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

-

“Again too narrow of base model .

“For example what about people who've suffered extreme blood loss due to traumatic accident or blood infection complications, where a total blood transfusion was required.”

Finkelstein,

That is the sort of response I don’t understand in this discussion. What part of at-or-less than 8 dL of blood don’t you get?

There is nothing narrow about it! If a patient had a blood count at-or-less than 8 dL and they were at least 15 years old then they were included.

Guess what that means? It means a trauma patient who’s at least 15-years-old and who’s lost enough blood that their count is at-or-less than 8 dL is included as suffering “extreme anemia”.

Guess what else that means? It means a trauma patient who’s at least 15-years-old and who’s not lost enough blood that their count is at-or-less than 8 dL is not included as suffering “extreme anemia”.

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

-

“If that is true and not hyperbole then you will have current hard facts of recent data to point to and incorporate into your model.”

Simon,

My statement was said of the world I live in. As I said, in the world I live in people are dying all around me and I’m tired of it.

This is not hyperbole. I’ve sat in room after room over my years with parents, siblings and children mourning the death of children, siblings and parents who succumbed to death refusing blood with their organ systems shutting down for lack of oxygenation.

To me this is not academic. To me this is as real as it gets. It’s the world I live in, and long ago I tired of sitting by watching it happen without doing more about it. It shames me to look backward at those years thinking I could have done more. Hence a long time ago I decided to do something about it, and to put my money and time where my mouth is at.

There is a reason why incident of JWs dying over blood refusal seems rare. I have shared this reason in various ways in this discussion, and no one has refuted this. The math demonstrates why this appearance exists. But it’s a false appearance. Thousand of JWs have died due to Watchtower’s blood doctrine and for one I’m not going to be silent about it.

If in your world JWs are not dying due to Watchtower’s blood doctrine then I’m glad for you. But I don’t live in that world.

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

-

“Yes, but it could be composed in a number of ways:

“2, 2, 2, 2, 2, 2, 2, 2, 2, 1 gives a different view of the data than

“10, 0, 0, 0, 0, 0, 0, 0, 0, 9 e.g. date range picked for best effect (bad surgeon one year? bus crash?) or

“10, 7, 2, 0, 0, 0, 0, 0, 0, 0 e.g. problem in the past more than recently”

Simon,

I understand your question, but if we assume either of the extremes you cite it would not change the hard count and it would not suggest we’d find something different over the span of 1961 to 2007, which is the period of my extrapolation.

If we assume the earlier years had higher mortalities because of the state of medical science in the treatment of severe anemia among patients refusing blood then using the mitigated average would be make for a conservative extrapolation, meaning the extrapolation would not be an overstatement but, if anything, and understatement.

If we assume the earlier years had higher mortalities because of the then state of Watchtower doctrine prohibiting more blood products then using the mitigated average would make for a conservative extrapolation, meaning the extrapolation would not be an overstatement but, if anything, and understatement.

I checked Beliaev’s other work using the same data set and none spell out the annual value of deaths.

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

-

“That the 7.5 million current / ~30 million total-ever JWs have the same increased risk of death as the 19 out of 103 patients who refused blood at the NZ hospitals used in the study.”

My extrapolation assumes people the world over have no more risk of dying due to severe anemia than the population of New Zealanders, and compared to the rest of the world New Zealanders have above average access to healthcare.

“I find the math approach a little simplistic as it doesn't cater for all the changing circumstances throughout the years (either belief, legalities or medical treatment options).”

That simplistic math you speak of assumes the most conservative of multiple factors each time multiple factors arise. In the case of “changing circumstances” two primary ones are the state of medical science (it’s better today than any point since 1961) and the state of Watchtower doctrine (in relation to blood it’s better today than anytime since 1961). Yet the math I’ve used is based on outcomes the result of the most current medical science and Watchtower teaching. That is to say, I’ve not made any regressive adjustments based on yesterday’s reduced medical science or yesterday’s Watchtower teaching, each of which would have driven my extrapolated value higher.

The two items you cite are in each case items where my extrapolation represents a conservative estimate.

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'd be interested in the distribution of patients. I know we have 1.9 per year as an average but was it consistent or was there a bad couple of years?”

Simon,

A 10-year period is a healthy chunk of time to mitigate extremes upward or downward.

In response to your question, unless I missed something, the study does not spell out deaths per year. But Beliaev has written other articles using the same data set. I’ll consult those when I have time to see if what you inquire of is spelled out in them.

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

-

“Surely you accounted for the differing legal policies that exist Worldwide for the protections of minors, who are protected in some lands by court order at different ages? If not, why was the age of '15' used in the study, when '18 yrs old' would've been a more conservative choice more applicable to Worldwide?

“And hopefully you remembered to account for those baptized JW's who are under 15 y.o., but are nevertheless included in the total Worldwide JW headcount (the figure you used was 7.4 million in 2011) which you used to calculate your guesstimate?”

My extrapolation assumes none of the JWs you mentioned died the result of refusing blood. This is another conservative aspect of my presentation.

