We have long been concerned about deceptive marketing to sell health care products, and deceptive public relations to push policy positions favorable to health care organizations' leaders. Deceptive marketing and public relations may morph into stealth marketing and stealth advocacy, and then outright propaganda and disinformation.
At the same time, we have long been concerned about how leaders have become unaccountable for the conflicts of interest generated and outright criminal and corrupt behaviors by their organizations. They have thus exhibted impunity.
These concerns have sometimes merged. We have occasionally written posts about how prominent figures in health care, thought leaders, or as health care marketers like to call them, key opinion leaders with impressive credentials, have used questionable data and logical fallacies to defend their and other health care leaders' conflicts of interest. For example, most recently, in 2015, I discussed a commenary in the prestigious New England Journal of Medicine defending conflicts of interest affecting health care academics. At the time, I wrote:
It was more surprising, given the reach of this journal, that these articles featured a catalog of logical fallacies in support of their arguments. We have noted that logical fallacies have been a stock in trade of those who actively defend laissez faire policies about conflicts of interest, and other kinds of interactions among health professionals and industry. However, I would not have believed that the New England Journal of Medicine would go along with this sort of thing.
The logical fallacies I cited were burden of proof, appeal to authority, ad hominem, appeal to pity, and the straw man fallacy.
I concluded with:
The series of articles about conflicts of interest that just appeared in the New England Journal, while ostensibly scholarly, published by the journal's "national correspondent" in the Medicine and Society section, appear to be polemical. They deployed a substantial number of logical fallacies to make the point that medicine and society have gotten too tough on conflicts of interest. They are notably short on logical, dispassionate discussion of the evidence. Thus, they seem more like posts on a very opinionated blog site rather than commentaries in a scholarly medical journal.
I had written similarly in 2012 on logical fallacies employed in a report by the European Society of Cardiology defending, again, conflicts of interest, and again on logical fallacies employed by the new Chancellor of UCSF in the Wall Street Journal, again to defend conflicts of interest affecting academic medicine.
Now, in 2019, we stil see academics with impressive credentials making arguments in national media based on poor data and logical fallacies, but now to defend the highest leaders of our country from charges of conflicts of interest and corruption.
Victor Davis Hanson's Nationally Syndicated Challenge to the Postulated Over-Investigation of the Trump Administration
Here is one recent, vivid, widely published example. An op-ed appeared in my local newspaper, the Providence Journal, an abbreviated version of a commentary by Victor Davis Hanson which appeared in the National Review, and was syndicated to numerous other right-wing or conservative publications, such as RealClear Politics, TownHall, and in syndication to multiple news media. Per the ProJo version, Hanson professes to be "a classicist and historian at the Hoover Institution, at Stanford University." His official Hoover Institute biograpshy states "Victor Davis Hanson is the Martin and Illie Anderson Senior Fellow at the Hoover Institution; his focus is classics and military history." It claims he has received multiple awards, and has hundreds of publications. Thus Hanson claims to be a public intellectual, not a polemicist, and may well fit the definition of a thought leader.
Hanson's main point was that President Donald Trump was being unfairly investigated. He started with quoting the famous question, "who will watch the watchers," and then goes on to suggest that Trump's watchers (auditors, investigators) need to be reined in, implying that it was unreasonable that the Trump administration " has become the most investigated, the most audited, and the most closely examined presidency in history."
I my humble opinion, in support of his contention, Hanson offered arguments were often illogical, and lacked any substantiating evidence. Therefore, his piece appeared to be propaganda. Let me first list some of its illogic.
Hanson's Logical Fallacies
Logical Fallacy: Affirming the Consequent
Hanson's main assertion was:
Given President Trump’s unconventional background, his wheeler-dealer past, and the hatred he incurs from the left, few ever give him the benefit of the doubt.
The paradoxical result is that his tenure in just two years has become the most investigated, the most audited, and the most closely examined presidency in history.
