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Bruce Dooley, M.D.'s avatar

Hard-hitting piece Manny. As you know I've watched this "Federation" now for 25 years since attending two of their annual meetings. Their latest "success" of course is pushing through their "Misinformation and Disinformation" policy as a solution to an "issue" actually created by them in June 2021. The foundation of this 12-page monstrosity rests on a legal opinion piece by Carl Coleman (a W.H.O. consultant) which was commissioned by FSMB. It is cited as #3 on page 1 of the document. I suppose they were aghast when he actually writes that it is bad policy to gag doctors:

Here's his seminal statement: "If physicians could not question prevailing standards without risking professional discipline, the result would be a substantial chilling effect on potentially valuable speech. The history of medicine contains numerous examples of once-accepted medical standards that were ultimately shown to be ineffective or harmful."

" As discussed in Part II, critics of physicians who disseminate medical misinformation typically emphasize the potential of medically inaccurate messages to harm public health.

However, from a constitutional perspective, focusing on the harms that could result from the content of physicians’ statements is not a promising strategy. The problem is that, even if

medical misinformation may contribute to risky behavior, disciplinary action is not the only way for states to mitigate this harm.

A basic tenet of First Amendment law is that, rather than imposing penalties on persons who communicate potentially dangerous messages, the appropriate response to misinformation is to

counter it with messages that are accurate—i.e., to engage in

“counterspeech.” Because counterspeech is available as an alternative policy option, courts are unlikely to find that disciplinary action is the least restrictive means of achieving the state’s

public health goals."

NOTE: There has been no counterspeech here in NZ! No debate.

Coleman goes on: "As discussed above, medical misinformation is commonly defined as information that deviates from current medical consensus, but not everything that deviates from professional consensus is indisputably false. For example, a position may lack evidentiary support

but be theoretically plausible, or it may be supported by some evidence but not enough to convince the professional community. While such positions might satisfy the definition of medical

misinformation, the fact that they remain unproven does not necessarily mean they are objectively wrong"

"In fact, many examples of medical misinformation discussed

in Part I of this Article could potentially fall into this epistemological grey area. This is particularly true in areas in which the scientific information is less certain or rapidly evolving. For example, although the medical community now agrees that masking is an effective means to prevent the spread of COVID-19, just a few months before that consensus emerged, public health authorities were actively discouraging masking among the general public. Physicians could point to the recent change in position as a sign that the evidence on masking is still in flux. Similarly, it might be difficult for boards to establish objective falsity when physicians make claims about unproven treatments or products

unless they can point to evidence establishing that those interventions are ineffective or harmful."

And finally he states: "Characterizing physicians’ public speech about medical matters as an aspect of professional practice would also have troubling policy implications. If disciplinary actions based on physicians’ public statements were subject to the more deferential standards applicable to the regulation of professional practice, licensing boards would be free to penalize physicians whenever

they express opinions that conflict with prevailing professional norms, even if those opinions cannot be shown to be objectively false. Physicians who believe that the existing standard of care is misguided would therefore have no way to express their views publicly without exposing themselves to potential disciplinary action.

If physicians could not question prevailing standards without risking professional discipline, the result would be a substantial chilling effect on potentially valuable speech. The history of medicine contains numerous examples of once-accepted medical standards that were ultimately shown to be ineffective or harmful. For example, in the late 1980s, a large study found that a group of drugs that physicians had widely considered essential in the treatment of heart attack patients in fact increased these patients’ risk of dying as compared to a placebo"

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MDskeptic's avatar

A great essay. I am practicing family medicine in the US but I have formal training in psychiatry. I recognize in your article some shades of the independent minded doctors I knew 40 years ago when I was beginning my training. Missing from your essay is the scorn I would heap upon gutless, spineless, mercantilist whores that identify as my colleagues and have bequeathed to the general public the sham profession which is contemporary medicine. The global covid debacle and scam could not have happened without the tacit approval of millions of sheep with MDs.

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