When doctors betray their profession

And now for something completely different...but depressingly the same in some ways.

Longtime readers—and I do mean longtime—might remember from several years ago a certain case adjudicated before the Vaccine Court. I'm referring, of course, to the Autism Omnibus. In Autism Omnibus, some 4,800 claimants were bringing action seeking compensation for "vaccine injury" characterized by autism. Basically, it was a large number of parents who thought vaccines had caused their children's autism seeking compensation from the Vaccine Court, and they implicated the MMR and thimerosal-containing vaccines, depending on the family. Because of the large number of cases and since all of the cases revolved around the same findings of fact a series of "test cases" were heard. These test cases were, in essence, the best cases the claimants' lawyers could come up with to show that vaccines caused autism. If these cases were considered meritorious, then the rest of the 4,800 cases would be allowed to proceed. The whole thing was a circus, with antivaccine legislators weighing in and a wide variety of quacks testifying with some truly bad science and wild ideas of how vaccines caused autism. Basically, the claimants relied on emotional appeals and pseudoscience, which is why all the test cases were ultimately denied compensation.

If there was one thing about the Autism Omnibus that was depressing, it was the plethora of "experts" who testified for vaccines causing autism, including Arthur Krigsman, Karin Hepner, Vera Byers, Ronald C. Kennedy, and Marcel Kinsbourne. I was thinking of this case when I came across a study in The Laryngoscope, a journal of otolaryngology about expert witnesses. A frequent claim by antivaccinationists is that vaccine manufacturers are like tobacco companies in the way they suppressed and twisted data for decades, hired PR companies and lawyers to protect themselves, and, of course, putting all sorts of doctors and scientists on their payrolls, to be trotted out at trials and hearings to deny that tobacco was dangerous or, later when even tobacco companies couldn't entirely deny the health effects of their products, to minimize how harmful tobacco was. However, it's not the vaccine manufacturers who are like tobacco companies. It's the antivaccinationists themselves. On the one hand, there were quacks testifying that vaccines cause autism in federal court. In this study by Robert K. Jackler, MD, Testimony by otolaryngologists in defense of tobacco companies 2009–2014, there are otolaryngologists testifying for the defense in suits brought against tobacco companies.

In 1999, a Florida class action suit (Engle v. Liggett) resulted in a huge award ($145 billion). The monetary reward was reversed on appeal, but the litigation led to a Florida Supreme Court decision in 2006 that upheld the Engle jury findings of widespread wrongdoing by tobacco companies. As a result, individuals could sue without the need to relitigate settled issues, such as the addictiveness of nicotine, the dangers of tobacco, and the long sordid history of tobacco company dissembling, denialism, bad science, and legal thuggery. That is why smokers and companies were left to fight out thousands of individual cases against tobacco companies. Because these cases have focuses mostly on whether tobacco caused the plaintiff's disease, expert medical testimony has been critical to them. By 2015, 120 cases have been decided, 70% in favor of plaintiffs. Most, as you might imagine, involved lung cancer, but a fraction involved head and neck cancer.

So Dr. Jackler plowed through court records of many of those cases. Specifically:

Data sources included expert witness depositions and trial testimony of otolaryngologists employed by the tobacco industry via its law firms in defense of lawsuits by smokers. Cases involving head and neck cancer were retrieved from as early as the late 1940s, but the emphasis of the study is on Florida cases between 2009 and 2014. The legal documents were retrieved via online databases including the Tobacco Deposition and Trial Testimony Archive collection via the University of California at San Francisco Legacy database (legacy.library.ecsf.edu) and tobacco documents online (tobaccodocuments.org/datta).[8] These depositions and trial testimony are in the public domain and readily available online. Links to the documents cited in the text are provided to allow the interested reader to view the entire original document.

News reports relating to recent Florida tobacco cases were retrieved via Google and Google News using search terms such as tobacco litigation, Florida tobacco cases, and Engle progeny cases—as well as specialty terms such as larynx, pharynx, oral, throat, head & neck, otolaryngology, and otolaryngologist. Case selection criteria included: 1) litigation in Florida against a tobacco company alleging smoking-related malignancy of the upper aerodigestive track; 2) board-certified otolaryngologist providing compensated testimony on behalf of one of the three major US tobacco companies (R.J. Reynolds, Philip Morris, and/or Lorillard); and 3) trial date between 2009 to 2014.

He then assessed the medical testimony to Jackler found nine cases of upper aerodigestive tract cancer involving testimony from six otolaryngologists serving as expert witnesses for the tobacco industry between 2009 and 2014. The cases included laryngeal cancer (5), esophageal cancer (2), oral cancer (1), and lung cancer (1). The expert witnesses included senior otolaryngologists who had been Board certified in 1974 to one who was Board certified in 1995. All but one were otolaryngologists in private practice, and while one was university-based. None of them had actually done a fellowship, and only two of them specialized in head and neck. (It used to be possible to do head and neck surgery after a general surgery residency, something that is much more difficult to achieve now.) The number of cases worked on for tobacco companies, including trial testimony, deposition, and/or request to review the case, per surgeon ranged from three to more than twenty.

These otolaryngologists repeatedly gave sworn testimony at odds with what science and evidence show in order to blame something other than tobacco for the plaintiffs' head and neck cancers. They blamed everything but tobacco, including things like alcohol, asbestos, cleaning solvents, gasoline fumes, genetic predisposition, the human papilloma virus, mouthwash, and salted meats. Yes, these things do contribute to head and neck cancer, but compared to tobacco they are are minor contributors to the disease. Some of the cases described in this paper defy belief in the utter contempt the "expert" witness showed for the jury by expecting them to believe the unbelievable.

How did they do it? They used typical tobacco company denialist tactics: Sowing uncertainty and doubt about the medical connection between tobacco and cancer in individual cases. Here's a one representative case:

In Mack v R.J. Reynolds (2010), the plaintiff started smoking at age 16, had a 40- to 80-pack history, and developed laryngeal cancer and chronic obstructive pulmonary disease.[10, 11] He had quit smoking some 10 to 15 years prior to diagnosis. In witness 1's deposition, he opined, “In this case he has an etiological soup” and provided an extensive list of potential causes (Table 3) (Fig. 1). He went on to say: “Doctors are lazy . . . . we don't take great toxicological histories.” When pressed by plaintiff's counsel regarding some of the more exotic causes on the list, he vehemently defended their inclusion. For example, regarding gasoline, he replied: “I can tell you that there are many, many, many, many articles talking about gasoline and larynx cancer. It is not just one. Many, many, many.” Witness 1 goes on to say that it is “common knowledge.” The witness went on to say, “I do not know what caused his larynx cancer. My opinion is that Mr. Mack, indeed, had squamous cell carcinoma of the larynx that was most certainly not due to smoking.” He based this opinion by stating that: “After you have quit for 10 years . . . risk of cancer of the larynx approaches never smokers.” He went on to say, “And I am not entirely certain what it was due to, but he had a number of occupational exposures to known carcinogens that are known to produce larynx cancer.”

It is not true that after ten years of having quit the risk of laryngeal cancer approaches nonsmokers. As cited in the paper, the risk of head and neck cancer remains elevated three- to four-fold above the risk in those who never smoked, even worse in people like the plaintiffs, who each had a very heavy smoking history of up to 80 pack-years. All of the testimony very closely resembled the testimony above, and I encourage you to read the article, which is not behind a paywall, but here's one more:

In the 2011 case, Blitch v RJ Reynolds, the plaintiff died of esophageal cancer in 1998.[20] When asked to allocate among the various risks, witness 3 stated: “She drank significantly, she smoked. She did have a prior HPV cancer. And she does have reflux. . . . It is difficult for me to determine how to allocate how much risk there is for each entity. However, there are certain studies that where they have tried to factor out smoking and look at alcohol use and these studies have shown that alcohol by itself can cause esophageal cancer, that HPV infection is associated with the causation of esophageal cancer, and reflux can cause esophageal cancer. So I can't determine in Ms. Blitch's case specifically which one has more weight or if they are all similar effect.”

Even though the HPV status of the patient's esophageal cancer was unknown, because she had cervical cancer decades earlier, witness 3 opined there was a high probability that she also had HPV of the head and neck.

See the technique? Each time, the expert witness tries to imply that it's not possible to tell which risk factor caused the patient's cancer, when it is known that tobacco is by far the most potent risk factor for developing head and neck cancer. Failing that, they try to make the jury believe that the patient had other risk factors (like HPV infection in their oropharynx) even when it is unknown if they had it. Because the burden of proof in a civil case is more likely than not (>50%), expert witnesses for the tobacco companies routinely asserted that they believed it was more likely than not that tobacco didn't cause the plaintiff's cancer.

In this, Jackler notes, they followed a script very carefully:

Comments made in the legal records indicate that hired experts were specifically engaged “to look at risk factors.” Testimony revealed that tobacco defense lawyers sometimes went so far as to write the opinion for the hired expert. The resulting testimony from multiple experts reads like peas in a pod—well coached and faithful to the tactical narrative that there are many, many causes of head and neck cancer—and that factors other than smoking must have caused the plaintiff's disease. During deposition and trial testimony, these witnesses cited a wide variety of nontobacco causes for the cancers, characterized by one witness as an “etiological soup” (Table 3).

The tobacco industry strategy is based upon the assumption that juries may be swayed by long lists of theoretical causes, which tend to resonate with the public's belief that a wide variety of environmental, occupational, and dietary exposures cause cancer. An obvious fallacy of this argument lies in the fact that literally billions of nonsmoking people are exposed regularly to gasoline fumes, use cleaning solvents, eat salted fish, or live in urban environments. Were these causative factors for head and neck cancer, with even a minute fraction of the potency of tobacco, the rate of head and neck cancer among nonsmokers would be much greater than what has been observed. Among habitual smokers, it is not credible to opine that rare and hypothetical causes, taken singly or as a lengthy list, are more likely than causative than tobacco to a degree remotely approaching  > 50%.

Exactly.

Jackler also notes another aspect of how these "experts" gave testimony. They routinely would go outside of their area of expertise, testifying, for example, about environmental and industrial toxicology, disciplines not typically within the expertise of an otolaryngologist or even most physicians. They would then refuse to agree that nicotine is addictive, making the excuse that they don't have expertise in that area. Not surprisingly, tobacco companies frequently argue that smoking is a choice and that a smoker gets cancer due to personal choice rather than addiction. None of this stopped witnesses from denying the validity of widely accepted authoritative sources, such as Surgeon General's reports. Indeed, another sordid part of this story is the number of psychologists who are willing to be shills for tobacco companies and testify that nicotine is not addictive.

Testifying for tobacco companies is also quite lucrative, particularly if you have a lot of honors and authority to sell. One such witness, Willard E. Fee Jr. (seriously, that's his name), is a professor emeritus of otolaryngology at Stanford, served 20 years as his department’s chairman and also served a term as president of the American Head and Neck Society, his field’s leading professional association. Dr. Fee collected $100,000 for one case. He's been doing this since 1976, having given depositions in over 100 cases. Others include Merrill A. Biel, an adjunct assistant professor of otolaryngology at the University of Minnesota-Twin Cities, and Kim R. Jones, a former associate professor at the University of North Carolina at Chapel Hill. Both are in private practice.

Not surprisingly, the tobacco industry is not pleased by Dr. Jackler's paper. Its only response was that Dr. Jackler’s critique has "no place in our judicial system" and to accuse him of "undisclosed ties to plaintiffs’ lawyers." Dr. Jackler denies such charges, although his study was funded by the Stanford Research into the Impact of Tobacco Advertising. Personally, I'd argue that Dr. Jackford's critique has every place within our judicial system and in the peer-reviewed medical literature. Unfortunately, such behavior by doctors is not unknown. Indeed:

The current president of the American Head and Neck Society, Dennis H. Kraus, said he had trouble understanding how professional otolaryngologists could offer such testimony against tobacco plaintiffs.

"I wish I were shocked," said Dr. Kraus, director of the Center for Head and Neck Oncology at the New York Head and Neck Institute. "Unfortunately I’m not."