Note that the superlative claims, that is those about the "most investigated," "audited," and "closely examined" presidency, are not substantiated. These are the essence of Hanson's argument is that Trump has been scrutinized for (morally) bad reasons, e.g., "hatred from the left." Hanson is arguing this based on the truth of the result, that his presidency is the most scrutinized. Yet even if it is, that does not prove the reasons were "hatred from the left," etc. Thus, this is an example of the logical fallacy of affirming the consequent, presenting an argument in an if p, then q format, but then stating that if q is true, p must have true as well.
Another example of this fallacy was a little way down the page:
his most frequent accusers — the media — have set themselves up as the country’s moral paragon. Journalists now see themselves as social-justice warriors who are immune from the scrutiny to which they subject others.
The result of such self-righteous moral exemption has led to journalism’s nadir, with an unprecedented lack of public confidence in the media. 'Fake news' now abounds, from CNN to BuzzFeed.
The argument here is a caustive one: if journalists are "immune" "social-justice warriors, then the result is "journalism's nadir," and "fake news."
Again, even if it is true that journalism is at its nadir, that does not mean Hanson's postulated cause, journalists as immune social-justice warriors, is true. However, Hanson's argument, that the investigations are unreasonable, and the auditors need to be audited, arises from his claim that the original auditors, the journalists, are "immune from scrutiny" and need to be reined in. Again, he states if p, then q, but then argues that because q, then p.
Logical Fallacy: Hasty Generalization
Trying strengthen his case that journalism as at a "nadir," with "fake news" abounding, Hanson then cited the case of a recent BuzzFeed article:
Recently, BuzzFeed (which first published the unsubstantiated Steele dossier) alleged that there was proof that Trump had ordered his erstwhile lawyer, convicted felon Michael Cohen, to lie.
Furthermore,
the BuzzFeed yarn drew a rare rebuke from Special Counsel Robert Mueller’s team, which disputed the veracity of the story.
That was one case, one anecdote. Hanson did not cite any other examples of faulty journalism in his commenatry. So this appears to be a version of the logical fallacy of hasty generalization, also known as an argument from small numbers, or anecdotal reasoning. Citing an anecdote of a particular pheonomenon means that the phoenomenon is possible, but obviously does not mean that the pheonomenon is common, or important.
Again, Hanson made his argument that the investigations of Trump by law enforcement are alos excessive,
The Department of Justice and the FBI are supposed to be our preeminent guardians of justice. But former director James Comey, former deputy director Andrew McCabe, former general counsel James Baker, and several other top FBI officials have either resigned, retired, or been fired — and some may soon be facing indictments themselves.
Setting aside whether resignations, retirements, or even firingsd under these circumstance indicate excessive zeal or criminal behaviore, and whether Hanson's speculation about indictments are valid, he cited only a few cases to imply that investigation of Trump has been excessive. So this is another case of reasoning from a small number of anecdotes, thus hasty generalization.
Base Rate Fallacy
Hanson went on to embellish his descriptions of the alleged misbehavior by a few Department of Justice personnel. In particular, he noted
On 245 occasions in sworn testimony before Congress, Comey answered that he either did not know the answers to questions or could not remember the details of events. Had any private citizen tried such stonewalling in an investigation, he or she would likely end up in jail.
He here was no longer citing one or a few anecdotes. 245 occasions seem to be a lot. However, Hanson's citation of it omits mentioning the numerator. Setting aside again the notion that people may go to jail for responding to questions under oath by claiming faulty memory or lack of knowledge, Hanson failed to state either how many questions Comey was asked Without knowing this, one cannot tell whether the Comey's behavior was frequent or rare. Thus, Hanson's implication that Comey committed some sort of crime, and that doing so discredits his investigation of Trump, was based on the base rate fallacy. He focused on the number of times an event occurred, while ignoring how many times it did not.
