Dr. Shawn Kerfuffle Update

I notice that Dr. Messonier has deleted  my response to his blog post defaming me. I guess polite, reasoned criticism is intolerable to him.

He has also written another post full of strawmen and cliches. He begins by trying to make his readers believe science-based veterinarians live in a fantasy world where nothing is done that is not validated by rigorous clinical trial evidence: “According to the skeptics, unless the therapy has been proven to work through numerous rigidly controlled scientific studies, they would be considered “alternative and unproven therapies” that should not be used in the practice of medicine.” Of course this is nonsense, and attacking a position your opponent doesn’t hold is vacuous rhetorical trickery.

A good definition of evidence-based medicine, which I have often quoted, is “the integration of the best research evidence available with clinical expertise as well as the unique needs or wishes of each client in clinical practice.” Clearly, no one is arguing that we should never do anything unless it has been validated by good clinical trials. The point of evidence-based medicine is simply to organize the evidence in a hierarchy from least reliable (anecdote, personal impressions) to most reliable (replicated and well-designed clinical trials), and to weight most heavily the highest quality evidence available for a given intervention. Obviously, this is too complicated for Dr. Messonier, who prefers to paint an image of an imaginary bogeyman called the “The Skeptic,” which he then pastes over the face of anyone with the temerity to suggest his personal experiences might be mistaken.

He goes on to accuse conventional veterinarians of choosing to kill pets rather than admit their methods have failed and refer their patients to someone, like him, who has the power to help them. How’s this passage for self-aggrandizing, closed-minded, mean-spirited mischaracterization of those who disagree with him?

“I’m still bewildered by the fact that many conventional veterinarians choose euthanasia as a solution for failure of their conventional treatments, rather than simply opening their minds to the healing power that exists when using clinically proven, time-honored natural therapies. My hope is that more owners will continue to seek doctors, for themselves and their pets, who are open-minded to doing what is in the best interest of the patient regardless of which therapy ultimately proves successful, or which one has been “proven” to work by artificially designed controlled studies.”

Note the use of “clinically proven” to mean “I think it works.” And the use of “proven” in scare quotes to denigrate the conclusions of scientific evidence. Then there’s the usual meaningless cliché “time-honored natural” to describe blind faith in tradition combined with the naturalistic fallacy. And finally we have the blithe dismissal of clinical trials as “artificially designed controlled studies.”

This is a portrait of a mind closed to any suggestion of its own fallibility and blind to the history of medicine in the last 200 years, which has seen progress in well-being unlike the previous total of human history thanks to the “artificial” methods of science. This is a doctor so certain that he is right that disagreeing with him is intolerable and must be denounced, with all the self-righteousness of the religious fanatic, as a willful refusal to see the truth that he sees so clearly.

Of course, civil debate about the facts of specific medical interventions is impossible with such an attitude. He’s never once tried to convince me of anything, merely taken my suggestion that his epistemology is flawed as a personal affront and gone on a tirade against a cartoon image of me and other veterinarians who don’t placidly accept his view. The best one can hope for in such situations is that, as he suggests, pet owners will listen to the quite different approaches we represent and decide for themselves where the best hope for their pets lies. I have no doubt Dr. Messonier is genuinely convinced he is offering the best medicine, and I have very little doubt that he is mistaken. However, I agree with him at least so far as to believe pet owners can see through closed-minded nonsense. I just happen to believe that will lead them towards scientific, evidence-based medicine rather than “time-honored” woo.

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