Posts by Marvin Shilmer

739

250,000 Jehovah's Witnesses have died refusing blood

by nicolaou in

80+ branch davidian cult members died in waco, texas.

250,000+ #jehovahswitnesses have died refusing blood.

stop this #cult!

Marvin Shilmer

-

“Is there something you needed to disclose a long time ago about your relationship with Beliaev?”

No.

For multiple reasons I have not asked Beliaev what he thinks of my extrapolations or whether he agrees, disagrees or thinks it at all possible to extrapolate as I have. Primarily I’ve refrained from these questions to avoid putting him into a potential quagmire that could occur in doctor-patient relationships he has or might have with current or future JW patients.

In the end either Beliaev and colleagues stand by their conclusions as published or they does not. If they stand by their conclusions then that is for them to answer for to their readers and those readers to decide as they will.

Whether my use of Beliaev’s conclusions is valid is for me to answer for to my readers and for those readers to decide as they will. This has nothing whatsoever to do with Beliaev and company (except whether these readers agree with Beliaev’s data presentation). Beliaev should not be put into a position of having to agree or disagree with work that is not his own, unless he chooses to make it his business.

Marvin Shilmer

739

250,000 Jehovah's Witnesses have died refusing blood

by nicolaou in

80+ branch davidian cult members died in waco, texas.

250,000+ #jehovahswitnesses have died refusing blood.

stop this #cult!

Marvin Shilmer

-

“He's friendly, and doesn't bite....”

Yes. I’ve had many discussion with him. In person he comes across even better!

Marvin Shilmer

739

250,000 Jehovah's Witnesses have died refusing blood

by nicolaou in

80+ branch davidian cult members died in waco, texas.

250,000+ #jehovahswitnesses have died refusing blood.

stop this #cult!

Marvin Shilmer

-

“So Marvin, you haven't responded the the problems discussed by Isbister in "Apples and Oranges" . I thought I would at least get a comment on why you don't think his criticisms are invalid.”

LisaRose,

I advised readers to get it from the horse’s mouth. Beliaev and his colleagues wrote a response to Isbister and it should speak for itself to anyone who cares to read it.

Marvin Shilmer

739

250,000 Jehovah's Witnesses have died refusing blood

by nicolaou in

80+ branch davidian cult members died in waco, texas.

250,000+ #jehovahswitnesses have died refusing blood.

stop this #cult!

Marvin Shilmer

-

“Marvin, with all due respect, you have thrown in the towel on this one.”

Suraj Khan,

Not necessarily thrown in the towel, but I have tired of participants complaining of lack of responses when the problem is they failed to read the response when they were made. In short, I tire of repeating things to people who don’t want to read and research for themselves.

At the end of the day, my work on the question of how many JWs have died the result of Watchtower’s blood doctrine is the first of its kind with any bases in hard facts. Those facts many not be as extensive as we’d like them to be, and they may not be as readily transposed onto a world scale as we’d like them to be, but they’re there nevertheless, and they’ve never been there before.

This is an aspect of Beliaev’s work I think not a single person here realizes for what it is. If they did, and if they understood things they say they understand, then they’d be seeking ways to make use of the data (regardless of Beliaev's finding on costs etc!) in relation to JWs suffering increased mortality due to refusing blood.

Anemia is the result of a broad spectrum of disorders, and JWs are just as susceptible to these as the rest of the population. Only when it comes to these disorders JWs have an increased risk because they are taught to refuse a therapy known to lower the risk.

In addition to the above, JWs have multiple risks of developing anemia because they refuse blood in response to any and all medical presentations. Hence JWs have the additional risk of developing anemia purely because of a religious doctrine!

For JWs these layers push morbidity and mortality risks through the roof! Has anyone here taken a look at mortality risk for JWs due to due to obstetric hemorrhage? Guess what? Hemorrhage leads to severe anemia, and people die from this whether obstetric or otherwise! Only, before Beliaev’s study we didn't have a broad review of severe anemia combined with blood refusale. We only had, for instance, research on mortality risk increase due to blood refusal combined with severe anemia related to obstetrics. Well, guess what? As it turns out you don’t have to deliver a baby to have increased risk of dying from anemia by refusing blood.

Marvin Shilmer

739

250,000 Jehovah's Witnesses have died refusing blood

by nicolaou in

80+ branch davidian cult members died in waco, texas.

250,000+ #jehovahswitnesses have died refusing blood.

stop this #cult!

Marvin Shilmer

-

“We're getting somewhere by getting you to see that you're making assumptions”

Adam,

Respectfully, it’s blather like that coming from you that led me to ignore nearly all your postings in this discussion. If you took time to read my article you’d see that assumption is presented as part of the extrapolation.

Otherwise, I don’t see anything new from you.

Marvin Shilmer

739

250,000 Jehovah's Witnesses have died refusing blood

by nicolaou in

80+ branch davidian cult members died in waco, texas.

250,000+ #jehovahswitnesses have died refusing blood.

stop this #cult!

Marvin Shilmer

-

“You have done what no other researcher has ever done - and in that regard your methodology is unique:

“Extrapolated from one country - New Zealand - to worldwide estimates, ignoring the variability of health treatment utilization both within countries and between them.”

steve2,

Of course I’ve done what no researcher has done before, and I’ve done it for one reason and one reason only:

The study by Beliaev is the only one known to me that allows any opportunity at all to extrapolate a worldwide statistic on deaths due to Watchtower’s blood doctrine!