Logical Fallacy: Incomplete Comparison
Consider again the two sentences written by Hanson above. Not only did Hanson not establish the rate Hanson claimed faulty memory or ignorance, he did not address how often "private citizens" make such claims. Thus, even if we knew the rate of Comey made these claims, we do not know the rate private citizens do so. This thus appears to be an example of the logical fallacy of incomplete comparison, described as "an incomplete assertion that cannot possibly be refuted. This is popular in advertising."
Hanson's Unsubstantiated Claims of Fact
I found the following relevant examples of claims about frequency or prevalence without any supporting data.
Half the country apparently believes Trump cannot be trusted.
everything he says and does is the object of pushback, opposition, and audit.
'Fake news' now abounds,
I found the following relevant examples of claims about causation without substantiation.
The sexual-abuse crises within the contemporary Catholic Church arose from the de facto exemptions from the law given to priests.
Too many assumed that men of faith were exempt from prosecution because as holy men they would be the last to violate the trust of minors
I found the following relevant unsubstantiated claims about peoples' intent or state of mind.
They all apparently believed that their loud liberal credentials gave them immunity from being held accountable for their harassment.
They apparently assumed that as supposed victims, they could not be viewed as being sympathetic to victimizers.
Journalists now see themselves as social-justice warriors who are immune from the scrutiny to which they subject others.
Weissmann apparently didn’t mind that the dossier was used by his colleagues to deceive the Foreign Intelligence Surveillance Court into granting a warrant to spy on an American citizen.
Credible Allegations of Trump's and Cronies' Conflicts of Interest and Corruption
While spinning his web of logical fallacies and unsubstantiated claims, Hanson ignored the rationale for the multitude of investigations of President Trump and associates. In fact, there is voluminous documentation of evidence suggesting he has numerous conflicts of interest and he and his regime are corrupt. We summarized some of the most recent data here, in October, 2018. As I said then, up to October, 2018...
In January, 2018, we first raised the question about how health care corruption could be pursued under a corrupt regime. We noted sources that summarized Trump's. the Trump family's, and the Trump administration's corruption.. These included a website, entitled "Tracking Trump's Conflicts of Interest" published by the Sunlight Foundation, and two articles published in the Washington Monthly in January, 2018. "Commander-in-Thief," categorized Mr Trump's conflicted and corrupt behavior. A Year in Trump Corruption," was a catalog of the most salient cases in these categories in 2017.
In July, 2018, we addressed the Trump regime's corruption again By then, more summaries of Trump et al corruption had appeared. In April, 2018, New York Magazine published "501 Days in Swampland," a time-line of starting just after the 2016 presidential election. In June, 2018, ProPublica reviewed questionable spending amounting to $16.1 million since the beginning of Trump's candidacy for president at Trump properties by the US government, and by Trump's campaign, and by state and local governments. Meanwhile, Public Citizen released a report on money spent at Trump's hospitality properties.
In October, we summarized the lengthy Tracking Corruption and Conflicts of Interest in the Trump Administration. It broke down Trump and cronies' behavior into the following four categories: 1) US government payments to the Trump Organization; 2) use of the power of the presidency to promote Trump brands; 3) U.S. government regulatory and policy decisions that benefit the business interests of the Trump family and senior advisors; and 4) private and foreign interests seeking to influence the Trump administration through dealings with Trump businesses. The lists of specific instances in each category go on for pages, and have grown since October through weekly updates.
Most recently, Citizens for Responsibility and Ethics in Washington (CREW) published a report that listed the following concerning Trump's first two years in office:
CREW has identified 12 foreign governments that have made payments to Trump properties during his first two years in office, each of which is likely a violation of the Constitution’s foreign emoluments clause....As an aside, in response to Hanson's claim that few have ever given Trump "benefit of a doubt," we discussed here all the credible allegations of misbehavior by Trump prior to his presidency that were investigated minimally, if at all, and which never led to any serious consequences for him. Trump had been accused of lying to investigators about his Mafia connections; accepting kickbacks; violating fiduciary duties and at least two instances of fraud; failing to disclose he was under grand jury investigation in a casino license application; and perjury. Also, his casino was found to have committed numerous violations of state regulations, and violating regulations regarding money laundering, but Trump paid no personal penalties.
