The Faculty Lounge

More Entrenched Obstruction by UK Psychiatrists

This is a guest post by my friend and coauthor Brian Hughes, of the psychology department at the National University of Ireland, Galway. Brian completely demolishes the claims by a band of recalcitrant psychiatrists that their preferred ME/CFS therapies are "evidence based." This essay, cross posted from The Science Bit, is a textbook example of how to expose bad science and bad medicine.

New Treatment Guideline, Same Old Denialism

Written by Brian Hughes on October 24, 2021

Last Monday, the UK’s National Institute for Health and Care Excellence (NICE) held its much anticipated roundtable discussion event, ostensibly to appease those (few) medical stakeholders who had baulked at the newly developed treatment guideline for ME/CFS.

Regular readers will be aware that NICE developed its guideline over several years following a rigorous assessment of the research evidence. However, for reasons that are still a little vague, some senior figures in Britain’s medical establishment let it be known that they were not that comfortable with what had been proposed. Despite the fact that NICE went so far as to pause the publication of its guideline in order to hear them out, the subsequent opportunity for calm discussion at the roundtable threw up no substantive issues. The guideline is now to be published this week, as was intended back in August.

It is, of course, appropriate that medical guidance be shaped by scientific rigour and review. But for years this was far from the case with ME/CFS. The two treatments previously presented as standard care — cognitive behavioural therapy (CBT) and graded exercise therapy (GET) — were each grounded in exceptionally weak science, and appeared to provide little or no benefit to ME/CFS patients. GET, in particular, appeared to be worse than merely useless; in many cases, it has been shown to damage patients’ well-being.

The recent history of the field has not reflected well on British medicine or, by extension, British psychology. Perhaps understandably hamstrung by cognitive dissonance, a number of senior academic panjandrums spent years sticking gamely to their guns, insisting that the therapies that they themselves developed, and drawn from medical theories that they themselves formulated, simply must be of value, no matter what the scientific data had to say.

In an ideal world, scientific evidence would have won out long ago. But the world we live in is far from ideal. And so it came to pass that these iffy therapies were dished out to thousands of patients, essentially on the say-so of so-called senior experts.

Like zealous internet conspiracy theorists, these folks insisted they had “done their own research.” They used this work to convince themselves, and their like-minded acolytes, that all was well.

However, when NICE conducted a formal evidence review as part of the development process for its new treatment guideline, it found that all the studies (not just most of them, but literally all of them) were so weakly designed as to produce evidence that was uniformly of “low” or “very low” quality. As evidence reviews go, it was quite the bloodbath.

Ripple

Lyrics written by Robert Hunter in 1970, music by Jerry Garcia.

Fellowship: Stanford Center for Law and History

From an email message that I received earlier this week:

The Stanford Center for Law and History is a residential fellowship that provides an opportunity to conduct research in the dynamic environment of Stanford University. The fellowship term is for two years. We expect that fellows will dedicate most of their time to pursuing their proposed research projects, and the fellowship is designed to ensure meaningful mentorship from faculty within both the Law School and the History Department. Fellows will also devote some time to organizing and implementing other Center activities, including an ongoing workshop series and an annual conference. The fellowship provides a significant opportunity to become part of a lively law-school-wide community of individuals with an interest in academia through attending weekly faculty lunch seminars and by participating in activities with the other fellows at Stanford Law School to learn more about one another’s scholarship and about academic life more generally. Fellows are also encouraged to attend and participate in the broad range of lectures and workshops available within the broader university, including inter alia, the History Department and the Stanford Humanities Center.

The direct link to the fellowship posting can be found here: http://m.rfer.us/STANFORDgJJGPm

Margaret Sova McCabe Stepping Down as Dean of University of Arkansas School of Law

Margaret Sova McCabe, who has served as Dean of Arkansas School of Law since 2018, will step down at the end of the academic year and return to teaching as a member of the faculty.  An interim dean will be named for the 2022-23 academic year.  Details regarding the dean search will be announced in the coming months.

CFP: Governing Bodies: Bodily Autonomy and the Law

This just in:

The University of Detroit Mercy Law Review is accepting proposals for virtual and in-person presentations for its annual symposium on Friday, March 4, 2022, in Detroit, Michigan. In-person presenters will be eligible for a travel and lodging stipend to help cover costs. 

This year’s topic is GOVERNING BODIES: BODILY AUTONOMY AND THE LAW. Bodily autonomy has been regulated or banned on many levels throughout our history, ranging from slavery to the right to an abortion, assisted suicide, transgender rights, and even issues surrounding the present COVID-19 pandemic. While these laws and regulations have led to controversy and protest, it remains unclear where exactly the line should be drawn limiting government power over our bodies, or if there should be a line at all. 

