by nicolaou 739 Replies latest watchtower medical
RD: I don't know how Marvin (Or anybody else) could statistically account for these types of things, but if they could be accounted for, they would inflate rather than deflate his numbers.
I am not sure how you would account for it either. I think the study simply chose patients who had severe anemia for whatever reason, thus they could have had any number of causes, so it's possible they are included in Marvin's calculation. Maybe Marvin can comment on that.
....thus they could have had any number of causes, so it's possible they are included in Marvin's calculation.
Lisa,
The things I mentioned can't possibly be included in Marvin's calculation. For a layperson, I actually do understand what I'm talking about pretty well here and picked those examples intentionally. :-)
Thrombocytopenia (Lack of platelets), for example is not the same thing as Erythrocytopenia (Lack of red cells, aka a form of anemia) at all. They are treated by the administration of two different blood components, both of which are forbidden to JW's
Marvin's numbers do not include all blood components forbidden to JW's; they include only one.
Good feedback then TD. As I said, I have no knowledge of medicine, other than a mild interest in the field. Mostly every one (including me) has been criticizing his numbers as being inflated. One reason is many feel the numbers are inflated because they didn't personally know of anyone who died because f refusing blood. I never bought into that, as the statistics he is using would not necessarily be that obvious. Still, I just couldn't make any sense of it, and his explanations just seem to make it worse.
I started wondering if I was missing something, so I finally realized that I needed to start over and really look at this thing with fresh eyes, so I am going slowly, asking one question at a time, to get to the bottom of it. I need the comments of people like you to help me, if we are ever going to figure it out.
The JW parent organization has made many adjustments over the years to blunt the sheer human cost of adherence to this doctrine. Nobody thinks twice about accepting gamma globulin today. It's the basis of most post-exposure vaccines. It's the basis for antivenins for snake and other poisonous bites. It's used to treat acyte thrombocytopenic purpura, Kawasaki's syndrome, etc. Yet there was a time when JW's were not supposed to accept gamma globulin.
This is why anything that's based on a simple calculation is fundamentally flawed.
A true model is needed taking into account the different factors of both WatchTower doctrine AND medical treatments available as well as the number of JWs around and the likelihood that they would refuse blood treatment and die as a result of it as each period of time (whether per year or per decade).
I also don't think it's unreasonable to suggest that years ago, when the JWs numbered less than 1 million, they were more 'die hard' than now. I could see a larger percentage refusing blood in years gone by than now.
Heck, I don't think you'd even get many JWs willing to sit through 7-day, 8am-9pm assemblies anymore like they used to!
Simple logic: if the period the study covered was the worst period for JWs dying then you can't apply the results to ALL periods. Does anyone truly believe that the risk has been constant and that changes in doctrine and treatment have no effect?
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“Now I understand a little better how you got your numbers. I have some questions about the study itself. For the Jehovah's Witnesses who died, do you know if any of them had an underlying condition that would have been fatal eventually, even if they had accepted a transfusion? For example, cancer, or some other serious illness?”
LisaRose,
The JW patients in palliative care were excluded from Beliaev’s study.
Don’t forget that the Beliaev study was a matched comparison. This means patient profiles and comorbidities were accounted for. So, for instance, in the 103 JW patient pool there were 8 with cancer and in the non-JW pool there were 15 patients with cancer. But regardless of condition, if treatment options were exhausted so a patient was in palliative care they were not included in the study because inclusion would skew the result.
Accordingly, the factor you raise is not one that would inflate my extrapolated value.
Marvin Shilmer
Marvin: Accordingly, the factor you raise is not one that would inflate my extrapolated value.
I am just asking the questions at this point. I understand the study excluded patients in palliative care. But they could have had cancer that was still being treated, no?
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“I don't know how Marvin (Or anybody else) could statistically account for these types of things, but if they could be accounted for, they would inflate rather than deflate his numbers.”
TD,
As you say, each of the factors you present would only increase my extrapolated value if they could be accounted for, and there are many others. Take, for instance, TTP (thrombotic thrombocytopenic purpura) patients. The outcome for these patients is dire without plasma exchange, but with plasma exchange therapy the outcome is greatly improved.
Prior to year 2000 JWs with this condition had to refuse this therapy and opt for a less effective alternative with greatly reduced efficacy. Since 2000 Watchtower doctrine allows JWs to accept transfusion of a plasma product known as cryosupernatant, which can be and is used effectively for plasma exchange therapy. This therapy has saved lives that otherwise would have ended prematurely.
But no deaths attributable to refusing plasma exchange therapy are counted toward my extrapolation. Were we to include these then my extrapolated number could only increase.
Marvin Shilmer
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“The things I mentioned can't possibly be included in Marvin's calculation.”
TD,
Exactly, and they are not.
Marvin Shilmer
As you say, each of the factors you present would only increase my extrapolated value if they could be accounted for,
Marvin: You keep with the assumption that things could only ever increase your value and seem blind to anything that could possibly decrease it.
When extrapolating very small numbers to very large ones the slightest change can have a dramatic effect on the final figure.
It's for this reason that I think your conclusions, while well intentioned, are possibly incorrect and misleading.
But no deaths attributable to refusing plasma exchange therapy are counted toward my extrapolation. Were we to include these then my extrapolated number could only increase.
But Marvin, I'm struggling to understand whether your extrapolation is reliable or not, even whether the nature of an extrapolation is something that is relevant in this case. That's not to pour cold water on all the work and research you've done, I appreciate that and I can only imagine how much time and effort you've spent on it, just that it seems to me not to be the best approach in tackling the whole 'blood transfusion' issue.
Who are we trying to reach here? Not the media and not the ex-jw community either. Not even the Watchtower Society for what chance do we really have in reforming their policy? No, we need to reach over all these heads and 'speak' to active Jehovah's Witnesses themselves - especially young parents.
Hmmmm . . . . .
