Greg, thanks for your comment but I hope you're not going to leave it there.

I think we'd all like to hear your take on what my agenda is.

It's probably very much like my agenda:
08:30 – 09:00 First coffee of the day, deal with administriva
09:00 – 10:00 Write Workshop assessment response
10:00 – 11:00 EP Honours project review
11:00 - 11:10 Coffee
11:10 – 12:00 Herbal Group project data review
12:00 – 12:30 Vacation Scholarship interview
12:30 – 13:30 Insecticide Honours project review
13:00 – 14:00 e-Learning demonstration
14:00 – 14:10 COFFEE!!!
14:00 – 16:00 Co-ordinate and assess Environment Students workshop
15:30 – 16:30 Review Med Students Research project proposal
16:30 – 17:00 Honours course administration

How do you get so much work done with so little coffee?

DOUBLE ESPRESSO!! (my hands shake like this normally, really)

I've heard acupuncture is good for that :)

Do you actually have any specific scientific or methodological objections to anything he says in the article? Or do you just want to keep making unsupported assertions about the reliability of the author?

You ask: "Why do people still choose to use non-Western health care services"? Here's one hypothesis: Because we're desperate. Because when "here's the best that the only successful explanatory framework we have for dealing with physical reality can do for you at this point in its history" doesn't solve the problem, we'll reach for anything that claims it can. And we'll cling to the belief it's helping regardless of what empirical observation says. Because we want to believe that somewhere out there there's an answer to our problem. Because we fear illness and death and don't want to accept how (relatively) powerless we are in the face of them. That seems a more parsimonious explanation than the alternatives that have been offered.

Dania,
your contributions would be more welcome if they had some type of point that was related to the content of the article you were 'commenting' on. This isn't Reddit.

I looked at Dr. Vagg's previous Conversation piece - can you point me to where he is 'discredited'? I take it you aren't basing your entire dismissal of his expert opinion on 'Dan Nobull's' post are you?

In any case, your swan analogy doesn't quite make the point you want it to make - it's simply an illustration of how inductive reasoning works, not an illustration of Kuhnian revolutions. Finding a black swan invalidates the inductive conclusion that all swans are white, but that doesn't bring about a 'paradigm shift' (to use a Kuhnian terms that has been horribly misappropriated by every management guru since) of the sort Kuhn was interested in.

Leaving aside the probably unfair generalisations about doctors (most doctors I've been to have been pretty 'holistic' in the sense of focusing on the overall health of the patient, and haven't rushed me out the door in 7.5 minutes either), the big problem here is that "hope and humanity" aren't much good if the treatment doesn't actually work. With regard to medical treatment, success will be wholly a matter of a physical (in this case organic) entity responding in the desired physical ways to particular physical interventions. And we have precisely one successful way of objectively measuring what physical reality is doing, and that's science.

For the non-physical (metaphysical, moral, aesthetic etc.) issues, there's people like me. But we can't make tumors shrink or arteries unblock. When your car breaks down you don't take it to a psychiatrist, so why take your body to someone who has shown no demonstrated ability to fix it?

Ummm You kind of lost me there. Science is a method, it is used to examining the natural world. You are not required to utilise this resource. Feel free to refuse vaccinations, antibiotics, etc. None of those things are compulsory in Australia. I have no problem with people choosing to use homeopathy, or iridology or any other CAM therapy. I don't think I should pay (through taxes) for something which is no shown to work (I am even comfortable with not knowing the mechanism, if 100 people are given the CAM of choice and another 100 are given a placebo and it is all adequately blinded and controlled, I am happy to accept the results). I take issue with people claiming that something works but "can't be tested by science". I am yet to find a medical intervention that cannot be tested by science, but I am open to suggestion. Your backyard mechanic still uses the principles of physics and the knowledge gained from learning and observation, unless he just burns incense or fits the Peter Brock energy polarizer to your car?

While I enjoyed the Foucaultian resonances of your post, phronesis i.e. practical wisdom doesn't really seem to be the issue here. The importance (and irreducibility) of subjectivity and the centrality of moral experience are core parts of my research work, so I'm certainly not dismissing them. And obviously there's a range of moral and experiential issues *surrounding* medicine that are extremely important. Whether to continue an invasive treatment for a terminal illness or enjoy whatever time is left is a phronetic issue. Which of two patients should get the one available transplant organ is a phronetic issue. Whether some conditions should be viewed as appropriate objects of treatment or not may well be a moral, religious, political or even aesthetic issue. All those are legitimate questions, and they cannot be solved by science itself.

