Thank you Rod and others who were able to understand my proposition. Another attempt is below:
 
I think quite a bit of confounding is at play here. I want to take this opportunity to clarify my proposition and solicit additional feedback.

Here I have read criticisms to the Lancet open letter, to religious debate, religious wars. And that’s okay because whereas my proposition may have been inspired by the letter, it is certainly not about the letter or its specific contents. Its not about Arabs, Jews, or any other ethnicity.

I am neither proposing a critical appraisal of the "two sides" nor a legal evaluation of their righteousness (or lack thereof). I am also not proposing we start with Gaza or restrict to Gaza.

Given the broad definition of health, I am proposing a new topic for healthcare research based on the principles of EBM and Ethics of do no Harm: human and environmental disasters associated with armed conflicts. Or may be the topic is not new…but whatever it is, it is not well known or very effective. To this end, I am imagining an international collaboration in form of a multidisciplinary research group. Any rational or ethical objections?

Provisional research questions could include:

 

 

 


From: Evidence based health (EBH) [mailto:[log in to unmask]] On Behalf Of Rod O'Connor
Sent: Thursday, July 24, 2014 7:09 PM
To: [log in to unmask]
Subject: Re: International Healthcare collaboration to research, prevent and treat human disasters associated with armed conflicts

There are certainly psychological and social factors that underlie conflict, whether engaged in by individuals or groups.  I have been preparing a book on why humans perpetually engage in conflict and war and suggest the following:


<!--[if !supportLists]-->1.       <!--[endif]-->Current aggressive feelings will initiate or sustain aggressive behaviour (if we are upset for whatever reason, we are likely to act aggressively)

<!--[if !supportLists]-->2.       <!--[endif]-->Problem-solving ideas, which appear first as intuitions, are influenced by prior beliefs and experience (solutions first arise intuitively, and violent events cue violent solutions)

<!--[if !supportLists]-->3.       <!--[endif]-->We ‘understand’ others actions by experience-based simulation as opposed to reasoning (if we don’t have the experience of another group we misconceive their actions, when if we were them we would do the same )

<!--[if !supportLists]-->4.       <!--[endif]-->The way in which we construct explanations is that all are incomplete.  Individuals and groups cherry-pick the parts that suit their favoured explanations, scientists do it too.  (We construct a preferred explanation for an event and then stick to it in the face of contrary evidence)  

<!--[if !supportLists]-->5.       <!--[endif]-->We perpetually adapt explanations in our personal lives to maintain hope and self-confidence, eg. 'I did not do the wrong thing when drunkenly offending my colleague because it was a xmas party and we had all been drinking and he should get over it'  (explanations are adapted to maintain positive feelings)

Training politicians and policy advisers to understand the role of such factors could be part of a health policy targeting reduced conflict.  Such a program would take a systems approach to reducing conflict, the aim would not be to pick bad guys.  Groups concerned with evidence-based health (as on this LIST-SERV) could be involved in developing such principles and programs.


Best wishes,
Rod

_______________________________________

Rod O'Connor BSc(Hons) CHEc PhD
Consultants in 'How we feel, think and decide'
Also Conjoint Associate Professor, School of Public Health &
Community Medicine, University of New South Wales
Sydney Australia
ph. +61-2 9555 9916  mob. 0413 60 70 73
Email: [log in to unmask]

Web:  www.RodOConnorAssoc.com

'Peace cannot be kept by force; it can only be
achieved by understanding' - Albert Einstein
________________________________________

 



Ansari, Mohammed said the following on 25/07/2014 8:15 AM:
[log in to unmask]" type="cite">

I don’t think it is about sides. Its about psychological, socioeconomic, equity, and other environmental factors…I would not encourage that we identify religion and race as variables in our analyses…..but rather more downstream factors as mentioned.   

From: Evidence based health (EBH) [mailto:[log in to unmask]] On Behalf Of Richard Saitz
Sent: Thursday, July 24, 2014 6:07 PM
To: [log in to unmask]
Subject: Re: International Healthcare collaboration to research, prevent and treat human disasters associated with armed conflicts

Seems to me there are two issues being conflated.

1. Is violence and resulting death a health issue? If they are then they are fair game for applying health evidence and appropriate for this list. I think the answer to that question is yes.

2.  Is determining that a particular government or group of people is responsible for violence and death more than some other group the expertise of people on this list? While etiology is obviously important, we are talking about situations in which the answer will come from opinion and that doesn't seem to me to be the expertise of people on this list....In addition saying that it was one group or the other that is more responsible does not seem productive from the EB health perspective. In this particular case you will definitely hear both sides demonizing the other. Maybe one is correct. But who will decide and based on what evidence? Some will likely answer me with some numbers to support a point of view but someone else will counter it with their numbers....

Rich

Sent from my iPhone


On Jul 24, 2014, at 12:14 PM, "Aicken, Catherine" <[log in to unmask]> wrote:

Yes, actually I think we *should* use this list to discuss the examples you gave, Alan (e.g. gun violence and climate change) as they impact on public health, as well as conflict/humanitarian issues, domestic violence, workplace injuries, and so on. I hope anyone working in evidence-based health would see the relevance to health policy/planning of surveillance re: mortality and injury/ill-health, on any of these issues – although they’re not diseases, evidence is still needed to respond most effectively. That evidence includes topics covered in the letter: in what numbers and where people are being injured or killed, the uncertainty around this (due to bodies still being trapped in rubble), and impacts of the conflict on hospitals, emergency services, relief workers.

