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Just to be clear, the universal consensus is that addiction is a chronic condition that can't be cured. It's also generally understood more as having a caustic than a shifting effect on the sense of self or individual personality- Addicted people are permanently impaired in their abilities to think and feel in relation to the associated substance. The best you can get is a sort of remission state, where the individual still requires self-monitoring and ideally monitoring by a social support network. I don't think this causes any problems for your rhetorical questions, I just want to suggest a degree of caution in the analogy, and provide some grounding info on addiction in case it continues to be used in the thread as a comparison point for attitudes regarding the self and autism spectrum disorders.
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Jun 28, 2014 23:08
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Willie Tomg posted:Its not universal consensus about addiction at all. Which is another, much more profound point that jibes with whatever else you wrote just fine. Or perhaps thats the joke and I'm the guy who makes it D&D friendly by removing all possible misinterpretable subtext? Hey! Speaking of that; The general stance in therapy and rehab is that thinking you are "cured" of your addiction is the first strong sign of a relapse- rationalization of re-exposure to the substance- this is why the term for someone who has gone through rehab with apparent success is "recovering", not "recovered." The position that addiction is a chronic condition is the position of all major research organizations and reputable treatment groups. NIDA's working on a "cure" using a receptor co-binding vaccine theory, but it's still probably at least 10 years out from any meaningful non-bench work, plus there are questions about the efficacy of the mechanism, which may have other significant pschiatric effects- we'll know whether the entire enterprise is viable once they get into animal phase testing. None of this has much to do with autism, though. Willie Tomg posted:So the autistic brain is not "wired differently" its just a thing where as long as you approach what's normally subtextual learning as a deliberative act and don't spill the wrong chemicals on it after its fixed, it works just like a normal one. OKay. Okay. I think the issue is that the "wired differently" framing usually incorporates a fully relativist sense of the individual self that refuses the idea of a negative neurological condition- all mental states or conditions are normal, people are just "wired differently". The "just", which does a lot of the work in that framing, is always present, if sometimes implicit. Ogmius815 posted:Science says that changes to his neuroanatomy made him behave differently. Science can't say poo poo about whether or not the rail made him a "different person" because something like that isn't empirically verifiable (what the hell does it mean to be a "different person"?). You are missing the point because you have a naive essentialist worldview. The concept of essentialism is bandied about a lot, and it means many different things to different people, not all of them negative- it might clarify things if you could expand on exactly what worldview you're accusing him of. Discendo Vox fucked around with this message at 23:35 on Jun 28, 2014 |
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Jun 28, 2014 23:30
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I don't think anyone ITT is categorically opposed to the research and development of a treatment or "cure" for autism, although what that treatment would resemble and its application remains an open question. I'm also not sure the question of who gets to make treatment decisions for autistic individuals is a particularly interesting question- the scenario doesn't seem to raise any issues different from the normal circumstances of individuals with reduced capacity and proxy care decision-making, an area that's pretty well defined legally, at least in the US. Ogmius815 posted:No you don't understand; we have to protect them. Being cured of autism is equivalent to dying because you become "a different person", you see. This. I don't think anyone ITT holds this position.
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Jun 29, 2014 00:26
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Tatum Girlparts posted:That was literally a thing someone either here or back in the vaxx thread said, curing is inherently 'killing' because they'd be a new person, it was a literal thing either Tank or one of his supporters said RE curing autism, at least one person ITT holds it, probably more. OK, I see. My reading was that E-Tank was pointing out that this was a position that Autism Speaks holds, not that this was his own position. It'd be helpful to distinguish this (imo much harder to defend) position, and the people who hold it, from all the folks rehashing the dualism/essentialism/mind/body etc debates. We've all heard the four corners of free will before and it's not a set of arguments that are made significantly more interesting by presenting them flavored with autism. The only place they really intersect is at the extreme end of anti-essentialism that is categorically opposed to normal/abnormal distinctions- otherwise it's not a very fruitful line of argument.