But whether a given treatment *actually works* or not isn't a moral issue: in the broadest terms, it's a question about how bodies react to interventions. How you feel in yourself is indeed a subjective matter, but whether a disease process has actually stopped or not isn't. And CAM doesn't present itself as an alternative *to* treatment but as a form *of* treatment - in other words, as a techne (if we're going to stick with Aristotle) for repairing dysfunctional bodies. It claims to work on the physical level. That being the case, its claims to efficacy have to be assessed within the same epistemic framework as any other claim of that sort. If it claims to do something else, then it should stop presenting itself as capable of intervening physically and explain what it actually does.

If you want to relate this back to phronesis, surely the phronimos doesn't believe things about the nature of the physical realm without appropriate grounds? That doesn't mean we "unweave a rainbow" or sink into "Single vision and Newton's sleep," but it does mean we base our moral choices on the best account of the physical facts available at the time.

The car example isn't meant as patronising (nor were my comments about Kuhn - when we put statements out there, we accept the possibility we'll be corrected. There's no malice in that). It's just a simple analogy about the appropriate practical response to a type of practical problem. As to why you take your car to a backyard mechanic, I confess I have no idea, but I hope they're qualified.

Seeing as you are apparently basing your views of Dr Vagg's credibility on Dan Nobull's post, let's go through the claims you're relying on. In your summary, Vagg:

1. "said a fluffy about locating the doctors' submission"

He said it wasn't easy to find. Without having the webpages of both Doctors for Families and the Senate inquiry as they appearted at the time Dr. Vagg wrote his piece I have no way of assessing that; however at worst it means he didn't see the link. If you go to the website even today the link hardly jumps out at you (it's right down the bottom), and it takes you to the Inquiry webpage where you have to hunt around for their actual submission. That's perhaps an indictment of someone or other's webpage design, but it's a stretch to accuse Vagg of dishonesty on such a basis.

2. "said another fluffy about being unable to locate particular literature (how naive does he think we are?)"

He said he only had access to the abstract. I don't know why that was the case, but if I had to hazard a guess I'd say he simply followed the link to Wiley or googled it - to access the full article he'd have to go through the Deakin library. Again, hardly evidence of evasiveness or deception.

Just so we're clear, is this the paper that, as Dr. Vagg correctly surmised just from the abstract and as even Mr. Nobull conceded, said absolutely nothing about same-sex couples? It concerned step-family situations, which is hardly relevant to adoptive parents, gay or otherwise.

3. "said another fluffy about a very significant report, totally misrepresenting it (I went and read it, and yes Dan Nobull was correct)"

Again, no fluffy here: he said it wasn't a peer-reviewed paper, and it isn't. Despite what Mr Nobull seems to think, it doesn't matter how many USyd logos you put on the report, it doesn't achieve the status of a peer-reviewed paper. If it did, my Conversation articles (which include a Deakin logo on the side) would have the same status as journal articles. As I try to drill into my first years from day one: if it ain't peer-reviewed, it ain't worth much.

4. "said yet another fluffy about the not non-existence of reliable science on gay sexual risky practices and the lack of research thereof in Australia (there are actual references to recent research posted by Dan Nobull to contradict Vagg)"

Dr Vagg didn't say such research didn't exist, and hence Mr Nobull's objection misses its target. He said the DftF submission mostly cited opinion pieces and quoted selectively from research on infection rates that does not allow us to "generalise about the health risks of actually being in a stable, loving and long-term relationship with a same-sex partner."

I'm at a loss as to why you think there's something patronizing in my pointing out that your swan example wasn't an apt example of a Kuhnian revolution. If you think I'm wrong, explain why.

Yes Jerry, but it does cost SOMETHING when it would be more cost-effective to provide education and not provide any hands-on treatment. Such a study has indeed been done before and published in the NEJM. http://www.nejm.org/doi/full/10.1056/NEJM199510053331406 In this study, cost for managing an episode of acute LBP was highest if the patient saw a chiropractor or an orthopaedic surgeon, and lowest if they saw a GP. The outcomes were the same regardless of who treated them.

This review adds to the negative evidence that suggests we should be putting our efforts into helping people with an acute episode of LBP to self-manage rather than making up treatments that aren't really effective. That's certainly what we do in my hospital.