The Boston Globe ran an op-ed today that perfectly characterizes a key failure of American journalism: that is, it reports on a medical question that can be answered by scientific research, but fails to even mention that such data exists or should exist.
The piece, headlined "Shocking Truths," claims that the arguments of critics of the Judge Rotenberg Center -- who oppose its inhumane electric skin-shock treatment of people with developmental disabilities -- are "too pat." The Department of Justice is currently investigating the school for human rights violations, after complaints from disability rights advocates.
Those concerns are groundless, author Lawrence Harmon argues. His proof? A five hour visit he made to the school in which he saw "nothing inhumane." Sure, he concedes, abuses have been found in the past -- but that's no reason to pay attention to the opposition of no fewer than 31 major disability advocacy groups.
As shallow as this reasoning is, it hides an even more profound failure of critical thinking. Harmon accepts at face value the claims of the school and of parents of students who support it that skin shock treatment "works" and is superior to what he calls "stupefying" doses of medication sometimes used by other programs.
But this is an empirical question -- and in decades of advocating a treatment its victims compare to "an attack by a swarm of wasps" -- the Rotenberg Center has yet to produce a single randomized controlled trial showing that its approach is effective -- let alone superior to others.
Rhetorically, Harmon asks, "Why do no practitioners other than Israel [Rotenberg's director] adopt this approach? Do they view skin shocks as cruel or do they fear the outcry of disability advocates and inevitable probes? Is skin shock, in some cases, a more humane treatment than heavy drugs and mechanical restraints?" He has a psychiatrist answer that he "doesn't know."
The disability rights groups know, however: they know that there is research from randomized controlled trials that supports other, more humane approaches. They know that there is none to support Rotenberg -- and they also know that research increasingly shows that sensory oversensitivity is a huge part of the autistic spectrum disorders often treated at the center. Given this, use of painful stimuli could be even more harmful to autistic kids than to others.
Using science to make medical decisions is not making a pat or black and white argument -- it is the same method that the FDA uses to clear drugs for marketing. If they are not first proven safe and effective, medications aren't allowed to be sold to the public. That standard is good enough for medications -- why shouldn't we use it for other treatments that can potentially do harm?
Why should we have lower standards for a skin-shock treatment used on our most vulnerable children? Parents' anecdotes and those of clinicians who profit from skin shock treatment aren't enough: you can find plenty of these in support of harmful, quackish cancer treatments, too. The fact that Harmon thinks that these anecdotes prove anything just shows how low his standards of evidence really are.
The Justice Department is right to have answered the disability rights groups with an investigation. It should conclude that the Rotenberg Center is conducting an unauthorized and inhumane experiment -- and refuse to allow any further use of its approach until it can prove that it is more effective than more humane alternatives. Given that the center hasn't been able to do that in its decades of existence, the program should be shuttered.
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