Detroit Mercy Law Review invites academics, scholars, practitioners, and other stakeholders to submit proposals for panel presentation and potential publication on topics involving governments and entities attempting to regulate bodily autonomy. These may include, but are not limited to, the following: slavery, vaccine passports and mandates, abortion laws, assisted suicide, data privacy issues, and transgender rights.   

Submission Procedure 

Proposals should be approximately 250–500 words, double-spaced, and should detail the proposed topic and presentation. Proposals must be submitted no later than 5 PM EST Friday, October 29, 2021, by email to Mackenzie Clark, Symposium Director, at lawreview@udmercy.edu. In your e-mail, please indicate whether your proposal is for a presentation only or if you plan to submit an article based on your presentation for potential publication in the Detroit Mercy Law Review. Also, please include a current CV or resume. 

Decisions will be emailed on or before Monday, November 7, 2021. Final completed manuscripts must be submitted by Friday, March 11, 2022, for consideration for publication by the Law Review staff. 

SCOTUS Politics

Today is my debut as a bi-weekly columnist for The Hill. Here is the gist of my first column:

Just last week, President Biden’s Presidential Commission on the Supreme Court of the United States released a lengthy set of “discussion materials” that undermined any meaningful attempts at depoliticization, or even balance, for the Court. Statutory expansion beyond the current nine justices – supported by a growing number of Democrats and clearly permissible under the Constitution – was essentially brushed off for its ostensibly “negative effects” on the Court’s “long-term legitimacy” that could “undermine its role in our legal system.” (At least five of the 34 commissioners have publicly disagreed with this supposition.)

Republicans, of course, never had qualms about tinkering with the Supreme Court’s composition, having fashioned an eight-member court during the nearly year-long blockade of Merrick Garland’s nomination in 2016. But determining the Court’s size is evidently an exclusively Republican prerogative.

The Commission did allow that term limits might be desirable, although Biden later said that he is opposed to the idea. In any case, that reform would likely require a Constitutional amendment, which would not be fully operative until somewhere between 21 and 46 years after ratification (depending on the details). Under most term limit proposals, a child born tomorrow could grow up, attend college, graduate from law school, and still be sworn into the Supreme Court bar by Justices Barrett, Kavanaugh and Gorsuch.

You can read the entire piece here.

UC Irvine Law Seeks Dean

This just in:

The University of California, Irvine (UCI) seeks a thoughtful and creative leader to serve as the next dean of its School of Law. UCI is noted as one of the most innovative American institutions of higher education. The New York Times named UCI No. 1 among U.S. universities “doing the most for the American dream.” UCI consistently ranks among the top 10 public universities in the nation, with a nearly 40% rise in applications over the last five years.

In 2008, the University of California, Irvine School of Law (UCI Law) was established by visionaries who wanted to reimagine legal education and respond to the opportunities presented by the practice of law in the 21st Century. The School built its reputation on a distinctive egalitarian composition and culture among faculty and staff, an unparalleled education that features interdisciplinary study and strategic problem solving, and a commitment to enrich communities through public service. In just a few years, UCI Law gained recognition as a top law school. U.S. News & World Report ranks UCI Law 19th in academic peer reputation. The leading Sisk et al. study consistently ranks its faculty among the top 15 in the nation for legal scholarly impact. It boasts top 10 programs in clinical training, tax law, and legal writing. The School’s prominence is enhanced by a deep commitment to public service, social justice, research excellence, and experiential learning. Its next dean will be a strategic and collaborative leader with a distinguished scholarly record who will guide the School through its next chapter of growth in prominence and impact.

Founded 13 years ago, UCI Law operates an annual budget of approximately $66 million. It has grown to serve nearly 500 students and employ 53 full-time faculty and over 100 additional faculty and staff. The faculty are highly regarded for their scholarly impact and expertise in skills training and clinical education. UCI Law hosts 18 centers, institutes, and projects that encourage collaboration, contribute in-depth research, and advance policy in specific areas of law. A recent addition, the Artificial Intelligence Public Policy Institute, offers research opportunities for students and faculty to examine the spectrum of ethical and legal challenges at the intersection of law, technology, and artificial intelligence.

In addition to the J.D. program, UCI Law offers a Master of Laws (LL.M.), a first-rate legal education to lawyers, judges, government officials, and others who wish to understand the legal system and practice of law in the United States. Additionally, a new Graduate Tax Program offers a one-of-a-kind LL.M. curriculum that gives students the doctrinal depth and practical skills they need to practice tax law at the highest levels, in the United States or abroad.

