing to do with claims about vaccines causing autism. And the articles you link to have been extensively debunked here by Orac and others.

@Kiiri 121: I can definitely see uninformed parents conflating Hep B with Vit K. Vit K has to be administered within the first hour of life, is part of standing newborn care orders EVERYWHERE, and is only held if the parents specifically demand it in their birth plan . . . but we will gently try to talk them out of it (and often succeed). Vit K is needed to activate clotting factors in the blood to prevent hemorrhagic disease of the newborn (a newborn has only a blood volume of about 300 ml, or a 12 oz can of soda for those of us stuck in the Imperial System. So bleeding is bad in neonates, as you can imagine.

Hep B (first dose) should be given as soon as possible but can wait for the parents to be reasonable informed before signing consent. It's typically given in the first 24 hours to prevent liver failure if the mom is infected and passes it to the baby during the birth (it's blood and body fluid borne).

Ah, the Humpty Dumpty defense, reliable fallback of the cornered interlocutor. But if you're going to take the position that no one can know what you mean by a word (or statement) until you tell them, then you can't very well ignore them when they specifically ask you to clarify your position and then call them "paranoid wacky" when they interpret your statements following the commonly accepted meanings.

Do you disagree that the mainstream establishment is clearly responsible for how people think about health care?

It's difficult to either agree or disagree with a statement so broad as to be essentially meaningless, especially since apparently I'm not allowed to assume that what you mean by it can be deduced from the commonly accepted meanings of the words you use, the grammatical structure in which they are arranged, and/or the context in which they were written (that, you see, is the weakness of the Humpty Dumpty defense - once you've invoked it, nothing you say means anything. It's the verbal equivalent of dividing by zero.) What I've been arguing from the beginning - as I've clearly stated several times - is that fears of "forced vaccination" are not "grounded in some reality," and that the article you referenced concerning end-of-life decision making is not evidence to the contrary.

"The difference between SBM and woo is that real doctors don’t ask for “faith” – they don’t need to, because they have evidence." Sarah the believer

How sad Sarah, the 'evidence' as you put it is an artificial construct, paid for and delivered just like that pizza you order on Saturday night.

It is a shame such an obviously intelligent person has been discombobulated by nice magazines and high sounding words.

"@ johnny #87: No demonstrated benefit? How do you explain away the disappearance of smallpox, polio, native cases of measles (all current outbreaks were brought from overseas), and now mumps?" Pancetta

Well you are living in cloud cook coo land if you think it's all disappeared. I love your 'native measles' medical anecdote, go to India, there is just as much Polio as there was and it's now called Bill Gates variant Polio. I guess the only thing you read is this blog and Pubmed to have a belief system stacked the way yours is! try reading something else.

" Let’s make vaccination of children a public health matter, carried out by the government. When the appropriate age comes, you go to the school building on designated days and have it done, for free.

If you want to opt out, you go there and opt out, and deal with the later consequences. But everyone is treated equally, and it is a community activity." NobRed

You missed out one thing - dealing with the consequences of vaccination, which is paid for by the taxpayer in special homes for very ill children. So let's keep it community based and balanced. But I would hardly call assaulting someone at a party of friends a community event.

“They don’t have the power to decide whether or not you can have a DNR, ” Seriously, are you insane? If they don’t sign, you can’t have the DNR. How is that not the power to decide whether or not you can have the DNR?

You think I'm insane because I don't see a doctor signing a form to say that a patient has made an informed decision as being the same as the doctor giving the patient permission to make that decision? That's interesting.

Here's another example, this time a California DNR (PDF). The section that a doctor is required to sign states:

I affirm that this patient/legally recognized health care decisionmaker is making an informed decision and that this directive is the expressed wish of the patient/legally recognized health care decisionmaker. A copy of this form is in the patient's permanent medical record.

That's not giving permission, that's recording that the patient made an informed decision, which is not the same thing at all. It certainly doesn't suggest that problems with EOL care have led people to mistrust vaccinations, or to think that doctors will vaccinated children without their parents consent, which is why you brought up EOL care in the first place.

Interestingly, in the UK most people's concerns around DNRs seem to be that doctors sometimes put one in a patient's notes without their consent. That should never happen, of course, but it's an example of people not getting the treatment they want, the very opposite of concerns about vaccination without consent.

I love your ‘native measles’ medical anecdote, go to India, there is just as much Polio as there was and it’s now called Bill Gates variant Polio.

"Bill Gates variant polio" gets a mere 12 hits on Google. It seems the only person who calls it that is you, or someone who uses the same repugnant misogynist blokesy language as you.

In India in 1972-4 6.4/1,000 children surveyed in Lucknow suffered from paralytic polio that's 640 per 100,000.

In India in 2014 the AFP rate was 12.46 per 100,000. Clearly, even if all those cases of AFP were caused by the polio vaccine, there would still have been a fall in polio by a factor of 50. In fact none of those cases of AFP were caused by polio. As the WHO puts it:

A total of 59,436 AFP cases were investigated in India in 2012, another 53,421 in 2013 and 53,383 in 2014. Not a single AFP case has tested positive for polio in 2012, 2013 and 2014. All AFP cases during the last 3 years have been due to non-polio causes.

Johnny has travelled as far as Liverpool Station and is therefore an expert on telling other people what to expect when they visit India.

“Bill Gates variant polio” gets a mere 12 hits on Google. It seems the only person who calls it that is you, or someone who uses the same repugnant misogynist blokesy language as you. " Krebby pants

Well the truth is getting round. It is flat earthers like you that insist that the Emperor's pants are up. Have a chat with NobRed, he knows all about bollocks reload. Next you will be telling us there is evidence for vaccine efficacy cos you read it somewhere in a peer reviewed medical pizza online order site.

"Johnny has travelled as far as Liverpool Station and is therefore an expert on telling other people what to expect when they visit India." Her Doccky

Docky has logged onto pubmed a couple times and is therefore and expert on 'evidence'. Give that boy a pat.

Apparently when a vaccine fails, there are lots of medical anecdotes we can draw on to reassure the public.

1. It is the process that caused the problem, not the vaccine 2. It isn't native measles, a naughty foreigner brought it in 3. That naughty virus mutated 4. We need on the way to 100% for herd immunity, this allows us to blame a few people who didn't sheep. 5. It is out of date 6. Dodgy batch 7. Dodgy doctor 8 Anything you like as long as you don't suggest/imply/insinuate/accept a bribe to fiddle the data........................

It is the smiling doctor in the picture that shows up the psychopath in the process. Lovely appeal to emotion, shame about the lack of science - again

The truth is that not a single case of AFP has tested positive for polio, vaccine-derived or otherwise in India since 2011, and that you are a compulsive liar.

Merriam Webster: permission: “the right or ability to do something that is given by someone who has the power to decide if it will be allowed or permitted”

Ummm… if doctors are the only ones with the power to decide that I can have a DNR, I only have the ability if the doctor so decides.

You appear to be hung up on why the doctor might deny me the ability to have a DNR. Again, what difference does it make? What difference does the formal wording of the document make? Unless someone is actually insane and making random decisions, deciding to give permission or not is always based on something.

Johnny has travelled as far as Liverpool Station and is therefore an expert on telling other people what to expect when they visit India.

Unfortunately, talk about Mr Gates encouraged me to again wade into the latest load of steaming tripe dumped out by Adriana Gamondes in her 70 part** epic series at AoA. It is insanely decorated with a composite foetus-in-utero //map of Africa ... and you know what that means!

Actually it means very little except in her wildly flailing imagination where she free associates Gates, tetanus vaccines, Kenyan bishops, bin Laden's assassination, the Clinton Foundation, population control, Mssrs Kissinger and Soros and oh yes, racism.

Throughout she connects ideas or people together and then says things like, "It is unknown" whether these are related. BUT they could be!

Today we are treated to Dan's creative writing as well when he similarly ( but less floridly) speculates about whether the veteran who killed Chris Kyle along with another gentleman AND a veteran who committed suicide- who both happened to provide humanitarian assistance after the earthquake in Haiti- were victims of the side effects of the anti-malarial, Lariam***. Not that he knows whether either of them even took the drug. But seriously, he knows a television producer who went to Haiti then and SAW how badly others were affected by nightmares and hallucinations. And others said they would never take it.

** it's ten really but seems like much more. *** -btw- if I were to ever again visit a country where malaria is endemic I would give Lariam a try because I am quite afraid of getting malaria and am a target for mosquitoes.

#155 Mefloquine – the military’s deadly malaria treatmentwww.army-technology.com/features/featuremefloquine-the-militarys-deadly…

#155 Former Peace Corps Volunteer Sues over Malaria Drug blogs.wsj.com/law/2015/03/27/former-peace-corps-volunteers-sues-over-malaria-drug/

www.fda.gov/Drugs/DrugSafety/ucm362227.htm FDA Drug Safety Communication: FDA approves label changes for antimalarial drug mefloquine hydrochloride due to risk of serious psychiatric and nerve side effects

I don't know which is more futile--waiting for 'Johnny' to post something true, or waiting for ken to post something relevant.

Seriously, they are beginning to give Whale.to a run for its money when it comes to sharing the sheer crazy......give it another year and they'll be full-on NWO / Illuminati, with a side of Levitating Dolphins for good measure.

#159 Shay just informing Denice #155 of the black box warning before she takes Lariam. Very relevant. Never read AoA.

Who in the world doesn't know about the warnings? How about the likelihood of adverse events? And the pre-indications Anyone can look that up.

I am. I've been following the vaccine manufactroversy since 2010. What I've seen is numerous stories that do not stack up, that turn out to be exaggerations or that have a clear non-vaccine cause.

Matthias Rath is an AIDS denialist and quack. That piece about pharma is completely accurate no matter who wrote it. Corroborated by many other sources. documentaries etc.

Wrong again. It's a known tactic to cite a bunch of sources and claim that they support one's argument when in fact the cites don't, or even refute the argument. That JGC was able to find that one source does not support the argument is enough to raise doubt that the other cites also support the argument. As the Latin expression goes, falsus in unum, falsus in omni. You have to prove that the listed cites support the claim of vaccines causing autism.

If you really think that signing a form to confirm that a person has expressed an informed wish to have a DNR is the same as giving them permission to refuse EOL care, I don't think it's me that is suffering from diminished cognitive function (to be sure I just tested my IQ and scored well above average, for what it's worth).

Of course, I do single out these meandering recitatives purely for their intrinsic entertainment value HOWEVER I have a far more nefarious purpose up my sleeve-

which is to point out to my sceptical brothers and sisters how much Gamondes, Olmsted et al will say just about anything to attract an audience, how much their material is pulled from their nether regions rather than verifiable sources and how much they pander to their audience by lining up the 'bad guys' or 'bad meds' or' evil corporations/ governments' to support their fantasies. Gamondes just strings up a list of people whom are already hated by her fellows and then, draws circles and arrows to connect them and blame them for all manner of ill. Dan constructs an argument against a drug based on 2 murders depicted in a movie and a suicide which led to a governmental action *without* knowing if the said actors even took the drug. Then the entire tale is likened to what happened with vaccines.

This isn't reporting and it isn't instructive in any way. Anyone can say anything about anybody or anything but it doesn't make it true or meaningful.

On that note, I am off to the bayside when they have boats and seafood restaurants which ar certainly more solid than Dan's speculation.

"On that note, I am off to the bayside when they have boats and seafood restaurants which ar certainly more solid than Dan’s speculation"

I'm going to have soup I took home from a lovely neighborhood bistro, the sit on my sunny deck and watch the boats parade for the opening of boat season.

Now I understand. Doctors are infallible judges of someone’s competence. But, we do not require doctors to declare that I “am of sound mind and body” when I make a will involving tens of millions of dollars (yes, in my dreams).

Actually we do. If the will is challenged on the basis that the testator* was not of sound mind**, then an expert witness -- a doctor -- will be called in to give an opinion on whether the testator was of sufficiently sound mind when the will was executed. Since the testator is by definition dead by the time of the will contest, this judgement will be based on witness reports of the testator's action and demeanor. Competent attorneys will make copious notes and ask the testator quite a lot of questions to ensure there is enough evidence if an expert witness is required. 

The difference between a will and a DNR is that there's lots of time to argue about the testator's mental state; the decision about the validity of a DNR has to be made immediately, under pressure. It makes sense to have competence determined by a doctor up front for a DNR but not necessarily for a will.     *testator (male) or testatrix (female) is the person executing the will.

**sound body is not required, and the requirement of sound mind is more limited than you might think. We had a will contest where the testator was psychotic according to the expert witness. But on the day he made the will, I guess he'd been taking his meds so the will was unheld.

Answer the question: if vaccines have no benefit why is there no more small pox in the world? Polio is left in only three countries, and India isn't one of them (Afghanistan, Pakistan, and Nigeria to be specific). The only measles in the US is that brought here from other countries. Refute that fact. You can't.

Reading articles on Pub Med isn't bad reading for the most part. Of course, unlike you, I read the whole article. And I don't read Age of Autism unless I'm looking for a good laugh.

[i]Anything you like as long as you don’t suggest/imply/insinuate/accept a bribe to fiddle the data……………………[/i]

You need proof of that. The other things on your list are easy to prove. Falsifying data requires a bit more.

She's added another comment to her latest. (Indeed, she seems to be aware that these blobs attract comparatively little interest from the regulars.)

"Similarly, Vaccination was originally conceived to save humanity from genuinely deadly disease, not to sterilize, drive polypharmacy, make incursions on civil rights or as cover for bombing raids. Maybe if it had never been drafted for any of those ulterior purposes, the tech would have advanced more quickly and would have been safer and more effective at this point. And maybe Einstein's theory of relativity [sic] would have led to the development of clean energy by now if it hadn't been appropriated for nuclear warfare. We may never know."

If they don’t sign, you can’t have the DNR. How is that not the power to decide whether or not you can have the DNR?

You appear to be hung up on why the doctor might deny me the ability to have a DNR. Again, what difference does it make? What difference does the formal wording of the document make? Unless someone is actually insane and making random decisions, deciding to give permission or not is always based on something.

Although it isn't all that far away, it seems so. The air is different and better for people with plant-based allergies ( like me). There's a huge bay with tidal marshes and wooded groves, various maritime industries (fishing boats, marinas, boat services, ferries) and restaurants and fish shops.

Actually we found very good Malaysian food in one of the less posh towns where you could watch the boats from the deck or the windows. My companion likes to look at old, useless junk in crappy store with which this town was rife. So it was worthwhile.

Device Walter@155 You forgot to mention the title of Dan's article is “This Dude Is Straight-Up Nuts” and make the requisite "that's exactly what I was thinking joke."

Gamondes gives me a headache (unless that's just how it feels to have your mind blown, but I'm pretty sure it's just a headache). I do like looking at the "absolutely incredible fine art," as one of her commenters describes it.

It was only a matter of time before the anti-vaccination people started trying to criminalize vaccines.

"As for the school vaccinations, same thing. I don’t know why people would be afraid of vaccinations taking place in a clinic-type setting if they don’t bring their kids to it." Zebra

Because this is the education system being hijacked to underwrite a flawed process. Bit like handing out free milk in schools when there is no food value at all in pasteurized milk, that policy has created generations of milk drinkers.

You know the shots of politicians eating beefburgers just before the BSE crisis kicked off. There we go, more total disaster because 'food experts' thought it ok to feed cows to cows. That was one very public time when being what you would call a 'food faddist' was actually the new black.

Banking crisis, middle East crisis, chronic illness crisis..... all driven by those proper experts you talk about and all paid for by the man in the street. If you wonder why we have a problem with nice pretend vaxxy clinics in schools it is because schools are supposed to be safe places that don't abuse kids - especially when the doccy is smiling whilst teacher looks on.

Same with telling kids at school the story about Jenner and the milk maids, some are unlucky enough to believe that fairy story.

Just to remind NobRed - I am not Mr Hill and never have been. Nor am I someone called Philldo. Get some tissues and put something on it.

"“Similarly, Vaccination was originally conceived to save humanity from genuinely deadly disease, not to sterilize, drive polypharmacy, make incursions on civil rights or as cover for bombing raids." NobRed

Well it has spectacularly failed Oh Nobby one. Now, like with other failed medical processes, they are trying to put all the spend into other markets.

" Polio is left in only three countries, and India isn’t one of them (Afghanistan, Pakistan, and Nigeria to be specific). The only measles in the US is that brought here from other countries. Refute that fact. " Panfried pubmed

Polio has been renamed NPFP, it hasn't gone. When there was a nuclear accident in the UK they renamed the power station, it was Sizewell B and became overnight Windscale, or was it the other way round.There was also a move to name radiation 'freaky moonbeams' to make it appear safer.

If you want to believe Bill Gates, then the fantasy is all yours baby. Blaming disease on immigrants is the kind of thing those people who support ethnic cleansing do - I guess you must be a proper doctor then? All that expensive training, maybe you should start selling shares with your ethos.

"Wrong again. It’s a known tactic to cite a bunch of sources and claim that they support one’s argument when in fact the cites don’t, or even refute the argument." julian Frost

yes this thread was started by a paper that implied there was no link between autism and mercury. When you read the paper it says nothing of the sort.

Meanwhile here in medical geekski central, all sorts of odd people are posting away like complete nutters, convinced they are really having an impact.

If only there were some way that stupid people could look stuff up on the internet when they wanted to look less stupid.

At least you can make a coherent argument-- it doesn't hold up for me, but it is thoughtful. First one so far; maybe we can learn something.

Second, I assume you understand from my other comments that my issue here is autonomy of the individual, or at least the perception of having 'ownership' of one's body.

I can imagine, for example, that a family member could sue the doctor who signed the DNR for wrongful death/malpractice, and bring in expert testimony that the testator was in fact not competent.

On the other hand, think of the trouble that would be saved if wills were treated like DNRs. (Providing you less business, of course.)

Given these observations, perhaps you could explain for whom "It makes sense to have competence determined by a doctor up front for a DNR but not necessarily for a will."

If only there were some way that stupid people could look stuff up on the internet when they wanted to look less stupid.

zebra, Does it ever occur to you to wonder why you encounter so many people you end up accusing of having poor reasoning, a poor education, poor communication skills, disordered thinking and/or cognitive impairment in your discussions on the interwebz? Isn't the fact that the common denominator is you a clue to what is going on?

Of course there would be someone to sue: the doctor(s) who failed to save the patient's life without good reason. I'm sure you must have examples of people whose doctors refused to sign DNRs despite their clear, informed and competent wishes, and examples of doctors being sued for signing DNRs when patients were not competent. Otherwise this looks very much like you just making stuff up to support your inane arguments.

"But I would hardly call assaulting someone at a party of friends a community event. I dunno, Andy Wakefield thought it was."

Yes but at least he was honest enough to give them a fiver for their trouble and everyone knew what was being asked of them. Taking a blood sample isn't going to kill you or reduced your life expectancy like a vaccine with loads of unknown effects waiting to floor your immune system.

Funny, not one of the parents at that party complained to the GMC about anything at all. Only a pharma shill newspaper reporter who was working for someone who had a financial interest in the subject and family members on the board of the publishing medical peer reviewed journals.

Why did no parents complain at all? And why has the consultant GIT surgeon that worked with Wakefield now been reinstated with all charges against him dismissed?

LW seems to have some legal background so maybe you could act like a grownup and allow him/her to follow up on this? Maybe you could go read the dictionary definition of "permission" I provided again and see if you can sort out your own reasoning on your own topic?

