The Faculty Lounge

How Britain's New NICE Guidelines Repudiate the CBT/GET School of ME/CFS Treatment

This is a guest post by Brian Hughes, professor of psychology at the National University of Ireland, Galway. It originally appeared on his blog, The Science Bit.

No More Mr NICE Guy…

Written by Brian Hughes on November 21, 2020

The newly released draft NICE guidelines for the management of “myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome” continue to cause a stir.

And rightly so. The new guidelines not only repudiate a heretofore favoured treatment approach for a particular illness, they also threaten to discredit an entire (albeit quirky) branch of medicine — and, for good measure, to cast clouds over significant swathes of psychology too.

* * *

Some of the content of the NICE documents is simply breathtaking. Here is an extract from expert testimony provided by Jonathan Edwards, professor emeritus of clinical medicine at University College London:

“Reviewing clinical trials in CFS/ME came as something of a shock to me in terms of methodologies considered acceptable…

What surprised me about PACE and other trials in ME/CFS was not so much that therapists were still using unproven treatments but that anyone should think it worth doing expensive formal trials with inadequate methodology.”

and

“Recent comments by three PACE authors in a published response to critique indicate how little the difficulties of expectation bias are understood.

The authors say that they prefer the altered outcome criteria that they introduced post-hoc because they gave results more consistent with previous studies and their clinical experience.

They do not seem to realise that outcome measures need to be predefined in order to avoid exactly this sort of interference from expectation bias.”

In other words, they couldn’t see the problem with having marked their own homework.

John Brown (May 9, 1800 - December 2, 1859)

On this day in 1859, John Brown was hanged for treason against the Commonwealth of Virginia. The introduction in this clip gets some of the facts wrong, but it is a powerful performance of his final speech at sentencing:

After the jump, Paul Robeson sings "John Brown's Body."

Northwestern Pritzker Seeks Director of SCOTUS and Appellate Advocacy Clinic

Northwestern Pritzker School of Law invites applications for a clinical faculty position to serve as the Director of its Appellate Advocacy Center, a Center in the Bluhm Legal Clinic, which includes the Federal Appellate Clinic and the Supreme Court Clinic. The Center represents clients appealing their cases before the U.S. Court of Appeals for the Seventh Circuit and the United States Supreme Court, and, using the tools of non-directive clinical pedagogy, provides students with opportunities to participate in appeals. In the Federal Appellate Clinic, faculty and students represent indigent criminal defendants before the Seventh Circuit; in the Supreme Court Clinic faculty and students collaborate as part of a Supreme Court litigation team in partnership with attorneys at Sidley Austin LLP.  

Candidates will be considered for appointment to the faculty of the Bluhm Legal Clinic of Northwestern Pritzker School of Law at a rank commensurate with experience and qualifications. We seek applicants for this position with distinguished academic records and/or a demonstrated track record of directing, developing, and teaching appellate advocacy or training courses.

Applications accepted here: Apply for Job

Please contact Elizabeth Fritz (elizabeth.fritz@law.northwestern.edu), Associate Director of Faculty Affairs, with any questions. 

More information after the jump.

Fellowship Announcement: The Ohio State University, Moritz College of Law

From an email message I received recently:

The Moritz College of Law invites applications for the position of Jeff & Cynthia Harris Fellow in its Entrepreneurial Business Law Clinic (EBLC) to start in Summer 2021.

The Fellow will assist the Director of the EBLC in running and teaching the clinic, which provides third-year law students with the opportunity to learn transactional lawyering skills by representing entrepreneurs, startups, small businesses, and nonprofit organizations. EBLC students typically work with clients on all phases of starting a business, including client intake, entity formation, and contract drafting. Students also learn how to protect and license the intellectual property of a business and how to use and secure licenses for others’ intellectual property. The Fellow will have several areas of responsibility, including 1) classroom teaching of lawyering skills, 2) supervising law students who represent clients under the Ohio Supreme Court’s student practice rule, and 3) engaging with the local and regional entrepreneurial community. The Fellow will be invited to participate in the academic life of the College of Law. A Fellow who wishes to engage in academic research will be supported in doing so.

