Magic Statistics

Lots of people feel this way about statisticians.

Sometimes I feel that way myself.

An 84-year-old man in a Winnipeg hospital could soon be put to death.  Doctors want to remove his ventilation and feeding tube.  This could be Canada’s Terry Schiavo case, except that it’s worse.  Terry’s family was divided over her treatment: Her husband Michael wanted doctors to pull the plug on his wife, while her parents wanted her care continued.  Samuel Golubchuk’s family, by contrast, speaks with one voice: Keep him alive.  Doctors, however, claim power of life and death over this poor man.  Lord, have mercy.

Canada’s national media are hardly covering the story, so we get a report from American columnist Jonathan Rosenblum.

A Winnipeg case currently winding its way to its grim conclusion pits the children of Samuel Golubchuk against doctors at the Salvation Army Grace General Hospital. According to the pleadings, Golubchuk's doctors informed his children that their 84-year-old father is "in the process of dying" and that they intended to hasten the process by removing his ventilation, and if that proved insufficient to kill him quickly, to also remove his feeding tube. In the event that the patient showed discomfort during these procedures, the chief of the hospital's ICU unit stated in his affidavit that he would administer morphine.

Golubchuk is an Orthodox Jew, as are his children. The latter have adamantly opposed his removal from the ventilator and feeding tube, on the grounds that Jewish law expressly forbids any action designed to shorten life, and that if their father could express his wishes, he would oppose the doctors acting to deliberately terminate his life.

In response, the director of the ICU informed Golubchuk's children that neither their father's wishes nor their own are relevant, and he would do whatever he decided was appropriate.

The ICU director’s edict is backed by Dr. Jeff Blackner, executive director of the office of “ethics” of the Canadian Medical Association.

Who told doctors they have sole authority over who gets treated and who doesn’t?

As Wesley J. Smith points out, the determination to kill Mr Golubchuk over the strong moral objections of his family flies in the face of lip service paid to “choice” in other medical controversies, such as abortion and assisted suicide.  It’s not about choice; it’s about “putting certain people out of our collective misery”.

In November, the family obtained a temporary court injunction preventing the euthanasia of Sam Golubchuk.  A judge is scheduled to decide tomorrow whether doctors will be allowed to begin starving and dehydrating him to death.  In the meantime, it is reported that his condition is improving.

As a final irony, Mr Golubchuk is a patient at the Salvation Army Grace Hospital.  The devil must be having a good laugh over that.

Sam Golubchuk’s family has set up a website publicising his situation and asking for donations to defray their legal expenses. Hospital lawyers working to have him killed are funded by the taxpayers.

Previous related post: Michael Schiavo, Guardian Of The Year

UPDATE (13 Feb.): Hallelujah! A judge has ruled that Mr Golubchuk must be kept on life support pending a full trial. 

Take the quiz: Which Great US President Are You Most Like?

h/t: Christian “Ike” Conservative

Banks can’t be trusted: Yukon Premier Dennis Fentie — Whitehorse Star, 8 February

An exhaustive investigation of the methods used in the analysis of Iraqi deaths conducted in 2006 and published by The Lancet has uncovered many serious violations of accepted ethical practices and possible data fabrication.

“Mortality after the 2003 invasion of Iraq: a cross-sectional cluster sample survey”, by Gilbert Burnham, Riyadh Lafta, Shannon Doocy, and Les Roberts, estimated that, due to the US-led invasion of Iraq, over 650,000 people died between March 2003, when the invasion began, and July 2006.  The study has been subjected to wide-ranging and prolonged criticisms, some of which have been discussed at this blog.