"The truth is that not a single case of AFP has tested positive for polio, vaccine-derived or otherwise in India since 2011, and that you are a compulsive liar." Krappedinyapants otherwise known as fucxy

Well it wouldn't would it, according to the CDC it is a different disease! Is that the best you can do? You are a compulsive shoveler of applied manure, par excel-lance!

let's test lots of people for RA and then announce they are all free of rabies. Or how about putting labels on cucumbers that say 'gluten free' or 'not known to cause hayfever'

We could put on the insert for flulaval vaccine 'not known to prevent influenza' ----oh look, they have already thought of that...................Next..................If you see Mr Hill, please apologise on my behalf.

Start with the will. You have the right to leave your estate to whomever you please*. However, it has been observed historically that (a) some people make wills while suffering some form of incapacitation or undue influence such that we do not believe the wills actually reflect their wishes; and (b) some people, you will be shocked to learn, actually forge wills to obtain benefits which the testator never intended them to have. 

Now, as to a DNR. In this case, even more than the case of a will, there is the possibility that the person executing the DNR (I'll call him or her the "patient" for short) may be under some influence that makes their decision suspect, or the DNR may be an outright fraud by someone who wants the patient dead. And this document has a very immediate effect: if it is honored, the patient will likely die (that's the point, after all), and if it is not honored, the patient may end up receiving treatment he did not want and explicitly rejected while competent.

The law needs some mechanism to ensure, in both cases (will and DNR), that the document presented is what it purports to be and reflects the wishes of the person who executed it. 

There is an entire body of law built up around proper execution and proving of wills**. Part of that is law about contesting wills and the sort of proof required. So, in particular, a will which is not holographic*** requires at least two witnesses' signatures in this jurisdiction. The witnesses do not give the testator "permission" to make a will or to include any given terms; rather their signatures attest to the Court that the will really is that of the testator. 

But will contests take time; counting initial research, trial, and appeal, they could easily go on for more than a year. But that's tolerable -- not much happens while waiting for a decision on appeal; the personal representative of the estate just maintains the property and waits.

Contrast this with a DNR. Things are happening and may continue to happen for years if the DNR is not honored. So we want something better than a will, some more reliable proof that the document presented should be relied upon. Legislatures have grappled with this problem and established procedures to try to protect patient autonomy without opening the door to fraud. Bringing in a doctor to, in effect, give expert witness up front is not unreasonable in this regard. 

I will also point this out: if you tried to make a will but didn't follow the required procedures (it isn't holographic but has only one witness), your will is null and void and will not be enforced, ever. But if you tried to make a DNR but failed to follow the required forms, that does not mean you stay on life support for years; your expressed decision can be presented to the Court, which can order life support discontinued. But, again, that may mean you received undesired treatment for a long time.       

***a holographic will is entirely written, dated, and signed in the testator's own handwriting. Such wills may not be valid in other jurisdictions but they are here. They are also will contest magnets; when I was working for a law firm half of the holographic wills we presented were contested.  

tl;dr: in the case of either a will or a DNR, legislatures must find a balance between respecting an individual's autonomy and preventing fraud or unfortunate decisions made while incapacitated. Because of the tight time constraints on operation of a DNR, the requirements in that case may reasonably be more stringent than the requirements for a will; that includes an up-front opinion by a person with relevant expertise (a doctor in other words) that the person executing the document is competent to do so.  

First, as to influence or fraud-- I go to a notary and have my will witnessed by two people. My bank provides the service, in fact; it's very convenient. Complex tv-crime-show conspiracy-plots aside, that suffices; no gun to my head, I'm not drooling and incoherent, and it is really me signing it.

You say: "The witnesses do not give the testator “permission” to make a will or to include any given terms; rather their signatures attest to the Court that the will really is that of the testator. "

Well, that's not the case at all-- their signatures attest to what I said; no gun, no obvious impairment, really me. Neither witnesses nor notary are attributed any special expertise, beyond what an ordinary person has.*

So the statement: "I need a doctor's permission to refuse treatment (get a DNR)" holds. Doctor is a special category; the doctor does in fact address the content of the document.

But the real problem here is that you still haven't answered my question of standing, or whose interests are being served. Can you give a concise answer to that?

*The notary is only assumed to be 'honest', and ensure that the witnesses are not parties to the document.

yes this thread was started by a paper that implied there was no link between autism and mercury. When you read the paper it says nothing of the sort.

Wrong thread. This thread is about incorrect claims that SB 277 will lead to forced vaccination. If you mean "The Parrot is still dead and MMR still doesn't cause autism", that dealt with a report that looked at the rate of autism and vaccines in the younger siblings of children with an autism diagnosis. So you're at best wrong and at worst a liar.

Wrong again. The politician in question ate that beefburger AFTER the BSE crisis to show confidence in the product. You can't even get timelines right.

Wrong again, particularly re the Middle East. The experts were ignored and war was declared, because the Bush Administration and the neo-conservatives thought they knew better than the experts.

The falsity of your claim has been pointed out before. You are once again lying in the face of proof to the opposite.

Meanwhile here in medical geekski central, all sorts of odd people are posting away like complete nutters, convinced they are really having an impact.

I'll try. The two witnesses and a notary are *not* sufficient to prove the will if contested. Your competence can still be challenged and the testimony of the witnesss and notary will be evidence used by the expert witnesses in assessing your competence at the time*.  Such a challenge takes time. 

In the case of a DNR, the decision must be made fast. There is no time for a court hearing**. So we can reasonably demand a higher burden of proof up front.

You ask, "whose interests are being served." Well, yours, mainly. The reason DNRs exist at all is because there's a presumption that you do want treatment, so legislatures require a certain formality to the decision to reject it when you are not competent to speak. Secondarily, it protects the medical personnel as there is proof that they are carrying out your wishes. 

Again, the difference between a will and a DNR is that there is time to research and argue and bring in expert witnesses regarding a will; there is not time to do so in a life-or-death situation where a DNR is relevant. 

*we had a case which turned on exactly that question: was the testator competent when the two witnesses and a notary witnessed his signature? The expert witness said he was.

** though such a hearing could be held later if necessary but by that time you will have been given treatment that perhaps you did not want. 

You own your body and have a right to make decisions about your care. If you are unable to express such decisions, someone else must make them for you. Legislatures have balanced the issues of patient autonomy, fraud, and incapacity, and have come up with procedures you can use to instruct those making such decisions for you. As part of that, they may require a doctor to determine up-front whether you are currently competent to make such decisions. 

I think that is reasonable. You don't. So pester your legislators about it and maybe they'll change the procedures. 

Given these observations, perhaps you could explain for whom “It makes sense to have competence determined by a doctor up front for a DNR but not necessarily for a will.”

A will does not necessarily require an upfront finding of competence or (for that matter) any medically authorized finding because it's not a medical document, which means -- among other things -- that honoring your wishes about the disposition of your estate does not necessarily have implications of any kind for medical practice or medical practitioners.

The same could not be said of your wishes to receive medical treatment up to a certain point but not beyond it. The honoring of those potentially has implications for numerous people. They are, in point of fact, so very different from the implications raised by your wishes regarding the disposition of your estate after your death that the two effectively have nothing in common, rendering just about all comparison between them pointless.

You're actually not the only person whose rights and interests need to be considered in order to guarantee that your wishes not to receive medical treatment are honored!.

And it's not just about you and the doctor, either! Emotionally compelling as it may be to you to conceive of the whole business exclusively as a power struggle between you and the he or she over competency/autonomy that takes place in the special little fantasy world that you two alone share, that's not really what a POLST is designed to accommodate!

The POLST form is a medical order indicating a patient’s wishes regarding treatments that are commonly used in a medical crisis. As a medical order, emergency personnel – such as paramedics, EMTs, and emergency physicians – must follow these orders. Without a POLST form, paramedics and EMTs are required to provide every possible medical treatment to sustain life.

POLST is also helpful in guiding treatment after the initial emergency. The brightly colored form gives you a way to tell doctors, nurses, and other health care professionals what types of treatment you do and do not want.

It makes sense to have a doctor sign a POLST because in practical reality, medical personnel are necessarily obligated to the ethical practice of medicine and not, per se, to your wish not to be resuscitated, the medical validity of which they have no ethical way of determining in the real, practical circumstance of your imminent death, which happens to be the circumstance that a POLST is designed to accommodate.

So. If you can think of a simpler, more expedient, less burdensome, fairer or otherwise better way of guaranteeing that the wish of a terminally ill patient in the end stages of treatment not to be resuscitated will be honored that creates fewer impositions on the autonomous rights of all concerned, feel free to propose it.

It would still be off-topic, of course. But the problem with your present position is that narrow, solipsistic emotional considerations are not the only kind. And at least it would address that.

The reason a POLST requires a doctor's signature is that it's purpose isn't to make you feel like you have the autonomous right to have your wish not to be resuscitated honored at each and every moment leading up to the event. It's to guarantee that you have it when you need it. And it does that.

How you feel about the way it does that is your autonomous business. You've got a right to it. But it's a separate right. And the POLST doesn't impinge on it. So you just have to learn to tolerate the discomfort of having rights

You keep repeating parts of this that I've answered-- the doctor who signed the DNR can be sued for malpractice, just as a will can be contested. Same issue-- was the testator competent at the signing, and different experts will have different opinions.

As to protecting the medical personnel at the time, asked and answered as well-- a legally binding DNR does that, whether the controlling statute requires a doctor's permission or not.

So, we come to the crux, which is your observation that this is indeed a "nanny state" kind of issue; it supposedly protects me from making a decision about my body for 'inappropriate' reasons, and it assigns power to judge what is 'appropriate' to anyone with an MD.

So yes, you and I may disagree on what modality is preferable, but what you haven't done is refute in any way the claim that I've been making, which is this:

It is reasonable to question the extent to which I may have autonomy with respect to my body, both de facto and de jure, in interacting with the medical establishment.

"I need a doctor's permission to refuse treatment." (This is clearly self-contradictory in conception, which is often referred to in modern colloquial usage as oxymoronic.)

After reading more of johnny's mind boggling reality dysfunction, I'm wondering why I can never find www.weirdideasandeverythingisaconspiracy.com.

"So. If you can think of a simpler, more expedient, less burdensome, fairer or otherwise better way of guaranteeing that the wish of a terminally ill patient in the end stages of treatment not to be resuscitated will be honored that creates fewer impositions on the autonomous rights of all concerned, feel free to propose it."

Asked and answered many times now. I go to my bank, where a standardized form containing all the information, with all the colors you like, is signed and notarized and witnessed by the nice bank lady and a couple of tellers.

Somehow, the notion that a "nice bank lady & a couple of tellers" should be sufficient for making life and death (literally) decisions, seems a bit off......

The objection to the nanny state is that it deprives competent individuals of the opportunity to exercise their personal autonomy. If a DNR becomes relevant, you must already be incapable of exercising your personal autonomy, thus you are at that moment exactly the person that the nanny state ought to protect.

There are procedures in place to protect you in that event, inclding ensuring that you are competent to make decisions in advance of the crisis. They seem reasonable to me, not to you. Take it up with your legislator.

zebra: let's make this really easy. A DNR is a MEDICAL ORDER. Medical orders are only to be followed when signed by a doctor. No signature, no order. No legality. Period.

So do you have a problem with brown eyes then Julian - is that a dog whistle for more segregation? Excluding people from society for their beliefs is a slippery slope.

The falsity of your claim has been pointed out before. You are once again lying in the face of proof to the opposite." Septicus rantus

So I take it you watched Susan Humphries brilliant expose on the bullshit of Polio vaccine then? Proper Johnny.

Once again, johnny proves he just doesn't get euphemisms, particularly euphemistic references to expletives about solid excrement.

Suzanne Humphries (note spelling) has had her arguments dismantled here before. I don't listen to her for the same reason I don't listen to creationists on evolution or Age of Autism on vaccines and autism. I ignore liars.

Just to belabor the point some more, this is untrue. If you are aware and competent*, you can refuse any treatment you want.  Doctors may argue with you -- I've seen a doctor actually plead with a patient not to do this to himself -- but if you're determined to refuse, then they're legally obliged to honor that refusal**.

if you're not aware and competent, someone must make a decision for you. There are several ways this could be done. We might have a rule that in this case you are presumed to consent to any and all treatment. We might have a rule that you are presumed to refuse all treatment and should be left to die.

Or we might (and do) have procedures whereby you could state in advance what you do and do not refuse. There are various effects and varying degrees of formality involved. A DNR is one example; it is, as MI Dawn points out, a medical order and thus must be signed by a doctor. A POLST is another example that requires a doctor's signature. A health care power of attorney is another example; so is an advance directive. These very likely could be executed in front of the nice bank lady and a couple of tellers. If none of the above is available, the Court may appoint a guardian for you and the guardian will make the decisions that you cannot make. 

If you don't like the range of choices available to provide for refusing treatment in case you are incompetent to do so at the time, or the formalities required, then bug your legislator to change them or offer others.    

**yeah, yeah, there may be cases where, through accident or ill-will, such refusal is not honored. That does not change the principle. 

@LW Thanks for the explainations, very informative. Starting to get a little repetitive but such is the nature of trying to explain something to zebra. A stopped clock is right twice a day but if it starts out wrong amd keeps moving it will always be wrong.

Which would be true if it was johnny and not Johnny. Easy mistake though, it confuses the hell out of me too. But the real victim is Johnny@127.0.0.1 who had his identity stolen. We should all agree to call lowercase johnny by his real name, Phillip Hills. It seems to bother him so maybe if enough people do it he'll switch to a new sockpuppet that's not the same as someone else's 'nym.

zebra, Have you ever talked to any doctors, medical ethicists or patients nearing the end of their lives about DNRs and EOL care, as I have? Or have you just blundered into yet another subject you have no clue about, as is your usual MO?

And a lawyer is qualified to assess a person's competence how? Let's say someone complains that their deceased parent, who was not resuscitated because of a DNR drawn up according to your model, was suffering from depression and was not competent to sign a DNR. Let's say the patient was in fact fooled or coerced into doing so by a beneficiary in their will. The lawyer is only going to check the patient's identity and isn't going to check their medical history or notice an impairment that is obvious to a medic but not a layperson. Who is liable to be sued? The lawyer? Or the doctor who withheld CPR?

LW seems to have some legal background so maybe you could act like a grownup and allow him/her to follow up on this?

An admonishment to act like a grownup from someone who uses the word "duh" and appears to have the intellectual capacity of a 6-year-old? Oh the irony. It seems you don't like what LW has to say either, despite the legal background.

Maybe you could go read the dictionary definition of “permission” I provided again and see if you can sort out your own reasoning on your own topic?

As I have pointed out repeatedly, a doctor signs a DNR to confirm the patient's expressed wishes about EOL care, it does not grant permission to refuse EOL care, it records the patient's wishes. I don't know on what planet recording someone's wishes is equivalent to granting someone permission, but it isn't the one I live on.

We have already seen that you don't understand the meaning of various English words and concepts, like "on average", "probability", "the gambler's fallacy", "filibuster", "parsimony", "hypothesis testing", "a", "the", "null hypothesis", "should", "can", "who", "consistent" (which you memorably described as "an obscure term of art"), and "oxymoron". I'll add "permission" to the list.

Incidentally, it does amuse me that people are having to give simpler shortened versions of their comments because of your apparent inability to read and comprehend more than a couple of paragraphs.

@capnkrunch, sorry for the repetition. If I'm trying to explain something to someone who doesn't get it, I tend to keep trying with the expectation that somehow I didn't explain clearly. But I guess that's pointless with someone who's determined not to understand.

LW, I'm sure zebra understands it, once again s/he has just dug himself into a hole and is too pig-headed to admit s/he has made a mistake. Trying to blame some people's mistrust of vaccines on problems with EOL care is just ludicrous; the rest is just an attempt to distract form his/her initial blunder.

I was, so far as I know, the first to use the 'nym 'Johnny' on this board. When you arrived, I was somewhat concerned that there would be some level of confusion, but in short order it was clear to me that, while I am a bit player here, any 'brand recognition' I may have is safe.

You settled on lower case, I have always used uppercase, along with my local IP address, and, in an effort to further separate us, I started signing 'Proper Johnny' when we were in the same thread, because, hey, I *was* here first and I wanted to make darn sure there was no confusion between us.

I have no strong opinion on the issue of your name - it may really be johnny, or Phillip, or something else, I really don't care. But going out of your way to create confusion is a dick move, and speaks to your character.

Julian Frost@214 Sorry, I didn't realize that lowercase johnny was now using uppercase and signing Proper Johnny. You are clearly more observant than I. Thanks for pointing that out Johnny@127.0.0.1.

LW@219 Oh, no need to apologize. If anything, I'm impressed that you didn't throw your hands in the air and yell (loudly type?) "how can I make it any simpler?" after the second time.

Perhaps our chav friend is under a geas that forces him to misspell names. Perhaps "anne-to-an" is a feature of Estuary English. Perhaps someone installed a macro on his computer to see if he'd notice.

Notice NARAD the red knob still can’t comment on the trashing of polio vaccine by Susan Humphries – takes a proper doctor to know one

Delphine if you want your vaccine belief torn to shreds check out Susan Humphries – another proper doctor who has blown the whistle on Polio vaccine fraud.

Oddly enough, the same misspelling is prevalent in osteopathy circles --https://www.facebook.com/osteopathandacupunctureessex/posts/88309916173… -- so it is possible that johnny picked it up there and now obstinately continues to parrot the error out of Oppositional Defiance.

Asked and answered many times now. I go to my bank, where a standardized form containing all the information, with all the colors you like, is signed and notarized and witnessed by the nice bank lady and a couple of tellers.

What part of "the autonomous rights of all concerned" do you not understand? That doesn't do it for the EMTs. They are required to do what it takes to sustain life, absent medical orders. The nice bank lady is not empowered or qualified to make your wishes into medical orders. A doctor is.

It's not complicated. You are not the only person whose interests need to be accommodated. You get the right to refuse medical treatment. But you don't get it entirely your way. Because it's not your world alone. That's life.

They are required to do what it takes to sustain life, absent medical orders. The nice bank lady is not empowered or qualified to make your wishes into medical orders

Great point. I know I said I wasn't going to respond to zebra anymore but your point reminded me of something I've been thinking. It might help to think of a DNR not as a doctor giving you permission to refuse treatment but rather as a doctor giving other healthcare workers to not provide treatment.

Not to overtax your attention span or anything. But the EMTs are required to do what it takes to sustain life absent medical orders for reasons that also have nothing to do with you, or your wish not to be resuscitated, or any individual's.

You can get the DNR by having a doctor sign a POLST. Since POLSTS are for patients with terminal conditions and less than a year to live, it's very likely that won't take the vast majority of them far out of their way.

Your little fantasy about doctors treading on your rights is exactly that. But even if one did, you would have recourse to another doctor. So it's not much of a problem, as far as I can see.

It might help to think of a DNR not as a doctor giving you permission to refuse treatment but rather as a doctor giving other healthcare workers to not provide treatment.

Or even as a doctor making your wishes a higher priority than any other medical consideration. Because that's what it effing is, in reality. The tyrannical doctor who isn't the boss of zebra is purely notional.

And by "purely notional," I mean that zebra is autonomously empowered to solve the problem of that nasty, rights-infringing doctor, simply by ceasing to imagine that one is threatening his or her right to a DNR.

I mean, it's not like doctors stand to benefit by doing that. And it's not like there's an iota of evidence that they are doing it. It's a fantasy. And one with no apparent topical raison d'etre, at that.