I understand. Money is a powerful motivator. Doctors are human beings; they are not immune to the lure of a lot of cashe for not a lot of work. If you don't mind cross examination and challenging questions from opposing lawyers during depositions and especially if you come across as authoritative and never in doubt, you can make a boatload of money as an expert witness. Of course, it helps your credibility if you're a gray-haired senior doctor with a confident demeanor, or at least a mid-career doctor. This sort of thing is not for early career doctors; they lack the gravitas and concomitant credibility to juries.

I'll conclude by asking the same question that Dr. Jackler addresses, namely whether it is ever ethical for a physician to testify on behalf of the tobacco industry. Given that the product sold by the tobacco industry is, by its very nature, addictive and and deadly, causing cancer, chronic obstructive pulmonary disease, and heart disease, I would argue that, no, it is never ethical for a physician to testify in such cases on behalf of tobacco companies. It's particularly disturbing to see doctors so enthusiastically participating in the denialist campaigns of tobacco companies in court. Unfortunately, the number of doctors who testify for the antivaccine movement is few, nearly all cranks. We need to remember that there are far more doctors, none of them cranks, who are willing to prostitute themselves to tobacco companies. Sadly, it's hard not to wonder whether things have changed as much as we'd like to think since the 1950s

Categories

More like this

More information has come to light on this situation. I noted on Monday that Shallit had not testified, despite being deposed, because after Dembski withdrew the TMLC had objected to allowing him to testify and the attorneys reached an agreement that he would not do so unless they used Dembski's…
I had tried to give the Dr. Mark Geier and his son David a rest for a while, as I suspected my readers may have been getting a little tired of my bashing them, no matter how deserved that bashing may have been. After all, they do shoddy science in the service of "proving" that mercury in vaccines…
The Autism Omnibus is now officially under way, having begun with the first test case, that of Cedillo v. Secretary of Health and Human Services. The Omnibus proceeding is the culmination of the legal cases brought to the Vaccine Injury Compensation Program by nearly 5,000 families who "feel" that…
William Dembski has this odd habit when someone publishes a criticism of his writings. Rather than engage in substantive refutation of those criticisms, he often claims either to be the victim of some cosmic unfairness by the Darwinian Inquisition, or he claims that the person criticizing him is…

So... Shouldn't it be incorporated into medical ethics, enforced by medical boards, that doctors aren't allowed to testify for pay? (If they participate in a trial, on any side, theyshould be reimbursed expenses only.) Must be some reason why this isn't current practice.

The other alternative is to take the experts out of the advocatorial process, by making them work for the court. Our system has all experts providing written agreement that they understand their role is to provide expertise to the court and not any one party. This is followed by a series of expert conferences where agreed issues are identified and specific reasons for remaining disagreement must be provided.

This doesn't stop all examples of this sort of 'the cause might be 14 other things' going on, but they come at much greater risk to the party that indulges in them.

Shouldn’t it be incorporated into medical ethics, enforced by medical boards, that doctors aren’t allowed to testify for pay?

That whooshing noise you heard was the sound of the point blasting over your head at Mach 2. The issue isn't medical practitioners appearing as expert witnesses. It's medical practitioners giving dishonest testimony.

By Julian Frost (not verified) on 20 Jul 2015 #permalink

A frequent claim by antivaccinationists is that vaccine manufacturers are like tobacco companies....

Since I'm too lazy to actually deploy it, just between us shills and minions, try looking at pages 4–5 here, say, starting with "Industry is also defined...."

Then substitute "pro-vaccine" for "anti-smoking."

True Julian, but without pay there's not as much reason for dishonesty. However, ChrisP makes a better point.

When I was working in the eDiscovery field, it was becoming common practice for the Courts to employ "Special Masters" who were Subject Matter Experts - whose sole job was to act as a referee between the two parties to determine the standards and processes for data collection, processing and review parameters, so that the overall process was fair and presented the best interests of both sides.

Perhaps Courts should appoint "Special Masters" to wrangle in expert medical testimony - working on behalf of the Court to establish proper guidelines for the experts.

I don't know if it makes sense in the context of cases today, but it appears that something needs to be done to improve the process and remove some of the bias from the current system.

"Unfortunately, the number of doctors who testify for the antivaccine movement is few...."

Unfortunately in the bigger scheme and fortunately in the numbers game, no? And, the lure for cash?

Sorry. I love your punch lines so these things stand out to me. Please email me for off-line.

By Not a Troll (not verified) on 21 Jul 2015 #permalink

@ Vasha

Shouldn’t it be incorporated into medical ethics, enforced by medical boards, that doctors aren’t allowed to testify for pay?

Two issues with your approach, here:

1 - time is money - or more to the point, anything worth doing is worth being paid for.
You could ask people to close their shop and spend half a day waiting and talking pro bono, but you are not going to get many volunteers.
It's not just MDs which are on topic here, the issue could be extended to any expert witness.
Worse, IIRC, in my country the computer forensic guy has the statute of expert witness, on retinue by the tribunal. Testifying is only a fraction of his/her job, there was a lot of work before that; I'm afraid he would deeply resent not being paid for any part.
(it's actually already happening, justice budgets for paying specialists being on the small size, but that's another topic)

Also, you may want to ask yourself why these people are volunteering for a day of boring debates. Which brings me to:

2 - an official wage is far from the only motivation people may be willing to lie and cheat.
I'm pretty sure most of the usual anti-vaccine suspects, MD or not, would gladly testify and spout their lies for free. It's an ego-trip for them, and the basis for their everyday job. Plus, some of them are true believers; they may think they are saying only true facts, but these are lies nonetheless.
Actually, I would expect bribes to be substantially higher and more hidden than an official wage. Removing an official compensation would do nothing for all the behind-the-scenes arrangements.

By Helianthus (not verified) on 21 Jul 2015 #permalink

I have seen anti-vaxxers use this article already to justify their woo. "See, you can't trust doctors! They will sell their souls!"

Of course, unlike Dr. Offit and Pan, these ENTs did their dirty work as privately as possible, it seems. Then they were exposed and are now scorned by their peers.

And finally, I find it interesting that one of the criticisms of these ENTs is that they were practicing out of their field in commenting on toxicology and such. Of course this is true, but it is forgotten by antivaxxers who embrace cranks like Mercola/Tenpenny (who are DOs), Humphries (a nephrologist), or Kelly Brogan (a psychiatrist.)

“I can tell you that there are many, many, many, many articles talking about gasoline and larynx cancer. It is not just one. Many, many, many.”

Comments like this one, by themselves, are not credible. There are many, many, many, many articles? List them. Show that the references support their position. I hope that the plaintiff's attorney had a field day with this guy.

The so-called experts who stray from the science should be sanctioned and barred from doing any more cases. This is not just a problem in product liability. It is a problem in medical malpractice as well. There is always someone who is willing to support the position of the party who is supplying the money.

By Michael Finfer, MD (not verified) on 21 Jul 2015 #permalink

About every 6 months a company mails me a meeting program for physicians seeking non-clinical careers utilizing their MD degree. Sadly over the last 10 years the thickness of this mailing has grown a lot, which would only happen if MD's were leaving clinical medicine (or at least contemplating it seriously enough to pony up the $1500 it costs to attend the meeting). A lot of the speakers talk about becoming a "consultant" (to other doctors wanting to leave medicine--seems like a pyramid-type scheme to me or becoming an expert witness available to testify. If more and more doctors sell out along this path, there will be more deviant testimony in US courts.

I don't think the medical boards are up for this either. I cite as an example the boastful proclamation yesterday by Mike Adams that no one's favorite "paleo cardiologist"--anti-vaccine/anti-anything-but-his-own-profit Jack Wolfson was apparently cleared by the Arizona Board of Osteopathic Medicine against a purported 38 complaints in the name of First Amendment Rights ( http://www.donotlink.com/g06j ).If so, it shows an amazingly poor understanding of the difference between First Amendment rights and the duties of a licensed physician.

By Chris Hickie (not verified) on 21 Jul 2015 #permalink

It's usually possible to find someone, somewhere, with at least plausible-sounding credentials, to say almost anything.

Over in the global warming wars we see this quite a bit -- there are quite a few people with some kind of science training, and even a small number of people who at one time did some climate and/or atmospheric science work, who work for the PR outfits that push the right-wing, fossil-fuel company line. One prominent example: the retired rocket scientist S. Fred Singer is both a global-warming pseudoskeptic, and has written quite a bit about how the dangers of second-hand smoke have supposedly been exaggerated.

Naomi Oreskes' book "Merchants of Doubt" shows how some of the same PR firms that fought tobacco legislation are now deep in the global-warming fight.

By palindrom (not verified) on 21 Jul 2015 #permalink

Unfortunately, the problem of certain physicians selling out for $$ from the legal system is not confined to defense of suits against the tobacco industry.

Fraud has been uncovered in relation to asbestos lawsuits. One case involved a radiologist named Ray Harron:

"CSX took the unusual step of suing the people suing it in 2007, accusing the lawyers and Harron of engaging in a RICO conspiracy to file fraudulent asbestos claims. The company identified hundreds of cases where Harron had initially found the patients clear of asbestosis, then switched his diagnosis. It presented 11 of those cases at trial, along with testimony of physicians that the plaintiffs had no evidence of asbestosis."

http://www.forbes.com/sites/danielfisher/2012/12/21/law-firm-hit-with-4…

Another area which could form the basis for a separate article is testimony from high-profile forensic pathologists in criminal cases. This kind of expert testimony is lucrative for those giving it. My perception is that the ethics involved can be shaky.

By Dangerous Bacon (not verified) on 21 Jul 2015 #permalink

@ Finfer, MD
I would agree wholeheartedly about your latter point re: malpractice experts. I have often been baffled that the plaintiff's side (this is usually where this happens) is able to find a physician to claim that there's a case to be made for malpractice. What's even more baffling is that, unlike with the tobacco trials where the industry was fighting for its life, medmal cases often only pay the plaintiff's attorney if they win (contingency cases). I would think that it would be in the best interest of the attorney to vet his or her chances of winning by running the case by someone reliable. Why risk hitching your wagon to a losing horse? One would think that economic pressures would keep the frivolous suits to a minimum, but it doesn't seem to work that way.

In regards to this blog post, I have been encouraged to see that at least some medical specialty societies have created guidelines for being an expert witness, but I'm not sure this extends beyond malpractice and into product liability cases. I would have to look into that further, but at least it's a start.

By Dr. Chim Richalds (not verified) on 21 Jul 2015 #permalink

And them you get the innumerate eejits a bit hung up on their own importance and apparent infallibility...

*cough* Roy Meadow *cough*

Experts, medical or otherwise, play an important role in righting wrongs. Limiting the compensation of those experts will have the effect of discouraging all medical experts, not just those who provide baseless testimony. Anything else would require a qualitative analysis of the testimony by a body other than the Court. Given that the AMA and state regulating entities seem to be unable to control doctors from issuing public statements like vaccines cause autism, it seems unlikely that those entities are ready to sanction doctors for testimony in a particular case.

Orac writes,

"And now for something completely different…but depressingly the same in some ways."

MJD says,

A new study from The University of Texas Health Science Center at San Antonio found that mothers with chemical intolerance's are two to three times more likely than other women to have a child with autism spectrum disorder or attention deficit hyperactivity disorder.

The authors said,

The children reportedly also were more sensitive to adverse effects from infections, medications, chemicals, foods and allergens.

http://medicalxpress.com/news/2015-07-autism-adhd-high-children-chemica…

It's depressing that medical doctors continue to expose chemically-sensitive individuals to vaccines with a natural rubber latex warning and say it's for the better good.

By Michael J. Dochniak (not verified) on 21 Jul 2015 #permalink

Dr. Chim @14 -- Our local academic (and still, thankfully, not yet quackademic) medical center has a policy of handling malpractice suits as follows: (1) If there appears to be a valid case, they try to settle. (2) If it looks bogus, they always defend tenaciously, even if it would cost far less to pay the plaintiff to go away.