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Jun 29, 2014 00:35
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The subject of prenatal condition screening and abortion is actually pretty contentious in bioethics, by my understanding. There are concerns that it represents a sort of decentralized eugenic impulse- that said, it's not usually invoked in the context of autism, since afaik there aren't meaningful prenatal autism screening tests. The ethical imperative is generally asserted collectively, not individually, anyways. I don't know of any bioethicists advocating for jail terms for the practice who aren't also anti-abortion- although that's started to shift as other, less health-related abortion screening practices start to become more common, and the need for some form of societal response becomes stronger. The real stress is over sex selection.
Discendo Vox fucked around with this message at 00:49 on Jun 29, 2014 |
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Jun 29, 2014 00:45
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fermun posted:This was skipped over, so I'll chime in my thoughts. Probably everyone, most states in the US have a Mature Minor doctrine, a legal status where a minor is allowed to refuse treatment for medical procedures despite the will of their legal guardian. Anyone considered capable of understanding their situation and consequences both of treatment and nontreatment legally has the right to decide for themselves most places in the US. So it would apply to everyone, those who have the most severe symptoms would be less likely to be determined in court to be fully capable of understanding their current situation and consequences of both treatment and nontreatment. Yeah, these or comparable laws pretty much resolve the consent issues for scenarios involving that set of facts. I'm not sure how the law operates abroad. Absurd Alhazred posted:I started out writing a post assuming that this was more or less the case, but then E-Tank posted the start of this page. Maybe you, me, all of us, should be giving our interlocutors the benefit of the doubt. Discendo Vox was right all along! Looking forward to my new custom avatar, though the old one is still pretty relevant  rkajdi posted:It's all childish hand-wringing unless we actively start saying that women shouldn't get either bodily integrity or informed consent on birth issues. Either say that these aren't real rights (good loving luck with that-- you're a textbook misogynist then) or allow for these things to happen. The stress over sex selection is yet again anti-choice zealots trying to pry their way into people's wombs. They, um, really aren't. The last place I heard from on this set of issues was from my University's fairly prominent women's studies department, a favorably received job talk from a female applicant who received the position. This is a difficult set of issues, and reducing them to a binary, with one side consisting entirely of "textbook misogynists" and "anti-choice zealots" doesn't actually remove that complexity- although it does frustrate the discourse. It's probably counterproductive to frame abortion as an absolute right which either exists or does not. There aren't any of those under the law, and there aren't very many philosophies that espouse absolute rights, either, particularly ones that could be used to construct an absolute right to abortion. Discendo Vox fucked around with this message at 03:26 on Jun 29, 2014 |
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Jun 29, 2014 03:23
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Absurd Alhazred posted:
My understanding is that it mostly exists to prevent the spread and, particularly, advertisement of sex-selective abortion practices. For some immigrant populations, the sex of the child is sufficiently important culturally that there was a concern that the practice would become common. It still likely is common, but the theory is it can't operate openly for that purpose. This isn't necessarily due to a preference by either individual parent, but rather the perpetuation of sexist cultural beliefs. A good correlative source, if you need evidence that this sort of practice exists, would be to look at the relative male and female population of orphanages in various countries. That said, this set of discussions is all quite far afield from autism. What are some other entities that are like Autism Speaks, that we could compare with that group?
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Jun 29, 2014 03:37
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How do you even enforce this?! Do you have a woman sign a declaration that she is aborting for a legitimate reason? This loving country.
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The current DSM is problematic in a lot of ways, and although the recent revision has improved and narrowed the criteria for autism spectrum disorder, it's still likely to cause massive overdiagnosis. It's a big separate can of worms, but the diagnostic procedure for psychiatric conditions is difficult at the best of times. Autism is especially problematic because a)we don't have a clear etiology for the disorder, b) our dataset likely actually contains multiple conditions with similar symptom sets, and c)the behavioral criteria for these conditions, even within a population, aren't particularly well-structured(although, again, they've improved). Two examining authorities can easily use the same criterion set to come to differing conclusions about an autism diagnosis.