I don’t like this any more or less than anyone else, but it’s the only one with a population sufficiently captured that also shares mortality of JWs in that population suffering death due to refusing blood. Hence my approach to maintain conservative assumptions at every turn in order to avoid making an overstatement.

“The "danger" is your conclusions have the superficial appearance of being well thought through until the reader looks squarely at the assumptions regarding accessibility of health care treatment.”

Readers who do not look squarely at the assumptions stated with the extrapolation have only themselves to blame for reading something into an extrapolation that’s not there. Stating assumptions, whether implicitly or explicitly is done for a purpose. This is what communicates the extrapolation made.

Otherwise you fail to account that the JW patients in the Beliaev group are just as likely to come from an array of socio-economic circumstances as are JWs anywhere else in the world who enter a given healthcare system, only in New Zealand we have a higher tide floating socio-economic boats because of a better than average healthcare system.

Marvin Shilmer

739

250,000 Jehovah's Witnesses have died refusing blood

by nicolaou in

80+ branch davidian cult members died in waco, texas.

250,000+ #jehovahswitnesses have died refusing blood.

stop this #cult!

Marvin Shilmer

-

“I requested a copy of a reply to this study and got it this morning. It is called "Apple and Oranges" by J.P Isbister.”

LisaRose,

I was wondering when someone would finally do at least a small bit of research.

Yes, Isbister wrote a letter to the editor criticizing Beliaev et al’s work and he gave his reasons.

Another well respected researcher named Aryeh Shander wrote his own letter, again criticizing Beliaev’s work.

What I found odd about these two responses was that these two men did not see the same supposed mistakes.

I recommend readers interested in this rather unique work authored by Beliaev and colleagues take time to review the original presentation in whole, and also their response to criticisms leveled by Shander and Isbister. Readers can find this response in the same journal of Vox Sanguinis as the criticisms were offered, the November 2012 journal issue.

Marvin Shilmer

739

250,000 Jehovah's Witnesses have died refusing blood

by nicolaou in

80+ branch davidian cult members died in waco, texas.

250,000+ #jehovahswitnesses have died refusing blood.

stop this #cult!

Marvin Shilmer

-

“So Marvin, as besty mentioned, what is the confidence interval and/or margin of error associated with your estimates?”

slimboyfat,

I have not calculated this and don’t intend to spend time doing it. If it’s important to you, you can spend your time doing it yourself based on what’s made available in my blog article, if you know how.

My work is not to predict how many have died but, rather, to offer a minimum value by using conservative assumptions at every turn.

Marvin Shilmer

739

250,000 Jehovah's Witnesses have died refusing blood

by nicolaou in

80+ branch davidian cult members died in waco, texas.

250,000+ #jehovahswitnesses have died refusing blood.

stop this #cult!

Marvin Shilmer

-

“These assumptions are naive in the extreme. You keep repeating them without an evident awareness of variations in accessibility of health care from country to coutnry.

“There are huge variations in the accessibility of health care not just from country to country but within countries.

“The clinical literature on health care utilization treats these issues as fundamentals - you gloss over them.”

Steve2,

I think you need to take another look at my assumption you complain of.

It is: New Zealand’s healthcare is not less than the rest of the world on average.

Do you seriously think that assumption is questionable as stated?

“The asumption about the frequency (or to use a better term. "the incidence") of JWs wordlwide suffering from severe anemia to JWs in New Zealand is laughably naive. How do you know? For goodness sake, Marvin, right here iwthin New Zealand the incidence of anemia differs widely across socio-economic groups.”

Assumptions are stated for individuals to understand what the estimate represents. When I compare socio-economics prevalent in New Zealand with the rest of the world I find it conservative to think JWs in New Zealand are no more likely to suffer severe anemia than JWs in the rest of the world on average. Particularly when it comes to JWs and severe anemia I see a commonality of refusing blood that should tend to drive a similarity since refusing red cell transfusion when needed increases risk of anemia.

“It is unsafe to make the kinds of extrapolations you have.”

That’s silly. Presenting extrapolations based on a data set combined with stated assumptions is standard issue. it's how extrapolations are presented.

“Yes, New Zealand has 80 hospitals but only 6 or 7 District Health Boardswhich individually govern several hospitals accroding to region and who disseminate information on "sentinel events".”

Point?

“A confidence level of 0.05 means nothing if the extrapolations are in question - as they definitely are in this case.”

P < 0.05 was of Beliaev’s results; not mine. So, point?

Marvin Shilmer

739

250,000 Jehovah's Witnesses have died refusing blood

by nicolaou in

80+ branch davidian cult members died in waco, texas.

250,000+ #jehovahswitnesses have died refusing blood.

stop this #cult!

Marvin Shilmer

-

An Observation

During this discussion it amazes me what little attention is given to substantive issues that impinge estimates of deaths due to Watchtower’s blood doctrine, and particularly due to anemia.

Anemia has many causes. But when it comes to JWs anemia has increased frequency versus the rest of the population for one simple reason: refusal of red cell transfusion.

This creates a vicious cycle. Refusing red cell transfusion puts a patient at greater risk of severe anemia. Severe anemia puts a patient at greater risk of mortality. Refusing red cell transfusion puts a patient with severe anemia at an even greater risk of mortality.

This added risk due to refusal of red cell transfusion represents a cascading event, and it presents a tremendous driver for increased mortality among JWs refusing red cell transfusion. This risk assessment was identified and quantified in the Beliaev study.

Yet among readers here claiming varying expertise in the healthcare field I’ve yet to see even one recognize and discuss this cascading event and how it drives numbers upward.

Marvin Shilmer