The result, of course, is that the local lawyers know that you don't sue them unless you're pretty sure you have a case.

By palindrom (not verified) on 21 Jul 2015 #permalink

Michael, kindly take your pretentious habit of writing in the third person and your fixation on latex and stick them both where the sun doesn't shine. You are not getting tedious and boring, you ARE tedious and boring.

By Julian Frost (not verified) on 21 Jul 2015 #permalink

Incidentally, I read that article MJD linked to. Curiously, said article doesn't appear to have a link to the study so that we can assess what it says for ourselves.

By Julian Frost (not verified) on 21 Jul 2015 #permalink

This is what gives the "shill" argument its legs. Greed is a powerful motivator. Couple it with pride of being reinforced as an expert and people will sell their souls for it.

It is why everything has a bias depending on where the money came from. Industry funded research is biased towards industry. Government funded research is biased towards government. Even if unconscious, our brains will lead to bias.

The so-called experts who stray from the science should be sanctioned and barred from doing any more cases.

The problem with this approach is twofold: First, you have to have a reliable way of determining whether a given expert witness has gone beyond legitimate scientific dispute, and second, the people who ultimately have power to make that determination are judges, not scientists. I would prefer not to bring perjury statutes into this, except in the most egregious cases where the witness knew or should have known that his testimony was false. The reason is that inevitably, such a rule will be politically gamed. Witness the fights over evolution and global warming--state legislatures have tried to insist that these are scientific controversies, when they are only politically controversial. IOW, as soon as you do this you open the possibility of some judge claiming that actual climate experts are outside the scope of science for claiming that anthropogenic CO2 is definitely driving a warmer climate (which is actually true), because you can find so-called experts who will say otherwise.

By Eric Lund (not verified) on 21 Jul 2015 #permalink

Michael Finfer, MD@10

This is not just a problem in product liability. It is a problem in medical malpractice as well.

I think it's even deeper than that. In cases involving complicated topics that require expert testimony it seems unreasonable to have it decided by nonexpert jurors (the other one that comes to mind is digital IP). They don't have the required background to judge the merits of expert testimony. When one expert says one thig and another expert says something else, deciding which one is right is pretty much impossible unless you yourself are also an expert.

Julian Frost@20

Incidentally, I read that article MJD linked to. Curiously, said article doesn’t appear to have a link to the study so that we can assess what it says for ourselves.

It was a bit hard to find but: http://m.jabfm.org/content/28/4/461.full

That said, it's off topic and troll feeding so I think we should leave it alone.

By capnkrunch (not verified) on 21 Jul 2015 #permalink

Julian Frost writes (#15),

You are not getting tedious and boring, you ARE tedious and boring.

MJD says,

Maybe this will melt the frost off your window Julian.

Several years ago I sent a "Potential Action of Harm' (i.e., natural rubber latex in vaccines) to the law firm Robins Kaplan Miller Ciresi .

It's the firm that won a 7.1 billion dollar settlement against Big Tobacco.

They said no....

A lawyer friend told me that "Big Pharma" is much more powerful than "Big Tobacco".

In my opinion money is a big de-motivator, especially when Big Pharma has more of it.

By Michael J. Dochniak (not verified) on 21 Jul 2015 #permalink

The "American Loon" continues his downward spiral....given his past & lack of any evidence of his assertions, no wonder lawyers wouldn't give him the time of day.....

A diversion, I know, but since you mentioned Karin Hepner, I thought I'd post an abusive email I received from her a decade ago, that well captures the calibre of the Omnibus petitioner's "experts": This is October 2005:

"My name is Karin Hepner. I have a Ph.D. in molecular biology. My husband is an M.D. We have three children with autism, all three of whom have serious bowel disease. My oldest son, age 4, who is the most severely affected, is a patient of Dr. Krigsman. Before we saw Dr. Krigsman there was not a single local GI who took our concerns seriously. We now have photos and objective pathological and histological data showing the severity of my son's bowel disease. More importantly, because of Dr. Krigsman my son is no longer up all night writhing in pain. Our local GIs determined this to be an autistic behavior. Its interesting that standard GI meds were able to help my son overcome these "autistic behaviors", dont you think?

"I will not waste my time or yours addressing the ludacrous and suspicious tone of your article. I can just issue you the following warning, in case you are concerned about your reputation: As a researcher I am privy to some of the emerging data regarding the link between autism, GI disease and vaccination, specifically the MMR. You should probably stop being suspicious of the brilliant minds who have made this link. It will make you look rather dim.

"Finally, I might suggest that you speak to other parents, such as myself, who can explain to you the necessity for requirements such as the "medical packet", which help Dr. Krigsman determine whether or not the child indeed has an autistic enterocolitis type disorder, or some more "mainstream" IBD which can be handled by a local GI. I flew 3000 miles to see him, and my severely autistic, rigid, fear-of-change little boy came with me. I would have flown 300,000 miles. Indeed, we are a desperate bunch. But not a stupid lot. I believe the stupidity is concentrated in baseless, ignorant drivel such as your published work. I eagerly await your next article, after all of Krigsman's and Wakefield's claims are confirmed in highly regarded, peer reviewed journals.

"Is this your way of helping society? Why would you piss on those who are actually making a difference? My son is no longer in pain. A decent person wouldn't belittle that.

"Sincerely Yours,

"Karin Hepner, Ph.D."

By Brian Deer (not verified) on 21 Jul 2015 #permalink

My sub specialty society actually wrote guidelines both for expert witnesses and about how negligence should be determined for a certain type of test. Personally, I thought the guidelines were appropriate and based upon the science as it was understood at the time.
When they were tested in court, they were thrown out. I was also disappointed in the expert witness's attitude toward that type of case. She is a very prominent member of our community.

If you want to read about that case, a write up is here: http://www.genomicslawreport.com/index.php/2014/08/19/medical-organizat…

By Michael Finfer, MD (not verified) on 21 Jul 2015 #permalink

I was going to respond to the latex loony's comment #23, but Lawrence nailed it.
The real reason you were turned down by Robins Kaplan Miller Ciresi wasn't because of some conspiracy, but because your "evidence" was a pile of horse apples.

By Julian Frost (not verified) on 21 Jul 2015 #permalink

Capnkrunch writes (#22),

That said, it’s off topic and troll feeding so I think we should leave it alone.

MJD says,

You irritate the roof of my mouth capnkrunch.

It's hypocritical to criticize doctors about tobacco usage when vaccines are well known to have contraindications (i.e. do harm).

By Michael J. Dochniak (not verified) on 21 Jul 2015 #permalink

@ Finfer, MD #26
It's a shame to see that, but not surprising, I guess. They're guidelines for professional behavior after all, and they're not going to prevent anyone from acting in an unethical and/or intellectually dishonest manner of that's their bent (just like the honor code is unlikely to stop a dyed-in-the-wool cheater). Even less surprising is that the courts don't care what's in the guidelines either--usually, only the courts decide what's good for the courts. Not an easy problem to solve.

By Dr. Chim Richalds (not verified) on 21 Jul 2015 #permalink

Ethics aside, the one place where I am least concerned to see this happen is in a court of law because it is clear who the expert is working for. Or at least the opposing lawyers should make it clear.

By Not a Troll (not verified) on 21 Jul 2015 #permalink

Julian Frost writes (#27),

The real reason you were turned down by Robins Kaplan Miller Ciresi wasn’t because of some conspiracy, but because your “evidence” was a pile of horse apples.

MJD writes,

Here's the "Potential Action of Harm" - You decide if it has validity.

There is growing public awareness and concern about latex allergies. Natural Rubber Latex (NRL) has been identified as harmful due to its allergenic proteins: many hospitals ban it in their facilities; government (OSHA) has issued warnings about it; and warning labels on vaccine packaging and delivery systems have become mandatory (FDA).

A growing percentage of people - particularly the youngest - have latex sensitivity which can cause a variety of health problems including atopy (i.e., many allergies) and allergy-induced autism. Our research indicates and the theory of our case is that the allergenic proteins from NRL stoppers and syringes can easily "leach" these allergenic proteins into vaccine solutions contained in the pre-loaded syringes. When the vaccine with the leached NRL allergenic proteins is administered to children, it is injected directly into the body - an unmistakable "avenue of exposure".

"Big Pharma's" continued use of NRL in the stoppers and syringes increases allergies and autism. Synthetic rubber (silicone) stoppers and syringes provide an acceptable substitute for NRL and does not have the allergenic proteins. However silicone does cost more than NRL.

The Supreme Court has ruled that parents cannot sue vaccine manufacturers for the vaccines themselves allegedly causing autism. It has not ruled on the question of NRL contamination from vaccine delivery/packaging systems. "Big Pharma" should be responsible for any harm caused by their choice of vaccine packaging.

By Michael J. Dochniak (not verified) on 21 Jul 2015 #permalink

Dr. Chim -- Props for getting "dyed-in-the-wool" right.

Now if we could just get people to stop "tow(ing) the line" and start "toeing the line".

By palindrom (not verified) on 21 Jul 2015 #permalink

@ Michael J Dochniak:

Have you ever entertained the thought that just POSSIBLY the reason that your ideas are being rejected is not because your critics are being paid by pharmaceutical giants to do so but because your ideas have no merit and that they're not supported by data?

I think that it might be valuable for you to talk with someone who is trained in counselling rather than having fruitless conversations on the internet with Orac's minions or visiting anti-vaccine echo chambers to get a little applause.

By Denice Walter (not verified) on 21 Jul 2015 #permalink

This is off-topic, but that doctor in the ad looks like a young FDR and it's creeping me out.

Of course, FDR had his own issues with smoking.

By Queen Khentkawes (not verified) on 21 Jul 2015 #permalink

As an observation:
Brian Deer has certainly attracted a gaggle of loonies.

By Denice Walter (not verified) on 21 Jul 2015 #permalink

MJD,

Maybe you could try again without using the term "“Big Pharma".

palindrom,

kudos to you for working to right these wrongs. However, those expressions are relatively rare. I would be much more grateful if you could get all of the people who "could care less" to stop doing so. Especially in "sever" cases.

By Not a Troll (not verified) on 21 Jul 2015 #permalink

Denise Walter says (#33),

I think that it might be valuable for you to talk with someone who is trained in counselling...

MJD says,

Typical pro-vaccine response - There isn't anything wrong with vaccines therefore you need psychological help.

Let's continue to improve vaccine safety before forcing parents to vaccinate (e.g., California SB-277).

By Michael J. Dochniak (not verified) on 21 Jul 2015 #permalink

Here’s the “Potential Action of Harm” – You decide if it has validity.

It has no validity. Denice is right -- get help.

Oh, I learned my lesson after a colleague died in the wool. Tragic industrial accident. No way to go at all, irregardless of all intensive purposes.

By Dr. Chim Richalds (not verified) on 21 Jul 2015 #permalink

I think one should reign in certain expressions instead of giving them free reign.

Here’s the “Potential Action of Harm” – You decide if it has validity.

Oh, it has validity, in the same way that the "vaccines cause autism" hypothesis had validity.

There is growing public awareness and concern about latex allergies.

Once upon a time, there was growing public awareness and concern about vaccines causing autism. That turned out to be false.

Natural Rubber Latex (NRL) has been identified as harmful due to its allergenic proteins:

Citation needed.

[M]any hospitals ban it in their facilities

Do you know what else hospitals have banned? Crocs (the shoe). There have been concerns that nurses wearing Crocs could build up a charge of static electricity severe enough to start fires.

..(OSHA) has issued warnings about it; and warning labels on vaccine packaging and delivery systems have become mandatory (FDA).

Argument by package insert? I thought that you would have hung around here long enough to know that vaccine package insert are Cover Your Backside documents written by lawyers.

Our research indicates and the theory of our case is that the allergenic proteins from NRL stoppers and syringes can easily “leach” these allergenic proteins into vaccine solutions contained in the pre-loaded syringes.

Ah, so you have actual research. Please link to it.

