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This article covers medical controversies at all levels including:
- disputes over scientific evidence for the safety and efficacy of medical practices
- controversy over political and economic influences on the practice of medicine
- public perceptions (including vocal minority opinions) of medical controversy, even points of view that are not accepted or considered controversial by the mainstream medical community.
Controversy within the medical communityEdit
An increasingly important means for resolving controversies within medicine is to rely on Evidence-based medicine and Systematic reviews of evidence. Several high-profile cases have called into question the efficiency of the current evidence-based approach to deciding the value of medical practices. For example, after systematic review of the safety and efficacy of some COX-2 inhibitors it was found that some negative data were not included in the analysis. There may be systematic sources of error that can cause inacuracies in systematic review processes that are used to evaluate medical treatments.
Controversies outside of the medical communityEdit
Controversy over medical practice frequently extends beyond the domain of internal debate within the community of medical professionals. Some medical controversies are major social, political and economic issues while others are less well known and primarily of concern to relatively small special interest groups.
Economic and political influences on medical practiceEdit
Government regulators have been struggling to balance the need to approve useful medical practices as quickly as possible while avoiding the introduction of treatments with unrecognized or unnecessary side-effects. Some observers of the process have suggested that regulatory decisions are biased by market forces and political influence. Some advocates of Emergency contraception have drawn attention to Susan F. Wood, who left her job as head of the Food and Drug Administration's Office of Women's Health in protest saying that, "scientific and clinical evidence, fully evaluated and recommended for approval by professional staff here, has been overruled." Some birth control advocates have suggested that religion is acting through politicians to control government regulation of medical practicesTemplate:Ref label. The question of which medical professionals can refuse to provide medical care for religious reasons is currently being decided by politicians and may ultimately involve the courts.
Does science shape medical practice or do market forces and legal constraints?
- biases introduced to medical practice by Pharmaceutical marketing
- Which provides the best care, free market or Publicly funded medicine?
Public perceptions of medical issues. How does the public perceive controversy that exists within the medical profession? What forces can cause controversy between the medical profession and outside groups even when there is consensus within the medical profession? Alternative medicine is a source of many medical controversies.
Wikipedia category for medical controversies, January 2006Edit
comment. Even if "the category exists primarily to make a point" it could serve a useful purpose. Even if some people would like to restrict the term "medical controversies" to disputes that can be resolved by conventional means within science, society as a whole does not make that distinction. Some people hold the point of view that "medical controversies" include topics that are not recognized as being controversial within medical science. I think Wikipedia can make room for coverage of that point of view. It is true that "the inclusion criteria are undefined" for the "medical controversies" category. As a starting point, we could establish objective criteria for determining if a particular medical controversy is notable enough for mention in Wikipedia. For example, if 10 publications exist from professionals (such as medical doctors) that address a particular medical controversy, then maybe that controversy could be mentioned in a Wikipedia article, with an appropriate citation to the most relevant publication about that particular controversy. If there are 50 publications about a particular medical controversy, then there could be an article about that controversy. Articles about a specific medical controversy should obviously be in the category for medical controversies. There could also be a general article for medical controversies that would discuss medical controversies in general terms, such as how they arise and how they are settled. I detect a significant amount of weariness on the part of some Wikipedians who seem to be tired of trying to keep non-notable medical controversies out of Wikipedia and keep non-scientific claims about medical controversies from creeping into Wikipedia. I am sensitive to this problem, but I feel it is a mistake to try to sweep the subject of medical controversies under the rug. I am willing to start a new Wikiproject just for articles about medical controversies within Wikipedia. I propose that the Medical Controversies Wikiproject start with a review of published books and articles about medical controversies. The Medical Controversies Wikiproject could also provide a discussion aimed at deciding on objective criteria for identifying those medical controversies that are notable enough to include in Wikipedia. I propose that this new Wikiproject would work in the spirit of existing efforts to promote verifiability of the content of Wikipedia. The scope of the project would be defined by the existing scholarly literature on medical controversies:
Google Scholar has many results for medical controversy including *Mammography screening for women under 50: women's response to medical controversy and changing practice guidelines
There are many published books that discuss medical controversies such as
The Entrez Pubmed search engine finds thousands of published articles about medical controversies:
- Applying a research ethics committee approach to a medical practice controversy: the case of the selective COX-2 inhibitor rofecoxib
- COX-2 controversy: where are we and where do we go from here?
- Distinguishing between Type I and Type II diabetes is a recognized area of medical controversy
- Antibiotic prophylaxis in severe acute pancreatitis: the never-ending controversy
- UV Radiation, Vitamin D and Human Health: An Unfolding Controversy Introduction
- Workshop summaries: the splenectomy controversy
- The new WHO classification of pituitary tumors: highlights and areas of controversy
- Science, Suffrage, and Experimentation: Mary Putnam Jacobi and the Controversy over Vivisection in Late Nineteenth-Century America
- The vitamin D and sunlight controversy--we will wait and see
- Brazil's AIDS controversy: antiretroviral drugs, breaking patents, and compulsory licensing
- Combination therapy for osteoporosis: considerations and controversy
- The articles listed above are from the first of well over a hundred pages of articles listed in PubMed that are about medical controversies.
All Wikipedians with an interest in adding content to Wikipedia articles that concerns medical controversies could be asked to participate in the Medical Controversies Wikiproject. Medical controversies that do not have enough scholarly references "on file" at the Medical Controversies Wikiproject pages would be excluded from Wikipedia articles. This would force Wikipedians to participate in a scholarly analysis of the literature before adding discussion of medical controversies to Wikipedia articles. --JWSchmidt 05:43, 5 Jan 2006 (UTC)
- ^ Echoing Other Cases, NEJM Says Vioxx Safety Data Withheld by Jennifer Couzin in Science (journal) (2005) Volume 310 page 1755.
- ^ Can Cochrane Reviews in controversial areas be biased? A sensitivity analysis based on the protocol of a Systematic Cochrane Review on low-level laser therapy in osteoarthritis by J. M. Bjordal, B. Bogen, R. A. Lopes-Martins and A. Klovning in Photomedicine and Laser Surgery (2005) Volume 23 pages 453-458.
- ^ COX-2 inhibitors: a story of greed, deception and death by G. M. Halpern (2005) in Inflammopharmacology Volume 13 pages 419-425.
- ^ Template:Note label Religion interferes with FDA ruling by Cynthia Martens (November 21, 2005) in The Badger Herald.
- ^ FDA Official Quits Over Delay on Plan B: Women's Health Chief Says Commissioner's Decision on Contraceptive Was Political by Marc Kaufman (September 1, 2005) in The Washington Post.
- ^ Romney scraps emergency contraception out for Catholic hospitals by Glen Johnson for the Associated Press (December 8, 2005).
- ^ Legal fight brewing after pharmacist disciplined on state birth-control rule: Cites conflict with Illinois Right of Conscience Act by Jim Suhr for the The Associated Press (December 18, 2005).
specific medical controversies
- AIDS reappraisal
- Biological psychiatry
- Chemical imbalance theory
- Controversies in autism
- Dental amalgam controversy
- Drug regulation - political influence on decisions
- Medical cannabis
- New Freedom Commission on Mental Health
- Osteopathic medicine
- Reproductive technology - including controversies related to Emergency contraception and Birth control.
- Schizophrenia - diagnosis
- Spirituality and Healing in Medicine
- stem cell research
- Vaccine controversy
other medical protoscience
more of the sameEdit
- Wikipedians continue to deny the existence of medical controversies as a valid subject: deletion