It is reasonable to question the extent to which I may have autonomy with respect to my body, both de facto and de jure, in interacting with the medical establishment.

Apparently zebra thinks that if there is any impediment whatsoever to your free exercise of your personal autonomy under any circumstances at all, then you have been robbed of all personal autonomy. I tried to point out that this isn't so. I was apparently unsuccessful.

But the EMTs are required to do what it takes to sustain life absent medical orders for reasons that also have nothing to do with you, or your wish not to be resuscitated, or any individual’s.

zebra doesn't seem to think very highly of EMTs nor have a very good understanding of how EMS systems in the US work. In #74 he said:

referring to my comment that I, as a paramedic, legally cannot withhold resuscitation without a doctor's order. Of course being the supergenius he/she is, zebra knows more about EMS than I do and more about law than LW. I'm not sure what you're profession is ann but zebra is probably more knowledgable than you about that as well.

Asked and answered many times now. I go to my bank, where a standardized form containing all the information, with all the colors you like, is signed and notarized and witnessed by the nice bank lady and a couple of tellers.

Additionally, even assuming you can get around the obstacle of the EMTs without causing more hellish complications for others than you're saving for yourself:

Can you see how that would not present a very high bar to clear from the perspective of someone who was more eager to see a frail, elderly person in his or her care shuffle off than that person was to go?

I mean, I don't think that would be an epidemic problem. But abuse of the elderly by home health aides is a documented occurrence. So there's a real basis for reasonably regarding it as a potential risk than there is that a doctor is going to high-handedly refuse to sign your POLST just because he or she can.

Plus there's nothing preventing the putative high-handed doctor's patient from finding another doctor.

Once again: "Better" means "better for all concerned," and not just "better suited to your taste and temperament."

I think you need a little bit more of a rigorous system for assuring that the person getting the document notarized is the person whose name is on the ID (and/or is acting willingly, wittingly, etc.) than a bank lady and some tellers can realistically provide, given what's at stake and the vulnerability of many people whose lives are nearing the end,

You're presumably not an Alzheimer's patient in the care of a home health aide. But a lot of people are. Your little modest proposal does not take the full range of their potential needs and interests into account. And they too have rights, what with being people and all.

I think you need a little bit more of a rigorous system for assuring that the person getting the document notarized is the person whose name is on the ID (and/or is acting willingly, wittingly, etc.) than a bank lady and some tellers can realistically provide

Despite the fact that, most certainly, IANAL, as it happens, I have been a notary public at a law firm! (Like most everybody else on the night shift, although not in the good old days of embossers.)

One might note that an acknowledgment only means that someone says that they freely signed something (past tense), not that they had the slightest idea what it was.

The same goes for a jurat, except that one has to take a Very Solemn Oath that one's statements in the document are true and sign in the presence of the notary.

It is reasonable to question the extent to which I may have autonomy with respect to my body, both de facto and de jure, in interacting with the medical establishment.

Apparently zebra thinks that if there is any impediment whatsoever to your free exercise of your personal autonomy under any circumstances at all, then you have been robbed of all personal autonomy. I tried to point out that this isn’t so. I was apparently unsuccessful.

Aha. Thanks for bringing that to my attention. I missed it the first time. The use of the phrase "de facto and de jure" by someone posting comments to the internet tends to go hand in hand with an inability to grasp that rights are contingent on factors and circumstances, in my personal experience.

I guess it kind of goes without saying that it's reasonable to question the extent to which one may have autonomy with respect to one's body, both de facto and de jure, when interacting with the medical establishment, if one happens to be ignorant on that point.

I mean, these things are good to know. Let's say you wanted the medical establishment to amputate your left arm because you had autonomous reasons of your own for wishing to be rid of it, for example. Because it doesn't extend to that point. And as a matter of both fact and law, one might reasonably expect the medical establishment to respond to a request of that kind by questioning the mental competency of the person who made it, Or possibly even putting him or her on 72-hour hold.

^ Another way of putting my previous comment is that a notarized document has no legal force other than against the signer.

Looks like it might be time to recommend that zebra deal with the beams before taking on the motes, doesn't it?

I am disappointed that I can't find even an effort at drawing a Superhero Notary Public. I may be able to get somebody on it.

Let’s say you wanted the medical establishment to amputate your left arm because you had autonomous reasons of your own for wishing to be rid of it, for example. Because it doesn’t extend to that point. And as a matter of both fact and law, one might reasonably expect the medical establishment to respond to a request of that kind by questioning the mental competency of the person who made it, Or possibly even putting him or her on 72-hour hold.

As you are probably aware, this hypothetical situation does sometimes occur, usually diagnosed as body integrity identity disorder or sometimes apotemnophilia. Even more bizarrely, a Scottish doctor has amputated healthy limbs in at least two of these patients, but not until other avenues had been explored:

He also discussed the procedure with his defence body and with the ethics committee of the General Medical Council. The patients, who had failed to respond to conventional treatment, were assessed and counselled beforehand by psychiatrists and a psychologist.

There's an interesting discussion of the ethics of this situation here. It may seem barbaric, but consider gender reassignment surgery, which is generally accepted. Medical ethics is an ever-fascinating area, full of shades of gray.

What irritates me about zebra's "motes and beams" is that beams are much worse than motes. I don't agree that problems of the medical profession are much worse than those of alt med or antivaxxers, or whatever zebra is defending at the moment.

And then there's "what about the poor EMT?". Which is kind of strange since the expert EMT says treatment would automatically be started without looking for a DNR.

So yes, you and I may disagree on what modality is preferable, but what you haven’t done is refute in any way the claim that I’ve been making, which is this:

It is reasonable to question the extent to which I may have autonomy with respect to my body, both de facto and de jure, in interacting with the medical establishment.

“I need a doctor’s permission to refuse treatment.” (This is clearly self-contradictory in conception, which is often referred to in modern colloquial usage as oxymoronic.)"

Which, apart from being correct, causes a problem for some who translate "question the extent to which..."

"Apparently zebra thinks that if there is any impediment whatsoever to your free exercise of your personal autonomy under any circumstances at all, then you have been robbed of all personal autonomy."

I thought I was on a science blog, but apparently I've stumbled on a Fox News subsidiary. Or maybe it's a false-flag anti-vax operation, designed to make the pro-vax side look inept and Authoritarian?

Okay, zebra, have it your way. Under certain dire circumstances, when you are incapable of exercising your own personal bodily autonomy through injury, disease, infirmity, or the like, the medical establishment will indeed act upon your body in the ways which society believes -- but you evidently di not -- best reflect what you would have done if you were able to exercise your personal bodily autonomy, which you were not. In pursuit of this, certain procedures are offered whereby you can express your desires for exercising your personal bodily autonomy in advance.

No. It requires a Doctor's Signature because despite what you think, it's very hard for a non-physician to distinguish if someone is of sound mind. In #199, you mentioned getting a will. Your comment was:

I go to a notary and have my will witnessed by two people. My bank provides the service, in fact; it’s very convenient. Complex tv-crime-show conspiracy-plots aside, that suffices; no gun to my head, I’m not drooling and incoherent

Leaving aside the sheer offensiveness of your characterisation of mental illness, your naivete is mindblowing. Signs of mental illness are often very subtle, and many mentally ill people can appear lucid. That you imagine that the signs of mental illness are always so unambiguous that people who are not medically trained can detect them astounds me. That is why a qualified physician has to fill out the DNR. With regards to wills as opposed to DNR's, wills are frequently challenged in court, and quite often the person contesting gets the will overturned. Suppose a DNR is implemented but then turns out to be incorrect, for whatever reason. Maybe the patient was mentally ill, maybe he/she was coerced. In that situation, you can't bring the patient back to life. To quote Ian Fleming, Death is forever. That is why DNR's and POLST's have to be so carefully drawn up.

I wasn't commenting on this because the argument was already off-topic. Let's just say zebra obviously has never been involved in a will contest.

Justthestats Everyone who works with scientific research for a living knows that prepublication peer review is the first step towards scientific acceptance, not the end-all-be-all stamp of scientific acceptance.

Oh really? maybe for scientists but for the rest of the world and the media when people hear "peer reviewed" its considered, case closed, science has spoken! GOSPEL

Clearly the pharmaceutical industry which has EVERYTHING at stake and a lot to lose will do everything and anything to make sure it maintains power in heath care. They operate like a cartel. strong arming scientists, infiltrating medical schools, sucking up to doctors, demonizing alt practitioners, creating doubt in the vitamin supplements etc. Cant you see that?

With peer review reduced to rubbish by former editors, there is no reason to believe any of the research on vaccine safety or any other drugs these monopolies push. The fact is you don't need most of the toxic medicine they recommend.

The damn is breaking the foundation is weak. Its just a matter of time. People are waking up. And if you are still clinging on to your erroneous faith in pharmaceutical science you may want to reconsider. ITS A HUGE FUCKING LIE.

Food is the ultimate medicine DUH! What do you get from food? vitamins what do you get from vitamins? nutrients. the building blocks of life.

Which is kind of strange since the expert EMT says treatment would automatically be started without looking for a DNR.

As a side note keeping that in your pocket is a poor choice. No one is going to rifle through your pockets before starting care, especially in a full arrest.

In a way, you are correct. I'm not going to go out of my way to find your DNR. Working a code is work intensive, I don't generally have the manpower to send someone to hunt down your DNR if it is not readily available. Also, it is well known that even small delays in CPR can cause worse outcomes. If I delay CPR on every patient to look through their wallet in order to confirm they do not have a DNR that is going be harmful to patients who do want to be resuscitated. Like I said before our default mode is resuscitate everyone and to suggest that we do otherwise is ludicrous.

In a way you are also wrong. If there is family or a caretaker on scene I will always ask about DNRs. If I have extra hands (one place I worked dispatched PD to every call and that's a pretty common practice) I will send someone to look for it. If it is not immediately available I will start CPR at least while they look for it. As was the case with your original link, I cannot honor something I don't have. If the DNR is found I will terminate resuscitation provided there is no return of spontaneous circulation. However, delaying care while we wait is going to lead to poor outcomes for those patients who do not have DNRs. As Sarah A succinctly put it in #83 "you can always die later, but once you’re dead there’s no re-do."

So again, there are issues but they are not what you seem to think they are. In this case it is with educating the family. First off, don't call 911. We're not cops, you won't see us unless you call first. Second, if we somehow end up there (maybe one family memeber disagrees and called us) make sure you have DNR immediately ready. Third, keep the DNR somewhere readily apparent in case something happens while no one else is around. Best is on the fridge. Once again you are being disingenuous*. It's not that I won't look for a DNR, it's that I won't delay care to ensure that there is none. That would be unfair to every patient without a DNR not to mention both unethical and illegal.

*I'm getting tired of calling you disingenuous so looked it up in thesaurus to see if I could switch it up this time but there's really no other word that fits as perfectly.

If nothing else, you have to give zebra this: he/she is pretty good at derailing the thread. If you trace the thread back it all stems from his/her statement in #22 that "it is difficult to allay fears when the fears are grounded in some reality," in reply to Dorit Reiss saying in #16 "but remember that the anti-vaccine people express concern that their children will be force vaccinated if efforts are, for example, held in school," and zebra's use of end of life care in support of that.

What's really bizarre to me is that the idea of vaccinating everyone as a community at school was zebra's idea to begin with. Which means this all started with zebra making a nonsense argument in support of a criticism of his/her own idea. I think that is pretty good evidence that zebra's intent was simply to be troll from the very beginning; which would be consistent with zebra's behavior in other threads as well.

You misinterpret the 'drooling and incoherent'-- for example, someone could be falling-down drunk. Probably, most notaries would decline to serve that person.

We have very high standards for determining that a person is a threat to himself (or others), allowing government to violate the person's physical autonomy.

For example, we do not prevent the homeless, many of whom are mentally ill, from sleeping on the street in freezing weather; we don't round them up and test them for psychosis or depression, and force them into institutions. But somehow, an otherwise apparently functional adult refusing to be subjected to some invasive procedure in the future is deemed "potentially not competent" a priori.

"What’s really bizarre to me is that the idea of vaccinating everyone as a community at school was zebra’s idea to begin with. Which means this all started with zebra making a nonsense argument in support of a criticism of his/her own idea"

Maybe you should go back and read the comments you perhaps missed when you flounced off. And explain what is a "criticism of his own idea"?

More anti-vax fol de rol: They often say that 'great minds think alike'- well, I don't know how that would apply in this case but...

I seem to have run across such a meeting of the "minds" today courtesy of Ann Dachel ( AoA) and Mike Adams ( Natural News)

Mikey ventures that perhaps the Governor of California supports laws that make evading vaccination more difficult in order to create a generation of vaccine 'damaged' individuals who will not baulk at menial, repetitive work.

Dachel speaks of a "generation of developmentally disabled" children who will soon become adults. "36%" of them have learning disabilities, so many are autistic or have psychological problems. Where will it all end? she moans. Of course, NONE of these issues have ever existed before the advent of increased vaccination or the ((shudder)) "Age of Autism".

-btw- Ann is old enough ( 70?) and Mikey is nearly old enough ( 48?) to recall nearly universal institutionalisation of the developmentally disabled and the mentally ill. Both should be literate enough to have read about these historically and about societal attempts to remedy problems associated with living conditions for these populations. Perhaps their reading is more biased towards material that fits their bent mindset.

BUT I do recall Mike elaborating upon the mistreatment of the mentally ill in hospitals as a way to discourage the employment of psychiatrics and psychologists in addressing these conditions.

Oh, I've been watching you make a fool of yourself this whole time which you would've known if you went back and read my comments. Either way it doesn't matter much since I was referring to your original comments that sparked this whole mess.

Exactly what it says on the box. You're from left field response to Dorit's response to your idea. Let's play back the tapes.

Let’s make vaccination of children a public health matter, carried out by the government. When the appropriate age comes, you go to the school building on designated days and have it done, for free.

If you want to opt out, you go there and opt out, and deal with the later consequences. But everyone is treated equally, and it is a community activity.

A. And re community event: some immunization coalitions actually organize local immunization clinics, to help those with access problems. Would that fit that? But remember that the anti-vaccine people express concern that their children will be force vaccinated if efforts are, for example, held in school.

It is difficult to allay fears when the fears are grounded in some reality. That’s why I recommend people like Orac deal with beams before taking on the motes.

My suggestion was for parents to take their kids to be vaccinated, or show up, sans children, to sign a form declining. That way there is equal treatment, and a clear record; I understand from reading that the records can be a real issue.

Clearly referencing the anecdotes, not saying vax fears are grounded in reality. But you already knew that. This is your idea of a serious debate?

Well, that submitted before I was done. Should start "zebra@249" and end "To quote a certain striped animal, 'This is your idea of a serious debate?'"

I am disappointed that I can’t find even an effort at drawing a Superhero Notary Public. I may be able to get somebody on it.

I like to draw, but am currently unclear about what visual characteristics might distinguish a notary public.

For example, we do not prevent the homeless, many of whom are mentally ill, from sleeping on the street in freezing weather;

Two remarks 1 - do you believe this sorry state of affair - letting human being freeze to their death - is as is ought to be? 2 - I don't know about your country, but in mine we have some good angels going around the street during wintertime trying to convince homeless people to reach a shelter and/or providing them with sleeping bags. We also have a lot of people lamenting the lack of accessible care for the mentally ill.

In short, the situation you describe is everything but "normal". It's this way because we don't have the resources nor perfect solutions to very complex situations. That's not exactly a good quality for a metaphorical yardstick.

I will go so far as to call you a very privileged guy if you don't have to worry about losing your home or your wits. Try to put in you head that not everybody has a life as perfect as yours.

But somehow, an otherwise apparently functional adult refusing to be subjected to some invasive procedure in the future is deemed “potentially not competent” a priori.

Because, you pillock, if someone whose job is to provide help to people doesn't do his job on your hypothetical functional adult, this defaulting helper is the one who will get blamed if it turns out this functional adult was in a suicidal mood when writing his "don't help me" letter.

For these reasons, a priori, a medic will do his/her best to help you, and worry about yours desiderata later.

I referenced the NYT article (and comments), which are about EOL, not vaccinations. So how could someone misinterpret that as validating the specific concerns of AV people about vaccinations?

Beth's anecdote was about someone being pushy WRT vaccination; I thought Beth was a regular Minion and had no reason to reject her input.

You obviously are not clear on the beam/mote concept. The ongoing debate between me and the Minions is that we need to fix the system and deal with real issues that affect lots of people in very bad ways, instead of focusing on trivia. If you fix the system, trivia will also be fixed.

Also, you have not been reading or understanding. The treating practitioner will not be blamed for anything if the law says that the DNR is valid when notarized and witnessed. That's the whole point, which I've now given multiple times, but you silly gooses keep repeating your nonsense.

I have difficulty understanding how supposedly educated, intelligent people keep repeating this mistake. Maybe they are trolling?

No. Dorit Reiss offered some criticism of your idea. You responded by offering support for that criticism instead of addressing it.

You said, "It is difficult to allay fears when the fears are grounded in some reality," in response to "But remember that the anti-vaccine people express concern that their children will be force vaccinated if efforts are, for example, held in school." Clearly referencing AV fears. Later you said "Clearly referencing the anecdotes, not saying vax fears are grounded in reality." If you can't understand how that is being dishonest, I don't know how to else to explain it to you.

This is earth, not htrae. Helianthus has shredded your "argument" pretty thoroughly, so I'll leave it at that.

I just checked my state Attorney General's website, and can find no indication that a doctor's signature is required for a living will or other advance directives. All that is required is for the documents to be witnessed or notarized.

The treating practitioner will not be blamed for anything if the law says that the DNR is valid when notarized and witnessed.

And as LW told you multiple times that is untrue. Even a will which is valid when signed and notarized can be contested on competency. A doctor is the expert witness needed to prove competency. Since there is no time to go to court and prove competency in a medical emergency it is done upfront with a DNR.

@zebra, I am very troubled that under your proposal a competent adult will be forced to get permission from the nice lady at the bank in order to execute a DNR. In fact, I am very troubled that a competent adult will be forced to get permission from two witnesses. I think executing a DNR should be like signing a check: it's got a signature on it, so it's valid. Making a life-and-death decision should require no more formalities than buying lunch. Are we agreed?

So, if you are held harmless by the law if you don't resuscitate in the case (b), why would you not be in case (a)?

I've pointed out that in case (b), the signing physician is the one subject to challenge and claims of malpractice. But in no case is the simple EMT responsible for anything other than following the law.

Now, either refute that logically or flounce off again until you feel confident enough to come back and troll some more.

Now can you tell us what the consequences are for medical personnel refusing to honor those because they aren't 'doctor's orders'?

"No. It requires a Doctor’s Signature because despite what you think, it’s very hard for a non-physician to distinguish if someone is of sound mind." Julian Frost

Are you kidding, there was hardly a doctor alive who could even diagnose swine flu and the consequence of that was media hysteria and panic. How on earth would a doctor be a competent judge of sanity - a large proportion of them, but not all, still believe in vaccination.

I’ll try. The two witnesses and a notary are *not* sufficient to prove the will if contested. Your competence can still be challenged and the testimony of the witnesss and notary will be evidence used by the expert witnesses in assessing your competence at the time*. Such a challenge takes time.