UCI Law’s next dean, the third in its history, has an opportunity to further advance the School’s reputation as an eminent and cutting-edge learning community, and to build upon its ethos and mission as a force for good. They will preserve and enhance the School’s established commitment to public service and social justice. And they will work with a thriving community that seeks to reform, reflect upon, and recommit to the role of law and lawyers in surfacing and abating historical and structural inequities in our region, nation, and world.

A Long Covid Patient and a Doctor Walk into a Room

Here is my latest piece on Social Science Space:

Going Around in Circles with Long COVID

Published on 10/19/2021 By Steven Lubet

(Image: Michel Bakni / CC BY-SA 4.0/ Wikimedia)

Readers of Social Science Space may recall that Dr. Jeremy Devine suddenly became the best-know psychiatry resident North America when he published a guest essay in the Wall Street Journal, asserting that Long COVID – a series of distressing sequalae following otherwise apparent recovery from COVID-19 – is actually a “psychosomatic-symptom disorder” that is “largely an invention of vocal patient activist groups.” In a later interview with London’s Sunday Times, Devine explained that Long COVID stems “from a subconscious desire to be sick” that may be “rooted in depression and anxiety,” for which he blamed  what he called “the chronic fatigue lobby.”

Devine is not alone in his views, which have been quoted uncritically in the New Yorker and elsewhere. Writing in medical journals, other psychiatrists have made comparable statements about the supposed psychogenic origin of chronic fatigue syndrome (also called myalgic encephalomyelitis or ME/CFS), claiming that patients are seeking to maintain the “benefits of the sick role.”

That got me thinking about how a primary care doctor with those beliefs might interview a new patient. Hence, the following imaginary conversation.

Patient: Good morning, doctor. I had COVID-19 about six months ago, but I still feel terrible, with headaches, dizziness, and brain fog. Do you think I might have Long COVID? 

Doctor: I am terribly sorry. Your tests are all negative, however, so it looks like you have fully recovered from the virus.

Patient: I sure don’t feel recovered. There are days when I can barely move because of the fatigue.

Doctor: That can be caused by what we call catastrophizing. You could be concentrating too much on your symptoms, instead of recognizing that you are feeling better.

Patient: But I am not feeling better. I feel awful.

Doctor: That is probably because you have been paying attention to vocal patient activist groups. They have unfortunately spread all sorts of invented ideas about the aftermath of COVID-19.

Patient: I have never heard of any patient activist groups, so how could they affect my symptoms?

Doctor: Good question. Some of their influence has been spread by the chronic fatigue lobby.

Patient: Really? A lobby? I have never heard of them, either.

Doctor: Let’s get back to your psychosomatic disorder. 

Patient: Psychosomatic disorder?  I came her for help with body aches and brain fog. 

Doctor: Yes, but those can be caused by your anxiety and depression. 

Patient: Wait a minute. Wouldn’t I know it if I had anxiety and depression? 

Doctor: No, you wouldn’t. 

Patient: Why not? 

Doctor: Because you are misinterpreting your symptoms due to a subconscious desire to be sick. 

Patient: I am not sure I can agree with that. 

Doctor: Oh, more evidence of depression. 

Patient: I really don’t think I’m depressed. 

Doctor: Even more evidence. 

Patient: So, no matter what I say, it will just prove that you’re right about depression? 

Doctor: Exactly. Listen, do you want to get better or not? 

Patient: Yes, of course I want to get better. What do you recommend? 

Doctor: I would like to refer you to a psychiatrist. 

Patient: Really? What would a psychiatrist to for me? 

Doctor: They would get you started on cognitive behavior therapy and a graded exercise program. 

Patient: But exercise has been making me feel even worse. 

Doctor: That’s because you haven’t been doing enough of it. You need to push yourself a little more each day. 

Patient: Seems risky. Is there any research specifically supporting graded exercise for people with Long Covid? 

Doctor: No, but psychiatrists have been prescribing it for ME/CFS for decades. 

Patient: Oh, I have read about that. I guess the conditions are similar, but don’t ME/CFS patients say that exertion makes them relapse? 

Doctor: They say it does, but only because they are holding onto the benefits of the sick role. 

Patient: Don’t you have a less patronizing answer than that? 

Doctor: Sure, you could call it an illness without disease. 

Patient: What does that mean? 

Doctor: It means they are having the experience of illness, but there is no medical cause for it. 

Patient: How does that explain their symptoms? 

Doctor: They have become deconditioned. You don’t want that to happen to you, do you? 

Patient: Can’t people tell the difference between being sick and being out of shape? 