Michael Spagat of Royal Holloway College, University of London, has posted a critical review at his website.  Here is the abstract:

I consider the second Lancet survey of mortality in Iraq published in 2006.  I give evidence of ethical violations against the survey’s respondents including endangerment, privacy breaches and shortcomings in obtaining informed consent.  Violations to minimal disclosure standards include non-disclosure of the survey’s questionnaire, data-entry form, data matching anonymized interviewer IDs with households and sample design.  I present evidence suggesting data fabrication and falsification that falls into nine broad categories: 1) non-disclosure of key information; 2) implausible data on non-response rates and security-related failures to visit selected clusters; 3) evidence suggesting that the survey’s figure for violent deaths was extrapolated from two earlier surveys; 4) presence of a number of known risk factors for interviewer fabrication listed in a joint document of American Association for Public Opinion Research and the American Statistical Association; 5) a claimed field-work regime that seems impossible without field workers crossing ethical boundaries; 6) large discrepancies with other data sources on the total number of violent deaths and their distribution in time and space; 7) two particular clusters that appears to contain fabricated data; 8 ) irregular patterns suggestive of fabrication in claimed confirmations of violent deaths through death certificates and 9) persistent mishandling of other evidence on mortality in Iraq presented so as to suggest greater support for the survey’s findings from other evidence than is actually the case.

Ethical violations are identified based on a comparison of the Lancet study’s survey methodology with the Code of Professional Ethics & Practices recommended by the American Association for Public Opinion Research (AAPOR).  The Code reads, in part,

II. Principles of Professional Responsibility in Our Dealings With People
. . .
D. The Respondent:

1. We shall avoid practices or methods that may harm, humiliate, or seriously mislead survey respondents.

2. We shall respect respondents' concerns about their privacy.

3. Aside from the decennial census and a few other surveys, participation in surveys is voluntary. We shall provide all persons selected for inclusion with a description of the survey sufficient to permit them to make an informed and free decision about their participation.

4. We shall not misrepresent our research or conduct other activities (such as sales, fund raising, or political campaigning) under the guise of conducting research.

Prof Spagat argues that the Lancet study authors violated all of those principles, potentially endangering the physical safety of survey respondents.

III. Standards for Minimal Disclosure

Good professional practice imposes the obligation upon all public opinion researchers to include, in any report of research results, or to make available when that report is released, certain essential information about how the research was conducted. At a minimum, the following items should be disclosed.

1. Who sponsored the survey, and who conducted it.

2. The exact wording of questions asked, including the text of any preceding instruction or explanation to the interviewer or respondents that might reasonably be expected to affect the response.

3. A definition of the population under study, and a description of the sampling frame used to identify this population.

4. A description of the sample design, giving a clear indication of the method by which the respondents were selected by the researcher, or whether the respondents were entirely self-selected.

5. Sample sizes and, where appropriate, eligibility criteria, screening procedures, and response rates computed according to AAPOR Standard Definitions. At a minimum, a summary of disposition of sample cases should be provided so that response rates could be computed.

Prof Spagat argues that every single one of those professional standards was violated as well.

Prima facie evidence of data fabrication is also presented, including a showing that the study incorporated almost all of the risk factors listed in “Interviewer Falsification in Survey Research: Current Best Methods for Prevention, Detection and Repair of Its Effects”, a document of the AAPOR and the American Statistical Association. Analysis of study findings supports the contention that some data appear to have been falsified.  

The Spagat paper’s documentation of shoddy and questionable practices is simply shocking.  In my view, it constitutes a damning indictment of the Lancet study.  Containing little technical statistical analysis, it should be accessible to interested non-specialists.  Although almost 50 pages long, it is well worth a read.

Prof Spagat concludes with a call for a formal investigation of the study.  One certainly hopes that would be possible but, in view of the stonewalling by study authors—in particular, manager of survey operations Riyadh Lafta—that would seem a faint hope.

Previous related posts:

• In the spotlight again: Lancet study of Iraqi deaths
• Lancet study “has no scientific standing”
• Lancet authors slow to provide answers
• “Main street bias” in Lancet study
• Lancet study of Iraqi deaths is statistically unsound and unreliable