Note that a signed and notarized will can still be contested on competence. It's reasonable to assume that would also be the case for DNRs. If the law said I needed to honor such a DNR, of course I would. Would I be thrilled about? No. The fact that it could be reasonably contested on competency (unlike a DNR signed by a doctor) opens me up to additional liability*. If I withhold resuscitation based on a DNR found to be invalid based on competency that could be negligence in the same way that withhold resuscitation based on an invalid DNR would be.**

Your argument only makes sense if we also change the law so that a signed and notarized document cannot be contested on competence. You can go ahead and make that argument if you want but I have to disagree. This would fail to protect vulnerable populations, the elderly and the terminally ill.

*Actually, it's difficult to successfully litigate against EMTs. Most of the liability would probably fall on medical director. That doesn't mean it's impossible though. **IANAL of course. Maybe LW could confirm my suspicions.

Now, either refute that logically or flounce off again until you feel confident enough to come back and troll some more.

Unfortunately the area I understand is probate (wills, will contests, guardianships, and the like). I can't really answer about malpractice suits or torts.

I just said, the DNR signed by a doctor can be challenged on competency. The doctor who signed it saying the testator is competent can be found to be incorrect by expert testimony. You know, that malpractice thing?

What exactly would EMT, hospital, or treating doctor, have done wrong in following a legal document, whether the law says a or b?

Still waiting to hear why crazy homeless people are less crazy than people who don't want invasive medical procedures.

I'm still waiting for zebra to respond to my modest proposal to reduce the formalities of making life-or-death decision to the same formalities as buying lunch.

I think executing a DNR should be like signing a check: it’s got a signature on it, so it’s valid.

One could make it completely equivalent by simply requiring MedicAlert to only sell DNR jewelry if paid by check. Problem solved.

The ongoing debate between me and the Minions is that we need to fix the system and deal with real issues that affect lots of people in very bad ways, instead of focusing on trivia. If you fix the system, trivia will also be fixed.

A notarized document provides some protection against forgeries and coercion. Those involve someone else infringing on my autonomy. My visiting the nice bank lady with my document is an autonomous act.

And the question remains: Why is a perfectly rational decision like refusing some possible future invasive treatment treated as requiring a test of mental competence?

Your argument only makes sense if we also change the law so that a signed and notarized document cannot be contested on competence.

Grieving relative:"you didn't save my dad. I will sue you!" Medic:"but he had this slip of paper saying DNR" GR:"He was depressive when he has it signed, He just divorced with mom."

The change in law suggested by zebra would impact a lot of other things in our society, notably all the little things about providing assistance to someone in need. Well, I guess the people working in suicide prevention could find another job as DNR witnesses.

"You want to jump off the bridge? Please say it again in front of my camera. Good. I cannot stop you anymore, please proceed."

Exactly. Generally speaking, I am very in favor of assisted suicide for the terminally ill - or more generally, of people having some choice on how they are going to leave this world. A Dutch friend of mine told me how his old mom choose euthanasia after a stroke left her half-paralyzed (a side effect of a bronchitis resulting from a bad flu she caught from another of her children). It was a cause defended by the late Terry Pratchett, and as an admirer of his prose and views on life, I cannot help but follow his views on this.

But there is one argument against medically-assisted suicide which I cannot refute: Peer pressure. It could be very easy to make people feeling unwanted. With some self-conscious people, you don't even have to do anything, they will do it all by themselves.

The ongoing debate between me and the Minions is that we need to fix the system and deal with real issues that affect lots of people in very bad ways, instead of focusing on trivia.

Funny comment from someone who has spent the last 3 days arguing about having DNR done at his local bank rather than with his regular physician.

There's nothing that says "fixing the system" like asserting that all of the obvious flaws in one's Big Picture will be adequately dealt with after the fact. In equity.

@zebra, why should I have to get permission from a notary to make this decision? If I'm satisfied that I'm not under any coercion, why should some notary be able to gainsay me? Or claim I was too drunk to sign and refuse to grant permission, as you suggested above? Why is a perfectly rational decision like refusing some possible future invasive treatment treated as requiring a test of sobriety?

How's that? Most states don't even specify any particular form of identification for notarization, and protection against coercion is laughable.

Apparently being able to get a DNR at the bank will increase vaccine uptake, eliminating annual physicals will reduce the use of CAM, and prescribing ginger tea will reduce the prescription of antibiotics for viral infections. Really? Did someone mention cognitive impairment?

What exactly would EMT, hospital, or treating doctor, have done wrong in following a legal document, whether the law says a or b?

Nothing. That doesn't necessarily provide legal protection. That being said, this is a hypothetical legal situation and neither of us are legal experts so debating this point further seems useless.

And the question remains: Why is a perfectly rational decision like refusing some possible future invasive treatment treated as requiring a test of mental competence?

It is unethical to provide a DNR to someone who is suffering a bout of depression or other uncontrolled psychiatric problem. Or someone pressured into it by family or caretakers. Or someone with a learning disability who can't understand what he/she is signing. Or anyone who doesn't understand what they are signing. Krebiozen@95 (quoting a comment from the original link you provided)

I can’t count the number of times I have met with a patient with a DNR order presenting with a serious but curable illness like pneumonia, facing “life support”. When I ask “are you sure you would not want to be on a breathing machine for a few days if that’s what it takes for a good chance of going home again” they look absolutely stunned, and reply along the lines of “I thought this form referred to being unconscious and on life support for decades, like Terri Schiavo or Nancy Cruzan”.

Like I said before, this is a protection for the most vulnerable people in our society. For you, as a fully competent adult it doesn't make any difference so needing a doctor's signature might just seem like an extra hoop to jump through. But the world does not revolve around zebra.

A notarized document provides some protection against forgeries and coercion. Those involve someone else infringing on my autonomy. My visiting the nice bank lady with my document is an autonomous act.

And the question remains: Why is a perfectly rational decision like refusing some possible future invasive treatment treated as requiring a test of mental competence?

Did you know that major financial decisions can also be treated that way? It's true. Contracts are signed on the assumption of mental competence; if you are found incompetent, or found to have been coerced or misled, the contract is null and void. You can't change your will if you're mentally imcompetent. Why are you expecting a *lower* standard of competence for matters of life and death than is expected of financial transactions?

(Note: I am aware that financial instutions and businesses are not always entirely responsible about this sort of thing, and that many will take willful advantage of a mentally incompetent person. This does not make me more willing to accept lower standards of competence for medical decisions. Quite the opposite, in fact, given the potential for abuse has already been so well demonstrated in the financial arena.)

There is no more or less reason to have a DNR notarized than there is to have a will notarized. You are simply trying to dodge the question:

What makes an advanced decision not to have some invasive procedure different from any other life-and-death decision, where there is some risk but no certainty?

Why is the standard for psych commitment so high, but not wanting CPR is considered a sign of potential lack of competence.

^^ At least it's next to impossible to fraudulently obtain a notary stamp, thanks to the stringent security measures that office-supply stores are justifiably famous for, backed up by the specialized training received by medical personnel in spotting fakes.

Well, at least that's been taken care of. Now everyone can just keep stock forms on hand and wave them at the EMTs when Auntie Warbucks has a little trip-and-fall accident.

You are (pardon the pun) dead wrong. If it can be shown that a person was not of sound mind when he/she wrote or updated a will, that will can be challenged and overturned. If a person wrote a DNR when not of sound mind and the DNR was implemented, then you can't bring that person back to life. If you don't understand the difference between the two situations then I can't help you.

You are once again just making an assertion "x is not ethical", ipse dixit, which has two flaws (at least).

Ethics is an arbitrary set of rules. Doctors can make rules for themselves, but that doesn't mean they are not violating my autonomy when they are following them.

But then there's the problem that, and I repeat, we have very high standards for violating a person's physical autonomy.

Taking a risk does not meet that standard. And getting a DNR is simply making a decision that carries some risk. So is sleeping rough when the temps are near zero.

Tell me why you have to test my competence when I want a DNR, but not when I take some other life-and-death risk. What makes it special?

Why should a will be notarized? Actually it doesn't need to be in this jurisdiction; the notary is required for the self-proving section, without which we have to produce at least one witness in order to prove the will even without a contest. So you're okay with a DNR that just has witness signatures?

For that matter, as I mentioned, you don't even need witnesses for a holographic will. So you're okay with the concept of a holographic DNR?

Taking a risk does not meet that standard. And getting a DNR is simply making a decision that carries some risk. So is sleeping rough when the temps are near zero.

Tell me why you have to test my competence when I want a DNR, but not when I take some other life-and-death risk. What makes it special?

God you're dense. We test your competency because we need to test everyone's. Your argument seems to have devolved into "it's inconvient to me, screw everyone else." We do it to protect, for example, someone with bipolar disorder going through a depressive phase or someone with a learning disability and a disinterested caretaker. There are certainly grey areas in ethics, taking measures to protect vulnerable populations is generally accepted as ok though.

Your continued use of this homeless argument actually seems to hurt your position. The way homeless are treated is terrible. The fact that we don't help those who are mentally ill and can't help themselves is a huge failing in our society. We need more protections for them, not less.

Why is the standard for psych commitment so high, but not wanting CPR is considered a sign of potential lack of competence.

Leaving aside the fact that this is a non sequitur, I eagerly await Z.'s exposition of his knowledge of how getting admitted to and discharged from mental hospitals (a state-by-state matter) works in practice.

Ethics is an arbitrary set of rules. . . , and I repeat, we have very high standards for violating a person’s physical autonomy.

Since ethics are so arbitrary, I hereby declare that "zebra's physical autonomy is unimportant." to be added to the arbitrary set of rules. I also add "justthestats's authority to change the rules is permanent, preeminent and unquestionable, as is this rule." to the set.

This rule change can be referred to as the "Everyone Loves To Violate zebra's Physical Autonomy Act (2015)"

Narad@293 Not to mention, "...but not wanting CPR is considered a sign of potential lack of competence," is just patently untrue.

zebra, as I keep saying, we don't do this because we question your competence, it is to ensure those who are incompetent (independent of their desire for a DNR) are not taken advantage of. You've revealed yourself to be not only dishonest but incredibly selfish and narcissistic as well.

The question is about why DNR rather than sleeping rough, or climbing Everest, or smoking cigarettes, or drinking, or buying a gun when you are bipolar?

I calculate that having a DNR is highly unlikely to reduce my life expectancy, at least as I want to live life. That's a risk I'm willing to take, and it isn't indicative of any mental illness.

So, as I clearly indicated, for me, the homeless mentally ill = beam. But somehow, we still maintain that high standard for psych commitment, and don't help them.

Why then is the standard so low for allowing doctors to assault my physical autonomy? What makes DNR special?

Let’s make DNRs a public health matter, carried out by the government. When the appropriate age comes, you go to the notary on designated days and have it done, for free.

If you want to opt out, you go there and opt out, and deal with the later consequences. But everyone is treated equally, and it is a community activity.

So, as I clearly indicated, for me, the homeless mentally ill = beam. But somehow, we still maintain that high standard for psych commitment, and don’t help them.

And that answers my previous question: Z. has exactly zero idea of how the mental-health system works.

Things we can add to the list of things zebra is ignorant/arrogant about: the situation of the mentally ill. The reason so many people with mental illness are homeless is not because we don't have roving bands of psychiatrists rounding them up and having them involuntarily committed, genius, it's because there aren't enough beds in inpatient facilities. It's all quite a bit more complicated than you seem to realize, but the problem is basically one of the (I'm hoping) unanticipated consequences of deinstitutionalization.

how getting admitted to and discharged from mental hospitals (a state-by-state matter) works in practice.

That's an easy one. (1.) Tell the judge that you are sorry you didn't remove the marlbourogh from your lips before telling the state trooper to kiss your phallis studded with diffuse-orgone-Arcturus-back-light to get in and then (2.) have your indian friend throw the marble water fountain fixture out the window to get out... No, wait. It is probably easier to just tell the cop to "tell the nearest Threat Fusion Center that I said "911 was an inside job" while being booked and biometrically scanned (gone are the days of a simple mug shot).

Inverse-tadger-tounging Louise Fletcher during the internment is totally a matter of violating a competent DNR order. Though, at this stage of the game, it is completely, nonstimulatingly irrelevant.

Unlike climbing Mount Everest, taking up smoking, going sky-diving, or whatever other examples you want to bring up, executing a DNR is giving an order to medical personnel to do something (let you die) that they would not otherwise be permitted to do. Is that clear? It is a different kind of act.

Since you haven't responded to my modest proposal for eliminating all formalities associated with executing a DNR, it seems you accept that there is some need for formalities beyond a signature.

You vociferously object to the existing formalities established by your legislature which has to balance protection of personal autonomy against protection of the vulnerable from being taken advantage of. So, as I have said repeatedly, take it up with your legislator.

Just don't seek medical attention and don't allow others to seek it on your behalf, and your personal autonomy will be fully protected and you won't have to go through any formalities at all.

There are plenty of beds. The homeless can't pay for them, because, well...you know, they are... mentally ill, and can't work.

But it is also true, as I know anecdotally in at least a couple of cases, and more broadly from reading, that some people just make that choice, because, you know, they are...mentally ill. And they can't be forced to undergo treatment.

Whereas unconscious people can be forced to undergo treatment. Unless they have a doctor's permission not to.

There are plenty of beds. The homeless can’t pay for them, because, well…you know, they are… mentally ill, and can’t work....

Holy fυck. This is a mind-boggling level of stupidity regarding involuntary commitment (which private hospitals won't even touch, in my experience).

I guess we can add "involuntary" to the list of common English words which zebra does not understand.

because there aren’t enough beds in inpatient facilities Hence the psychiatric breakthrough known as Greyhound Therapy.

I guess we can add “involuntary” to the list of common English words which zebra does not understand.

As well as the reason for the 1970s reforms in mental-health law, which preceded deinstitutionalization.

Why then is the standard so low for allowing doctors to assault my physical autonomy? What makes DNR special?

This "argument" doesn't even make any sense. CPR isn't the same thing as being locked in a hole to rot.

Also, no, there are not “plenty of beds,” No matter, the gaps are filled by the prison system, in which neither over-crowding nor involuntary confinement are concerns.

^ Moreover, since Z. has been playing fast and loose with the DNR–advance directive distinction ("somehow, an otherwise apparently functional adult refusing to be subjected to some invasive procedure in the future is deemed 'potentially not competent' a priori," in which he also includes a blanket prognostication about the behavior of notaries), allow me to specify CPR for whom. I will use Wisconsin's definition:

(a) The person has a terminal condition [or] (b) The person has a medical condition such that, were the person to suffer cardiac or pulmonary failure, resuscitation would be unsuccessful in restoring cardiac or respiratory function or the person would experience repeated cardiac or pulmonary failure within a short period before death occurs [or] (c) The person has a medical condition such that, were the person to suffer cardiac or pulmonary failure, resuscitation of that person would cause significant physical pain or harm that would outweigh the possibility that resuscitation would successfully restore cardiac or respiratory function for an indefinite period of time.

Thanks. Yes, that was the disorder I had in mind. And it's fascinating that it worked. I guess I'm a little surprised that it did. But if it did, I don't think it's barbaric at all..

I think you need a little bit more of a rigorous system for assuring that the person getting the document notarized is the person whose name is on the ID (and/or is acting willingly, wittingly, etc.) than a bank lady and some tellers can realistically provide, given what’s at stake and the vulnerability of many people whose lives are nearing the end,

You’re presumably not an Alzheimer’s patient in the care of a home health aide. But a lot of people are. Your little modest proposal does not take the full range of their potential needs and interests into account. And they too have rights, what with being people and all.

It's a medical order because it's an order ("an authoritative direction or instruction; command; mandate") and because it's medical ("of or relating to the science of medicine, or to the treatment of illness and injuries").

But somehow, an otherwise apparently functional adult refusing to be subjected to some invasive procedure in the future is deemed “potentially not competent” a priori.

Is an apparently functional adult who gets asked to show the train conductor a ticket being deemed "potentially a hobo" a priori, would you say?

There are plenty of beds. The homeless can’t pay for them, because, well…you know, they are… mentally ill, and can’t work.

it's also true, as I know anecdotally in at least a couple of cases, and more broadly from reading, that some people just make that choice, because, you know, they are…mentally ill. And they can’t be forced to undergo treatment.

There's a little more to it than that "some people just make that choice." But I'm not surprised it went over your head.

Whereas unconscious people can be forced to undergo treatment. Unless they have a doctor’s permission not to.

In reality, people can refuse emergency medical treatment by making their wish to do so clear to a doctor, who then takes effective action to ensure that they're carried out.

But if that's not good enough for you, you don't have to just stand around complaining that you're not being spoon-fed autonomy and burped afterwards. The choices are nearly limitless. You can always go deep into the woods on the coldest evening of the year to die alone, like a Robert Frost poem without the last stanza, for example.

Why is the standard for psych commitment so high, but not wanting CPR is considered a sign of potential lack of competence.

The standard for involuntary psychiatric hospitalization is not all that high. (That would be the 72-hour hold I mentioned earlier.)

The standard for involuntary psychiatric commitment might or might not be. It varies by jurisdiction.

So, as I clearly indicated, for me, the homeless mentally ill = beam. But somehow, we still maintain that high standard for psych commitment, and don’t help them.

Why then is the standard so low for allowing doctors to assault my physical autonomy? What makes DNR special?

So you're saying that since we don't adequately provide help to mentally I'll homeless, we shouldn't provide protections for them in other places either? This is the same appeal to bigger problems you used in the homeopathy thread. Only this time instead of saying we should focus on fixing on problem over another you're actually saying we should unfix something (assessing compentency to protect incompetent people from being taken advantage of) because we haven't fixed a bigger problem first.

What is it you're hung up on? Do you not recognize how assessing competency protects those who are vulnerable from being taken advantage of? Or is it that you understand but think it's not important because you think it infringes on your automony?

So, as I clearly indicated, for me, the homeless mentally ill = beam. But somehow, we still maintain that high standard for psych commitment, and don’t help them.

Really. I must've missed it. Your argument seemed to be that we don't help the homeless so we shouldn't protect the incompetent from unfair DNRs. Never once did you say we should be helping the homeless. In fact, overall you come off as extremely callous and self centered. Shall we review?

For example, we do not prevent the homeless, many of whom are mentally ill, from sleeping on the street in freezing weather; we don’t round them up and test them for psychosis or depression, and force them into institutions.

Still waiting to hear why crazy homeless people are less crazy than people who don’t want invasive medical procedures.

Taking a risk does not meet that standard. And getting a DNR is simply making a decision that carries some risk. So is sleeping rough when the temps are near zero.

Tell me why you have to test my competence when I want a DNR, but not when I take some other life-and-death risk. What makes it special?

And getting a DNR is simply making a decision that carries some risk. So is sleeping rough when the temps are near zero.

For example, we do not prevent the homeless, many of whom are mentally ill, from sleeping on the street in freezing weather; we don’t round them up and test them for psychosis or depression, and force them into institutions.

I know this may be a shock to zebra, but just having a psychiatric diagnosis is not grounds to be involuntarily held, let alone committed. I should know, I have like three or four. You have to be an immediate danger to yourself or others, and there have to be no less restrictive options available. And that is for a hold.

There are plenty of beds. The homeless can’t pay for them, because, well…you know, they are… mentally ill, and can’t work.

Why does it matter? I've already arbitrarily declared your physical autonomy, whatever that is, to be unimportant, so you should be grateful there is any barrier at all. Why are you still complaining? That seems dangerously close to questioning my authority to arbitrarily set the rules, which automatically makes you an unethical person, with all the consequences that entails. This is your only warning.

zebra's mind is so powerful he can create houses at will, so he could only possibly be homeless by choice. Try to see it from his perspective; it's hard for him to comprehend the plight of mere mortals.