Doctor: Not if they have anxiety and depression. 

Patient: Now you are becoming circular. You begin by assuming they have a psychosomatic symptom disorder, and then you keep relying on the same disorder to prove you were right in the first place. Don’t you see how patients might have a problem accepting that? 

Doctor: Not after they realize how compassionate I am. 

Patient: It sounds like you think you can read minds. 

Doctor: Yes, of course. After all, I am a doctor.

On October 13, 2021, the Journal of the American Medical Association reported that “more than half of COVID-19 survivors” experienced continuing symptoms, including fatigue and mobility impairments, six months after “recovery.” The authors of the study warned that these after-effects are occurring “on a scale that could overwhelm existing health care capacity, particularly in low- and middle-income countries.[

Washington and Lee Law Seeks Dean

This just in:

Washington and Lee University (W&L) seeks a dynamic and distinguished academic leader with a track record of notable contributions to the field of law to serve as its next Dean of the School of Law. Founded in 1850, the Washington and Lee University School of Law (W&L Law) is a student-centered school that has trained lawyers for more than a century and a half. Ranked 35th in the most recent U.S. News & World Report, W&L Law offers a highly personalized approach to legal education, emphasizing small classes and experiential education. With a relentless focus on positive student outcomes, W&L Law prides itself on the rigor of its academic program, its high employment and bar passage rates for graduates, and—most importantly—its supportive and close-knit community.

W&L Law is committed to training transformative lawyers, and its alumni are among the School’s greatest assets. W&L Law’s graduates sit on federal and state benches throughout the nation, practice law in large corporate firms and small family practices, prosecute and defend criminal cases, represent the government at the national, state and local levels, lead businesses, advise corporations, advocate on behalf of public interest groups and serve in a myriad of ways advancing society and the nation in the practice of law and various leadership roles. It counts among its alumni many distinguished practitioners, judges, and entrepreneurs, including two U.S. Supreme Court Justices and the third highest number of American Bar Association presidents produced by any single school.

W&L Law’s small size, along with the faculty’s historical focus on teaching and culture of mentorship, have fostered an intimate and supportive learning environment. W&L Law’s history is rooted in a culture of student-centeredness, emphasis on teaching, practice-experienced faculty, and student mentoring. W&L Law draws its students from a broad geographic reach; current students represent 37 states, the District of Columbia, and several foreign countries. Similarly, its alumni practice law throughout the country; on average, W&L Law graduates take the bar exam and start their legal careers in 25 different states each year. Each year, approximately 50% of each graduating class are employed in law firms (of all sizes), 25% in judicial clerkships, and the remaining 25% in government, public interest, and business sectors.

W&L Law seeks a Dean with the creativity, passion, drive, and stature to build on the Law School’s success to date. The Dean will possess a real commitment to diversity and inclusion and a genuine understanding and appreciation of the unique mission of W&L Law. The Dean will prioritize enhancing academic success and connecting with alumni and friends to further support W&L Law. Candidates must have a JD and the scholarly achievements necessary to satisfy the requirements of a tenured law professor at W&L Law.

New Mexico Law Announces Four Dean Finalists

UNM Law announced that their four dean finalists are Jason Czarnezki (Pace), Norman Bay (Wilkie Farr & Gallagher), S. David Mitchell (Mizzou), and Camille Carey (New Mexico.)

Results of Law Professor Twitter Census 2021-2022 Edition - 10/17/21

Below the fold are the results of the 2021-2022 Law Professor Twitter Census. You can also download the raw data here. The list includes areas of academic interest, for faculty who self-identified with that information. The list is arranged by school, instead of individual users' last names.

Here are responses to some anticipated questions from inquiring minds who want to know:

1. How was the census developed?

The list is based on previous censuses, conducted in 2012, 2015, 2018, 2019 and 2020. It was amended and updated by contributions from blog readers in response to this post. I added additional or deleted very few names myself, based on law prof accounts that I have happened to encounter (typically because they follow me on Twitter or I follow them) or if I knew someone had changed schools, left the academy, etc. I made no concerted effort to update the list myself.

2. How accurate is the census?

Not at all. If there are corrections, additions, etc., please feel free to email me directly at bcrawford at law dot pace dot edu.  I'll republish from time to time based on new data I receive, but likely not until next year.

3. Why isn't my information listed in the census? Why isn't my colleague's information listed?

The census relies almost exclusively on self-identification. To be included in the list, you had to actively add yourself to it (as indicated here).