This is a 12-month contract with full University fringe benefits, presumptively renewable for a second year. The ideal start date will be July 1, 2021. The successful candidate will begin teaching in August 2021. The College of Law is an integral part of one of the world’s great research and educational institutions. Founded in 1891 and consistently ranked nationally as a top-15 public law school, the College boasts a collegial community of approximately 570 students and more than 50 faculty members. The College is known for its rigorous academic program, the pioneering research of its world-class faculty, a deep commitment to teaching and professional training, and the development of future leaders. The Ohio State University is committed to establishing a culturally and intellectually diverse environment, encouraging all members of our learning community to reach their full potential. The Ohio State University is an equal opportunity employer.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability status, or protected veteran status. Requires successful completion of a background check.

To apply for this position, please send an email including all application materials to moritzhr@osu.edu  with the title of this position in the subject line. Please include a resume, list of 3 references, and cover letter. Applications are due by December 31, 2020 and will be reviewed on a rolling basis. Interviews are expected to take place in January 2021. Questions can be directed to Professor Paige Wilson at wilson.3980@osu.edu. More information is available at https://www.jobsatosu.com/postings/104547.

Ave Maria Law Seeks Director of Clinics

This just in:

Ave Maria School of Law seeks applicants for a tenure-track position to begin in the 2021-2022 academic year. Specifically, the Law School seeks to hire a Director of Clinics who can run a veterans clinics as well as manage the other clinical offerings provided by the Law School. Applicants must have a Juris Doctorate or equivalent degree and a strong academic record, as well as knowledge of veterans law. Clinical experience and administrative skills are particularly desirable. Duties will also include teaching, scholarship, and service to the law school community.

Ave Maria offers students a distinctive legal education marked by the integration of the Catholic faith and the law. Students are trained to reflect critically on the law and to understand that all areas of legal practice serve the common good. The law school emphasizes the importance of faith and community among its faculty, staff, and students, and seeks applicants attracted by, and supportive of, its mission.

Ave Maria has an increasingly diverse student body and desires to provide students with faculty role models and mentors of shared background and experience. As such, we particularly encourage applications from women and members of underrepresented groups within the profession.

Ave Maria is located in Naples, Florida along the coast of the Gulf of Mexico. Naples has been recognized for its healthy lifestyle and excellent quality of life, and is known for its cultural activities and institutions as well as for its many and varied natural attractions.

Applicants should send a cover letter and resume to Professor Mollie Murphy, Chair, Faculty Appointments Committee, at mmurphy@avemarialaw.edu, and to Kathleen Shelmerdine, Director, Human Resources Office at kshelmerdine@avemarialaw.edu.

Law and Society Association Announces Call for Nominees for Prizes and Awards

The Law and Society Association is soliciting nominations for various awards for scholarship in the field of law and society. The awards will be presented at the Annual Meeting.  More info available on the LSA homepage here.

Below the fold is a list of all the prizes.  

I served as chair of one of the prize committees last year comprised of diverse group of international scholars. Our committee really did read all of the submissions with care, so please consider nominating yourself or a colleague! (Some prizes require that nominators be LSA members; 2020 or 2021 memberships count for this purpose.)

Call for Submissions for the Distinguished Scholarship Award in Election Law

In addition to the John Hart Ely Prize, the AALS Section on Election Law has established a second professional award this year: the Distinguished Scholarship Award in Election Law.

This prize will be awarded annually for “a single work that exemplifies excellence in the field and that is published within a given year.” The term “work” is defined broadly.  

Any scholarly work that has been published in 2019 or 2020 will be eligible for this year's award. If you have published an article, book, or other piece of scholarship and wish for it to be considered for this award, please let Gene Mazo, Chair of the Section on Election Law, know by Monday, December 7, 2020. You can write to him at eugene.mazo@louisville.edu.

Columbia’s Richard Briffault Wins John Hart Ely Prize in the Law of Democracy

This just in from Gene Mazo:

The AALS Section on Election Law has established a new lifetime achievement award: the John Hart Ely Prize in the Law of Democracy. This prize will henceforth be presented annually by the Section’s executive committee to a senior scholar for his or her "extraordinary lifetime contributions to election law or the law of democracy in the United States." The John Hart Ely Prize is intended to serve as the most prestigious award in the field of election law.

