Alternatives and Medical Dissidence

2019 ◽  
pp. 209-238
Author(s):  
Alex Broadbent
Keyword(s):  
Alternative Medicine ◽  
Anecdotal Evidence ◽  
Medical Evidence ◽  
Main Current ◽  
Professional Opinion

This chapter introduces the notion of medical dissidence: conscious deviation from the main current of professional opinion. Cosmopolitanism is applied as a way of getting to grips with the popularity of Alternative Medicine despite its common dismissal among the literati. Most efficacy claims are not well supported in Alternative Medicine. However, it is not necessarily irrational to give them credence, or to rely on anecdotal evidence, because testimony is so central to nearly all medical evidence, and people are very differently placed in the reasons they might have to believe or disbelieve testimony. In addition, there may be non-curative value in alternative medicine. Cosmopolitanism does not advise an attitude of “anything goes,” but does urge humility on those of whatever persuasion who dismiss other traditions or people as irrational.

Issues in California Workers' Compensation: Substantial Medical Evidence, Causation, and Apportionment

2020 ◽  
Vol 25 (5) ◽  
pp. 12-15
Author(s):  
Steven D. Feinberg
Keyword(s):  
Compensation System ◽  
Workers Compensation ◽  
Medical Evidence

Abstract This article describes special aspects of addressing and defining substantial medical evidence, causation, and apportionment in the California Workers' Compensation system. Substantial medical evidence is framed in terms of reasonable medical probability, and the opinion must be based on fact and not be speculative. The issue of whether the injury occurred in the course of employment is left to the Trier of Fact (WCAB judge). The issue of arising out of employment is a medical issue left to the physician. Apportionment applies to both the industrial and nonindustrial cause of the disability.

Spine Impairment Evaluation: Sixth Edition Approaches

2009 ◽  
Vol 14 (1) ◽  
pp. 1-5
Author(s):  
Craig Uejo ◽  
Marjorie Eskay-Auerbach ◽  
Christopher R. Brigham
Keyword(s):  
Functional Status ◽  
Spinal Injury ◽  
Current Medical ◽  
Clinical Testing ◽  
Medical Evidence ◽  
Sixth Edition ◽  
Whole Person ◽  
Rating Process ◽  
Impairment Ratings ◽  
Class Assignment

Abstract Evaluators who use the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, should understand the significant changes that have occurred (as well as the Clarifications and Corrections) in impairment ratings for disorders of the cervical spine, thoracic spine, lumbar spine, and pelvis. The new methodology is an expansion of the Diagnosis-related estimates (DRE) method used in the fifth edition, but the criteria for defining impairment are revised, and the impairment value within a class is refined by information related to functional status, physical examination findings, and the results of clinical testing. Because current medical evidence does not support range-of-motion (ROM) measurements of the spine as a reliable indicator of specific pathology or permanent functional status, ROM is no longer used as a basis for defining impairment. The DRE method should standardize and simplify the rating process, improve validity, and provide a more uniform methodology. Table 1 shows examples of spinal injury impairment rating (according to region of the spine and category, with comments about the diagnosis and the resulting class assignment); Table 2 shows examples of spine impairment by region of the spine, class, diagnosis, and associated whole person impairment ratings form the sixth and fifth editions of the AMA Guides.

Clinical Update: Understanding Causation: An Example Using Carpal Tunnel Syndrome

2007 ◽  
Vol 12 (6) ◽  
pp. 5-8 ◽  
Author(s):  
J. Mark Melhorn
Keyword(s):  
Risk Factors ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Legal Responsibility ◽  
Medical Evidence ◽  
Anatomic Structure ◽  
Legal Professionals ◽  
Compensation Systems ◽  
Tunnel Syndrome ◽  
Four Levels

Abstract Medical evidence is drawn from observation, is multifactorial, and relies on the laws of probability rather than a single cause, but, in law, finding causation between a wrongful act and harm is essential to the attribution of legal responsibility. These different perspectives often result in dissatisfaction for litigants, uncertainty for judges, and friction between health care and legal professionals. Carpal tunnel syndrome (CTS) provides an example: Popular notions suggest that CTS results from occupational arm or hand use, but medical factors range from congenital or acquired anatomic structure, age, sex, and body mass index, and perhaps also involving hormonal disorders, diabetes, pregnancy, and others. The law separately considers two separate components of causation: cause in fact (a cause-and-effect relationship exists) and proximate or legal cause (two events are so closely related that liability can be attached to the first event). Workers’ compensation systems are a genuine, no-fault form of insurance, and evaluators should be aware of the relevant thresholds and legal definitions for the jurisdiction in which they provide an opinion. The AMA Guides to the Evaluation of Permanent Impairment contains a large number of specific references and outlines the methodology to evaluate CTS, including both occupational and nonoccupational risk factors and assigning one of four levels of evidence that supports the conclusion.

Alternative Medicine Use Common in Epilepsy

2005 ◽  
Vol 38 (7) ◽  
pp. 18
Author(s):  
MICHELE G. SULLIVAN
Keyword(s):  
Alternative Medicine ◽  
Medicine Use

Abusive Men's Use of Children to Control Their Partners and Ex-Partners

2007 ◽  
Vol 12 (1) ◽  
pp. 54-61 ◽  
Author(s):  
Marisa L. Beeble ◽  
Deborah Bybee ◽  
Cris M. Sullivan
Keyword(s):  
United States ◽  
Intimate Partner Violence ◽  
Partner Violence ◽  
Emotional Abuse ◽  
The United States ◽  
Intimate Partner ◽  
Anecdotal Evidence ◽  
Multiple Variables ◽  
The Relationship

While research has found that millions of children in the United States are exposed to their mothers being battered, and that many are themselves abused as well, little is known about the ways in which children are used by abusers to manipulate or harm their mothers. Anecdotal evidence suggests that perpetrators use children in a variety of ways to control and harm women; however, no studies to date have empirically examined the extent of this occurring. Therefore, the current study examined the extent to which survivors of abuse experienced this, as well as the conditions under which it occurred. Interviews were conducted with 156 women who had experienced recent intimate partner violence. Each of these women had at least one child between the ages of 5 and 12. Most women (88%) reported that their assailants had used their children against them in varying ways. Multiple variables were found to be related to this occurring, including the relationship between the assailant and the children, the extent of physical and emotional abuse used by the abuser against the woman, and the assailant's court-ordered visitation status. Findings point toward the complex situational conditions by which assailants use the children of their partners or ex-partners to continue the abuse, and the need for a great deal more research in this area.

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