{"id":4136,"date":"2003-02-03T16:53:20","date_gmt":"2003-02-03T16:53:20","guid":{"rendered":"http:\/\/peterlevine.ws\/?p=4136"},"modified":"2003-02-03T16:53:20","modified_gmt":"2003-02-03T16:53:20","slug":"the-gold-standard-for-medical-information","status":"publish","type":"post","link":"https:\/\/peterlevine.ws\/?p=4136","title":{"rendered":"the “gold standard” for medical information"},"content":{"rendered":"

I spent some time writing my article about Medline<\/a><\/p>\n

as a "gold standard" of medical advice and information of the<\/p>\n

Internet. No individual knows enough about medicine to make a direct assessment<\/p>\n

of the information presented on this huge portal, which adds half a million<\/p>\n

new scientific references every year. To decide if the material on Medline<\/p>\n

is reliable and useful, we cannot apply what my friend Anton Vedder calls<\/p>\n

"primary epistemic criteria," such as "consistency, coherence,<\/p>\n

accuracy, and accordance with observations." But we can use what<\/p>\n

he calls "secondary epistemic criteria," and they are all in<\/p>\n

Medline’s favor. We can easily see that it is well-funded, separated from<\/p>\n

profit-seeking companies, and run by distinguished professional organizations<\/p>\n

and bodies. <\/p>\n

So should every American who goes online for medical information consult<\/p>\n

only Medline and those sites to which Medline links? One problem is that<\/p>\n

government officials, including medical doctors, may have political agendas.<\/p>\n

In 2002, various agencies of the United States Government removed information<\/p>\n

about condom use and abortion from their Websites, allegedly because elected<\/p>\n

politicians favored sexual abstinence before marriage and opposed abortion<\/p>\n

on moral or religious grounds. For example, the National<\/p>\n

Cancer Institute<\/a> had posted information denying a link between abortion<\/p>\n

and breast cancer until an anti-abortion Member of Congress objected,<\/p>\n

calling it "scientifically inaccurate and misleading to the public."<\/p>\n

Another federal Website<\/a><\/p>\n

removed its positive assessment of condoms’ role in preventing the transmission<\/p>\n

of disease. After the removal was criticized, similar material reappeared<\/p>\n

online with the following additional text (in bold): "The surest<\/p>\n

way to avoid transmission of sexually transmitted diseases is to abstain<\/p>\n

from sexual intercourse. …" A liberal Member of Congress said,<\/p>\n

"We’re concerned that their decisions are being driven by ideology<\/p>\n

and not science." The President of the Planned Parenthood Federation<\/p>\n

of America put the charge more strongly: "They are gagging scientists<\/p>\n

and doctors. They are censoring medical and scientific facts. It’s ideology<\/p>\n

and not medicine." [See Adam Clymer, "Critics Say Government<\/p>\n

Deleted Sexual Material From Web Sites to Push Abstinence," The<\/p>\n

New York Times<\/a>, November 26, 2002, p. A18; and Adam Clymer, "U.S.<\/p>\n

Revises Sex Information, and Fight Goes On," The New York Times,<\/p>\n

December 27, 2002, p. A15.]<\/p>\n

There is controversy about the reasons behind these particular choices<\/p>\n

to post, remove, and revise online information. However, we need not resolve<\/p>\n

the facts in these cases to see that government Websites may be written<\/p>\n

on the basis of "ideology and not medicine." Actually, all<\/p>\n

<\/i>science is thoroughly imbued with normative choices about what is<\/p>\n

important to study, what outcomes should be valued, and how much risk<\/p>\n

to tolerate. Thus a more sophisticated critic might say something like<\/p>\n

the following: "The Federal Government presents its medical websites<\/p>\n

as a ‘gold standard’ and claims that nothing but dispassionate science<\/p>\n

determines decisions about what to include. In reality, all medical advice<\/p>\n

involves an element of normative judgment, whether deliberate or unconscious.<\/p>\n

However, because government Websites are lavishly funded and linked to<\/p>\n

the organized medical profession, they threaten to monopolize discourse<\/p>\n

about important topics. Hence, we demand that these Websites disclose<\/p>\n

their normative or ideological leanings and refer explicitly to alternative<\/p>\n

perspectives."<\/p>\n","protected":false},"excerpt":{"rendered":"

I spent some time writing my article about Medline as a "gold standard" of medical advice and information of the Internet. No individual knows enough about medicine to make a direct assessment of the information presented on this huge portal, which adds half a million new scientific references every year. To decide if the material […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[8],"tags":[],"class_list":["post-4136","post","type-post","status-publish","format-standard","hentry","category-internet-and-public-issues"],"acf":[],"_links":{"self":[{"href":"https:\/\/peterlevine.ws\/index.php?rest_route=\/wp\/v2\/posts\/4136","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/peterlevine.ws\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/peterlevine.ws\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/peterlevine.ws\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/peterlevine.ws\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=4136"}],"version-history":[{"count":0,"href":"https:\/\/peterlevine.ws\/index.php?rest_route=\/wp\/v2\/posts\/4136\/revisions"}],"wp:attachment":[{"href":"https:\/\/peterlevine.ws\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=4136"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/peterlevine.ws\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=4136"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/peterlevine.ws\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=4136"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}