The Supreme Court has ruled that parents cannot sue vaccine manufacturers for the vaccines themselves allegedly causing autism.

Wrong Michael. The Supreme Court has not ruled on the vaccine causation hypothesis at all. In addition, the verdicts that have been given on the question is that vaccines do not cause autism.

Typical pro-vaccine response – There isn’t anything wrong with vaccines therefore you need psychological help.

What a lovely straw man you made. There is a difference between claiming antivaxxers massively exaggerate the risks of vaccines and claiming vaccines are perfect.

Let’s continue to improve vaccine safety before forcing parents to vaccinate (e.g., California SB-277).

SB277 doesn't force parents to vaccinate, it just makes it harder for them to claim a hogwash exemption. A parent who is determined not to vaccinate can still homeschool.

By Julian Frost (not verified) on 21 Jul 2015 #permalink

I think we should just loose certain expressions.

All right, I'm out!

By palindrom (not verified) on 21 Jul 2015 #permalink

Brian Deer @ 25

Since you brought the topic up,there is an increasing body of evidence as far as the brain-gut connection in autism,and how GI symptoms can influence behaviour,but it's all on cellular and genetic level.I found this article in a friends Twitter feed this morning.It provides a very good overview of most of the research that backs this up,with links to every study cited.Unfortunately none of this was known ten years ago,and all parents had for an explanation were Wakefield's lies.

By Roger Kulp (not verified) on 21 Jul 2015 #permalink

Julian Frost writes (#40),

A parent who is determined not to vaccinate can still home school.

MJD writes,

Laws (SB-277) that take away public-education opportunities for children hurt our society.

Julian, do you need a link for this?

By Michael J. Dochniak (not verified) on 21 Jul 2015 #permalink

I see that a particularly tiresome antivaccine loon who is obsessed with latex has returned. He should note that I find him just as tiresome as everyone else here does, perhaps even more so because I see all of his comments and most commenters can more easily ignore him.. If he continues to be tiresome enough to continue to bore me to tears beyond some point that I'm unwilling to put up with it any more he will be gone.

I have no problem believing that expert will lie, invent and otherwise distort the justice system. However two of the most egregious cases I have read about idn

There was a libel &/or slander case a few years ago involving accusations of child abuse and sexual molestation. Lillie & Reed v Newcastle City Council & Others

A considerable part of the case rested on the reliability or validity of child witnesses who were videotaped when interviewed. One expert(the defence witness) testified that the videos showed the clearest examples of 'real' child molestation as he had seen in a long time.

The expert was American and it turned out that, due to incompatibilities in video formats, the witness had only seen one of the videos and read two or three transcripts out of 14 or so children filmed at the time he first took the stand @ para 426 and 427. As the judge remarked, “This was not a promising start to the day.”

If anyone has several hours to waste wants to read a gripping case of a miscarriage of justice, hysteria, malpractice, malice, incompetence, lack of due process and a few dozen other things the case is at http://www.5rb.com/case/lillie-reed-v-newcastle-city-council-others-no-…. It's about 33 pages but it reads more like a detective story or some twisted tale of evil than a court case. The judge, BTW, is an excellent writer

In what for Canadians was and still is a major case an expert witness, Michael Welner, testified at the Guantanamo kangaroo court trial of Omar Khadar, with most of his opinions based on a German or Danish right-wing hate magazine's review of a Danish anti-Islamic book. When asked if he had read the book, he had to admit that “no he had not as it had not been translated and he did not read Danish”. I have read the transcript and it seems to me that the rest of his testimony was simply invented. He certainly knew nothing about Islam. Blast, I seem to have lost the link to his testimony but this gives a flavour of what he is like http://www.dailykos.com/story/2010/10/28/914422/-Google-Searches-Underm….

Further googling suggests that he is totally a gun for hire. His publication record as far as I could find consists of one bio-psychology paper probably a spin-off from his MA or Ph.D research. Certainly there is nothing to make me think that he is qualified to testify in the types of cases he does other than total abject loyalty to his paymaster.

By jrkrideau (not verified) on 21 Jul 2015 #permalink

Err that last post should have read about 333 pages.

By jrkrideau (not verified) on 21 Jul 2015 #permalink

The "expert witness" thing in general is one of major broken aspects of the American judiicial system. Part of the problem is corruption — unscrupulous "experts" in it for themselves. But there are deeper issues in the system — which sets issues we might think of as questions of fact as questions of dueling opinions between two "experts", one for each side, and typically winds up adjudicating them on the basis of the experts' ability to project an aura of 'authority' to lay-people on a jury.

I've mainly looked into this myself in how evidence is used in criminal cases — various forms of forensics, including, of course, forensic medicine. About the best I can say for dueling-medical-examiners is that the abrogations of science tend not to be as monstrous as those committed by the non-medical 'forensics' witnesses... But what is mocked more than 'truth' is 'justice'. Poor defendants can't afford anyone to go up against the State's MEs, while defendants with means easily can acquire the services of MDs who make much more credible-sounding presentations to juries. The ME knows medicine, not presentation an expert-serving-as-a-witness. The defense counters with an expert-at-being-a-trial-witness, who has just enough credentials to have testimony admitted...

While ethics-challenged 'professionals' can make quite a bit of $$ as expert witnesses, I think there are other appeals — notoriety, ego-gratification, the buzz of walking a hire-wire in public, fascination with the larger show... In the early 90s I was contacted by an attorney building a list of potential expert witnesses for the defense in a civil case involving a VERY well-known celebrity. I wasn't the 'right person' for saying what they wanted said with maximum authoritativeness, which was basically trivial and oversimplified in terms of how anyone-but-a-lawyer would understand the issues involved. (First Amendment rights vs. privacy rights mainly...) But it kind of got me excited anyway — I would have done it for nothing just to have had the experience — and felt a pang of resigned disappointment that they never called me back. (The suit was settled out of court for an undisclosed sum...)

Oh the irony.

Laws (SB-277) that take away public-education opportunities for children hurt our society.

1) Given that people who refuse to vaccinate put the immunocompromised at risk and thus deny them public education opportunities, right back at you Michael.
In fact, your argument is not even wrong.

By Julian Frost (not verified) on 21 Jul 2015 #permalink

Yes, laws that take away public-education opportunities hurt our society. "Belief/religious" exemptions from vaccination take away public education opportunities from immune-compromised children, and from children who have genuine medical reasons why they shouldn't be vaccinated against certain diseases. Given a choice, I'd rather put the burden of homeschooling on the unreasonably-worried parents of a basically healthy child than on the already-overburdened parents of immune-compromised children.

Eliminating non-medical exemptions from the vaccine mandate doesn't take away public education opportunities, it protects them.

Orac writes (#45),

I find him just as tiresome as everyone else here does,

MJD says,

Here's what I find disturbing, such an articulate and well educated person like Orac uses the word "everyone".

@ Respectful Insolence participants, if you hear from me no more know that Orac has pulled the plug.

In my opinion, a tiresome counter-point of view is better than total agreement.

I like this blog, please do not ban me Orac!

By Michael J. Dochniak (not verified) on 21 Jul 2015 #permalink

In my opinion, a tiresome counter-point of view is better than total agreement

IMO, a tiresome monomaniac who hijacks threads should give serious thought to mending his ways if he really likes this blog.

Everyone is tired of him.

I can second the "Everyone."

If he was more than a 1-trick pony, he'd be fun to kick around a bit more, but not in his current delusional down-spiral....

One can only think of so many latex fetish jokes, after all.

Everyone et al

*raises hand* I'm part of the "everyone".

Counterpoint is one thing. Endless harping upon an idee fixe is another. You have no peer-reviewed literature for us to review that proves your idea. You have, as lilady pointed out many times, turned an asthma attack into anaphylaxsis. And, your continual referral to yourself in the 3rd person is pretentious.

If Orac bans you, by the way, you can still read the blog and the comments, and maybe learn something (though past history has shown that isn't happening with you). You will just not be able to comment.

JP @54 -- Well, our host could be more flexible, and stretch his criteria a bit .... but not more flexible or stretchy than .... [Homer Simpson voice] ... mmmm, latex.

Indeed, too much is enough.

By palindrom (not verified) on 21 Jul 2015 #permalink

MJD, I asked you for evidence of your claims. You gave me bad poetry. I, too, am sick of you.

By Gray Falcon (not verified) on 21 Jul 2015 #permalink

"Here’s what I find disturbing, such an articulate and well educated person like Orac uses the word “everyone”."

Add me to the list who agrees that Orac wasn't really exaggerating.

You don't want to be banned? Then listen to the f*cking evidence. You're arguments have been refuted here many times, and every time you come back, repeating the same tired mantra, tone-deaf to the cogent arguments made.

In a nutshell, learn some intellectual honesty...

It’s depressing that medical doctors continue to expose chemically-sensitive individuals to vaccines with a natural rubber latex warning and say it’s for the better good.

Michael, your evidence that doctors willfully expose patients who they already know are sensitive to latex to latex for any reason whatsoever, let alone 'for the better good', would be what exactly?

It’s hypocritical to criticize doctors about tobacco usage when vaccines are well known to have contraindications (i.e. do harm).

Which vaccines on the recommended childhood immunizations chedule cause more harm than the infectious diseases they protect against, Michael?

Which tobacco products reduce the smokers overall risk of an adverse health outcome?

Or are you offering a false comparison?

EBMOD says (#59),

In a nutshell, learn some intellectual honesty…

MJD says,

If I understand Orac's article entitled "When Doctors Betray their Profession", intellectual honesty is not easily found in a nutshell.

As an example, the FDA warns consumers about natural rubber latex contamination in vaccines but pharmaceutical companies and physicians continue to betray their profession with its use.

@Orac,

If you want me to stop responding because you and a minority of your minions disagree just send an e-mail. :-)

By Michael J. Dochniak (not verified) on 21 Jul 2015 #permalink

It's not a minority, as far as I can tell, and it's more than just disagreeing. It's getting sick and tired of your monomania about latex in vaccines. It really is incredibly tiresome. You're basically the bore at the party who drones on and on and on about the same subject, never deviating, never acknowledging criticism, never responding to criticism, and never shutting up when people quite understandably tell you how tired they are of your nonsense.

a minority of your minions

Just because only some of the regular commentariat here has posted objections to your screeds doesn't mean that the others approve of it. I usually take the solution Orac has suggested of just scrolling past your comments, and the only reason I haven't done so with this one is because, at the moment I loaded the page, it was the most recent comment. Your signal to noise ratio is way below 1.

And I find it telling that you describe us as Orac's "minions". That implies that he is providing some inducement, other than the quality and subject matter of his writing, to read and comment here. Which is not the case. Some people are paid to troll certain message boards. I do not know if you specifically are one of them, but what I have seen of your comments on this board is consistent with that hypothesis. Or maybe you do it just for what you consider fun.

TL;DR: I'm OK with Orac dropping the banhammer on this guy. He's earned it.

By Eric Lund (not verified) on 21 Jul 2015 #permalink

a colleague died in the wool. Tragic industrial accident. No way to go at all, irregardless of all intensive purposes.

It's enough to drive you star-craving mad.

By herr doktor bimler (not verified) on 21 Jul 2015 #permalink

Just because only some of the regular commentariat here has posted objections to your screeds doesn’t mean that the others approve of it.

I killfiled him long ago and experience no temptation whatever to turn it off.

Just because only some of the regular commentariat here has posted objections to your screeds doesn’t mean that the others approve of it.

It ain't my blog so I don't get to recommend the banning of other commentors.

By herr doktor bimler (not verified) on 21 Jul 2015 #permalink

And I find it telling that you describe us as Orac’s “minions”.

To be fair, various of the regulars also refer to those who post comments here regularly as minions. Tongue in cheek, I presume.

Mr. Dochniak - if you can show evidence that natural rubber latex in the quantity and method similar to what one might experience from injections (including immunizations), please do so. I can't imagine that anyone other than the natural rubber latex industry has much vested interest in not changing over to a less risky alternative product - assuming the risk is proven. My understanding is that you currently have a conjecture on how it could happen, not evidence that it does to any significant extent.

