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Renee Maunder (Forum, NZ Skeptic 103) laments that I failed to supply a detailed list of references in my article on ACC and sexual abuse claims (NZ Skeptic 102). In my copy, I saw the Health Practitioners Competency Assurance Act 2003, the Shorter Oxford English Dictionary, ACC legislation, public utterances by the NZ Association of Counsellors and similar organisations, ACC Press Releases, ACC’s Best Practice Guidelines, the pseudo-research by Massey University (paid for by ACC) and the Crimes Act. She mocks my comments about syndromes.

My article defined a syndrome as “a group of symptoms or pathology which consistently occur together, especially with an (originally) unknown cause.” A syndrome permits cause to be determined from symptoms or effects. It would be fair to say (for example) that medical practitioners might expect to find maybe four, six or a dozen symptoms that, through the medium of syndromes, lead to establishing the cause of a disease or disability. The keynote is predictability and certainty.

No-one has yet been able to formulate a “sexual abuse syndrome” because any effects which may occur are idiosyncratic and unpredictable.

These matters lie at the heart of the ACC Sensitive Claim process. Evidence of cause and effect is imperative. In the absence of evidence external to complainant allegations, the attribution of psychological conditions to sexual abuse is unscientific, unethical, and downright dangerous. But ACC and its counsellors make that attribution thousands of times each year.

Ms Maunder seems to think I suggested a “mental injury” should be a “syndrome” in order to be real. No I didn’t. The “narrow definition of mental injury” used belongs to s.27 of the AC Act and is entirely subjective – “a clinically significant behavioural, cognitive, or psychological dysfunction” can mean pretty much anything. In terms of the ACC legislation, cover for “mental injury caused by certain criminal offences” requires credible, testable evidence of several aspects, but ACC and its counsellors fail to meet that criterion.

The three main aspects are :

  1. Evidence that the alleged Schedule 3 criminal sexual offence actually did occur;
  2. Evidence that a s.27 “mental injury” actually exists; and
  3. Evidence that the alleged offence caused the mental injury – and that the injury was not due to some other trauma in the claimant’s life.

Ms Maunder sees anomalies around my comments about “proper evidence”. Pretty simple, really. Every such claim is an allegation of a serious crime. Unless ACC has credible evidence of the three aspects noted above, it has no business approving cover for claims.

Ms Maunder suggests my comments are “obviously absurd” unless I show that only ACC-registered counsellors can refer “patients” for claims. It is common knowledge that counselling is an unregulated activity. Anyone can do it. A person wanting to be registered on the ACC gravy train as a counsellor must jump through the hoops set up by the Counselling Costs Regulations.

Finally, she says “Mr Waugh refers twice to laws that are being broken, but never actually sets out which statutes these are.” Concealing a crime is itself a crime. ACC’s Guidelines for Therapists Working with Adult Survivors of Sexual Abuse 2001 states: “The therapist is asked to bear witness to a crime…” In my opinion, witnesses to such crimes have an obligation to report them.

The Crimes Act 1961: Part 10: Crimes against rights of property: s.228(b) makes it an offence to dishonestly use a document for pecuniary gain. In the absence of credible evidence of criminal sexual offences and/or proof that claimed mental injuries were caused by such offences, it is dishonest to submit documentation for monetary compensation or other valuable considerations. ACC abets this deceit and is therefore also culpable.

The obvious starting point for these claims is clear evidence that the claimant did experience a criminal sexual offence. The almost foolproof way to do that is by a conviction or an admission of guilt. But in the ACC system, the alleged offender does not even have to be identified or advised of the allegations, and if he has been, he cannot defend himself. Shades of The Trial by Franz Kafka??

Gordon Waugh (abridged)

Sodium toxicity?

Siouxsie Wiles in her article in the latest NZ Skeptic (103) claims that ingestion of 62 mg of sodium carries a “considerable risk of side effects including lethargy, weakness, irritability, seizures, coma and even death.” I doubt it. The recommended daily intake of sodium is round about 2000 mg; a slice of commercially baked bread contains somewhat more than 62 mg sodium.