We are very pleased to announce that the inaugural winner of the John Hart Ely Prize is Professor Richard Briffault of Columbia Law School.

Professor Briffault has taught election law longer than any other active scholar in the American legal academy. He is the author of more than 75 law review articles, in the process profoundly influencing our understanding of public funding, campaign finance, state and local government law, and other topics in the law of democracy.

The John Hart Ely Prize will be presented to Professor Briffault at an AALS awards ceremony on Tuesday, January 5, 2021 at 1:15 p.m. If you will be attending AALS this year, please try to make it.

Congratulations to Richard!

Proposed British Guidelines Reject Useless Chronic Fatigue Syndrome Treatments

As David Tuller and I explain in a new article on STAT, there is finally some good news from the U.K. on ME/CFS. The influential National Institute for Health and Care Excellence (NICE) has issued a new draft guideline, rescinding it previous recommendation of graded exercise therapy (GET) and cognitive behavior therapy (CBT). This change is a repudiation of the psychiatric school that has been pushing these therapies for decades, on the theory that ME/CFS symptoms are caused by "unhelpful illness beliefs." Most U.S. medical authorities -- including the CDC and Mayo Clinic -- have already stopped recommending GET and CBT, so the NICE draft is an important step toward bringing British medicine up to date, and making it more humane toward ME/CFS patients.

Here is the gist of our STAT article:

In a draft of new ME/CFS clinical guidelines released last week, a key British agency has not only explicitly rejected graded exercise therapy and cognitive behavior therapy as treatments for this condition but also the rationales behind them. The draft from the National Institute for Health and Care Excellence (NICE) acknowledges that there is “no therapy based on physical activity or exercise that is effective as a treatment or cure for ME/CFS” — just what patients have argued for years. Moreover, notes the draft, “CBT is not a cure for ME/CFS and should not be offered as such,” although the therapy may help patients “manage their symptoms.” The new guidelines will replace a 2007 version that promoted the two interventions.

Medicine can be both wondrously innovative and stubbornly resistant to change. In 1847, the Hungarian physician Ignaz Semmelweis could not convince his fellow doctors in Vienna to wash their hands before delivering babies as a way to prevent often fatal cases of puerperal fever in new mothers. It would be another 30 years before Joseph Lister gained widespread acceptance for his approach to sterilization and aseptic surgery.

Things are better these days, with an average time lag of only 17 years before research evidence reaches clinical practice. The British psychiatrists and others still pushing graded exercise therapy and cognitive behavioral therapy for ME/CFS have done their part to keep the median delay as high as it is.

Clinical guidelines developed by NICE are influential in medical practice around the world, including in the U.S. Its new draft on ME/CFS is a long-overdue and much-needed corrective to years of misguided and potentially harmful recommendations.

You can read the entire article here.

Updated Guide to Submitting Essays, Commentaries, Reviews to Online Law Review Companions

I've updated and expanded my guide to submitting to online law review companions at 60 law schools. It is here on SSRN. 

As before, the document contains information about word count limitations, subject matter preferences, submission details and other guidelines authors may find relevant when considering sending their work to law review presences online. There's a column indicating whether the online companion articles are included in the HeinOnline Law Journal Library.

Corrections, additions, refinements to this chart are always welcome.

 

Among Sidney Powell's Distinctions

Both the Washington Post and New York Times have published profiles of Sidney Powell. The Post reports:

At the age of 23, Powell was hired as an assistant U.S. attorney in San Antonio, a distinction she has many times said made her then the youngest federal prosecutor in the country.

I don't doubt that she was the youngest AUSA in 1978, when she graduated from UNC-Chapel Hill and began her career in Texas, but she was not the youngest AUSA in history.

That was Roy Cohn, who graduated from Columbia law school at age 20 and had to wait until his next birthday to be admitted to the bar. Irving Saypol, U.S. attorney for the SDNY, hired him that day (Cohn was already working in the office as a clerk).