By Mephistopheles… (not verified) on 21 Jul 2015 #permalink

If ever there was an industry more truly deserving of the phrase "table injury" than Big Tobacco, I've yet to hear of it. I'm surprised they even bother to fight such cases, rather than just throw some go-away money at people who probably aren't going to be around much longer anyway. Sheer bloodymindedness, but I guess it's not a business that hires on empathy.

As for the paid prostitutes spreading FUD on their behalf; just goes to show how disgracefully useless their "professional" tradesbodies and regulators are. But short of their own memberships demanding en mass that the bums be thrown out, I'm not sure what else can be done to rein them in. Foxes guarding henhouses is an age-old problem, unfortunately.

...

As to MJD, +1 for please block him already. What sparky has there is what the head shrinks call a fixed delusion, and no amount of logical argument or hard evidence is ever going to convince him otherwise. Engaging does him no good and only makes everyone else testy and rude. I just wish his loved ones would get him to a psychiatrist for medication and counselling. He's obviously a smart guy and it's tragic to see a mind wasted by a potentially treatable disease, not to mention how deeply distressing it must be to everyone around him.

Seriously, this one-trick pony has got to go, if only for his own mental health.

As to his links:

Adverse reactions stemming from latex allergies include forms of dermatitis or latex allergy at the point of exposure.

And his whole theory has been debunked over and over and over again - mostly because he is unable to provide even a scrap of evidence to justify it.

De-lurking to chime in on the possibility of banning MJD. Like Narad, I've killfiled him and never looked back. Makes for a more pleasant and informative reading experience.

paid prostitutes

You mean there are unpaid prostitutes? Prostitute interns? Amateur prostitutes?

Learn something new every day.

By Mephistopheles… (not verified) on 21 Jul 2015 #permalink

Regarding the topic of the post, I touched base with a physician who has written a number of times on ethics, the politics of ethics and conflicts of interest. He is not defending the doctors who testify for tobacco companies when he writes:

"They are basically ignoring all of the medical evidence on the morbidity and mortality associated with smoking for their own personal gain. I can't imagine that the opposing attorneys would not draw all of those lines."

However, he brought up an interesting point I found plausible although God help the doctors who perjure themselves.

"The political argument in the case of litigated cases is that these doctors are providing a service to insure that the defendants have a defense capability and I am sure that trial lawyers everywhere would rally to their defense."

If someone is the lawyer-ly type I would be curious to know their thoughts on this.

By Not a Troll (not verified) on 21 Jul 2015 #permalink

^ Last line of my comment is mine not his.

By Not a Troll (not verified) on 21 Jul 2015 #permalink

Mr. Dochniak - neither of those links says anything about autism. Nobody questions that people can have allergic reactions to latex which can, in some cases, be life threatening. I personally have had reactions to urushiol, but don't claim that poison ivy causes autism (though I'm open to evidence to the contrary).

By Mephistopheles… (not verified) on 21 Jul 2015 #permalink

“The political argument in the case of litigated cases is that these doctors are providing a service to insure that the defendants have a defense capability and I am sure that trial lawyers everywhere would rally to their defense.”

IANALNDIPOTV. As I understand it, an ethical lawyer would provide the best council available consistent with current law, regardless of whether the person or corporation being sued has done those things he/she/it is being sued for. That is a lawyer's job. I've heard that deliberately finding experts who would lie to support the defendant (or plaintiff, for that matter) would be frowned upon - though I suppose it might not be unethical.

Of course, if lawyers would rally around someone who lies in order to provide a credible defense, that says more about lawyers than about whether that's a good thing.

By Mephistopheles… (not verified) on 21 Jul 2015 #permalink

Sigh...
counsel
IANALNDIPOOT

By Mephistopheles… (not verified) on 21 Jul 2015 #permalink

IANALNDIPOTV ??? You got me there.

I can imagine that if the area is outside of the lawyer's expertise he would only proceed to find an expert who agreed with his case.

Although I do get what you are saying about certain lawyers. One of the places I worked at shared a cafeteria with a law firm. I once made a lawyer joke to co-workers before realizing I was outnumbered. Luckily it didn't seem to phase the lawyers too much. Perhaps they've heard them all.

By Not a Troll (not verified) on 21 Jul 2015 #permalink

IANALNDIPOTV ???

I am not a lawyer, nor do I play one on TV.

I’ve heard that deliberately finding experts who would lie to support the defendant (or plaintiff, for that matter) would be frowned upon – though I suppose it might not be unethical.

If the witness is hired expressly to lie, that's suborning perjury.

@Julian Frost #20

Medical Express is the go-to site for your openly dishonest anti science trolls for exactly this reason: ME throws out the hunks of red meat, in exactly the form to get the target audience riled up, while concealing the link to the source paper - which may well have precisely nothing to do with the allegations made in the ME summary.

By Robert L Bell (not verified) on 21 Jul 2015 #permalink

Julian @41: I heard that hospitals banned Crocs because they have holes in them so if you dropped a syringe on your foot you could get a needle-stick injury. (I also listened to a friend complain that her hospital banned those glove-shoes because they didn't provide protection from rolling over your foot with a gurney.)
+1 to less MJD. A boring troll is the worst kind.

By JustaTech (not verified) on 21 Jul 2015 #permalink

If the witness is hired expressly to lie, that’s suborning perjury.

A quick skim of the literature and related news stories strongly suggests that expert witnesses are almost wholly immune from perjury charges. Basically, it looks like you have to lie about your credentials.

Nebraska uses crocs in their Ebola treatment facility. They keep a rack of them in the donning/doffing area, in several sizes. When a worker comes out of the hot zone, the crocs are dropped into a bucket of bleach and water.

No, this is not an urban legend. I watched a presentation by one of their staff at the Integrated Public Health and Healthcare Systems Preparedness Summit in Schaumburg last month.

(My life is a thrill a minute).

@LW

If the witness is hired expressly to lie, that’s suborning perjury.

I edited the phrase "suborning perjury" out of my comment as I started thinking about plausible deniability ("What? No, your honor, I didn't ask her to lie - I asked her to tell us what we wanted to hear.") But then, I've never been a lawyer nor have I played one on TV.

By Mephistopheles… (not verified) on 21 Jul 2015 #permalink

Mephistopheles O'Brien, I think you're creative enough to be a lawyer; an ethical one of course.

By Not a Troll (not verified) on 21 Jul 2015 #permalink

Narad,

Well, now the question of how do you prove an expert is committing perjury is going to occupy my night. Maybe compare to his/her body of work?

The doctor I contacted wrote something else about experts in court. Something I don't quite get what he meant but was pondering.

"But I am also very negative on our legal system and how it manufactures "experts" on either side of the issue. It leads to a trampling of a probabilistic approach to medicine (everybody is aware of somebody's 90 year old grandfather who has been smoking and drinking for 70 years and HE did OK) and turns it into a political all or none debate."

By Not a Troll (not verified) on 21 Jul 2015 #permalink

Also agreed on the banhammer for Douchnik. He's been here for at least four years, from what I can see, and has mostly just posted the same comment over and over again.

Has: I wouldn't wish him on his loved ones. He hates his autistic son, and I really wonder if his wife is still around.

RK: Once again, the gutbrain thing was made up. Please don't start harping on that again.

By Politicalguineapig (not verified) on 21 Jul 2015 #permalink

shay @86

OK, that may not be exactly "trilling," but I find that sort of stuff quite interesting. I've recently been looking at info on donning and doffing (surgical or similar) gloves - not exactly exciting, but both processes are important and neither is particularly easy to do properly.

I think this actually falls in today's theme. Real medicine and real science are hard work. People can spend their lives caring for patients or doing research and never come up with anything that is a "breakthrough" or grabs headlines, though they may have done vast amounts of good. Some people seem to desperately need recognition, and I suspect a subset of those people turn to things like "expert witnessing" or contrarianism specifically to attract attention - and money.

Proper and effective use of protective equipment is a recognized issue in dealing with diseases like Ebola. The person or people who came up with the idea of using Crocs as you described may very well have saved numerous lives. We may never learn their names, but we recognize the names of quite an array of kooks and quacks.

Well, now the question of how do you prove an expert is committing perjury is going to occupy my night.

It oughtn't to; nearly everything an expert witness says is, implicitly, expert opinion. It doesn't matter how crazy-ass it is.

#48 sadmar
Another serious problem with 'experts' in court cases is that many of them are woo 'experts' not real ones because their 'science' is usually crap. The US National Research Council did a report Strengthening forensic science in the United States: a path forward in 2009 on forensic sciences as practised today. There is a tone of complete incredulity throughout the book. The authors are either polite enough or politically astute enough to not call a lot of forensic science

Among a few things I took away from it were, polygraphs have no scientific basis but a huge “placebo” effect, similar to West African witchdoctors, there are no useful reliability or validity figures in fingerprint analysis (however fingerprint analysts will assure you they never make a mistake; so much for falsifiability ) and hair analysis isn't.

By jrkrideau (not verified) on 21 Jul 2015 #permalink

DB @13

Another area which could form the basis for a separate article is testimony from high-profile forensic pathologists in criminal cases. This kind of expert testimony is lucrative for those giving it. My perception is that the ethics involved can be shaky.

There was Charles Randal Smith, an Ontario Coroner who thought that his job was to aid the prosecution and caused several wrongful convictions.

By Militant Agnostic (not verified) on 21 Jul 2015 #permalink

I'm not a medical person, and, in fact, have never worked in a medical related field. I read RI (and a few other sites) to learn. Surprisingly, people like MJD make the best teachers, not because of what they post, but because of the well documented and well delivered slap downs the assembled minions… well, deliver.

However, note that I said people like MJD, and not MJD his own self. MJD keeps spouting the same debunked crap over and over. The only thing his cites accomplish (and unlike a lot of loons, he does provide them) is to show all the research that doesn't support his idea. Not ideas, but idea, singular. From mid-2011 until now, all I have learned from MJD is that latex is another way that vaccines don't cause autism.

I don't learn from him any more, so I wouldn't miss him a bit.

Among a few things I took away from it were, polygraphs have no scientific basis but a huge “placebo” effect, similar to West African witchdoctors…

I'll take your word for it.

I've had to take a poly a couple times, and even dated a polygraph examiner for a while, and have found out a few things. First, I am apparently an excellent polygraph subject. Second, don't even think of playing poker with a handful of polygraph examiners. You will loose.

Polygraphs may be psudo-science, but a well trained operator doesn't need a machine.

Responding to See's comment #93 --

Planned Parenthood, July 14: At several of our health centers, we help patients who want to donate tissue for scientific research, and we do this just like every other high-quality health care provider does — with full, appropriate consent from patients and under the highest ethical and legal standards. There is no financial benefit for tissue donation for either the patient or for Planned Parenthood. In some instances, actual costs, such as the cost to transport tissue to leading research centers, are reimbursed, which is standard across the medical field.

http://www.factcheck.org/2015/07/unspinning-the-planned-parenthood-vide…

Now take a sexual departure.

By palindrom (not verified) on 21 Jul 2015 #permalink

See Noevo: "Here are some doctors really betraying their profession:"

O'Keefe is a liar and a criminal. Never believe any video he is involved with.

Now read this:
http://articles.philly.com/2015-03-30/news/60606995_1_cord-blood-liver-…

Then listen to the parents as they learn how their child who died so young will help so many:
http://www.radiolab.org/story/grays-donation/

If you deny their contribution, you are horrible person who denigrates the suffering of the children the research saves. May your deity of choice show pity on your selfish desire to see kids suffer greater due to your desires.

Having observed over the last 7 years that the American Academy of Pediatrics lack the spine to sanction member anti-vax pediatricians, it is reaffirming to see that the American Academy of Cardiology Ethics and Discipline Committee has admonished and censured at least two cardiologist members for giving what appears to be less-than-expert testimony: https://www.acc.org/about-acc/our-bylaws-and-code-of-ethics/code-of-eth…

By Chris Hickie (not verified) on 21 Jul 2015 #permalink

Chris: "May your deity of choice show pity on your selfish desire to see kids suffer greater due to your desires."