I know this may be a shock to zebra, but just having a psychiatric diagnosis is not grounds to be involuntarily held, let alone committed.

I'm the one that's been saying that the standard is very high to violate a person's physical autonomy. Multiple times.

I’m the one that’s been saying that the standard is very high to violate a person’s physical autonomy.

Two scenarios: A DNR is executed when the patient was mentally ill or coerced when it was compiled. A patient has a DNR but due to a mix up the patient is resuscitated. What would be a greater violation of autonomy? The latter, because you can't bring the dead back to life. That is why the conditions to get a DNR are so stringent.

I see it's "lets try to distract from the point we can't answer by cherrypicking quotes and changing the subject" time. So let's summarize and tie the nuanced threads together for those who can't work it out (apparently everyone here).

Orac's claim that equating vaccination to bodily violation was unfounded because "one can always refuse treatment"

did not take into account reasonable fears about "the system" not always (de facto or de jure) fully respecting an individual's desires.

I also suggested how I thought the project of vaccination should be framed. I think it should be a public health matter, meaning that its purpose is to protect the population in general, as opposed to protecting individuals. Why?

Because the correct answer to "how come society can force me (or my child) to get vaccinated?" is "to protect others". Why?

Because we have very high standards for violating an individual's physical autonomy. Because we do not intervene when a mentally ill person simply puts himself at risk, we only do so when there is perceived imminent danger. If that is the case for someone who is actually mentally ill, then you have no argument with respect to refusing vaccination or future invasive medical treatment.

So all the hand-wringing, oh the humanity, think of the children, arguments that you want to make just don't hold up. They might be effective propaganda in some cases, but they aren't rationally consistent with how our USA society actually works. The vaxers have a rational argument about personal autonomy, and "but woo" doesn't answer it.

zebra, here's some advice. Ethics is far more complicated than "Freedom good! Coercion bad!" If you can't understand that, don't comment here.

The point of the whole mental illness discussion was to point out that you have yet again blundered into a subject about which you are just blatantly and completely f*cking ignorant, as copiously evinced by your statements like "there are plenty of beds," "the mentally ill can't work," etc., etc.

Here's another thing you're apparently too dumb and full of yourself to realize: having a diagnosed mental illness in the psychiatric sense is not the same thing as being non compos mentis in the legal sense. If you are in the throes of the acute phase of a particularly bad episode, you might be considered legally incompetent to make your own decisions, but even that is not a guarantee. There is nothing about the mentally ill that entitles you to point at them and say, "Look! We even let those people make their own decisions!"

In fact, you seem generally dim when it comes to any knowledge of the law at all. A DNR is a legal document about a life-and-death matter, dimwit. I do not need a legal document to get a haircut, or move to a different city, or whatever. As a society, we have certain standards when it comes to legal documents. A DNR requires a physician's signature. I can see all kinds of practical reasons for this, like the fact that a decision of the magnitude of a DNR should be based on informed consent about one's condition and chances of survival/quality of life after CPR; in general, I would imagine that a physician would do a better job of providing information of that nature than Joe Average off the street.

I suggested that Orac’s claim that equating vaccination to bodily violation was unfounded because “one can always refuse treatment” did not take into account reasonable fears about “the system” not always (de facto or de jure) fully respecting an individual’s desires.

Equating vaccination to bodily violation was unfounded because one has the right to refuse treatment. A competent adult can exercise this right though we acknowledge that, because medicine is administered by human beings and human beings are regrettably fallible, sometimes that exercise is not honored through error or, on rare occasions, through malice. We have an entire court system devoted to redressing violations of rights in such cases. A person who is incompetent to exercise that right, whether through infancy, injury, disease, mental illness, etc., retains the right to refuse but, because he or she actually cannot exercise it, a substitute decision-maker will exercise it on his or her behalf. There are certain laws, based on commonly-held societal values, which the substitute decision-maker must follow. Because we value personal autonomy, there are provisions in law (which may vary from State to State) allowing a competent adult to provide advance directives to the substitute decision-maker. These laws are written by legislators who must balance the right of a competent person to make such directives with the right of a vulnerable person not to be coerced or deceived (whether by another human being or by mental illness or chemical abuse, etc.) into making a directive which does not in fact reflect his or her desires. These laws may therefore seem overly onerous to some people, and inadequate safeguards to others. 

So you've gone full nutso now, huh? This is the same kind of statement as the one everyone originally had a problem with. And I'd note that by saying this you've pretty much admitted you were lying in #104 when you said

Back to your current statement. There's no truth there. AVers are still free to choose not to vaccinate their kids. No one is going to break down their doors and forcibly vaccinate their children. However, that does not mean they have freedom from consequences of that choice. With rights come responsibilities. They are exercising their rights which they are and will always be free to do. They are also shirking their responsibilities which has consequences; in this case no public schooling.

Ms Gamondes (AoA) has presented us with another opportunity for merriment as well as generally proclaimed derision by posting further free associated prose with a big DIFFERENCE: she includes a synopsis of her earlier episodes that neatly ( heh) summarises her various floating points of verbal conglomeration accompanied by similarly overworked and congealed 'artwork'. It is in effect a *guide* to her most recent meandering bs.

BUT there's another facet in this gem: those visual images! ** Todays illustration lacks the distracting overwrought cut and paste miasmic quality ( which nicely complements her scavenger hunt-style writing technique) of her earlier images BUT presents with CLARITY ( of all things!) her thesis: Vaccines are Big OIL! How could we have missed something so obvious?*** AND it's *blue* yet!

At any rate, I can note that because she sees a vague visual resemblence between an oil rig and a hypodermic .. well, there must be a connection! And if you can see it, it must be there!

Freud, as you may know, wrote about how dreams and primary process thought incorporated shifting images unrestrained by the constraints of reality ...a wish is reality! And here it is, illustrated, for our perusal.

** for the uninitiated, prior to my studies in the social sciences, I studied art ( amongst other things) and worked in advertising before realising the error of my ways and coming over from the darkside.

What you seem to be missing despite my humorous attempts to illustrate it is that you lost bigtime when you asserted that ethics are arbitrary. If ethics are arbitrary, not violating your personal autonomy might be something you value, but it has no privileged status over any other arbitrary rule anyone else might prioritize.

OK, sorry, I didn't get what you were trying to say. I agree with you, except that I don't see how I 'lose'.

To avoid definition issues: I think of "ethics" as something that applies within a group or organization, like doctor's ethics--clearly defined rules of behavior. And arbitrary means that they are derived from some arbitrary original purpose or principle, not "random" in detail.

My illustration, with apologies to JP, is exactly that even when we see the motivation as delusional, we don't interfere with personal physical autonomy unless there is an imminent threat of harm, not simply risk.

having a diagnosed mental illness in the psychiatric sense is not the same thing as being non compos mentis in the legal sense.

By example, his argument for the bank teller being able to assess his customer fitness is simply "I’m not drooling and incoherent".

By this measure, Stephen Hawking wouldn't be allowed to make a single decision. Writing scientific books? Don't even think about it.

On the other hand, I had a schizophrenic friend. He had troubles finding the right meds, needed a tight daily schedule to be planned, and his bouts of paranoia eventually wrecked his marriage and his social life. But apart from this, he was a functional adult, and zebra's bank clerk wouldn't think twice about letting him sign things. I have lost track of him and his estranged family. I would be very afraid of letting him take decisions of life and death unsupervised.

Orac’s claim that equating vaccination to bodily violation was unfounded because “one can always refuse treatment”

every adult has the right to refuse any medical intervention and no one—I mean, no one—is questioning that)

Which is capable of being read to mean that one can always refuse treatment, if you go out of your way to impose that meaning on it without regard to context or common sense.

did not take into account reasonable fears about “the system” not always (de facto or de jure) fully respecting an individual’s desires.

I also suggested how I thought the project of vaccination should be framed. I think it should be a public health matter, meaning that its purpose is to protect the population in general, as opposed to protecting individuals. Why?

Because the correct answer to “how come society can force me (or my child) to get vaccinated?” is “to protect others”. Why?

Society can't force you or your child to get vaccinated. You are perfectly free to forego vaccination. The decision to do so is not without consequences. But nobody's are. And nobody has a right for them to be. Because it's a stone impossibility, among other things.

Because we have very high standards for violating an individual’s physical autonomy. Because we do not intervene when a mentally ill person simply puts himself at risk, we only do so when there is perceived imminent danger. If that is the case for someone who is actually mentally ill, then you have no argument with respect to refusing vaccination or future invasive medical treatment.

People have a very broad and capacious right to refuse medical treatment, contingent on reasonable factors and circumstances.

@zebra Let me try to summarize your points because I think we've gotten way off track. Please correct me if I'm wrong.

1. AVers fear that patient automony will be violated is justified. In this case, the concern is that their children will be vaccinated without their consent. 2. Community vaccination programs will allay those fears. Something along the lines of everyone goes to school a few times a year and either brings their kids to be vaccinated or doesn't bring their kids and opts out.

As I understand it everything else (the EOL care, the homeless issue, etc) is offered as support for these two underlying concepts. Is this an accurate interpretation of what you have been trying to say? Again if not please correct me.

"I see it’s “lets try to distract from the point we can’t answer by cherrypicking quotes and changing the subject” time. So let’s summarize and tie the nuanced threads together for those who can’t work it out (apparently everyone here).

Orac’s claim that equating vaccination to bodily violation was unfounded because 'one can always refuse treatment'

did not take into account reasonable fears about “the system” not always (de facto or de jure) fully respecting an individual’s desires.

I also suggested how I thought the project of vaccination should be framed. I think it should be a public health matter, meaning that its purpose is to protect the population in general, as opposed to protecting individuals. Why?

Because the correct answer to “how come society can force me (or my child) to get vaccinated?” is “to protect others”. Why?

Because we have very high standards for violating an individual’s physical autonomy. Because we do not intervene when a mentally ill person simply puts himself at risk, we only do so when there is perceived imminent danger. If that is the case for someone who is actually mentally ill, then you have no argument with respect to refusing vaccination or future invasive medical treatment.

So all the hand-wringing, oh the humanity, think of the children, arguments that you want to make just don’t hold up. They might be effective propaganda in some cases, but they aren’t rationally consistent with how our USA society actually works. The vaxers have a rational argument about personal autonomy, and “but woo” doesn’t answer it."

If he was in the middle of an episode and wanted a DNR because he was worried that a microchip might be implanted in his body during CPR or something, sure. But if we're just talking day-to-day absentmindedness about medications (I mean, my advisor takes a few medications and has one of those day-of-the week pillboxes) or general eccentricity, I don't see why that would preclude self-determination about one's own life. And thank G-d for that, considering that I'm a bit absentminded and eccentric myself.

OTOH, there have been times when I was not entirely "in my right mind" about things like, say, wanting to be dead in an immediate sense. Frightening but true. Even so, I've always passed every MMSE I've been given and probably would not be declared incompetent to make medical decisions by a physician based on the criteria I was just looking at. BUT there have been times when I probably could have been compelled to undergo psychiatric treatment involuntarily if I hadn't been with it enough to know that it's always easier to just do it "voluntarily."

It's complicated, and I'd say I'm more comfortable with erring slightly on the side of self-determination, but we also need protections in place for those who truly are incapable of making medical decisions, like people with severe dementia, etc. Otherwise you could have someone pressuring granny into signing a DNR or an advance directive based on certain ulterior motives, like anticipation of a nice inheritance, say.

I'm pretty sure it all actually boils down to this: zebra's smarter than everyone else, and he has a "better solution" to any problem imaginable that nobody else has ever thought of. If anybody calls him out on blatant ignorance or misrepresentation of facts, he changes the subject or makes baseless accusations of "cognitive impairment" or something.

Let's not forget his debut where he was lecturing everyone about "physics woo" and accusing Krebiozen of the gambler's fallacy or something, all the while dripping with completely unfounded condescension.

zebra@337 I read your post. I wanted to simplify it because I think there's a lot of extraneous information and everytime I don't address yiur entire post you've accused me of cherry-picking despite the fact that the rest of the post in no way negated what I said about the quoted part. I believe that your quoted post pretty much boils down to the 2 points I suggested above. For 1 the relevant parts are:

...did not take into account reasonable fears about “the system” not always (de facto or de jure) fully respecting an individual’s desires. ... The vaxers have a rational argument about personal autonomy, and “but woo” doesn’t answer it.”

I also suggested how I thought the project of vaccination should be framed. I think it should be a public health matter, meaning that its purpose is to protect the population in general, as opposed to protecting individuals.

We need to trace this back to #8 to see what you think making it a public health matter actually entails.

Let’s make vaccination of children a public health matter, carried out by the government. When the appropriate age comes, you go to the school building on designated days and have it done, for free.

If you want to opt out, you go there and opt out, and deal with the later consequences. But everyone is treated equally, and it is a community activity.

1. AVers fear that patient automony will be violated is justified. In this case, the concern is that their children will be vaccinated without their consent. 2. Community vaccination programs will allay those fears. Something along the lines of everyone goes to school a few times a year and either brings their kids to be vaccinated or doesn’t bring their kids and opts out.

Addendum to point 2: Community vaccination programs will allay those fears and remove the need for public school mandates. The only caveat being that you never explicitly stated that your idea solve the problems mentioned in point 2 but I think it was strongly implied.

1. School mandates are not forced vaccination. Removing non-medical exemptions does not mean thugs are going to kick down their doors and forcibly vaccinate their kids. It does mean that if they want to take advantage of public schooling they have a responsibility to vaccinate their children. They are free to choose not. They are even free to choose to stay entirely away from doctors and their scary needles. But in doing so their are shirking their responsibility and the consequence of that is no public school.

2. Free community immunization at schools is a great idea. Actually, I'm all for it. It does not, however, address the issues you think it does. AVers are terrified of the government forcing them to vaccinate their children. If there is a mass immunization program that takes place at school and is paid for by the government that is quite a bit more scary than it being done at a private doctor's office. And, since they still have the opportunity to opt and attend public school anyways you have failed to protect the general population which, in your own words, is what your idea is all about in the first place.

Orac’s claim that equating vaccination to bodily violation was unfounded because “one can always refuse treatment”

Orac wrote no such thing. This isn't the first time you have invented a quotation, attributed it to someone and then argued with the strawman you have constructed. This is dishonest, as I have pointed out to you before.

As I've pointed out to you before, it's childish and petty to purposely misunderstand a typo where I use " instead of '.

1) Someone is going to be 'the smartest person in the room', but I don't think "smart" is a valid metric; I go along with the concept of different kinds of intelligence.

When sadmar was around, I certainly didn't think I was the top dog in the argumentation department. However, at the moment, I think I'm darn good at challenging people to get outside their comfort zone.

Since it seems to be open mic night, I want to briefly comment on assisted suicide. Though I don't like the the thought of physician assisted suicide**, I can find no particular reason not to have some other profession dedicated to helping people end their lives quickly and painlessly, preferably without making too big a mess, scaring passersby, or engaging in criminal trespass. Such services should be available to any person capable of signing a contract, with only sufficient safeguards to confirm the person's identity and ensure s/he is not acting under threat or duress.

** When my mother gets her knee replaced, I want the doctor to be utterly clear on his/her success criteria. The doctor should not be thinking, "hmmm... I could work really hard on this and have her live and walk, or I could get out of here in time for golf."

It’s complicated, and I’d say I’m more comfortable with erring slightly on the side of self-determination

Oh, I would agree. I didn't want to imply that I would have wanted my friend put under a tight leash.

I actually lost contact because I moved away in a different city. Last I heard of him from a common friend, just before his marriage broke,.either he was trying to deal with some serious family issue, or he was spiraling into a serious paranoid phase (or something close, IANAD).

I wish there has been someone to magically tell me which it was. Should we have believed him and said "that's really bad, let me introduce you to a good lawyer I know", or should we have said "please go back on your meds"?

I don't. I think you are trying to get me to say something so you can go back through the comments and point out "but you used this word here and that word there, and that makes you a liar".

I also think that you may have difficulty reasoning at an abstract level-- you keep making up these narratives about what the AVers think and what I think they think and so on, and how they will respond to your version of what I say should be done.

If you disagree with something I said at 337, specifically, tell me what it is. I'm nowhere near as good as sadmar, but what I said is what I mean.

Orac’s claim that equating vaccination to bodily violation was unfounded because ‘one can always refuse treatment’

did not take into account reasonable fears about “the system” not always (de facto or de jure) fully respecting an individual’s desires.

You have identified a circumstance in which an individual's right to refuse medical treatment might not be respected -- ie, when the individual's life is at stake and the validity of his or her wish to end it isn't known and/or knowable.

It's not reasonable to fear that forced vaccination is imminent because (a) that circumstance exists; and (b) a bill to eliminate personal-belief exemptions is being proposed.

The latter, all by itself, should be sufficient to allay those fears, from a reason-based perspective.

It practically couldn't be any clearer that the issue is not about who decides whether children should be vaccinated and why but about who decides children should attend public school and why.

I also suggested how I thought the project of vaccination should be framed. I think it should be a public health matter, meaning that its purpose is to protect the population in general, as opposed to protecting individuals. Why?

Because the correct answer to “how come society can force me (or my child) to get vaccinated?” is “to protect others”. Why?

Because we have very high standards for violating an individual’s physical autonomy. Because we do not intervene when a mentally ill person simply puts himself at risk, we only do so when there is perceived imminent danger.

Right. That's why there's not forced vaccination. That's why nobody is contemplating forced vaccination. And that's why it's not reasonable to fear forced vaccination.

If that is the case for someone who is actually mentally ill, then you have no argument with respect to refusing vaccination or future invasive medical treatment.

With respect to refusing vaccination, true. But it's you who have no argument. Because that's not a reasonable fear.

But it's not reasonable to fear that your wish not to be resuscitated will be disrespected, if you take reasonable steps to ensure that it's followed.

So all the hand-wringing, oh the humanity, think of the children, arguments that you want to make just don’t hold up.

They might be effective propaganda in some cases, but they aren’t rationally consistent with how our USA society actually works. The vaxers have a rational argument about personal autonomy, and “but woo” doesn’t answer it.”

Are there no mentally ill homeless demonstrating that our USA society is one in which we only intervene when there's perceived imminent danger.where they live?

It's therefore reasonable to fear a political and practical impossibility that nobody supports, is proposing, or has any interest in proposing, even though there's not the least threat of it coming to pass -- ie, forced vaccination.

And what did I write at 337? As I’ve pointed out to you before, it’s childish and petty to purposely misunderstand a typo where I use ” instead of ‘.

A typo? What difference does it make whether you intended single or double quotation marks? Both are used to denote a direct quotation* and never to denote an indirect quotation i.e. a description (or misinterpretation, to be more accurate) of what someone said, as you used them at #337. As I understand it in US English single quotation marks are only used for quotations nested inside double quotation marks.

What is childish and petty is making up your own meaning for words, and now punctuation marks, and arguing with people when they point out you are mistaken.

* They can also be used to denote irony, unusual usage, to refer to a word rather than its meaning, for a gloss in linguistics, for the titles of artistic works and for nicknames and false titles, none of which could possibly apply to the way you used them.

Says the person who failed to notice that (at the abstract level), the only circumstance under which the state ever permits the autonomous personal choice to refuse medical treatment to be secondary to anything is:

I see it’s “lets try to distract from the point we can’t answer by cherrypicking quotes and changing the subject” time.