Alan Hart

Siouxsie Wiles replies:

Apologies, the reference to 62 mg of sodium per phenylbutyrate tablet was completely meaningless without referring to how many tablets are prescribed. While it is difficult to see what Burzynski actually prescribes in terms of sodium phenylbutyrate, the doses he describes for the antineoplastins (which remember are metabolites of sodium phenylbutyrate) vary hugely from less than 100 mg per kg body weight per day up to 25 g per kg body weight per day ( and he has stated on many occasions that high doses are needed to be effective.

To put that in perspective, if we took a person weighing 70 kg, the 100 mg dose would be about half the recommended daily sodium intake, while the 25 g dose could be as much as 100 times the recommended daily intake. As these doses will be on top of what people are getting in their diet, it is hard to see how patients aren’t being put at risk of the side effects of sodium toxicity.

Morality or instinct?

Mark Ottley (“Scientifically determined morality”, NZ Skeptic 103) makes a lot of fuss about something which is no more than the development of instinct. Societies evolve in the same way as individuals and any behaviour which assists prosperity of the society or its survival will be selected by evolution and eventually incorporated in the genes of the individuals. This is called an instinct. Birds have an instinct to build nests. All organisms have an instinct to reproduce.

Morality is what people do. All societies attempt to discourage behaviour that harms the society and encourage behaviour that benefits it. Over time, all societies develop a basic approved morality which may be enforced by laws, education, or religion, and over the course of time some of it will be instinctive. Some will require education or training. It is not surprising that all successful societies have similar instincts of basic morality.

A tendency to cooperate, obedience to the laws, nurturing of children, concern for human life and for the family, have evolved in all successful societies. A constant problem is genetic variability, where some individuals are less reliable.

Another is the clash with other instincts. The most basic instinct of all is selfishness. Without it none of us would be here at all. So all societies have to try and control it, or devise safe procedures to permit its indulgence.

There is also the instinct to kill others, animals or humans. Without it we could never have fed ourselves or fend off enemies. So we promote ‘sports’ which safely indulge the killer instinct. although we have not given up killing approved enemies.

There are degrees of adherence to officially or legally encouraged morality and Mark Ottley has surveyed some of those that are promoted. Without some diversity, no society would be able to make the changes that are going to be needed for future survival.

Vincent Gray

Mark Ottley replies:

Thank you to Dr Gray for taking the time to provide feedback. I am especially grateful that he largely interpreted my article as I intended it to be interpreted.

Dr Gray outlines a descriptive evolutionary account of morality popularised since at least the 1970s. Ideally aspects could be clarified further by recent research and important ultimate/proximate distinctions. As one example, human ‘genetic selfishness’ typically develops into a stronger basic instinct for altruism than for selfishness – given that the ‘self’ is always a dead end but kin are not (Kenrick, Griskevicius, Neuberg, & Schaller 2010). However, to describe such considerations in detail was not my main objective.

Instead, my article “makes a lot of fuss” (definitely!) about two main points, both of which I regard as relatively novel and important and thus worth sharing with fellow skeptics. The first is that research from a range of fields (biological, psycholexical, cross-cultural, psychiatric and so on) has resulted in an unsought empirical convergence over the past decade, suggesting a six factor model of personality and morality. Six factors, not more and not less. The utility of a scientific model includes clarity of concept, parsimony, consilience, predictive accuracy and so on, and this model appears to possess such qualities given my reading and clinical practice to date.

The second point is that we have advanced to a point where evidence-based morality is feasible not just in theory, but in practice. Cultural practices either enhance or detract from human wellbeing. These variables of cultural practice and wellbeing are increasingly well understood, measurable and controllable. Positive implementation requires effective dissemination, hence further fuss over the descriptive and prescriptive symbolism I.T.E.A.C.H. in my article.

Dr Gray is absolutely correct that we must retain some diversity to make moral progress, and I highlighted the importance of “evolutionary processes of cultural variation, selection and retention” in my article. What we have in the way of evidence-based morality is a beginning not an end. However, it is an important beginning to acknowledge and advocate for in a world where most advocate non-evidence-based moral models (often from a superstitious and religious point of view), or deny the possibility altogether (often from a philosophical or scientism point of view).

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