Are you kidding? God loves seeing people suffer, especially children. Jesus liked kids, God hates everyone who isn't a fetus or a straight dude. It's funny, for all the nonsense of joy they talk, most Christians worship a pretty dour dude.

By Politicalguineapig (not verified) on 21 Jul 2015 #permalink

JustaTech @84, I suppose that makes more sense than the static electricity explanation.

By Julian Frost (not verified) on 21 Jul 2015 #permalink

My recommendation would be to ignore "see" - he's only looking for another rabbit hole to jump down.

See@94: You're clearly delusional if you think abortion doctors are getting mad rich on $30-100 for a tissue sample. Go look up the packaging and postage requirements and fees for sending biologicals through the mail, just for starters. Obvious smear job is obvious, and your uncritical embrace of notorious professional liars is duly notied.

Mephistopheles@75:

You mean there are unpaid prostitutes? Prostitute interns? Amateur prostitutes?

See also: Tea Partiers.

Shay @87

OT-do you mean Schaumberg, Germany? If so, you just up the autobahn from me.

Leider night.

Schaumberg, Illinois (165 miles from Paris, Illinois, and within driving distance of Rome and Berlin Illinois, as well).

NICHT. Not "night."

#98 Johnny

Polygraphs may be pseudo-science, but a well trained operator doesn’t need a machine.

Exactly, you have just explained why a polygraph seems to work.

Whatever validity a polygraph may have (and I really have not seen any wildly convincing studies that it has any) is probably a factor of an excellent operator & the Witch Doctor placebo effect. If you know you cannot successfully lie then either you don't or, if you try, the polygraph says you are having a seizure, and both your mother and your first-grade teacher would have said, accusingly, “Johnny” !

Among some of North America's New Agers a crystal ball or pyramid might be just as useful. Come to think of it the Scientology “two tin cans and a meter” seem function well (for some value of well) with the faithful.

I remember hearing an anecdote when I was an undergrad that our dept. (Psychology) had a clinical psychologist who could to diagnose organic brain disease with amazing accuracy using a Rorschach Inkblot Test. As the Clinical graduate student who was relating it pointed out, it was very likely the psychologist would get the same result with an empty cigarette package.

I suspect (Again, I have not seen any decent evidence that I can recall) that it would be fairly easy to teach people to beat the polygraph. I have heard some speculation that a psychopath might not even need any training. :)

I cannot remember if I ever saw any real cross-cultural studies. It would be very interesting to see just how accurate an American polygraph operator would be with someone, say, from China or Korea assuming no earlier cultural cross-contamination.

By jrkrideau (not verified) on 22 Jul 2015 #permalink

NaT:

“The political argument in the case of litigated cases is that these doctors are providing a service to insure that the defendants have a defense capability...

This is part of the structura; 'flaw' I mentioned. The U.S. trial system is adversarial, with only the jury as 'deciders of fact'. It's based in the Enlightenment concept that 'truth will emerge from vigorous exchange'. In theory, the defense gets to put up it's case without restrictions, and if its witnesses try to pul any BS, is up to the prosecution to rip it apart on cross, and/or counter with their own witnesses on re-direct. In practice, it doesn't work that way, but the exceptions are to many in number and too inconsistent to discuss w.brevity.

'Suborning perjury' is a no-no for lawyers, and can get them disbarred, but they have to KNOWINGLY put a witness on the stand for the purpose of telling a lie, so that's easily avoided by just not asking certain questions. E.g. even if the attorney believed the witness's testimony would be false, it's OK as long as the attorney doesn't know the witness knows its false.

Defense attorneys are especially adept at discussions with their clients that go right up to the line w/o crossing over, so they can preserve the option of having the client testify. Still, one reason defendants DON'T take the stand is often that the lawyer won't risk suborning perjury. However, juries receive standard instructions that they can draw no conclusions based on whether a defendant does or doesn't get called – as there are other legit reasons that could lead to such a choice.

As Narad says, much of any 'expert' testimony will be bracketed as 'opinion', and thus defined as outside the question. I would doubt that serves as a blanket exception, and I'd have to imagine that in some cases 'expert' witnesses have made knowingly false statements on questions of fact that would at least be arguable as perjury – but I have the feeling that's rare as a well-prepped witness should be able to weasel around the subject w/o lying directly, and even the rare possible violations are almost never (if ever) prosecuted as just not worth the bother given the backlog in the criminal courts.

Perhaps its possible that 'false' expert testimony is a civil case could lead to the 'expert' facing a lawsuit, but you'd have to ask a real attorney about that.

"I am sure that trial lawyers everywhere would rally to their defense.”

Well, that's a bit vague. Yes, many trial attorneys would hold to the abstract principle. Others however – public defenders especially – have seen it misused so much they'd be quite open to reforms...

Polygraph tests are often administered as a means of eliciting statements form defendants who are reluctant to speak to investigators. While the polygraph itself is inadmissible, the answers given are as statements of record. Thus some polygraph 'operators' know nothing about interpreting polygraphs, and just know how to use the frame of 'administering the test' as a ruse for subtle interrogation.

I suspect (Again, I have not seen any decent evidence that I can recall) that it would be fairly easy to teach people to beat the polygraph. I have heard some speculation that a psychopath might not even need any training.

Robert Park, who wrote the "What's New" columns that came out weekly from the American Physical Society for a couple of decades or so (with a disclaimer to the effect, "Opinions are the author's and are not necessarily shared by the APS, but they should be."), would agree with you. He was fond of pointing out that no spy was ever discovered through a polygraph examination--most notoriously, Robert Hanson repeatedly passed such exams. Polygraphs aren't quite reiki or homeopathy level bunk (it's not completely absurd that there would be detectable effects), but they are still bunk (observed effects are indistinguishable from observer bias).

By Eric Lund (not verified) on 22 Jul 2015 #permalink

Schaumberg, Illinois (165 miles from Paris, Illinois, and within driving distance of Rome and Berlin Illinois, as well).

I went to school not far at all from Bingen, WA. (Pronounced "Bin-jin." Bingen-on-the-Columbia, as it were.

I've gotten to where I can here someone mention Versailles, IL (pronounced locally as verSALES) without cringing.

"hear."

I'm under-caffeinated, obviously.

I hear Goethe Street in Chicago is pronounced "Go-thee Street." So it goes.

If you really want to hear French names mangled, go to Detroit.

Or should I say, d'Etroit.

If you really want to hear French names mangled

A highly literate old gent I used to know learned this as a child -- to be read phonetically:

Less Mar Sallies:

Less En Fants Dee La Batteries,

Le Jower do Glore Est aRIVvee

March ons! March ons!

... and so on.

I understand, by the way, that that the Tour de France is going to climb Alp De Hueys pretty soon.

By palindrom (not verified) on 22 Jul 2015 #permalink

I've know someone who currently lives in the U.S. who is very happy to come back to Canada just because the average person is more likely to know how to pronounce his name properly.

His name is Jean-Paul.

By Jenora Feuer (not verified) on 22 Jul 2015 #permalink

My Herr Professor father used to tease me by reading French literature aloud in a perfect hochdeutsch accent.

I wish there was a way to adequately convey what he did with splendeurs et misères des courtisanes.

My dear wife is driven to distraction by Brits pronouncing "Michigan" with a hard "ch", as if spelled "Mitchigan", instead of the soft French-derived "sh" sound.

By Krebiozen (not verified) on 23 Jul 2015 #permalink

My dear wife is driven to distraction by Brits pronouncing “Michigan” with a hard “ch”, as if spelled “Mitchigan”, instead of the soft French-derived “sh” sound.

There is a way to distinguish between the Birmingham in England and the one in Alabama, at least if the speaker is knowledgeable. The H is pronounced in the latter but not the former.

Likewise between the Berlin in Germany and the one in New Hampshire. The first is Ber-LIN, the second is BER-lin.

I hear Goethe Street in Chicago is pronounced “Go-thee Street.”

There is a Couch Street in Portland, OR. If you pronounce it as you would the piece of furniture, you are identifying yourself as an out-of-towner. The locals rhyme it with "hootch".

By Eric Lund (not verified) on 23 Jul 2015 #permalink

And yet up in Kankakee County everyone pronounces "Bourbonnais" without the final S. Go figure.

Similarly, Houston, Texas ( HEW ston) and Houston Street ( HOUSE ton) which formally delineates the hub of the universe, SoHo, but not Soho. Which isn't far from Chelsea- but not THAT Chelsea.

By Denice Walter (not verified) on 23 Jul 2015 #permalink

There an area near me called The Boleyn (after the pub there, named after Ann Boleyn for whom Henry VIII built a hunting lodge there), and all the locals pronounce it 'bow-linn' (apologies for clumsy phonetics), which used to bug me, as it is traditionally pronounced 'bo-linn' in Britain. "Plaistow" is pronounced 'Plar-stow' ("plar" to rhyme with "far"). I won't even mention Arkansas, for fear that someone will mention English English pronunciation of Magdalene, St. John, Menzies, Beauchamp, Leicester...

By Krebiozen (not verified) on 23 Jul 2015 #permalink

Well, there's Arkansas (final s silent) and Kansas (final s pronounced), so....

Kreb, you left out a personal favorite -- Worcestershire.

shay,

Kreb, you left out a personal favorite — Worcestershire.

That is a good one - for those that don't know, it is pronounced 'wooster' for reasons that entirely escape me. I have hours of fun teasing my long-suffering spouse about the pronunciation of various words in Britain. There's also Norwich (silent 'w'), Slough (rhymes with 'now') and Caius (sounds like 'keys') College. The 'h' in 'ham' is dropped as Eric observed, so Buckingham is usually pronounced 'Buckingam', but the 'h' is sounded in 'herb'.

Verging out of place-name territory, 'tomato' (but not 'potato' - Brits are inconsistent), 'oregano', 'basil' and 'alumin(i)um' spring to mind. There are also some differences in meanings of words that cause occasional confusion - 'grafter' (means a hard worker in the UK), 'table' (as in table a motion, means the opposite in the US and UK) and 'fanny' (there's a contralateral distinction, but let's not go there). I have also had to advise an American to avoid using the word 'pollywog' (meaning 'tadpole' - she was using it as a pet name for someone) as 'wog' is just as racially offensive an epithet in the UK as the n-word is in the US.

By Krebiozen (not verified) on 23 Jul 2015 #permalink

Contralateral's the wrong word. Contraventral? Contradorsal? Whatever.

By Krebiozen (not verified) on 23 Jul 2015 #permalink

Many years ago I frequently listened to a radio program, produced by a Canadian university, that presented various "radio plays." On one occasion, the host (again, Canadian) was introducing the piece as being about Dawn Jewan. It took me a while to realize that it was Don Juan. The Jew-an pronunciation was what was used in the Brit production of the play.
Ever since then, I have pronounced the sauce as wor-sester-shyer.

I also offer up Featherstonehaugh, pronounced as fanshaw.

I always thought it sort of funny that 'Nova Scotia' was translated into French- 'Nouvelle Ecosse' when it isn't even English but Latin.
Nouveau Brunswick I can understand.

By Denice Walter (not verified) on 23 Jul 2015 #permalink

@ doug

I have pronounced the sauce as wor-sester-shyer.

By lengthening the end, the radio host could have pretended he/she was going for the Italian form, Don Giovanni.

There is a city next to Boston called Worcester. Depending on who you ask, it's pronounced either "wooste" or "Wor-ses-ter".
Pity the poor foreign tourist trying to ask for directions...

By Helianthus (not verified) on 23 Jul 2015 #permalink

My great home state has oodles of difficult-to-pronounce place names.

Counterintuitive?

JP, that's funny.

Pareidolius and I have discussed non-Spanish pronunciations of city names derived from Spanish in California.
San Rafael, Vallejo etc.

My father could really ( deliberately) slaughter French at a fast pace.