That's one hell of a way to try to evade having emitted a stream of blindingly stupid remarks about the mental-health system that didn't even serve to demonstrate the injustice of your precious DNR time-waster.

Z. is apparently under the impression that his internal version of the use–mention distinction should be universally understandable as extending to sentences versus propositions.

“I see it’s “lets try to distract from the point we can’t answer by cherrypicking quotes and changing the subject” time. So let’s summarize and tie the nuanced threads together for those who can’t work it out (apparently everyone here).

You were the one who brought up the homeless issue in support of why we should not require proofof competency for a DNR. Later you changed your position and claimedbyou had said homeless was the "beam" and what we need to fix it. I quoted every time you brought up homelessness to show that you never even came close to saying that. Go back and read the posts. There's no additional parts of any of those comments that changes what you said.

Orac’s claim that equating vaccination to bodily violation was unfounded because ‘one can always refuse treatment’

did not take into account reasonable fears about “the system” not always (de facto or de jure) fully respecting an individual’s desires.

School mandates are not forced vaccination. Removing non-medical exemptions does not mean thugs are going to kick down their doors and forcibly vaccinate their kids. It does mean that if they want to take advantage of public schooling they have a responsibility to vaccinate their children. They are free to choose not. They are even free to choose to stay entirely away from doctors and their scary needles. But in doing so their are shirking their responsibility and the consequence of that is no public school.

I also suggested how I thought the project of vaccination should be framed. I think it should be a public health matter, meaning that its purpose is to protect the population in general, as opposed to protecting individuals. Why?

Let’s make vaccination of children a public health matter, carried out by the government. When the appropriate age comes, you go to the school building on designated days and have it done, for free.

If you want to opt out, you go there and opt out, and deal with the later consequences. But everyone is treated equally, and it is a community activity.

In general, I think this is a good idea. However, because parents can still opt out and send there kids to school it fails to "protect the general population." It fails to address the issue of low vaccine uptake that SB277 is designed to correct.

Because the correct answer to “how come society can force me (or my child) to get vaccinated?” is “to protect others”. Why?

No one can force you to do anything. But there are consequences for your actions. Freedom does not mean freedom from consequences.

Because we have very high standards for violating an individual’s physical autonomy. Because we do not intervene when a mentally ill person simply puts himself at risk, we only do so when there is perceived imminent danger. If that is the case for someone who is actually mentally ill, then you have no argument with respect to refusing vaccination or future invasive medical treatment.

Again, no one is forcibly vaccinating your children. If you want your child to attend public you have some responsibilities to ulfill. One of them is immunization because it protects not only your child but his classmates as well. Don't want to fulfill your responsibilities? That's certainly your choice but the consequence is you don't get to take advantage of public education.

So all the hand-wringing, oh the humanity, think of the children, arguments that you want to make just don’t hold up. They might be effective propaganda in some cases, but they aren’t rationally consistent with how our USA society actually works. The vaxers have a rational argument about personal autonomy, and “but woo” doesn’t answer it.

See this is why I was trying to simplify things. Not to set a trap but because you say the same thing in different ways so I end up just repeating myself. This is not a rational argument and no one has ever answered it with "but woo." I've explained why twice already just in this post.

When sadmar was around, I certainly didn’t think I was the top dog in the argumentation department. However, at the moment, I think I’m darn good at challenging people to get outside their comfort zone.

Get over yourself. You've made a fool of yourself more times than I can count just in this one thread.

So let’s summarize and tie the nuanced threads together for those who can’t work it out (apparently everyone here).

When everyone disagrees with you, it doesn't necessarily follow that you're Galileo. Sometimes it means that you're Lord Kelvin.

One might note that Z.'s retconning in #337 omits the original lever arm, "If you want to opt out, you go [to the school building] and opt out, and deal with the later consequences. But everyone is treated equally, and it is a community activity."

This of course is utterly absurd from a practical standpoint, not least because of the need for schools to assume, wholesale, the role of middleman in student–physician information control (it has to come downstream from the physician and then the upstream requires a FERPA waiver).

I also suggested how I thought the project of vaccination should be framed. I think it should be a public health matter, meaning that its purpose is to protect the population in general, as opposed to protecting individuals.

I am not suggesting a perp-walk for those people, just that they have to go to the school office at some point to sign a document in person. It’s about everyone being treated equally.

Note how it changed from a community thing to now being entirely optional. As I said back then, it's really no different from the current model. Either way, if you choose not to vaccinate all you need to do is fill out some paperwork and file it with the school. Only difference is in the current system you can fill it out at home whereas in zebra's you need to go into the office to fill it out.

Allow me to rephrase "Note how it changed from a community thing to now being entirely optional," to "Note how it changed from something where everyone goes and you either bring you kid to be vaccinated or you don't and opt out to everyone who wants their kids vaccinated goes and those who don't go separately 'at some point.'"

Which works solely to the extent that Z. gets to make himself the population most vulnerable to abuse of the system in the latter case, not that he qualifies for one in the first place.

That also means not cherrypicking (taking out of context) phrases or sentences, but explaining why you think a complete thought is wrong. If I say xxx because yyy, that's a complete thought. You would say, 'no, yyy doesn't support xxx, or 'yyy isn't true', or something like that.

These fears are absolutely not grounded in reality. There is no forced vaccination. There is a requirement to be vaccinated if you want to attend public school. I really, honestly can not make it any more simple. If you can't understand the difference e between this and forced vaccinatin

If you can't understand the difference between that and forced vaccination you are either incomprehensibly stupid or an incredibly obnoxious troll. Honestly I think there's ample evidence demonstrating that you are both.

I've been using single quotes to indicate a (short) paraphrase or imagined language for decades and I've never had anyone misunderstand it (until now.) Maybe it's a hip internet thing that doesn't require formalization, like using "oxymoronic" to describe something contradictory-- although Wikipedia attributes that to W. F. Buckley. You really need to get with the modern era.

If I had used no quotation marks, I expect you would still have made some equally outraged comment that 'Orac never said that'. (See how I used the single quotes there?)

And yes, that was absolutely a personal attack. I made the same point 4 times in #353 and you ignored completely.

See, you are simply trying to go back to your already refuted claim that I was talking about vaccination, when I was actually talking about the system not necessarily honoring one's wishes, de facto or de jure, and I used EOL issues as an example.

If you were interested in a productive dialogue, you would stick to my sentence in the comment that I have designated as a clear statement of my position. But, since you have no refutation of what I say there, you are trying to change the subject to cherrypicking words from previous comments.

There is a rational argument about autonomy. I've made it. If AVers use it to invoke a slippery slope, that doesn't make it any less a rational argument about autonomy.

Which, of course, is defined by Z.'s internal rules (and apparent omniscience). Because it's "a hip internet thing," or something, which naturally points straight at Z.

Then again, one might observe that in neither case was the affectation necessary in the slightest. Maybe that's the "hip" part.

You know, if I were trying to argue, "It is difficult to allay fears [of antivax parents that children would be forcibly vaccinated] when the fears are grounded in some reality", I would bring up documented cases where attempts really were made to treat children against the wishes of their parents, with the enthusiastic support of the medical profession in the person of Orac. I wouldn't even have to look outside the archives of this blog. We could then have an interesting discussion of the difference between cancer and VPDs, with a possible excursion into whether a child should be receive the rabies vaccine if bitten by a rabid animal, whether the parents consent to the vaccine or not ...

I imagine an interesting conversation sparked by that and then look at the tedium of the past few days. Sigh.

Actually we could discuss how those who advocate for parental rights *uber alles* perhaps reflect an antiquated notion- not of this day and age- wherein children were thought of appendages of their parents with little or no rights of their own rather than as individuals. More as parcels of property than as human beings.

Interestingly one of my profs ended his series of lectures on child development with a short history of the development of the *concept* of the child itself, tracing through earlier ideas of the child as a heathen ( in need of the Word), a miniature adult ( in need of a job and discipline) or a child of Nature, pure and free, entire unto itself- not to be fooled with by over- socialised- and lost- moderns.. That last one was Rousseau -btw-( not the artist, the writer).

He outlined how the treatment of children as students, patients, workers or members of Society at large corresponds to whatever concept is most prevalent in their era: think of how earlier religious teachers sought to banish the Devil from unruly children or how Dickens endeavored to sympathetically portray the fate of poor, working children. Indeed would the State ever intervene in behalf of abused, mistreated, medically neglected or overworked minors in those times?

Thus Orac describes something modern: children have rights and parents can misuse them and need to answer to the government. Perhaps most people today can agree on this, it's only a few self-centred miscreants who go overboard and usurp their own children's rights to suit their own needs.

That also means not cherrypicking (taking out of context) phrases or sentences, but explaining why you think a complete thought is wrong.

That's not what 'cherrypicking' means, it refers to selectively choosing evidence that supports a position while ignoring evidence that does not, nothing to do with quoting out of context.

I’ve been using single quotes to indicate a (short) paraphrase or imagined language for decades and I’ve never had anyone misunderstand it (until now.)

Perhaps that says more about the people you have been attempting to communicate with previously than it does about your abuse of English.

Maybe it’s a hip internet thing that doesn’t require formalization, like using “oxymoronic” to describe something contradictory– although Wikipedia attributes that to W. F. Buckley.

I suspect that's a novel excuse for ignorance of the English language, which is ironic given your propensity for accusing others of being poorly educated, but I'm always willing to learn. Can you give an example of someone other than yourself doing this "hip internet thing" of making something up, putting quotation marks around it and attributing it to someone?

I'm a director of a digital media company, taking a break from coding an Android app for mobile devices to write this. Is that "with the modern era" enough for you?

If I had used no quotation marks, I expect you would still have made some equally outraged comment that ‘Orac never said that’.

Probably, since as others have pointed out, what you wrote ( “one can always refuse treatment”) is not even an approximate paraphrase of what Orac wrote ("every adult has the right to refuse any medical intervention and no one—I mean, no one—is questioning that").

If I had used no quotation marks, I expect you would still have made some equally outraged comment that ‘Orac never said that’.

Ann had already addressed the accuracy of the paraphrase @335, but Z. apparently couldn't be bothered to deal with it at the time. Then again, from Z's comment 208 ("very long and not to the point"), one might infer that she's in the "filibuster" penalty box.

Of course, everything must now depend on Retcon #337. The pseudo-Socratic construction proceeds from the bottom up, but I'm not going to bother inverting it at the moment. As Dorit originally pointed out, school vaccination clinics are the worst place to try to allay parent's "autonomy" fears. Anyone who's perused AoA or MDC is familiar with the theme of keeping one's kids at home on days when such events are taking place.

Thus, the original brilliant idea was to make people go to such events in order to ensure that their children weren't vaccinated. In addition to the analogies I've already offered, it's like having to go to the polls in order not to vote.

It is perfectly possible to make a case against requiring vaccination based on bodily autonomy, and this would not necessarily be a woo-based case. People can, and do, argue that they don't want to have their children vaccinated just because they don't want to have their children vaccinated.

To counter, one would point out that the state has an interest in public health; that having large numbers of unvaccinated people congregating in places such as public schools encourages the spread of diseases which can be dangerous; and that this may be sufficient reason to legislate that people participating in certain activities (such as attending public schools, or travelling to certain countries where certain diseases are endemic) are vaccinated against some number of diseases. One might also mention that those who could vaccinate but refuse to are freeloading on those who took the very small (but measurable) risks associated with vaccination, while increasing the risk of spreading disease in the community as a whole.

Naturally, some will resort to the age old argument of "I don't wanna get a shot!!! You can't make me!!!" As things stand now, they can choose not to participate in those activities which require said shot.

To avoid definition issues: I think of “ethics” as something that applies within a group or organization, like doctor’s ethics–clearly defined rules of behavior. And arbitrary means that they are derived from some arbitrary original purpose or principle, not “random” in detail.

They're plainly both systematic and reasoned. I mean, you can argue with the reasoning. But you can't say they're not the product of it.

There is a rational argument about autonomy. I’ve made it. If AVers use it to invoke a slippery slope, that doesn’t make it any less a rational argument about autonomy.

Perhaps that says more about the people you have been attempting to communicate with previously than it does about your abuse of English.

IIRC, it wasn't too unusual on Usenet to use double quotes to denote string literals and single quotes for, e.g., token values, but mere paraphrase is preposterous, given that any such construction can be rewritten as a that-phrase.

See, you are simply trying to go back to your already refuted claim that I was talking about vaccination....

Now, either refute that logically or flounce off again until you feel confident enough to come back and troll some more.

Ann had already addressed the accuracy of the paraphrase @335, but Z. apparently couldn’t be bothered to deal with it at the time. Then again, from Z’s comment 208 (“very long and not to the point”), one might infer that she’s in the “filibuster” penalty box.

It is perfectly possible to make a case against requiring vaccination based on bodily autonomy, and this would not necessarily be a woo-based case.

It seems to be worth noting yet again that Z.'s tedious repetition of variants on "but woo" is simply a self-serving caricature that demonstrates – again, yet again – that he has no familiarity whatever with the topic (that was) at hand.

See, you are simply trying to go back to your already refuted claim that I was talking about vaccination, when I was actually talking about the system not necessarily honoring one’s wishes, de facto or de jure, and I used EOL issues as an example.

You said, “It is difficult to allay fears when the fears are grounded in some reality,” in response to “But remember that the anti-vaccine people express concern that their children will be force vaccinated if efforts are, for example, held in school.” Clearly referencing AV fears. Later you said “Clearly referencing the anecdotes, not saying vax fears are grounded in reality.” If you can’t understand how that is being dishonest, I don’t know how to else to explain it to you.

And in your next comment you went back to talking about DNRs. How exactly did you refute my claim. I don't see how "the fears" in your comment could refer to anything but forced vaccination.

If you were interested in a productive dialogue, you would stick to my sentence in the comment that I have designated as a clear statement of my position.

Note that I addressed literally every sentence in #337. I couldn't have missed it unless you actually didn't designate a sentence in #337 as a clear statement of your position. , Which you didn't.

But, since you have no refutation of what I say there, you are trying to change the subject to cherrypicking words from previous comments.

Where'the cherry-picking? If you look at the whole post there's nothing that changes the meaning of your words to something other than what I said. Once again: Dorit Reiss@16

A. And re community event: some immunization coalitions actually organize local immunization clinics, to help those with access problems. Would that fit that? But remember that the anti-vaccine people express concern that their children will be force vaccinated if efforts are, for example, held in school.

It is difficult to allay fears when the fears are grounded in some reality. That’s why I recommend people like Orac deal with beams before taking on the motes.

My suggestion was for parents to take their kids to be vaccinated, or show up, sans children, to sign a form declining. That way there is equal treatment, and a clear record; I understand from reading that the records can be a real issue.

There is a rational argument about autonomy. I’ve made it. If AVers use it to invoke a slippery slope, that doesn’t make it any less a rational argument about autonomy.

No. Besides the fact that you've done a piss poor job supporting your argument (the closest you've gotten to providing evidence in support of it is "read the comments" of the link you provided, since that article itself actually refuted your claim) when you invoke an otherwise rational argument in an insane way it is no longer rational.

As was explained to you many times the implied consent used to treat unresponsive patients in life threatening emergencies is very different from the informed consent needed for routine preventative treatment like vaccination. Laypeople might conflate the two and believe that concerns regarding EOL care justify concerns over forced vaccination but that does not make it a rational argument. Justified or not, your proposed solution does nothing to alleviate those fears and as pointed out by at least 3 people now potenially aggrevates them; a point which you have conveniently ignored every single time.

Two things also occur to me as an afterthought. The first regards the overarching premise that Z. advanced when he nailed his fec theses to the door the first time @325:

Because we do not intervene when a mentally ill person simply puts himself at risk, we only do so when there is perceived imminent danger. If that is the case for someone who is actually mentally ill, then you have no argument with respect to refusing vaccination or future invasive medical treatment.

All because he was asshurt about his asshurt over the unfairness of DNRs not being a free-for-all proved to be a stupid irrelevancy that he can't figure out whether to discard or try to salvage,* like deciding whether the yogurt is really just too moldy or one can soldier on with the menu.

The second thing is what the DNR babbling would look like as an actual legal argument rather than a collection of sophomoric platitudes. The only option that occurs to me is based in the 14th Amendment, and would really have to proceed in two steps: (1) even if the terminally ill are a cognizable group ("Duh"), the statutory inclusion of arbitrary [sic] conditions is unfair to....

Oh, wait. The terminally ill can't be a cognizable class for this to work, because ultimately, "conditions" would have to go.

Phew, on to... (2) Now that such distinctions have been obliterated, there is no rational basis for requiring the involvement of a physician. Strict scrutiny is right out.

* "[Y]ou are simply trying to go back to your already refuted claim that I was talking about vaccination." No, I was talking about the mentally ill the whole time, from which follows my summary, which in no way should suggest that I have not been absolutely correct at every step of the way, even though I didn't actually start tediously invoking the word 'imminent' until the whole mental-health system thing blew up in my face "cherrypicking" began as a response to my terrifying insight.

We have already seen that you don’t understand the meaning of various English words and concepts, like “on average”, “probability”, “the gambler’s fallacy”, “filibuster”, “parsimony”, “hypothesis testing”, “a”, “the”, “null hypothesis”, “should”, “can”, “who”, “consistent” (which you memorably described as “an obscure term of art”), and “oxymoron”. I’ll add “permission” to the list.

I guess we can add “involuntary” to the list of common English words which zebra does not understand.

Why is the standard for psych commitment so high, but not wanting CPR is considered a sign of potential lack of competence.

... he's kind of stuck with airway management, ETI or extraglottic. Fortunately, that's a negligible issue, because Right Livin' Autonomy:

I calculate that having a DNR is highly unlikely to reduce my life expectancy, at least as I want to live life.

Correct, but, and this is the significant point I've been arguing, the public health argument is not a "counter" to the autonomy argument.

Let's say we have a mother who sends her child to school with three Snickers bars for lunch every day.

In case 1, the school sends a note home telling the mother to stop doing that because she is endangering the health of her child, because Snickers bars are fattening and rot your teeth.

In case 2, the school tells the mother to stop doing it because there are children with peanut allergies, and the candy represents a threat to their health.

In case 1, the mother has a reason to fear that her autonomy with respect to how she raises the child is being threatened. She may exaggerate the extent to which the autonomy might be restricted in the future, but it is not unreasonable to have the concern in the first place.

In case 2, it would not be rational to think the ban had anything to do with her dietary decisions for the child.

The best way to cause the mother to be really paranoid, of course, is to mix the two messages, because then the legitimacy of the public health argument can be called into question: "That's just an excuse to take away my autonomy."

But, as I said earlier, that's a nuanced analysis, and this is Dr OrOz's blog, and it may be just too hard for the Minions to follow.

Correct, but, and this is the significant point I’ve been arguing, the public health argument is not a “counter” to the autonomy argument.

Let’s say we have a mother who sends her child to school with three Snickers bars for lunch every day. In case 1, the school sends a note home telling the mother to stop doing that because she is endangering the health of her child, because Snickers bars are fattening and rot your teeth. In case 2, the school tells the mother to stop doing it because there are children with peanut allergies, and the candy represents a threat to their health.

The reason for insisting on vaccination in schools is the same as case 2 in your example. Unvaccinated children are not only far more likely to get the diseases but ipso facto to become infectious. They thus pose a risk of harm to students who can't be vaccinated for medical reasons or are immunosuppressed. Let's extend your case 2. Suppose the mother, having received the warning letter, continues putting the Snickers bars in her child's lunchbox in defiance of the instruction. In that case, the school would be entitled take further action. It may even choose to tell the mother that her child will not be allowed to attend that school until she stops including the Snickers in the lunchbox. In principle, there is no difference between this and not allowing a deliberately undervaccinated child from attending school until the child's vaccines are up to date.