This is a list for evidence-based health which I view as broader than evidence-based medicine, or evidence-based clinical practice. Even concerning evidence from clinical trials – haven’t we seen that politics and policies are hugely important, in the extent to which laws compel companies to publish trial data? Thank you Nourieh for posting the link to the letter - I hope others don’t shy away from posting on political issues relevant to health.

Kind regards,

Catherine

From: Evidence based health (EBH) [mailto:[log in to unmask]] On Behalf Of Alan Adelman
Sent: 24 July 2014 15:07
To: [log in to unmask]
Subject: Re: International Healthcare collaboration to research, prevent and treat human disasters associated with armed conflicts

So does that mean we should use this list to discuss the recent atrocity in Ukraine or the gun violence in the US that takes thousands, not just hundreds of lives per year or climate change that affects our lives. While these issues affect health The solutions are more in the 'political' arena rather than the medical. It would be nice if there was a 'cure' but people have been killing each other since the beginning of time.

This is a human issue and tragedy. I just don't think that this is appropriate for an evidence based list serve. I wouldn't want to see this listserve used to bring the readers attention to these types of issues whether or not it was published in lancet. I just think there are other more appropriate outlets.

Alan adelman, MD

Professor, family & Community Medicine

Penn state College of Medicine

Hershey, PA USA

Sent from my iPhone


On Jul 24, 2014, at 9:23 AM, "Ansari, Mohammed" <[log in to unmask]> wrote:

The World Health Organization defines “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”.

Regional conflicts and violence are legitimate concerns for healthcare professionals and healthcare researchers. In fact, it is unethical not to be concerned about such human/public disasters and put them aside as “political”. This word “political” I do not even know what it means except a euphemism for gag orders.

I think healthcare professionals and scientists need to team up with sociologists and anthropologists to investigate the causal factors for such poor health of regions and communities. With proper understanding, appropriate healthcare interventions can be tested and implemented.

I think the research agenda is so overwhelmingly important that WHO and various governmental agencies would be ethically compelled to fund.

Shall we start a collaborative research working group based on the principles of ethics, science, and EBM?

Kindly,

-----Original Message-----
From: Evidence based health (EBH) [mailto:[log in to unmask]] On Behalf Of Douglas Badenoch
Sent: Thursday, July 24, 2014 6:57 AM
To: [log in to unmask]
Subject: Re: An open letter for the people in Gaza, the Lancet

Thanks Martin

I saw the message last night but decided to let it run.  I'd like to congratulate the contributors so far in their measured responses.

Strictly speaking, with my list owner's hat on, you're right about the remit of the list.  As list owner I've never been too rigid about enforcing the list remit to the letter.  For one thing, it would be too much work for what is an unpaid role, and for another, it would stifle the value of the list itself.

Personally, I feel that the original post was both acceptable and morally important.  Here we have an ongoing public health disaster and I do think it is right for us to consider it.  The causes of avoidable harm are surely central to any evidence-based health discussion. 

Avoiding "finger-pointing" in that context is a failure to address that aetiology.  In my humble opinion of course!

Clearly not everyone agrees with that, but equally clearly some of our members do.

I think as long as we remain polite and respectful, and mindful of the purpose of the list, we can address this disastrous situation in a way that, at the very least, may remind those desperate people whose lives are being destroyed in this conflict that they are not forgotten.

Best regards

Douglas

Dawes, Martin wrote:

> I think Douglas Badenoch who runs this list is not available to see

> this posting so I am taking the liberty of reminding people of the use

> of the list as posted on the JISC web site

> https://www.jiscmail.ac.uk/cgi-bin/webadmin?A0=evidence-based-health

> /This list is for discussion of teaching, practice and implementation

> of EBH. / / / I would respectfully suggest that we close this

> discussion.

> Martin

> /

> /

> From: Mike Kronenfeld <[log in to unmask]

> <mailto:[log in to unmask]>>

> Reply-To: Mike Kronenfeld <[log in to unmask]

> <mailto:[log in to unmask]>>

> Date: Wednesday, 23 July 2014 15:35

> To: "[log in to unmask] UK"

> <[log in to unmask]

> <mailto:[log in to unmask]>>

> Subject: Fwd: An open letter for the people in Gaza, the Lancet

> I want to protest that this is an inappropriate use of this listserv

> which is not an appropriate place to have a discussion on what is

> currently happening in Gaza.

> Michael Kronenfeld

> University Librarian

> A.T. Still Memorial Library

> A.T. Still U. of the Health Sciences

> 5850 E. Still Circle

> Mesa, AZ  85206

> (480) 219-6091

> ---------- Forwarded message ----------

> From: *Nourieh Hoveyda* <[log in to unmask]

> <mailto:[log in to unmask]>>

> Date: Wed, Jul 23, 2014 at 3:18 PM

> Subject: An open letter for the people in Gaza, the Lancet

> To: [log in to unmask]

> <mailto:[log in to unmask]>

> Dear colleagues

> An open letter for the people in Gaza, published in the Lancet 23rd of

> July 2014,  By Paola Manduca, Iain Chalmers, Derek Summerfield, Mads

> Gilbert, Swee Ang, on behalf of 24 signatories

> If you wish to read / support the letter please see link

> http://www.thelancet.com/gaza-letter-2014

> Kind regards

> Nourieh

> --

> Michael Kronenfeld

> University Librarian

> A.T. Still Memorial Library

> A.T. Still U. of the Health Sciences

> 5850 E. Still Circle

> Mesa, AZ  85206

> (480) 219-6091

> Http://www.atsu.edu/atsmlib

> [log in to unmask] <mailto:[log in to unmask]>


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