By Denice Walter (not verified) on 23 Jul 2015 #permalink

The tourists to the city of my birth are easily discerned by "Queen's KWAY" (Quay, key) and "Yawnj Street" (Yonge, young)

Also, related: KWAH-beck.

Krebiozen -- Marylebone confounded me as a sprog.

I grew up in the St. Louis area and the streets with French derived names have had all of the french pronunciation beaten out of them by the locals.

“Plaistow” is pronounced ‘Plar-stow’ (“plar” to rhyme with “far”).

I'm curious to hear what you do with the second syllable. There is a town by that name not too far from me. We pronounce the first syllable to rhyme with "glass" and the second to rhyme with "how". Neither of which is obvious to a non-local.

There is also a Thames River running through New London, CT. Locals pronounce it as spelled, unlike the one in England.

By Eric Lund (not verified) on 23 Jul 2015 #permalink

He was fond of pointing out that no spy was ever discovered through a polygraph examination–most notoriously, Robert Hanson repeatedly passed such exams.

True, as far as I know. However,the number of cognizant agents uncovered is only one metric. The polygraph program has uncovered multiple security risks and kept untold numbers of 'unacceptable' people from having access in the first place.

For example, there is a story of a guy who had passed his investigation, and during the pre-employment polygraph said that he wasn't a Soviet agent. The machine said 'false'. Upon further discussion, the guy said that in a previous life, back in WWII, he was a soviet spy, but that 'version' of him had been killed in the war. He was not employed by the U.S. Government.

As far as large quantities of mispronounced cities, Oklahoma has to make the short list. The result of Romanizing a non-Roman language, no doubt.

The result of Romanizing a non-Roman language, no doubt.

You mean English?

I always thought it sort of funny that ‘Nova Scotia’ was translated into French- ‘Nouvelle Ecosse’ ...

I've long thought strange that the names of countries and places should be translated at all. They are names, not descriptions (with notable exceptions, such as The United States of America and the former USSR).

@JP. Many of the cities have names given by the tribes that were relocated to the Indian Territory such as the Choctaw, Chickasaw, Cherokee, Creek, Seminole and many others.

So, you get cities like Pawhuska, which I'm pretty sure I remember pronounced Paw Husky.
It's been too long since I've lived there to think of especially egregious examples, but here are a few:

Wewoka, Konawa, Weleetka, Coweta, Owesa, Ochelala, etc.

I'm pretty sure the s was prounounced in Verdigris.

By squirrelelite (not verified) on 23 Jul 2015 #permalink
The result of Romanizing a non-Roman language, no doubt.

You mean English?

Well, I meant a handful of Native American languages, and I suspect you knew that, but, whatever.

Yeah, I was facetiously making the point that any language except Latin that's written in the Roman alphabet is a non-Roman language that has been "Romanized." I'm guessing mispronunciations probably have more to do with unfamiliarity with the orthography of native languages, say, or the fact that many of them have been driven extinct altogether.

What stands out to me isn't translating something like "New York" (where the "New" is the normal English word "new") or "England," where "land" is again an English word used as such--it's the inconsistent way of changing pronunciations, giving us "Genoa" and "Moscow" for "Genova" and "Moskva."

There's less of that in English than there used to be, so we've still got "Rome" and "Leghorn" and "Austria" for places in Europe, but don't have an alternate name for Paramaribo.

JP: "My great home state has oodles of difficult-to-pronounce place names."

I am surprised that they did not include Sedro-Woolley. In which the Spanish word is pronounced in English as "Cedar"... okay, not seedar, but as seeder. Face it, there are too many pronunciation exemptions from the rules in English.

And I thought learning the non-conforming gender noun and verb tenses rules in Spanish was difficult. At least that language was phonetic!

^ Or white people hearing the Indians call a place by its name and writing down their best approximation of what it sounded like. Spellings of place names are often different from actual Indian orthography, actually; the city of Yakima vs. the Yakama Nation, for instance.

it’s the inconsistent way of changing pronunciations, giving us “Genoa” and “Moscow” for “Genova” and “Moskva.”

There’s less of that in English than there used to be, so we’ve still got “Rome” and “Leghorn” and “Austria” for places in Europe, but don’t have an alternate name for Paramaribo.

I had a dinnertime conversation about this with some good friends in Portland years ago; how we say Florence instead of Firenzia, for instance. I think that, when it comes to European cities with long-established English names, they aren't going to change. Somehow or other - it would be an interesting research project to look at how - we started calling them that, a long time ago, since those were the foreign place-names we were actually talking about a long time ago.

"...it’s the inconsistent way of changing pronunciations..."

Exactly. We drive visitors and the newly relocated crazy with these gems which are spelled like the last word but pronounced like the first:

Chi-lie > Chili (like the food)
Ave-on > Avon (like the company)
Char-lot > Charlotte (like in North Carolina)

By Not a Troll (not verified) on 23 Jul 2015 #permalink

Face it, there are too many pronunciation exemptions from the rules in English.

True, but "cedar" isn't one. ;) Any time "c" is followed by e, i or y it is pronounced like s; otherwise, like k. And the "a" in "cedar" and the "e" in "seeder" sound the same because we have vowel reduction in English, where unstressed vowels get reduced usually pretty much to a schwa.

English orthography sure is weird, I'll grant you; makes sense, since it's such a weird, b@stard language. Some might say we're due for an orthographic reform, but if it means writing "skool," "nite," "thru," "foneem," etc., I am not so sure I could adapt.

"Some might say we’re due for an orthographic reform, but if it means writing “skool,” “nite,” “thru,” “foneem,” etc...."

Um...how much texting have you seen? I think we are well on our way to your nightmare scenario.

By Not a Troll (not verified) on 23 Jul 2015 #permalink

Not a Troll: "Btw, I didn’t know the “CA names” video was a thing. Thanks JP!"

At least they asked how the "j" was pronounced. There is a reason that "La Jolla" is pronounced with the "j" sounding like an English "h", and the "ll" like a "y." Yet some Californians don't understand when I pronounce the name of one American camel relative as "yama" instead of "lama" (it is an animal in a country that speaks Spanish, not some Buddhist dude).

By the way, many of the NY names are of Dutch origin. It is also a phonetic language, and you just have to learn the rules. A double o, "oo" is a long "o" like in "go", and an "oe" is like a long "u" or "oo" in English. So confusion is expected.

Though sometimes I don't get the subtleties, but here is a guide:
http://www.heardutchhere.net/DutchPronunciation.html

I tried my broken interpretation of Dutch pronunciation to say the names of some places (many that I have been too), my score was about 50% or so:
http://www.heardutchhere.net/Plaatsnamen.html

(married to a guy with lots and lots of sequential vowels in his name, and we may not pronounce it right, but it is better than some others around here!)

Um…how much texting have you seen? I think we are well on our way to your nightmare scenario.

Mercifully little. I myself only text in grammatically and orthographically correct English, because I am weird like that, and because I don't text much, I suppose.

I don't think short-hand "text" spellings are going to make it into the OED any time soon, though. ;)

The one-l lama,
He's a priest.
The two-l llama,
He's a beast.
And I will bet
A silk pajama
There isn't any
Three-l lllama.

-Ogden Nash

JP: " and the “a” in “cedar” and the “e” in “seeder” sound the same because we have vowel reduction in English, where unstressed vowels get reduced usually pretty much to a schwa."

Something I would not know. Though I would if I bothered my BA in Linguistics daughter, but she would than likely give me a lecture for five minutes or just roll her eyes. I was just going on my immersion in Spanish as a youth (yes, it was my first language, but I speak as well as any three year old... I have the Annunciation down, it is at the post-toddler grammar/vocabulary where I totally fail).

After I watched the video on upstate NY place names and listening to some of the Dutch pronunciation (and I swear some of the vowel sequences sounds were different because it either not phonetic or there were additional rules on consonant placement, I am voting for the latter), that the NY place names may have changed from the original Dutch over time.

(an aside: many of the names in the sate of New York end in "kill", which in Dutch simply means it is near running water like a creek, not that they wish to terminate the living).

JP: "Mercifully little. I myself only text in grammatically and orthographically correct English, because I am weird like that, and because I don’t text much, I suppose."

Both of my younger children text with full words and proper grammar! They did this even when one had to press a key three times to get the actual letter. Which made it interesting when I took them to Disneyland five years ago and the trip to the restroom was almost finished before I got the text!

Oh crud. How did I miss this before hitting "send": I have the Annunciation down, it is at the post-toddler grammar/vocabulary where I totally fail)....

It is supposed to be: "I have the pronunciation down, it is at the post-toddler grammar/vocabulary where I totally fail)."

@Chris:

Oh, English spelling is certainly unusually bad, but a lot of the things that seem random and nonsensical are actually following a deeper structure. A lot of the really silly spellings in English were started on purpose, to create associations with Latin words that aren't actually cognate, etc. And then there are the spellings like "colour," etc., which were changed to look more French and thus fancier or something. (We Americans threw that right out, thankfully. ;-) ) There was a time when almost all the "or" endings were being spelled "our," and "er" endings were typically being spelled "re," again, to look more French.

Oh crud. How did I miss this before hitting “send”: I have the Annunciation down, it is at the post-toddler grammar/vocabulary where I totally fail)….

It is supposed to be: “I have the pronunciation down, it is at the post-toddler grammar/vocabulary where I totally fail).”

I kinda figured, but it was fun to imagine you having the Annunciation down. :)

JP, you missed Ogden Nash's postscript to his ditty. It recognized the three-l lllama as a type of conflagration… .

By Bill Price (not verified) on 23 Jul 2015 #permalink

Ah, yes, silly of me:

* *The author's attention has been called to a type of conflagration known as a three-alarmer. Pooh.

My 17-year-old texts with spelled words. Sometimes he gets the homonyms right, but occasionally he confuses homophones. Another place where your children look at you and ask, "Why bother? I won't need it later." (Like my generation did with advanced algebra and trigonometry): spelling. My son has a cell phone and its spell-check suggests the words for his sentence three letters in. If he can read, spelling is optional. This does not bode well for his future job prospects. Lately I am suggesting farming and threatening with ditch digger.

I grew up in rural western Pennsylvania. Native American names were everywhere.

Thanks for the links, Chris. I will be exploring the Dutch pronunciations. Even more curious since my family hails from Pennsylvania Dutch country (which is really German, as most know). It will be interesting to see if I find any cases where what I thought was German is really Dutch.

I have to confess I really don't know much about language and thought "Annunciation" was just another trade word in the vocabulary of linguists. So, I am glad you cleared that up!

By Not a Troll (not verified) on 23 Jul 2015 #permalink

Mrs Woo, we probably were within several hours of each other at least part of our lives. I grew up in Western NY near Lake Ontario. Btw, I was born in Niagara Falls (the city not the Falls) which has been an endless butt of jokes all my life.

By Not a Troll (not verified) on 23 Jul 2015 #permalink

Not a Troll: "I have to confess I really don’t know much about language and thought “Annunciation” was just another trade word in the vocabulary of linguists. So, I am glad you cleared that up!"

Seriously, i had not heard of “Annunciation" until a random spell check threw it in my comment! I don't know how that happened since I was on my kitchen laptop, and not on my tablet (where spell-check tends to be more dictatorial).

doug,

The Jew-an pronunciation was what was used in the Brit production of the play.

Cringe. As a Brit, I have known how to pronounce 'Juan' since I read Castaneda in the 70s.

Ever since then, I have pronounced the sauce as wor-sester-shyer.

Me too, originally as a joke to confuse my USian spouse, but it's become a habit.

By Krebiozen (not verified) on 24 Jul 2015 #permalink

Eric Lund,

“Plaistow” is pronounced ‘Plar-stow’ (“plar” to rhyme with “far”).
I’m curious to hear what you do with the second syllable. There is a town by that name not too far from me. We pronounce the first syllable to rhyme with “glass” and the second to rhyme with “how”. Neither of which is obvious to a non-local.