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Jun 29, 2014 03:48
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Absurd Alhazred posted:Okay, I guess I wasn't making myself clear: how do you stop a woman aborting her fetus once she learns that it is of a sex she doesn't like? From what you're saying and what I read on the wikipedia page, I guess the laws may be targeting specific screening services, but, I mean, it's absolutely common to learn at some point what sex your fetus is, if you want to. Is the usual way always beyond the threshold of legal abortion in these States? Absurd Alhazred posted:How does it work? Is a doctor basically obligated to prove to a jury that the abortion they performed was for legitimate reasons? And then there's a chilling effect due to that, just like in States where the father is required to be informed? Absurd Alhazred posted:That's just saying that this expert does not think that false positives are a problem here in light of the intervention proposed, that is, that it is not going to cause harm to non-autistic people falsely misdiagnosed to be such, not that it's "mostly made up". Are you familiar with prophylactics? A false positive diagnosis of autism can be really harmful, in as much as it changes the entire curriculum and treatment of the child. It might be less of an issue for those diagnosed incorrectly later in life, but at the early age many children are being diagnosed at now, it raises the possibility of treating a child inappropriately, while simultaneously missing some other treatable condition. This is not a new phenomenon. rkajdi posted:At least as far as the US is concerned, think again: http://jezebel.com/new-study-shows-that-sex-selective-abortion-bans-are-to-1585545601 This is some special intersectional bigotry. Also, LOL at the idea that this ban isn't being done as backdoor way to restrict basic rights, since most good (i.e. white) people won't care since it's restricting right to "those people" (i.e. Indians, Muslims, and East Asians) Taking anything coming out of the Anti-Choice Right at face value regarding abortion is a mistake. They are by far the most disengenuous and outright evil human beings I've had the misfortune of dealing with. Please don't cite Jezebel (saying "think again" and following up with a Gawker network cite is really a warning sign). The policy report they're citing isn't any better than the site itself, and its assertions aren't apposite to my statements on the issue. I mean, look at the method section- it's a joke to think they're getting accurate data with that approach. I appreciate that the Right abuses regulation to shut down abortion clinics, it doesn't follow from this that sex selective abortion laws are categorically illegitimate or that the practice doesn't occur. Discendo Vox fucked around with this message at 04:11 on Jun 29, 2014 |
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Jun 29, 2014 04:00
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I'm just going to ignore the abortion debate since it's a derail that's gone well off the deep end at this point.Cranappleberry posted:Your critiques are valid. However, restricting the criteria further due to the limitations you state might decrease over-diagnosis but lead to under-diagnosis, a potentially worse problem. I'd actually favor an underdiagnosis scenario at present- the negative outcomes of the overdiagnosis of ADHD, which led to the proliferation of a new set of drugs of abuse, is a good example of the exact sort of consequence that worries me at this point. Additionally, I suspect that most overdiagnosis is diagnosis by examiners insufficiently familiar with the criteria and tests in effect. My concern is that ongoing overdiagnosis, with the self-identification and advocacy that accompanies it, can actually impede research in the area. That's been a pretty big trend over the past 15 or so years. Since the success of Act Up, there's been a lot of imitation of that model, which has caused problems when the model isn't appropriate to the situation, or when there's industry capture of the advocacy group, which is sadly frequently the case nowadays.
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Jun 29, 2014 04:24
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mods please consider moving thread to E/N
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Jun 30, 2014 21:59
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Autism isn't well-defined clinically- there's no well-supported etiology for any of its "forms". It's very likely that the disease/disorder is actually several different diseases being lumped together due to poorly defined criteria and poor education of practitioners who use the criteria (this latter point is a huge problem). As a result, a circular diagnostic framing has occurred and overdiagnosis is almost certainly rampant. What makes the subject especially messy is that individuals come to self-identify with the diagnosis, and feel as if their cultural identity is threatened by either a diagnostic reversal or by a possible "cure". Support and advocacy groups have a strong potential to exacerbate this problem, regardless of their other benefits.