Instead of pushing back on President Trump’s refusal to divest from his business, allies in Congress have embraced the arrangement. 53 U.S. senators and representatives made more than 90 visits to Trump properties during his second year in office, up from 47 visits by 36 members the prior year, and similarly, at least 33 state-level government officials visited Trump properties, likely resulting in taxpayer funds going into Trump’s coffers.
More than 150 political committees, including campaigns and party committees, have spent nearly $5 million at Trump businesses since he became president. In Trump’s second year in office, CREW tracked 33 political events held at Trump properties—13 of which Trump himself attended, meeting and speaking with wealthy donors.
Special interests held at least 20 events at Trump properties during the president’s second year in office. Since Trump took office, at least 13 special interest groups have lobbied the White House, some for the first time, around the same time they patronized a Trump property, suggesting that making large payments to Trump’s businesses is viewed as a way to stay in his administration’s good graces.
Over the past year, President Trump made 118 visits to properties he still profits from in office, bringing his two-year total to 281 visits. CREW also identified 119 federal officials and employees who visited Trump properties over the past year, up from 70 the prior year.
In addition to making frequent visits to his properties, President Trump and other White House staff have promoted Trump businesses on at least 87 occasions. Trump himself mentioned or referred to his company 68 times during his second year in office, more than double the 33 times he did so the prior year.
Paying members at Trump’s resorts and clubs have received benefits beyond getting occasional face time with the President. Four Mar-a-Lago members have been considered for ambassadorships since his election, and three other members—with no federal government experience—acted as unelected, non-Senate-confirmed shadow officials in Trump’s Veterans Administration.
Hanson ignored all that.
Discussion
So here is one example, one anecdote, showing, in my humble opinion, an extreme case of illogical, unsupported argumentation in defense of our current president against multiple credible allegations of conflicts of interest and corruption. These allegations should concern anyone who cares about conflicts of interest and corruption in health care, because the presidency sets the tone for the whole country, and up to now, the executive branch of the US government provided the most and best resources for preventing and challenging conflicts of interest in health care. Obviously, these allegations should also concern anyone who cares about the state or representative democracy in the US.
This case is notable because of the academic credentials of the person whose argumentation was so illogical and unsubstantiated. Someone with such a prestigious academic position ought to know better, I think.
The case was also notable for how this widely published article seems to have inspired no criticism to date. Of course, note that analyzing a short article filled with logical fallacies and unsubantiated claims likely takes much longer than writing said article. Furthermore, note that the criticism takes much more space than the article itself. This makes it hard to do criticism that is likely to be noticed much or have much effect.
So in conclusion let me take something I wrote about bad arguments in support of conflicts of interest in medicine in 2015, and edit it for a 2019 audience [additions in brackets]
it is most disappointing that conflicts of interest are now being uncritically and illogically publicly defended by people in positions to exert so much influence on health care [and the greater political economy, and all of society].
Then
True ... reform requires such substantive reform of the financial arrangements among corporations ... and others who make decisions about patients' or the public's health [and about the health of the political economy and the greater society]. To decide how to accomplish such reform, we need a better discussion informed by logic and evidence, sans logical fallacies. Those who lead health care [the political economy, and the greater society] ought to be able to participate in this discussion under these conditions.
Musical Interlude
To lighten things up a bit, here is a 1978 video of Elvis Costello live performing Watching the Detectives
from Health Care Renewal http://bit.ly/2sZi3uY Watching the Detectives: Logical Fallacies and Unsubstantiated Claims to Denigrate Investigations of Leaders' Conflicts of Interest and Alleged CorruptionHealthy Care Renewal
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