4. How does this year's data compare to the numbers from prior years?

For an historical comparison, here's the data from prior years:

	2021-2022 Version (10/17/21)	2020-2021 Version (9/17/20)	2019-2020 Version (9/13/19)	2018-2019 Version (8/15/2018)	2015 Version (1/23/2015)	2012 Version (7/26/2012)
Total  Number Users	1477	1368	1310	1105	553	204

More law prof Twitter users joined in the most recent academic year than in the academic year immediately prior, but I do not expect the number of law prof Twitter users to grow substantially. My sense is that those who are interested in the medium have adopted it.

5. Who is included in the census?

The list is meant to cover only individual tweeters who are full-time faculty members at law schools.  The list is not meant to be a comprehensive account of everyone (adjuncts, librarians, practitioners, programs, institutes, students, group blogs) publishing law-related tweets. Consistent with past practice, emeritus faculty are included in the census.

6. What good is this information?

Either not at all or not much.  It might be a handy reference for quickly finding someone's Twitter handle, but I don't put any stock in the completeness or "meaning" of the info.

        7. But we must know: Which school has the most faculty members on Twitter? 

This census is useless as a metric of anything meaningful. But schools with 10 or more law profs on this list include: Boston College, Boston University, University of British Columbia, Cardozo, Colorado, Emory, Fordham, George Washington, Georgetown, Georgia, Harvard, Houston, Indiana Maurer, Indiana McKinney, Miami, Nebraska, University of New South Wales (Australia), Northwestern, NYU, Ohio State, Ottawa, Pace, Penn State, Rutgers, SMU, St. Louis University, Stanford, Tennessee, Texas A&M, Toronto, Berkeley, UC Irvine, UCLA, UNC, University College Dublin, UNLV, Utah, Virginia, Wake Forest, and Yale.

Here are responses to some anticipated questions from inquiring minds who want to know:

1. How was the census developed?

The list is based on previous censuses, conducted in 2012, 2015, 2018, 2019 and 2020. It was amended and updated by contributions from blog readers in response to this post. I added additional or deleted very few names myself, based on law prof accounts that I have happened to encounter (typically because they follow me on Twitter or I follow them) or if I knew someone had changed schools, left the academy, etc. I made no concerted effort to update the list myself.

2. How accurate is the census?

Not at all. If there are corrections, additions, etc., please feel free to email me directly at bcrawford at law dot pace dot edu.  I'll republish from time to time based on new data I receive, but likely not until next year.

3. Why isn't my information listed in the census? Why isn't my colleague's information listed?

The census relies almost exclusively on self-identification. To be included in the list, you had to actively add yourself to it (as indicated here).

4. How does this year's data compare to the numbers from prior years?

For an historical comparison, here's the data from prior years:

	2021-2022 Version (10/17/21)	2020-2021 Version (9/17/20)	2019-2020 Version (9/13/19)	2018-2019 Version (8/15/2018)	2015 Version (1/23/2015)	2012 Version (7/26/2012)
Total  Number Users	1477	1368	1310	1105	553	204

More law prof Twitter users joined in the most recent academic year than in the academic year immediately prior, but I do not expect the number of law prof Twitter users to grow substantially. My sense is that those who are interested in the medium have adopted it.

5. Who is included in the census?

The list is meant to cover only individual tweeters who are full-time faculty members at law schools.  The list is not meant to be a comprehensive account of everyone (adjuncts, librarians, practitioners, programs, institutes, students, group blogs) publishing law-related tweets. Consistent with past practice, emeritus faculty are included in the census.

6. What good is this information?

Either not at all or not much.  It might be a handy reference for quickly finding someone's Twitter handle, but I don't put any stock in the completeness or "meaning" of the info.

        7. But we must know: Which school has the most faculty members on Twitter? 

This census is useless as a metric of anything meaningful. But schools with 10 or more law profs on this list include: Boston College, Boston University, University of British Columbia, Cardozo, Colorado, Emory, Fordham, George Washington, Georgetown, Georgia, Harvard, Houston, Indiana Maurer, Indiana McKinney, Miami, Nebraska, University of New South Wales (Australia), Northwestern, NYU, Ohio State, Ottawa, Pace, Penn State, Rutgers, SMU, St. Louis University, Stanford, Tennessee, Texas A&M, Toronto, Berkeley, UC Irvine, UCLA, UNC, University College Dublin, UNLV, Utah, Virginia, Wake Forest, and Yale.

Bass Lines [UPDATED] [UPDATED]

Here are some songs with iconic bass lines (played on either bass or guitar bass strings). You can tell they are iconic because even cover versions, which artists often attempt to make distinctive, still rely on the same lines. [Don't miss the update on great session bassists at the bottom of this post.)