The second syllable rhymes with "low" - funnily enough my local doctor's phone message tells those with urgent conditions to visit the A+E department in Plaistow, mispronounced so the first syllable rhymes with "play"; the disembodied voice on the tube used to get it wrong too but has been fixed (lots more weird London pronunciations for those interested, "Borough" for example). Interestingly Plaistow used to be a lawless part of London cut off by marshland with secret paths only known to locals, or so a local historian was telling me.

There is also a Thames River running through New London, CT. Locals pronounce it as spelled, unlike the one in England.

There's yet another ridiculous pronunciation that I hadn't even noticed. I feel so sorry for those learning English as a foreign language.

By Krebiozen (not verified) on 24 Jul 2015 #permalink

By pure coincidence I just found this link in my inbox. It's an article about American English and how it evolved. I funny to remember, as a kid, wondering why Americans had taken our language and mangled it so strangely, not realizing that if anything American English is closer to English English than their common ancestor.

Now if someone could explain to my why Americans say, "I could care less", when they mean the opposite...

By Krebiozen (not verified) on 24 Jul 2015 #permalink

Sheesh. ^It's funny...

By Krebiozen (not verified) on 24 Jul 2015 #permalink

I’ve long thought strange that the names of countries and places should be translated at all.

It's an old habit, and not unique to English. Consider Praha, known to German speakers as Prag and to English speakers as Prague (we probably got that one via French). It reaches ridiculous levels in Switzerland, where both German and French are official languages: the second largest city in Switzerland is called Genève if you are speaking French and Genf if you are speaking German (in English we call it Geneva), and a certain town north of Bern, which happens to be on the border between the French- and German-speaking parts, is always listed at railway stations as Biel/Bienne.

In China there is the further issue of multiple languages using the same writing system. Cantonese gave us such place names as Peking and Canton. Today English speakers call those cities by their Mandarin names, Beijing and Guangzhou, although the former is still Péking in French, and their IATA airport codes (PEK and CAN, respectively) reflect the Cantonese names. With Beijing, however, I am puzzled by the habit of some English speakers of pronouncing Beijing with a French J; the English J is closer to how it should be pronounced.

By Eric Lund (not verified) on 24 Jul 2015 #permalink

One of the issues with English spelling is that, sometime in the 1500s (i.e., after printing had been introduced to England), English had a vowel shift that none of the languages of continental Europe went through. Thus, for example, E has approximately the same value in languages ranging from Portuguese to Polish and Italian to Swedish, but not in English. It didn't help that English continued to borrow words from continental languages. Nor did it help that English was relatively late in standardizing spelling; Shakespeare is known to have spelled his own name nine different ways.

Spanish had some other shifts that were not shared by neighboring languages. The pronunciation of J like an H (in Castilian Spanish, it's more like the German hard CH, which has no equivalent in English nor in any other Romance language--the Spanish probably acquired that sound from Arabic) is one of those shifts. The tendency to shift stressed O to UE (e.g., Spanish nuevo vs. Portuguese novo) is another one.

By Eric Lund (not verified) on 24 Jul 2015 #permalink

"Now if someone could explain to my why Americans say, “I could care less”, when they mean the opposite…">

It is because some of us are dumb.

Also, I very much appreciate your English place name instruction. I most likely will never to get to visit but I can dream....

By Not a Troll (not verified) on 24 Jul 2015 #permalink

"I don’t think short-hand “text” spellings are going to make it into the OED any time soon, though"

Thanks for the reassurance, JP but I think it is a losing battle. Cool that you are fighting it though.

By Not a Troll (not verified) on 24 Jul 2015 #permalink

In the words of James Nicoll, "We don't just borrow words; on occasion, English has pursued other languages down alleyways to beat them unconscious and riffle their pockets for new vocabulary."

Place names in the US tend to fall into one of five categories:

1) Geographic. Great Falls, Sault Ste Marie, Montana
2) American Indian: Chicago, Squelim, Passamaquoddy
3) Personal: Colfax, Lincoln, Mansfield
4) Olde Country/Classical: Berlin, Paris, Memphis
5) Religious: Santa Fe, Los Angeles, Shiloh

As a former Michigander, I grew up learning multiple languages just to pronounce city names correctly. :)

I also text - frequently - and use proper English. Not to say autocorrect doesn't sometime get the better of me, when I hit "send" in a hurry before proofreading. (And the less said about some of THOSE texts, the better...) My kids know not to use "l33t" words with me. I won't answer. The only one who gets away with that is my mom, because she still has one of those "tap,tap,tap to get the right letter" phones. So getting "R U OK" from her is allowed. Anyone else gets no answer.

# JP
I live in Ontario so I am some distance from Paris (370KM) and London (450km) but Moscow is only 35km away and Athens is about 70km. Warsaw is a good 175km. Ah, all the joys of international travel with the customs hassles.

English orthography sure is weird I don't want to scare you but englishspellingproblems.blogspot.co.uk/2013/07/regular-and-unpredictable-spellings-in.html. See http://unspell.blogspot.com/p/home.html for the solution. :) Strangely enough it makes a lot more sense than any other solution I have read about.

BTW does anyone know why Google so badly mangled the Google Maps interface? It now has so much junk I can hardly see the map and I have yet to figure out how to get rid of it.

# Denice Walter
I always thought it sort of funny that ‘Nova Scotia’ was translated into French- ‘Nouvelle Ecosse’ when it isn't even English but Latin.

Seems a francophone habit; witness “Exit” versus “Sortie” in the red lights over the doorways.

# Delphine
Yawnj Street” (Yonge, young)
That's a new one for me but then I'm not from the porcine city. I'll have to pass it on to a friend who collects these. Urh, my English - Canadian spell-checker flagged Yonge

I wonder how many people outside the province can pronounce Gananoque as a native would?

# Kreb
why Americans say, “I could care less”, when they mean the opposite… I am not sure but I think it should be/was originally said with a rising inflecting “I could care less?” But this is only a guess.

I feel so sorry for those learning English as a foreign language.

And for those native speakers learning to read and write. I have seen suggestions that it takes children learning to read and write in English up to 3 or 4 times or as long as someone learning to read and write in Finnish or Spanish and some other languages, probably Russian come to think of it, that are written phonetically and with consistent rules. http://www.theatlantic.com/education/archive/2015/02/how-the-english-la…

In English one just has to memorize thousands of spellings and pronounciations “ Write, write, rite, right and cough vs enough or said vs bed. I wonder if Chinese is easier to read and write.

By jrkrideau (not verified) on 24 Jul 2015 #permalink

I wonder if Chinese is easier to read and write.

It wasn't for me.

@ shay:

I tried a video course in Japanese which I re-played several times without making much progress. I found Chinese impossible so I gave up.

By Denice Walter (not verified) on 24 Jul 2015 #permalink

I wonder if Chinese is easier to read and write.

Chinese characters, not so much. You have to learn several hundred to be even functionally literate, and several thousand to be fully literate. But the Pinyin transliteration system is, if you include tone markers, a one-to-one mapping between spelling and pronunciation. Admittedly, it's quite different from what English speakers are accustomed to: X represents a SH sound (borrowed from Portuguese either directly or via Vietnamese), C represents a TS sound (common in various East European languages such as Polish), and Q represents a CH sound (this one seems to be a Chinese innovation). Thus hilarity often ensues when a clueless Anglophone tries to pronounce a Chinese name containing one of these letters (in addition to the issues of tonal vs. non-tonal languages). Obviously there are regional variations within China as well: ZH represents a J sound in some provinces and a Z sound in others (I infer that Beijing is in the former group since that is the recommendation of the language books I looked at before I visited China).

However, English may be a particular problem with people prone to dyslexia. Some years ago I heard about an Australian boy living in Japan, who was claimed to be dyslexic in English but not in Japanese. Japanese has both Chinese style characters (kanji) and two sets of phonetic marks (kana), so if you know how to spell a word you know how to pronounce it, but not the reverse--one major reason why Japanese use business cards is so that your contacts will know exactly which of the many possible spellings of your name is the correct one.

3) Personal: Colfax, Lincoln, Mansfield

There is a town called Lincoln in New Hampshire, which I am pretty sure is not named after the president. I'm not sure whether it's named for the town (and surrounding county) on the east coast of England, or for the town in Massachusetts (which is named for the one in England). It is possible, even likely, that one of Abraham Lincoln's ancestors took the name from the English town.

And then you get place names like Danvers and Henniker (these are towns in Massachusetts and New Hampshire, respectively). AFAIK these are not native words, but neither are they derived from any other place name (Henniker bills itself as being the only town in the world with that name).

By Eric Lund (not verified) on 24 Jul 2015 #permalink

OK, book recommendation time: Names on the Land by George R. Stewart tries to explain/give the background for the name of every place in the United States as of World War II.

"Tries to explain" because there are a few cases where he had to say "nobody knows where this came from," and I can't guarantee he left nothing out.

Also, while Dutch may be spelled phonetically, the way New Yorkers pronounce Dutch-derived names isn't particularly close to how the Dutch pronounce them now. Some years ago, I was talking to a visiting out-of-towner; she's from elsewhere in the U.S., had been living in the Netherlands for several years and speaks some Dutch, and confused everyone thereby. What's the "Fon Veek" expressway? We say "Van Wike" (rhyming with like) or "Van Wick."

Vicki, just found a used copy online and ordered it. Sounds like something right up my alley.

Vicki: "Also, while Dutch may be spelled phonetically, the way New Yorkers pronounce Dutch-derived names isn’t particularly close to how the Dutch pronounce them now"

I am not surprised. That happens in English too. We visited a friend when he was in the Navy and stationed in Groton, Connecticut. This is near New London, which is by the Thames River. And it is not pronounced "tems."

Eric Lund: "Japanese has both Chinese style characters (kanji) and two sets of phonetic marks (kana), so if you know how to spell a word you know how to pronounce it,..."

Many many years ago I went to a science presentation at a child's high school. It was about historical earthquakes and how they help scientists think about future earthquakes. About three hundred years ago there was a major quake on the American west coast that caused a historic tsunami in Japan.

The American native population that experienced the earthquake did not then have a written language, but did leave some pictographs in various places (plus there are whole forests that slid into water where they were preserved).

There are written records from Japan. They came from all sorts of sources from government offices to letters, etc. One way they figure out who wrote them was how they were written. The kanji are the more educated elite who can go to school for many years to memorize all those characters, and the kana were from farmers, fisherman and other "regular folk."

I have to agree with the earlier post about that doctor looking suspiciously like Franklin D. Roosevelt. In a similar vein, I was listening to some old time radio broadcasts on the internet archive and heard a commercial for Fatima cigarettes "doctors agree, Fatima is the best smoke"
They used to push cigarettes as a sugar delivery system, believe it or not.

181 Eric Lund

Re: Dyslexia in Chinese vs English.

Yes I have heard of the same thing about someone reading Japanese but not English. There apparently are documented cases of someone reading one language but not another. I always thought it was likely due just to the differences between an alphabetic and ideogram based language (which I have just learned is a logographic writing system) but interestingly enough there is a paper (http://www.ncbi.nlm.nih.gov/pubmed/15343334) that suggests alphabetic and logographic writing systems may use different parts of the brain. Also there seem to be reports showing a much lower incidence of dyslexa in China vs English-speaking areas.

On the other hand, I think things like perceptual reversals such as p for q or b for d is another additional learning load for alphabetic systems. Apparently once you memorize enough ideograms there is some consistency whereas English and consistency are not even distant cousins

By jrkrideau (not verified) on 25 Jul 2015 #permalink

Semi-lurker chiming in late --

May I suggest that maintaining a monomaniac's outlet for repeating a delusion might actually hurt the monomaniac in terms of getting treatment? Good night, good luck and good riddance to MJD.

Also, as a native of a certain N.H. town, I fully support Krebiozen's pronunciation guide in #169. I will, however, plead the Fifth on whether the N.H. version mirrors its English counterpart in being "a lawless part ... cut off by marshland with secret paths only known to locals." : - )

By Scottynuke (not verified) on 26 Jul 2015 #permalink