Yes, zebra said something, so you have to "disagree", even though you aren't disagreeing with anything I said there.

zebra said something, so you have to “disagree”, even though you aren’t disagreeing with anything I said there.

I pointed out that an unvaccinated child posed a threat to any students who were immunosuppressed or who couldn't be vaccinated, and that Public Health therefore WAS a counter to personal autonomy, just as in your case 2, Public Health gave the school the right to insist that the mother stop putting Snickers Bars in her child's lunchbox to protect the pupils at the school who had peanut allergies. You are being very obtuse and very, very disingenuous.

"In case 1, the mother has a reason to fear that her autonomy with respect to how she raises the child is being threatened. She may exaggerate the extent to which the autonomy might be restricted in the future, but it is not unreasonable to have the concern in the first place."

“In case 1, the mother has a reason to fear that her autonomy with respect to how she raises the child is being threatened. She may exaggerate the extent to which the autonomy might be restricted in the future, but it is not unreasonable to have the concern in the first place.”

"The best way to cause the mother to be really paranoid, of course, is to mix the two messages, because then the legitimacy of the public health argument can be called into question: “That’s just an excuse to take away my autonomy.”"

"I also suggested how I thought the project of vaccination should be framed. I think it should be a public health matter, meaning that its purpose is to protect the population in general, as opposed to protecting individuals." NobRed

I wouldn't worry about this type of ranting - the purpose of vaccination might be to protect the public - that's the spin. It's nothing more than a soundbite though, the evidence for protection just isn't there.

"Richard Smith, who edited the British Medical Journal for more than a decade, said there was no evidence that peer review was a good method of detecting errors and claimed that “most of what is published in journals is just plain wrong or nonsense”. There you have it, the guy that produced the premiere medical peer review rag in the UK says it's all baloney. No wonder NobRed is so out there.

"The peer review process – long considered the gold standard of quality scientific research – is a “sacred cow” that should be slaughtered, the former editor of one of the country’s leading medical journals, Richard Smith has said.

There we are boys, looks like Gorxski central is a bastion of bull and populated by wallowing woo donkeys!

"Correct, but, and this is the significant point I’ve been arguing, the public health argument is not a “counter” to the autonomy argument." Julian It is if the 'public health' standpoint is based on medical peer review - or woo. Why should an idiot with a peer review paper overrule a mother who can see it's a pile of........................... Chairman Mow produced lots of edicts..................

Argument: You can't make me do things that affect my body because of body autonomy. Counter argument: The things you do to your body affect others around you. The government has an interest in improving the general level of health and avoiding the spread of disease. The government can thus require you to do things that affect your body in order to participate in certain government run activities (subject to exemptions as defined by the government).

The purpose of the counter argument is not to refute the concept of body autonomy, but to point out the reasons and authority to require actions that, at first glance, appear to contradict a principle of body autonomy.

In case 2, it would not be rational to think the ban had anything to do with her dietary decisions for the child.

And yet this is the fear that AVers have, hence everyone taking issue with you saying it is rational. A particularly poignant example was Jack Wolfson.

“It’s not my responsibility to inject my child with chemicals in order for [a child like Maggie] to be supposedly healthy,” he said. “As far as I’m concerned, it’s very likely that her leukemia is from vaccinations in the first place.”

“I’m not going to sacrifice the well-being of my child. My child is pure,” he added. “It’s not my responsibility to be protecting their child.”

*** Let’s say we have a mother who sends her child to school with three Snickers bars for lunch every day.

In case 1, the school sends a note home telling the mother to stop doing that because she is endangering the health of her child, because Snickers bars are fattening and rot your teeth.

In case 2, the school tells the mother to stop doing it because there are children with peanut allergies, and the candy represents a threat to their health.

In case 1, the mother has a reason to fear that her autonomy with respect to how she raises the child is being threatened. She may exaggerate the extent to which the autonomy might be restricted in the future, but it is not unreasonable to have the concern in the first place.

In case 2, it would not be rational to think the ban had anything to do with her dietary decisions for the child.

The best way to cause the mother to be really paranoid, of course, is to mix the two messages, because then the legitimacy of the public health argument can be called into question: “That’s just an excuse to take away my autonomy.” ***

But, as I said earlier, that’s a nuanced analysis, and this is Dr OrOz’s blog, and it may be just too hard for the Minions to follow.

Let’s say we have a mother who sends her child to school with three Snickers bars for lunch every day.

In case 1, the school sends a note home telling the mother to stop doing that because she is endangering the health of her child, because Snickers bars are fattening and rot your teeth.

In case 2, the school tells the mother to stop doing it because there are children with peanut allergies, and the candy represents a threat to their health.

In case 1, the mother has a reason to fear that her autonomy with respect to how she raises the child is being threatened. She may exaggerate the extent to which the autonomy might be restricted in the future, but it is not unreasonable to have the concern in the first place.

If her autonomy with respect to how she raises her child is sufficiently threatened by the knowledge that there are limits on it to give her cause for fear, how does she live with compulsory education requirements, child labor laws, and the prohibition on serving alcohol to minors?

As capkrunch pointed out, you used the phrase. And he (she?) also pointed out that antivaxxers use "personal autonomy" as a justification for vaccine refusal. You then repeated your Snickers Case 1 Case 2 argument.

In case 2, it would not be rational to think the ban had anything to do with her dietary decisions for the child.

Yet, that is precisely what some antivaxxers do argue. They argue that requiring their children to be vaccinated violates their personal autonomy.

The best way to cause the mother to be really paranoid, of course, is to mix the two messages, because then the legitimacy of the public health argument can be called into question.

The authorities are not mixing the two messages at all. Antivaxxers are straw-manning and shouting "personal autonomy!" (case 1) when the issue is about the safety of others (case 2).

That's your idea of nuance? It's not that cut and dry. The problem is AVers conflate case 1 with case 2. In theur eyes there is no difference, their freedom is being affected either way. The problem is that no one has ever advocated taking their choice away. It's always been about public health. You can choose not to vaccinate your kids but then you don't get to endanger other children by sending them to public school.

I think the best approach to protecting public health is removing non-medical exemptions for public schooling. You apparently disagree. The reason you disagree, is that this provides reasonable cause to fear loss of personal autonomy. As has been pointed out to you there is no forced vaccination and this fear is unreasonable. You seem to be making the same mistake AVers do. Health freedom does not mean freedom from consequences. In addition, your proposed solution still allows unvaccinated children to attend public, endargering the health of other children.

*** Let’s say we have a mother who sends her child to school with three Snickers bars for lunch every day.

In case 1, the school sends a note home telling the mother to stop doing that because she is endangering the health of her child, because Snickers bars are fattening and rot your teeth.

In case 2, the school tells the mother to stop doing it because there are children with peanut allergies, and the candy represents a threat to their health.

In case 1, the mother has a reason to fear that her autonomy with respect to how she raises the child is being threatened. She may exaggerate the extent to which the autonomy might be restricted in the future, but it is not unreasonable to have the concern in the first place.

In case 2, it would not be rational to think the ban had anything to do with her dietary decisions for the child.

The best way to cause the mother to be really paranoid, of course, is to mix the two messages, because then the legitimacy of the public health argument can be called into question: “That’s just an excuse to take away my autonomy.” ***

In addition to the analogies I’ve already offered, it’s like having to go to the polls in order not to vote.

And please note that the idea of having parents "forced" to go to the school a certain day in order to opt out of vaccinating their child is from someone who just after started complaining about being "forced" to go to his/her doctor to have a DNR signed. And then he/she starts saying other people have a beam in their eye, or something.

zebra - I am choosing not to discuss a hypothetical example for Snickers. I am choosing to discuss current (and proposed) vaccination policies.

1. Self interest - vaccination will likely protect you from specific diseases with known risks of complications at a very small personal risk.

2. Public interest - vaccination will help protect the community from those same diseases at a very small personal risk.

The body autonomy argument against vaccination: I don't want to take that small personal risk for either benefit, so I shouldn't have to. The government's authority stops at my skin; you cannot make me vaccinate.

I don't see anything in either argument for vaccination that can be construed as either more or less an issue with body autonomy.

"In case 2, it would not be rational to think the ban had anything to do with her dietary decisions for the child."

Is: No, you're wrong, it would be rational, because those irrational AVers make exactly that irrational argument.

Really? The authorities are not telling people that getting your child vaccinated is good for your child? While also telling them that it is needed for herd immunity? Amazing. (I wish I had some of whatever you are drinking or smoking.)

This speaks to the question of the role of government. And 1 is a reasonable starting point for a slippery slope argument, while 2 is not.

If the role of government is to protect me from myself, that means my entire existence is at its mercy.

There's no reasonable such possibility in case 2-- I will be affected only when my actions affect others.

zebra, I was directly quoting you from #387 in my comment #396. So stop accusing me of misquoting you. As for your last paragraph, I was referring to the following:

In case 1, the mother has a reason to fear that her autonomy with respect to how she raises the child is being threatened. She may exaggerate the extent to which the autonomy might be restricted in the future, but it is not unreasonable to have the concern in the first place.

In case 2, it would not be rational to think the ban had anything to do with her dietary decisions for the child.

The authorities are not telling people that getting your child vaccinated is good for your child? While also telling them that it is needed for herd immunity?

So NobRed, now we have established that medical peer review, by one of its top authors, is complete quana, it rather means that the whole of this thread, and most of the rest of the site is a dead duck. I love the way everyone has totally ignored this material fact, bit like no comment on Susan Humphries debunking polio vaccination. Kind of validates the anti vaxx position. Chicken boys......

“I also suggested how I thought the project of vaccination should be framed. I think it should be a public health matter, meaning that its purpose is to protect the population in general, as opposed to protecting individuals.” NobRed

I wouldn’t worry about this type of ranting – the purpose of vaccination might be to protect the public – that’s the spin. It’s nothing more than a soundbite though, the evidence for protection just isn’t there.

“Richard Smith, who edited the British Medical Journal for more than a decade, said there was no evidence that peer review was a good method of detecting errors and claimed that “most of what is published in journals is just plain wrong or nonsense”. There you have it, the guy that produced the premiere medical peer review rag in the UK says it’s all baloney. No wonder NobRed is so out there.

In case 2, the school tells the mother to stop doing it because there are children with peanut allergies, and the candy represents a threat to their health.

It's almost like Z. has not the slightest idea about the audience he's telling everyone how to effectively communicate with.

"Chris Cuomo on CNN: 'I can't have my kids bring peanuts to school but a parent has a choice on whether to vaccinate their kids?' Hey bro, tell it to the CDC -- vaccines caused those peanut allergies! -0-"

Zebra there is no point trying to rationalise with these people. When you are rational, they are irrational, when you are irrational out of sheer frustration, they appear rational..

It's a kind of scientology game that no one can win. I have already pointed out that their gods of medical peer review are now telling us what we knew, medical peer review is bullshit. But it is all they have, well NobRed has a pile of tissues because he is the kind of person who gets off on wasting people's time with woo discussions and fallacy.

Zebra there is no point trying to rationalise with these people. When you are rational, they are irrational, when you are irrational out of sheer frustration, they appear rational..

It’s a kind of scientology game that no one can win. I have already pointed out that their gods of medical peer review are now telling us what we knew, medical peer review is balony. But it is all they have, well NobRed has a pile of tissues because he is the kind of person who gets off on wasting people’s time with woo discussions and fallacy.

You keep saying Susan Humphries. Do you mean Dr. Suzanne Humphries? Is she the crackpot to whom you constantly refer? Or is there another tinfoil hat wearing attention-seeking scumbag out there named Susan Humphries who also lies about the polio vaccine?

In case 1, the school sends a note home telling the mother to stop doing that because she is endangering the health of her child, because Snickers bars are fattening and rot your teeth.

In case 2, the school tells the mother to stop doing it because there are children with peanut allergies, and the candy represents a threat to their health.

In case 1, the mother has a reason to fear that her autonomy with respect to how she raises the child is being threatened. She may exaggerate the extent to which the autonomy might be restricted in the future, but it is not unreasonable to have the concern in the first place.

I disagree, on the grounds that she can easily stop sending her child to school with three Snickers bars for lunch without any loss of parental autonomy, not excluding her right to feed her child three daily Snickers bars, if she so wishes.

In case 2, it would not be rational to think the ban had anything to do with her dietary decisions for the child.

The best way to cause the mother to be really paranoid, of course, is to mix the two messages, because then the legitimacy of the public health argument can be called into question: “That’s just an excuse to take away my autonomy.”

The best way to cause the mother to be really paranoid is a sustained campaign of harassment, stalking, hang-up calls, and threats of death, kidnapping, and financial ruin.

On consideration, I suppose I also disagree with Case 1 on the grounds that if the school really thought she was endangering her child, she wouldn't be hearing about it via a note the school sent home with him or her. There's a mandate to report.

So NobRed, now we have established that medical peer review, by one of its top authors, is complete quana, it rather means that the whole of this thread, and most of the rest of the site is a dead duck.

But you haven't established that peer reviw is"complete quana", johnny. All you've done is note that in the opinion of one former journal editor pre-publication peer review needs to be improved.

Correct, but, and this is the significant point I’ve been arguing, the public health argument is not a “counter” to the autonomy argument.

"Correct, but, and this is the significant point I’ve been arguing, the public health argument is not a “counter” to the autonomy argument."

That's an exact quote both times. There's water treatment plants that are less full of sh*t than you.

If the role of government is to protect me from myself, that means my entire existence is at its mercy.

I disagree, on the grounds that it is the role of government to protect its citizens from themselves if that's what it has to do to protect their rights, which does not put their entire existences at its mercy and indeed cannot, since there's a robust and unambiguous prohibition against it doing so, both de facto and de jure.

Ooooh Delphine flower, I hardly think Humphries is a crackpot. She has more medical qualifications than most of this site. So do you read the BMJ or are you just a bypass poster?

Suzanne Humphries has a medical degree and is (or was) a qualified neprhologist--that's it to the best of my knowledge.

That said, having an advanced or medical degree hardly disqualifies one from being a crackpot as well--just consider examples like Gerson, Burzynski, etc..

"That said, having an advanced or medical degree hardly disqualifies one from being a crackpot as well"

So much so that any that somehow can't afford to or can't get into an accredited institution of higher learning will buy degrees on the internet.

You really can't trust a string of letters after a name to enforce rigorous, analytical, logical, or rational thoughts; no matter which institution grants them.

Wait just a minute, dear boy. You trash the medical community, yet you cite Suzanne/Susan/Suellen Humphries' medical degree to lend credence to her fear-mongering?

Sure, in one breath they castigate an author and an editor @ BMJ who detaled Wakefield's malfeasance and then scoff at pharma support there but then applaud a prestigious ( past) editor and research published there that agree ( at least in their fevered imaginations) with their own woo.

Thanks for pointing out that medical peer review means whatever you have paid for it to mean. It is like watching crap in a washing machine on this blog, you make up whatever you want to and discuss precious little.

Delphine disappointed not to have a masturbation-themed nickname May 6, 2015. Don't worry, it will come. If that's what, as a proper doctor, you aspire too, consider it in the pipeline.

You have to write something a bit more sexy than 'naa boo yaa'. All we are seeing is 'vaccine believers' and pharma shills over and over - why do you wonder why so many people have lost faith in what you do?

Dr. Humphries is a nephrologist who "left conventional medicine" and has since embraced quackery such as homeopathy and claims that vaccines cause kidney damage. She also describes vaccines as "disease matter" and claims that people have never been vaccinated voluntarily.

A brief perusal of her website revealed claims that whooping cough can be treated successfully with vitamin C. She cites an uncontrolled case series of 26 children from 1938 with no laboratory confirmation of pertussis but fails to mention a controlled study the same year that concluded:

Twenty-one cases of whooping-cough have been treated with large doses of vitamin C. The illness lasted an average of thirty-five days, compared with forty-one days in twenty control cases, a difference which lies within the limits of statistical error.

The average rate of weight gained was practically the same in both the treated and the control cases. These figures are in keeping with the general clinical impression that there was no striking difference in the course of the disease in the two sets of cases, and the assertion of Ormerod and UnKauf that the paroxysmal period of the disease is shortened " from a matter of weeks to a matter of days" was not confirmed. [...] It is considered that the statement that the administration of vitamin C in whooping-cough has an effect upon the course of the disease is at present unproven.

I think it is extremely irresponsible of Humphries to make such claims and cherry-pick the evidence to support them. An unvaccinated child is up to 26 times more likely to get whooping cough (note the distinction from pertussis) than a vaccinated child, and there is no good evidence that vitamin C will have any beneficial effects. Even if it did, is it really better to be coughing for up to seven weeks instead of preventing the disease entirely by keeping up to date with booster shots?

That was just the first of her articles that caught my eye. I dread to think what other dangerous nonsense she promotes.

"I think it is extremely irresponsible of Humphries to make such claims and cherry-pick the evidence to support them." knob

Well you would, you are a vaccine believer " Even if it did, is it really better to be coughing for up to seven weeks instead of preventing the disease entirely by keeping up to date with booster shots?" Knob

Whooping cough vaccine is about as woo as you can get boy, massive whooping cough vaccine failure has only just left us, until the next one.

B52 bombers spraying Detroit with DDT isn't a cherry pick, you twat, it's something the public need to know about. It's medical peer reviewed research that is the lot of cherry pie.

The dangers of DDT appear to have been exaggerated. There is no good evidence to support claims that it leads to eggshell thinning in raptors, it has only weak estrogenic effects, does not cause cancer (animal feed contamination with aflatoxins led to that erroneous conclusion), and has neurotoxic effects only in enormous doses (greater than 5 grams in humans). I have seen convincing arguments that restrictions on DDT use have led to millions of deaths from malaria.

I'm still waiting for your evidence that DDT causes polio-like effects in humans in the doses children were exposed to in the US some decades ago.

Whooping cough vaccine is about as woo as you can get boy, massive whooping cough vaccine failure has only just left us, until the next one.

Multiple independent studies (see references section in this article) have found that a full course of pertussis vaccination is 70% effective against pertussis infection five years later, and the remaining 30% are protected against paroxysmal coughing aka whooping cough. That doesn't constitute "massive vaccine failure" on my planet, but I suppose you claim that all those studies were 100 of those studies were manipulated by some shadowy global conspiracy.

Hiccup - ^ should read: "I suppose you claim that all 100 of those studies were manipulated by some shadowy global conspiracy.

"I have seen convincing arguments that restrictions on DDT use have led to millions of deaths from malaria." The DDT debate with respect to malaria/vector control is ongoing in the circles in which I work and travel. DDT's hardly the boogeyman some have made it out to be, I worry more about resistance.

Oh, goody, Phildo has decided to switch capitalization to impersonate the sane Johnny, so I get to see his twaddle. All is not lost, though:

Side note, I think it's interesting that THEO is a supporter of zebra's while johnny disagrees with him (though misattributed to Narad).

That's what I meant. It's just as well that he can't use blockquotes, because his style further identifies him as Philip Hills, Hope Osteopathic Clinic Essex.

Oops, didn't realize that Krebiozen got the totally original nickname "knob", I thought that was still referring to Narad (easy mistake tovmake considering johnny has previously referred to Narad as "knob"). Regardless, in #141 johnny misattributes a zebra quite to Narad, #186 Narad quoting Gamondes as Narad's own words, and #388 and 408 zebra as Narad again.

