Thank you for the clarification, Bagge. Just wanted to be sure I understood your position.
Dr. MacDonald willingly appeared in the film. His interview in the film is being used, albeit as it seems in a "misunderstood version of reality", to promote the sales of medical treatments and goods in a manner which exploit the patient. The following quote is just one example of the many such "misunderstood versions of reality".
I have seen the film, and now that you're bringing this up, I'm going to at least re-watch the segment Dr. MacDonald was in so I can see how his research was portrayed. It's been a while since I've seen it so I don't recall all the specifics. I remember that he was examining brain cross sections under a microscope in his own basement, but beyond that I need a refresher.
I don't know that his appearance in the film would equate with supporting everything which was portrayed in the film one way or the other - his segment was one of many and the editing and voice overs on the film could be used to support and portray the position of those creating it, whatever position it was. That applies to everyone else in it.
Dr. Shapiro and other infectious disease specialists were also interviewed in the film, they were on camera very briefly - do you also view their appearance in the film as being used in such a way as to support and portray the position of those who created it?
The film is the product of the vision of those who created it. If you disagree with the perspective portrayed and the way those in the film were portrayed, is that perspective and portrayal the responsibility of Dr. MacDonald's and Dr. Shapiro's and others who were interviewed - or does that responsibility rest with Kris Newby and others who made the film?
Bagge wrote:http://www.lymediseaseresource.com/word ... e-disease/
What does a biofilm have to do with Lyme disease?
Towards the end of the documentary “Under Our Skin” there is a brief interview of Dr. Alan MacDonald who is given credit for discovering the role of biofilms in protecting spirochetes from antibiotics and/or organic bactericides. This discovery stimulated a wave of research regarding biofilms and their role in chronic Lyme disease with some exciting progress.
Dr. MacDonald has made this statement,
inmacdonald wrote:My beliefs and the evidence above does notg [sic] yet prove the existence of Biofilms of borrelia burgdorferi. At this time there is no published peer reviewed paper to endorse the existence of borrelia biofilms.
Therapy decisions and discussions of "quackery" are not my responsibility---
My medical pactice [sic] has never involved prescriptions for therapy of any type.
I am a Board Certified Pathologist, certified by the American Board of Pathology.
I am a Laboratory Diagnostician.
It is not polite for you to assert that there is "responsibility" on my part for: ......."harmful "quack" remedies, claimed to be "cyst busters" and "biofilm disolvers [sic]".
Well, yes, Bagge - seems Dr. MacDonald does not accept responsibility for how other people decide to interpret his research and apply it, and he's not advocating any specific treatment based on his research. I believe him, and I can't see any reason not to believe him.
But your position is that even if this is so, all well and good - that until research is published in a peer reviewed publication that he needs to make some sort of public pronouncement that he has speculated that Borrelia biofilms exist and solid evidence of their existence has yet to be presented.
Bagge wrote:Dr. MacDonald's interview in the film is being used to promote the sales of medical treatments and goods in a manner which exploit the patient. He is aware of these happenings, and was likely paid for his role in the film, yet he seems unwilling to accept any responsibility for his role and come forward to make a public cautionary statement as an effort to minimize the exploitation.
Dr. MacDonald's continued willingness to allow his film appearance and research to be used to exploit patients is in my opinion against medical ethics and responsible conduct.
I wouldn't know whether or not anyone interviewed in the film was paid to show up in the film - Dr. MacDonald or Dr. Shapiro or anyone else. Instead of speculating on that, why not ask them?
Even if they were paid, does that change the outcome in terms of how the movie was produced and the message it contained?
I understand your position that Dr. MacDonald could have made a statement somewhere along the line that he has been speculating about the existence of Borrelia biofilms in a place where patients could view it. But how many researchers do you think should do so and under what conditions? There is so much research out there that can hold disclaimers on it for those reading it - whether it involves Borrelia burgdorferi or Vitamin C and its impact on the immune system or whether or not caffeine is good for you.
Barthold has made statements to the press in the past about how his own research leaves unanswered questions and should not have been taken one way or the other as evidence that Bb is a chronic infection. I have respect for that, that he states the outcome is uncertain and he thinks more research is needed. But as a patient, you would have to go out of your way to read these interviews. Barthold didn't exactly drop in on patient support groups and say these statements. Is Barthold responsible for not doing so?
I see where you're coming from, but I think a bigger problem in general is that ANY research anyone does can be misinterpreted and/or misapplied. The question is whose responsibility is it that their research is misinterpreted and/or misapplied - the researcher or those doing the misinterpreting and misapplying of that researcher?
Is it an either/or question or an "and" question? Do they both share an equal amount of responsibility, and if so, how far do they need to go?
Because as far as I know (citing a question I made further upstream), Embers et al are not going around filming themselves and submitting a message to youtube that patients should not try pulsed-dosage antibiotics just because they indicate it is something worth investigating in future studies. Yet this is exactly what you want Dr. MacDonald to do.
Regardless of this, you know as I do that people are going to try pulsed-dosage antibiotics and doctors are going to apply it in their practices as a matter of empiric therapy. Is this the right thing or wrong thing to do?
This is where people generally begin splitting into camps: 1) everything must be studied in DB RCT before anyone else uses it, or 2) what's the harm in a little off label usage and empiric treatment for individual patients?
I'm not a doctor, so I can't weigh in on #2. As a patient, I have to weigh very carefully whether or not I'm willing to take a drug for off label applications and would need a lot of information to make that decision.
On #1 - of course I strongly desire clinical trials be held on a particular treatment before it is widely used. At the same time, I'm concerned clinical trials miss a lot of the impact that a drug or treatment has once it's released into the wild and used by people who do not fit the qualifying subject profiles of those in the trial... Like how people with preexisting conditions start using the treatment when the trials never tested it on someone with preexisting conditions. Fun for everyone when weird effects start showing up. Not.
I don't think this is a simple issue that begins and ends with your view of Dr. MacDonald's responsibility for how his research is interpreted and applied by others.