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Jul 2, 2014 03:52
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Asbergers is folded into ASD in the current version of the DSM- however, iirc there is a utility grandfathering exception for some part of the previous criterion sets, I can't remember which one. Again, most controversies and policy problems involving autism stem from the fact that we have no empirically rigorous definition or basis for the condition, but it has nonetheless been heavily used professionally and in lay society, including as a form of self-identification. Despite the fact that a diagnosis of autism actually means very little, affected individuals, their families, and care professionals cling to the definition and have formed a broad set of societal associations for its use. To be overly cute about the whole thing, it's like autism has become the furry fandom of the psychiatric world- except way more popular.
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Jul 3, 2014 07:37
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Who What Now posted:Does anyone know about the book "A Shot In The Dark"? My father-in-law just mentioned reading it and wondering about the causal link between vaccines and autism. I'm 100% sure it's bullshit, but has there even been a mass debunking of the book? Here's a decent one (I haven't vetted the site, though). It's the usual inflation of early anecdotes and rejection of subsequent investigation finding no harm. edit: Ooh, an essay by the lead author! Discendo Vox fucked around with this message at 01:51 on Jul 6, 2014 |
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Jul 6, 2014 01:47
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Clochette posted:Asperger's syndrome no longer exists as of the DSM-V. Someone who would have been diagnosed with Asperger's a few years ago would now be diagnosed with autism, specifically high-functioning. Autism spectrum disorder, actually. And iirc there's a carveout for people previously diagnosed with asperger's.
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Jul 7, 2014 00:53
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I think so. Gimme a second and I'll pull the actual diagnostic material- we'll see how off my memory is. OK, first off, here's the end of the DSM-5 material defining a mental disorder: DSM-5 posted:Approaches to validating diagnostic criteria for discrete categorical mental disorders have included the following types of evidence: antecedent validators (similar genetic markers, family traits, temperament, and environmental exposure), concurrent validators (similar neural substrates, biomarkers, emotional and cognitive processing, and symptom similarity), and predictive validators (similar clinical course and treatment response). In DSM-5, we recognize that the current diagnostic criteria for any single disorder will not necessarily identify a homogeneous group of patients who can be characterized reliably with all of these validators. Available evidence shows that these validators cross existing diagnostic boundaries but tend to congregate more frequently within and across adjacent DSM-5 chapter groups. Until incontrovertible etiological or pathophysiological mechanisms are identified to fully validate specific disorders or disorder spectra, the most important standard for the DSM-5 disorder criteria will be their clinical utility for the assessment of clinical course and treatment response of individuals grouped by a given set of diagnostic criteria. Notice that disorders don't need to have etiological or mechanical validity. Diagnoses under the DSM are thus often little more than "here's some stuff we can lump together". There's no good explanation for what autism is mechanically, so it's very likely that the term "autism" is actually capturing several different scenarios. The idea of a single monolithic cure for autism is thus likely to be nonsensical, because "autism" as a term is probably referring to a bunch of different illnesses-and some cases where nothing is wrong! ...OK, looks like I was wrong. The ASD diagnosis is too long to reproduce, but the relevant material indicates that those with Asperger's should be generally placed under ASD. The carveout was for individuals whose symptoms fit criteria for a new disorder, social (pragmatic) communication disorder, instead. "High-functioning" and "asperger's", like most of the other labels people like to append to the disorder, isn't actually considered a separate diagnosis in the DSM- it's just folded into ASD. There are sub-specifications, but they're more clinical (and sort-of better defined) in the document (e.g., "ASD with catatonia"). Discendo Vox fucked around with this message at 01:21 on Jul 7, 2014 |
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Jul 7, 2014 01:14
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A note to factor into these issues is that the effects of many medications on lived experience are ego systonic, meaning that even if there are pervasive, fundamental changes to the individual's self, identity, personality etc aren't noticible to the person themselves- changes are rationalized and subsumed by the subconscious to create the perception of continuity. Often only other people can notice the changes in behavior.
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Jul 7, 2014 23:11
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