Right, and in #430, which I saw, he further misattributed a JGC comment to me. He's as dumb as a f*cking rock.

"Quana"? Really? Johnny is feeling a bit left-out and needy, what with Zebra's arguments taking up all the attention and leaving none for him.

On the basis of him being batsh!t crazy (no offence intended to those with SMI), I assume he meant guano.

I have started hearing all johnny's comments in my head voiced by Nigel Farage. This is not a good thing.

Seems to be going a bit far, even for health-food faddists; I'll stick with potatoes. Maybe it's meant as a face mask...

Perhaps 'Johnny' meant Qiana, although why he's invoking a 70's polyester disco fabric is anybody's guess.

"Multiple independent studies (see references section in this article) have found that a full course of pertussis vaccination is 70% effective against pertussis infection five years later, and the remaining 30% are protected against paroxysmal coughing aka whooping cough. " krebbsie

But we now know that medical peer review is horseshite - it never was evidence. Get you head out of your rear and start breathing.

"Referring to John Ioannidis’ famous 2005 paper “Why most published research findings are false”, Dr Smith said “most of what is published in journals is just plain wrong or nonsense”.http://www.timeshighereducation.co.uk/news/slay-peer-review-sacred-cow-…

You are all being left behind in the dark ages - tut tut, all that posting based on 'sacred cows'. I assume non of you have a higher academic position than the editor of the British Medical Journal - if he says medical peer review is cow dung then you should all come up to speed.

“Multiple independent studies (see references section in this article) have found that a full course of pertussis vaccination is 70% effective against pertussis infection five years later, and the remaining 30% are protected against paroxysmal coughing aka whooping cough. ” krebbsie

But we now know that medical peer review is horse twang – it never was evidence. Get you head out of your rear and start breathing.

“Referring to John Ioannidis’ famous 2005 paper “Why most published research findings are false”, Dr Smith said “most of what is published in journals is just plain wrong or nonsense”.http://www.timeshighereducation.co.uk/news/slay-peer-review-sacred-cow-…

You are all being left behind in the dark ages – tut tut, all that posting based on ‘sacred cows’. I assume non of you have a higher academic position than the editor of the British Medical Journal – if he says medical peer review is cow dong then you should all come up to speed.

This is exactly right! but they can't Johhny their entire profession is built on woo. Patented chemical based medicine.

How can anyone trust any of these vaccine studies funded by drug companies? This is the bigger point and most important of all. Fraud has been going on since the inception of PEER REVIEW. We are just now finding out about this. I wonder for how many decades or centuries for that matter we have bought into so called scientific facts and studies postulated by the medical community that were based on fraudulent peer review?

Who is funding the study is the first clue and if its funded by a mulitnational billion dollar company with products to sell there must be an independent watchdog group overseeing it. Sadly that does not happen.

These corporations publish whatever they want and say "LOOK LOOK PEER REVIEW" and the media is happy to promote it on the nightly news as gospel. and the american people eat it up.

And in the meantime we are told GMO foods are safe, get your mercury laced vaccines for the flu at the blinking red light at Wallgreens, and take your prescription drugs for arthritis. And for good measure they fabricate studies showing vitamin supplements dont work and are a waste of money. But by all means consume these patented chemicals we have studied proven safe. SHEESH And the critics like defecting MD's Humphries, Brownstein, Etc who know the truth are suddenly called kooks, cranks, loons and quacks? STFU! already

But we now know that medical peer review is horse twang – it never was evidence. Get you head out of your rear and start breathing. “Referring to John Ioannidis’ famous 2005 paper “Why most published research findings are false”, Dr Smith said “most of what is published in journals is just plain wrong or nonsense”.

Even if Smith was right, and many people disagree with him, it doesn't automatically mean that every single study ever done is wrong (apart from the ones that agree with your deluded ideas, of course). I'm sure no one here would suggest uncritically accepting a single study, but when 100 different studies from different parts of the world agree, we can be pretty sure they are correct. The fact that the incidence of pertussis has fallen by more than 90% everywhere vaccination has been introduced also strongly supports the efficacy of the vaccine.

You are all being left behind in the dark ages – tut tut, all that posting based on ‘sacred cows’. I assume non of you have a higher academic position than the editor of the British Medical Journal – if he says medical peer review is cow dong then you should all come up to speed.

You really aren't very bright are you? Dr. Smith has not been editor of the BMJ for more than a decade, and is an ardent supporter of vaccination. For example, he wrote:

Three million children die every year in poor countries from diseases that can be prevented by vaccination. Millions more die from diseases—like malaria and AIDS—that should be preventable by vaccines if they were developed. Unfortunately existing vaccines are not reaching these children because of failures in delivery systems, lack of resources, and the high price of some newer vaccines. Moreover, new vaccines may not be developed because private companies can't foresee a good return.

I was interested to see that Dr. Smith is the brother of comedian Arthur Smith. Perhaps that explains his statement last year that there is no point in finding a cure for cancer as it is "the best way to die".

Do they have problems, yes, but what is this magical replacement system that will uncover the truth about reality that they seem to have full faith in without ever tell us what it happens to be or how it works?

THEO - you mention vitamin supplements. As far as I am aware it has been shown that the body will not use any more than it needs. So shoveling in a massive overdose of vitamins per day is pointless. A waste of money. Therefore the vitamin pill pushers are driven only by the desire to make money. In fact, that puts them in exactly the same category as you place the 'pushers' of modern pharmaceuticals. Pushing a product that is ineffective and unnecessary.

"As far as I am aware it has been shown that the body will not use any more than it needs" wang disfunction

Number of deaths from vitamins and minerals last 10 years? Number of deaths from patients on the right medication exceeds the number of deaths from those on the wrong medication - look it up. That means with a doctor in the equation whose only approach is pharma isn't looking good.

So now you have no medical peer review - what ya got boys. Sounds like the party just went pfut........

"Do they have problems, yes, but what is this magical replacement system that will uncover the truth about reality that they seem to have full faith in without ever tell us what it happens to be or how it works?" Wahaykay

Don't worry dear, when those people thought the world was flat and then they heard it was a sphere, the same things came up. For a start believing that disease is some unlucky magic is hard to let go of, that we need the snake oil to fix it is another one, or the orachopper to take it away.

Perhaps if you quietly left the scene, all of you, and let some proper professionals take over, you might learn something.

Theo, are you enjoying the stunned silence. Now their baby has gone, they don't know what to do with themselves.

Smith wants it replaced with open online publishing and post review. A reasonable idea but probably unrealistic from a publisher's perspective. Nowhere does he say we should throw out the scientific method or invalidate all the studies we currently have. I'm pretty sure johnny and THEO's alternative is to throw out everything we've done up to this point and switch to relying on anecdotes and Mercola.com and friends.

What a horse trader, you are as false as your fallacies boy and you still can’t see the ship sinking

Opposing him, Georgina Mace, professor of biodiversity and ecosystems at University College London, conceded that peer review was “under pressure” due to constraints on reviewers’ time and the use of publications to assess researchers and funding proposals. But she said there was no evidence about the lack of efficacy of peer review because there was no “counterfactual against which to tension” it.

Theo, are you enjoying the stunned silence. Now their baby has gone, they don’t know what to do with themselves.

No. We recognize the limitations and have for quite some time. You offer nothing that hasn't been discussed here and at SBM in depth. The difference between science and pseudoscience is that we recognize problems, both with our current knowledge and our methods and work to correct them. And, as I said before, you are greatly misrepresenting Smith's words. He doesn't want to throw out the whole process. Studies would still be done, they would still use the scientific method, replication would be necessary for them to be adopted, etc, etc. The only difference would be instead of prepublication peer review it would be open and done post publishing.

" We recognize the limitations and have for quite some time. You offer nothing that hasn’t been discussed here and at SBM in depth. The difference between science and pseudoscience is that we recognize problems, both with our current knowledge and our methods and work to correct them" Chudmuffler

The only 'problem' you all seem to recognize is that a growing body of public and professionals is seeing right through 'a pill for ill' and the biased way it is presented as the only 'scientific option'.

Your method only stops fallacies when the profit margin drops. You accept a flawed testing method for vaccine efficacy by re inventing the placebo. Georgina is part of the existing process, the one where all academics only exist in publications, they don't actually do very much.

This is such a baloney sentence crunchy, it is so full of holes it is hard to know where to start. The last flu pandemic was pseudoscience, what is the difference?

Current medical peer review is kapooti, you get the pizza you pay for - how on earth is that science? You offer nothing except religious rants about medical peer review, citation required........what is the point on citing gabooni?

In the United States, overdose exposure to all formulations of "vitamins" was reported by 62,562 individuals in 2004 (nearly 80% [~78%, n=48,989] of these exposures were in children under the age of 6), leading to 53 "major" life-threatening outcomes and 3 deaths.

Number of deaths from patients on the right medication exceeds the number of deaths from those on the wrong medication

You assume that the medicine is the cause of death, not the condition which the patient was taking medication for. You're a damn fool.

Given by the kind of 'evidence' antivaxer's typically embrace,, I'd say they want working scientists to release their data in the form of unsupported assertions presented in YouTube videos, or failing that as rants found on whale.to.

Theo, your evidence that GMO foods are NOT safe for human consumption would be...what, exactly? Be specific.

Theo, your evidence that vaccines are 'laced' with inorganic mercury would be...what, exactly? Be specific.

Theo, your evidence that prescription drugs for arthritis (e.g., Enbrel) are neither safe nor efficacious would be...what, exactly? Be specific.

And for good measure they fabricate studies showing vitamin supplements dont work and are a waste of money.

I'm still waiting for johnny's response to Dr. Smith's enthusiastic support of vaccination. He also believes in the eradication of polio through vaccination:

Afghanistan, Pakistan, and Nigeria are the countries where polio has never been eradicated. India was one of those countries, but after a massive effort where 2.5 million health workers vaccinated 174 million children in three days, polio has been eradicated in India.

How can johnny believe anything this provaxxer writes? Aren't his claims about peer review are rendered worthless by this?

I could really upset "johnny" and "THEO" by letting them know my *NORMAL MD* measures my vitamin levels and prescribes what I need based on the results. (Due to surgery, I can't get all I need from foods). Xe does not recommend mega-doses nor handfuls of various drugs. Xe *is* working with me to help me lose weight, exercise more, and hopefully get me off some of my Rx drugs.

Of course, this is totally contrary to what "johnny" and "THEO" believe regular MDs do. They have this idee fixe that all MDs are true pharma shills who live to push medications.

Not only that, but I had to ASK to have my vaccines updated, as their records were off and they thought I'd already had the ones I needed. They offered both thimerosol-free (single dose) and multi-dose options. Since I didn't care either way, I happily signed my consents and got my mercury.

I'm also of the generation who used to paint ourselves with Merthiolate for cowboys and Indians games. It was also heavily slopped onto any injuries by our parents - I think the sting of that stuff will live in my mind forever. It was in all our vaccines. And, at the time, as teens, my brother and I got our first contact lenses, it was in all the soaking solutions.) So if thimerosol was that dangerous, my friends, siblings and I would all be drooling maniacs like "johnny" and "THEO".

However, the only autistic person in our family was a cousin in the 1930s. We might have some Asperger's on all sides, but never severe enough for diagnosis. Lots of "quirky" family members, both male and female, vaccinated and unvaccinated.

h[]ps://www.sciencebasedmedicine.org/peer-review-and-the-internet/ Steve Novella talks about using the Internet to improve the peer review system.

h[]ps://www.sciencebasedmedicine.org/does-peer-review-need-fixing/ A certain friend of the blog talks about how criticisms of peer review are overblown and looks at solutions.

All studies should be vetted by a committee of experts in those fields that are not beholden to special interests. The problem is most scientist have careers they want to advance and do not want to go against the consensus, power and money. So they go with the flow knowing if they argue and refute the study they will potentially end their career dry up finding for research and be called a loon or a quack. Thats not science thats an agenda by a powerful pharmacutical cartel with 1 goal absolute control over medicine.

Peer review should not be scrapped but it needs overhauling with 100% complete transparency. We have been told its sanctified and trustworthy thats clearly false. Since its been manipulated for so long ALL vaccine studies should be vetted by an independent group to see where the fraud is, that includes drugs too. Our side can direct people to these studies right away.

@JGC for Arthritis take Glucosamine (as HCI), MSM and white willow bark. cured no side effects. in harmony with the body.

You don't need a drug for arthritis. There are at least 15 diseases I know of off the top of my head that can be reversed with diet supplements and lifestyle 100% safe zero side effects.

GMO foods are like vaccines. no long term studies they dont do immediate damage but have long term implications. Plus all of Europe is against them.

WAIT she is a quack going against the establishment. she cannot be trusted. Do you see why its so hard to change medicine?

May 7, 2015 THEO – you mention vitamin supplements. As far as I am aware it has been shown that the body will not use any more than it needs. So shoveling in a massive overdose of vitamins per day is pointless. A waste of money. Therefore the vitamin pill pushers are driven only by the desire to make money. In fact, that puts them in exactly the same category as you place the ‘pushers’ of modern pharmaceuticals. Pushing a product that is ineffective and unnecessary.

Have you ever heard of optimal nutrition? Functional Medicine?probably not......The human body does not get its daily required nutrients day in and day out. This is the ROOT cause of many diseases. the soil does not contain the nutrients it did 100 years ago, your body is deficient in lots of nutrients. Supplements can fill the gap and provide a boost. My gosh get up to speed already this is old news. go investigate

At least the next time some anti-vaxer throws up a link to something like Ginger Taylor's "86 Research Papers Supporting the Vaccine/Autism Link" we can tell them "johnny says they're invalid because PEER REVIEW!

Vitalism is a philosophy (way of thinking about life) which understands that someone or some intelligent energy source or some non-material force or inborn power makes us alive and coordinates all functions of life. The truth about how the body works is simple: We are self-healing self-regulating organisms. Health and adaptation comes from inside us.

This inborn innate intelligence sustains every vital aspect of life in your body: including growth, healing, cellular function, reproduction, immune system, breathing, balance, heart beat, etc.

How do we manage this vital life force within us? With mercury, aluminum, chemo, formaldehyde,radiation, surgery? or with optimal nutrients, avoiding toxins, pure clean water/hydration, sleep, balanced diet, fruits and vegetables lean proteins/ a whole foods diet like PALEO? The answer is in the fuel you are putting in your body. Food is medicine.

THEO @ 475: You do understand that immunization (through vaccination) is people using their adaptive immune system and immunologic memory to prevent illness, right?

Vitalism is a philosophy (way of thinking about life) which [postulates] that someone or some intelligent energy source or some non-material force or inborn power makes us alive and coordinates all functions of life.

The truth about how the body works is simple: We are self-healing self-regulating organisms./blockquote>

Except, of course, when all too frequently we're fail to be self-healing, and die or suffer chronic illness and injury instead.

As does illness (type 1 diabetes, cancers, Parkinson's, Huntiinton's chorea, custic fibrosis, MS, ets.)

This inborn innate intelligence sustains every vital aspect of life in your body: including growth, healing, cellular function, reproduction, immune system, breathing, balance, heart beat, etc.

Apparently "inborn innate intelligence" is a synonym for entirely non-intelligent processes like gene regulation, cell physiology, etc.

Only when used to treat disorders involving malnutrition, vitamin and mineral deficiencies, etc. If you acquire viral meningitis or develop cancer, for example, you're not going to eat your way back to health whatever foods you consume.

THEO's lapsing into something resembling the English of a native speaker is, of course, diagnostic of a cut and paste.

Starting? He doesn't believe the flu "is catching." Immunology basically was completed by A.T. Still in the Phildoverse. (Although I'd love to hear about his career in managing cardiac units.)

Richard Smith, who edited the British Medical Journal for more than a decade, said there was no evidence that peer review was a good method of detecting errors and claimed that “most of what is published in journals is just plain wrong or nonsense. He went on to say that if peer review was a drug it would never get on the market because we have little evidence of its benefit but lots about its adverse effects".

"You do understand that immunization (through vaccination) is people using their adaptive immune system and immunologic memory to prevent illness, right?

It is the body not just self-healing, but actively preventing illness, so it doesn’t need to heal." Justabull That's a nice fairy story bull, but you don't have any evidence to support it. The adaptive immuno theory, moderated by vaccination is also a fairy story too. Next you will be telling us that vaccines save lives.

Oh geez, not that old chestnut. You can isolate pathogens on most people and there is no disease. Of course there are germs, but they are not the 'cause' of all disease, it is like blaming skids on the road on car accidents.

Looking for germs as the cause of all diseases is a dead end. Look what antibiotics have led us to, and who prescribes those? Proper doctors, you can't blame that on alt med.http://www.theguardian.com/science/2015/apr/06/drug-resistant-disease-c…

One place is happenstance, two places is coincidence, but after three places it is time to give up skiing.

johnny @481: So, if there is no such thing as the adaptive immune system, what do you offer as an alternative explanation?

Theo, these people are sicker than most, their believe system has screwed them senseless. They all think disease is a mystery event caused by bad luck and deficiency in medication! They can't even understand what arthritis is and how to help people with it, all they offer everything is steroids and antibiotics. They only have two or three spanners in the box!

johnny has made it pretty clear that we can't trust peer reviewed studies. THEO hasn't responded because he doesn't need to. They live in a free for all world where simply saying something makes it true, unless of course it is said in a peer reviewed journal. THEO's word is the proof.

If germs don't cause disease, then antibiotic-resistant germs are no threat to anyone. So why criticize the medical profession for the existence of harmless antibiotic-resistant germs?

If germs don’t cause disease, then antibiotic-resistant germs are no threat to anyone. So why criticize the medical profession for the existence of harmless antibiotic-resistant germs?

Wouldn't it be nice if they could at least be internally consistent? I expect that much from anything else in the fantasy genre.

Three million children die every year in poor countries from diseases that can be prevented by vaccination. Millions more die from diseases—like malaria and AIDS—that should be preventable by vaccines if they were developed. [...] Afghanistan, Pakistan, and Nigeria are the countries where polio has never been eradicated. India was one of those countries, but after a massive effort where 2.5 million health workers vaccinated 174 million children in three days, polio has been eradicated in India.

Both Johnny and Theo are from Cloud Cuckoo Land, because there is certainly no consistency in their beliefs.

So, if there is no such thing as the adaptive immune system, what do you offer as an alternative explanation?

Delphine, Those exit polls have made me very depressed. Looks like we're getting Con-LibDem Coalition 2.0 :-(

Philip Hills has been to India, believe it or not. It's extraordinary finding germ theory denialists in the 21st century. We can sequence viral DNA and even assemble one, inject it into an animal and the animal gets sick, yet these people still don't believe it. Astonishing.

ScienceBlogs is where scientists communicate directly with the public. We are part of Science 2.0, a science education nonprofit operating under Section 501(c)(3) of the Internal Revenue Code. Please make a tax-deductible donation if you value independent science communication, collaboration, participation, and open access.

© 2006-2019 Science 2.0. All rights reserved. Privacy statement. ScienceBlogs is a registered trademark of Science 2.0, a science media nonprofit operating under Section 501(c)(3) of the Internal Revenue Code. Contributions are fully tax-deductible.

336d Piston Pump Wholesaler Quotes & PriceList

Stainless Steel Castings, Gray Iron Casting, Ductile Iron Casting - Yogem,https://www.yogemcasting.com/