Sunday, July 29, 2012

FoSiM: The local "mini-me" of Institute of Science in Medicine: Same Bull, different faces.

Dr Harriet Hall and her 26 "Founding Fellows" created the "Institute of Science in Medicine" [ISM] in mid-2009 as a "501(c)(3) organization for US federal tax purposes" registered in Colorado.

It self-describes as:
ISM is a non-profit educational organization dedicated to promoting high standards of science in all areas of medicine and public health.
and in PDF files includes:
Institute for Science in Medicine, Inc. (ISM) is an international, educational and public-policy institute, incorporated in the State of Colorado, and recognized as a 501(c)(3) organization for US federal tax purposes.
The local Australian variant, "Friends of Science in Medicine" [FoSiM] self-describes as:
 Our Association was formed at the end of 2011 out of concern about the increasing number of dubious interventions, not supported by credible scientific evidence, now on offer to Australians.
FoSiM was created by Loretta Marron and John Dwyer and three other of their little friends. It took them several months to incorporate an Association in NSW and register a website.  The five "Founders" were necessary under NSW law to form an Association.

Hall and Marron would've known of each other in 2007, both appearing in "The Skeptic" magazine (Australia) and possibly met at a "Skeptics" conference, such as James Randi's TAM7 (The Amazing Meeting) which had a large Australian contingent.

By 2009,  their names appear together in articles, they are both speakers on "The Skeptic Zone" by Richard Saunders and are both closely connection to a number of other high-profile Australian Skeptics like Rachel Dunlop, Kylie Sturgess and Karen Stollznow.

Dr Hall appears in the first list of "Friends", January 2012.

The "mini-me" relationship extends further with their DNS names:

Dr Hall's group has the obvious website name:
Where the local "mini-me" has a website name unrelated to it registered name, "Friends of Science in Medicine", but exactly congruent with being the local arm of ISM. 
There is a test/development site at:
Why does this matter?

If you read the first policy document of ISM [PDF] as a Declaration of Intent, it finishes with some very worrying 'Recommendations':
The world’s health care systems need to be rooted in a single, science-based standard of care for all practitioners.
Effective, reliable care can only be delivered by qualified professionals who practice within a consistent framework of scientific knowledge and standards.
Practitioners whose diagnoses, diagnostic methods, and therapies have no plausible basis in the scientific model of medicine should not be licensed by any government, nor should they be allowed to practice under any other regulatory scheme.
Any statute permitting such practices should be amended or repealed as necessary to achieve this policy.
Unscientific practices in health care should further be targets of aggressive prosecution by regulatory authorities.
 This unambiguous Declaration of Intent gives the ISM, and it's mini-me, FoSiM, specific Agenda:
  1. It is an explicit recognition that this is a Political not Academic or Scientific 'debate'. ["As a consequence of these practitioners being legitimized through political rather than scientific means, ...] In no way are either of these bodies "Educational" or "about Science". They are only Political Lobby groups, yet aren't registered as such.
  2. ISM/FoSiM want nothing less than making the practice of "Alternative" Medicines illegal ["change of statues"] and practitioners subject to "aggressive prosecution".
  3. Who will judge what has, and has not, a "plausible basis in the scientific model of medicine"?
    • They don't define either "Science" or it antithesis, "Pseudo-Science", i.e. on the formal, strict basis for this rather extreme decision.
    • They don't suggest a forum in which this 'debate' might occur and the formal bodies that will be charged with these judgements. There is no, and can never be, a Global Council of Science charged with making ultimate decisions of what is/is not "True Science".
    • Nor do ISM/FoSiM suggest whom has adequate qualifications in both Science and Jurisprudence to even suggest answers to these problems, define the Terms of Reference for any Tribunal convened and the training and selection of whom might be selected to sit in Judgement.
    • Do ISM and their "mini-me"s assume that Politicians will have sufficient knowledge, be free from bias and all Conflicts of Interest to sit on these Tribunals?
    • There seems to be no idea of Professions being able to defend themselves on any other grounds but an undefined "scientific model" and seemingly without means of Appeal or cause for Redress.
  4. What isn't spelled out here, but is noted on the FoSiM site, is the assumed Dawkins Appropriation: anything ISM and their "mini-me"s decide is "Medicine" is automatically included in their Field of Practice. Which, by definition, makes that practice or technique now illegal for any other Profession to practice.
Given the extreme published position of ISM and the close alignment of ISM and its "mini-me", FoSiM, comments like this from Australian apologists strike me as ignorant, uninformed or disingenuous in the extreme:
Having an organisation like FSM to kick-start a public debate about the value of science in healthcare is invaluable. 
So to the extent that FSM can get the media and the general public thinking about how much they might value science as opposed to pseudoscience in their healthcare it can only be a good thing. That’s why I stopped sitting on the sidelines of the debate and signed up when I found out about them.
No, this is not a "debate", this is not something of little concern, an effort of well-intentioned, altruistic experts. It is anything but that.

Just to emphasise this is a consistent, reiterated position, a quote from another article:
[From criticism of ISM/FoSiM in the MJA] Indeed, it is not melodramatic to point out that if Friends of Science in Medicine were to succeed in their stated aims, they would achieve a dystopia – a medical ‘1984’ where only one way of knowing the body in health and illness is permitted in public discourse. 
Well, for starters, it IS melodramatic to call FSM dystopian. Allow me to also point out that FSM are not talking about public discourse, they are talking about university training of health professionals. The logic of this argument rests on an assumption that scientific knowledge is not special. 
Again, No so! Read the ISM Policy...

ISM and their clones want any type of Healthcare they declare "not science" to be illegal, and practitioners "aggressively pursued". Once started, this is a very slippery slope. Ultimately, internal Politics reliant on funding and 'connections' will determine what treatments are allowed and which will be deemed "unscientific". The world of Medical Politics is already riven with such extreme dysfunction and violent internecine warfare that few outsiders understand how bad it is.

Are ISM and its clones seriously suggesting the public put their health, and the lives of all their foreseeable descendants, into the hands of an unaccountable, deeply discordant and divided profession with no alternatives whatsoever? That's not going to end well for us, the paying public.

This campaign by ISM is hard-core Political Lobbying by the dominant Healthcare Profession for exclusive control of the domain.

They seem to not be happy with having captured over 99% of the Healthcare Dollar and now want everything, presumably in anticipation of making a grab for a much larger slice of our income. After all, you wouldn't want to die from poor Medical care, would you?

In the USA they've increased National Healthcare Expenditure (NHE) from ~5% in 1960 to ~18% now, with the numbers of uninsured and under-serviced folk steadily increasing, but without any commensurate improvement in the most basic of Healthcare Outcomes: Life Expectancy.
The USA is ranked globally around 80th on that measure, whilst spending 50-100% more of GDP...

Projections on the CMS site include that by 2050, NHE will account for 30% of US GDP. They don't suggest how much higher than the current ~25% the rate of uninsured will be.

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