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, as well as most others who have commented here, feel that one small study in one very small country, cannot simply be extrapolated to apply to Jehovah's Witnesses everywhere.”

When a question has loomed for decades and data comes along that is useful toward an answer then using that information for sake of extrapolating an answer is fine so long as assumptions used in the extrapolation are shared.

Honestly, I don’t understand what the beef is, other than this discussion began in relation to someone and something readers here, in general, loathe.

Steve2 accuses me of dressing something up. Well guess what? That’s his characterization. No more. No less. What I’ve done is to share facts of the matter and spelled out my assumptions. Then I shared the math. That’s not dressing up. It’s called sharing information for readers to do with as they please.

LisaRose accuses me of failing to clarify or respond to critiques. I do not intend to respond to any and all critiques because some critiques need no response. But I don’t know of any relevant question asked me in this discussion which I’ve failed to answer, though I have been wrongly accused of doing just that.

So what is really going on here?

I haven’t seen anyone refute the raw data Beliaev brings to the table.

I haven’t seen anyone refute the math of my extrapolation.

I haven’t seen anyone demonstrate any assumption on my part that has not always been a part of my extrapolation.

Very importantly, though I’ve seen people complain of assumptions I’ve made I haven’t seen anyone demonstrate that my assumptions are anything other than conservative at every turn, and this is in my view where lay the power of my extrapolation. I’ve presented and presented these conservative assumptions and why, in my view, they are conservative. No one responds on this point to show the choice I opted for in the form of an assumption is not conservative.

So what is really going on here?

Remember folks. When it comes to Watchtower’s blood doctrine we’re talking about the killing off of people. Thousands of people. If sharing the best answer we can give based on the best data set we have is wrong then call me unethical because I’m going to do it every day of the week to help people wrap their brains around what’s happening to JWs the result of Watchtower’s blood taboo. To the rest of you. I say shame on you! Maybe in your sanitary world what you prefer works for you. But in the world I live in people are dying all around me and I’m tired of it. Someone has to do the hard work of looking at whatever data is available toward helping people understand the scope of killing. Who here volunteers to do this job? Please stand up and be counted, and then put your time and money where your mouth is at.

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

-

“…most people would agree that Marvin's extrapolated statistical study in New Zealand is too far focused on one individual health problem…”

Therein I think is a disconnect for some readers.

I get an impression that readers here hold too narrow a view of what is defined in Beliaev’s study as “severe anemia”.

As spoken of in Beliaev’s study “severe anemia” is a condition that could occur across a very wide range of patient presentations. The criterion is patients at or over age 15 with hemoglobin at or lower then 8 grams dL. No underlying condition is applied. If a patient was at least 15 years old and had hemoglobin at or lower then 8 grams dL and refused blood then he or she was included (except for a few identified palliative care patients whose inclusion would have skewed results).

This definition for “severe anemia” used by Beliaev is one of the things making this study so revealing when it comes to mortality suffered by the JW population for 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

-

Earlier it was pointed out that Drs. Isbister and Shander independently wrote criticism of Beliaev et al’s work.

I was surprised to see Isbister’s objection resting primarily on certain variable differentials when Beliaev’s work adjusted by logistic regression for each variable cited by Isbister. This is all the more surprising given this is expressly stated within Beliaev’s work. It’s as though Isbister didn’t thoroughly read the article.

Dr. Shander’s primary complaint focuses on the study failing to make a comparison between clinical benefit of transfusion versus another well-defined intervention, preferably one that meets what Shander presents as optimal management of JW patients. I will, though, point out that alternate treatment options applied to the JW patients is very well documented in Beliaev’s presentation. But these alternative treatments were not isolated to form a model for comparison.

I agree that moving forward the approach Shander suggests would have been more useful for the stated dual purpose of outcome and cost analysis. But for purposes of having a retrospective view of what has been occurring with JW patients the result of refusing blood, I see nothing from Shander that would argue the point.

As things are published, what Beliaev and colleagues did was present the facts as they found them, including establishing a criterion based comparison group where significant differentials were adjusted for by logistical regression.

Importantly, and for reason that should be obvious, Shander at no time suggests that the deaths that occurred among JWs did not occur, and it is these actual numbers of deaths that are important to my extrapolations. When it came to the numbers of deaths what Shander complained of was whether a higher number of deaths with lower Hb values skewed the picture of mortality among patients with higher Hb values (but still within the overall range used to define “severe anemia” within the article). But, again, it was the overall number of deaths used in my presentation which would not changed based on Hb values (again within the range).

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

-

“The people that know me and trust me are probably aware of all the stunts you've already pulled and anyone else can easily see from how you behave.”

As an aside, my observation and opinion is that those who know you are probably aware of your good behavior and your bad behavior, including stunts you’ve pulled. I’d say the same is true of me too.

I’d say the same of everyone here who’s been around here for any serious length of time. Everyone here has their warts.

Now can we please keep the discussion point? Cedars? Simon? Everyone else?

I can’t believe I’m wasting one of my (now) few allotted posts to share this opinion.

Marvin Shilmer