Jambalaya

"Jambalaya (On the Bayou) was written and released by Hank Williams in 1952, reaching number one on the country charts where it remained for fourteen weeks. It may be the most frequently covered number of all of Williams's great songs. There has always been speculation that piano player Moon Mullican coauthored the music, receiving under-the-table royalties even though his name does not appear on the copyrighted music. Mullican released a version of "Jambalaya" in the same year as Williams, though it has been mostly forgotten (listen to it at the bottom of this post).

Unfortunately, there is no video of Hank Williams performing "Jambalaya.")

Hard Times (ca 2020) Come Again No More

 

 

Tenure in Office

"The Prince of Pompadoodle, by the great Walt Kelly; posted here without further comment:

Continue reading The Prince of Pompadoodle after the jump:

Confirmation Bias is a Helluva Drug

I have this post up today on Social Science Space:

Confirmation Bias Is a Helluva Drug

Published on   by Steven Lubet

Intense political partisanship can lead to extraordinary cognition errors. It is therefore unsurprising that President Trump’s supporters see ballot-fraud conspiracies behind even the slightest voting irregularity, while every presidential tweet is taken for proof that the election is being stolen. For the most-avid MAGA enthusiasts, there is apparently no claim too wild to embrace, as confirmation bias does its inexorable work.

We expect to see confirmation bias play an active role in the politics, where there is a satisfying emotional payoff from assuming the worst of the other side. We do not expect the same phenomenon among highly educated professionals, especially in their seemingly well researched publications. But it turns out that even the most astute physicians, in the grip of motivated reasoning, may end up believing fantastical tales about lawyers and the legal system, so long as they confirm their assumptions about medical malpractice abuse.

Consider Dr. Paul Offit, a renowned academic pediatrician and vaccinologist, with a well-earned reputation as the scourge of scam artists, quacks, and dangerous frauds. His many outstanding books have exposed autism’s “false prophets,” the harms inherent in the anti-vaccine movement, and the dangers of taking advice from celebrities and politicians. In 2013, he won Robert P. Balles Prize in Critical Thinking from the Center for Skeptical Inquiry for Do You Believe in Magic?: The Sense and Nonsense of Alternative Medicine. There may be no doctor in America more identified with critical thinking than Paul Offit.

Nevertheless, Offit himself recently fell for a patently phony story about medical malpractice.

Post-Election and Post-Zoom Blues...

Most of us are experiencing the double whammy of reacting to an extremely contentious and never-ending presidential election, and at the same time, we were finishing our first full semester of distance teaching (and some like me, have even become elementary school teachers to our children, ugh!). Obviously, these stresses were considerable. Indeed, a host of articles provide us useful guidance on how best to cope with the election. Fewer articles explore the impact of Zoom on teachers and students, though some in fact have labelled the phenomena: Zoom fatigue. Not enough articles however have explored much needed self-assessment of the effectiveness of our Zoom teaching efforts. I suspect many reviews will have to wait for student evaluations. Despite that wise decision, I believe it would be useful to start to honestly ponder how much students learned, and whether they learned effectively. 

For instance, I often teach 70-170 students per fall semester, often teaching two sections of torts. I perhaps was a bit lucky this semester because I previously asked for a break from teaching torts. Instead, this semester I taught upper-level courses--products liability and administrative law--where I could focus on teaching practical lawyering skills. Each class had roughly dozen students. In that environment, teaching via Zoom had many benefits. I could literally look into each student's eyes, albeit via a computer, and tell if they were understanding the materials, had questions, or simply disagreed with me. Zoom-teaching also allowed me to easily and seamlessly add extra-sessions with all or some students, based on my practicum-based class structure and grading system (in each class, the students were paired and had to litigate a case based on the theory taught in class coupled with a real-life fact pattern). While I look forward to the students reactions, last week I invited several of my colleagues to attend the final oral arguments in each class. I believe my fellow-professors and dean were extremely impressed with our students (no surprise in some respects because FIU Law students are consistently outstanding). Thus, it appears in these courses, Zoom-learning worked.

I nonetheless wonder, what if instead of teaching these soon-to-be lawyers, I had to teach from 70 to 170 first-year law students. Would I be able to effectively teach them negligence? Strict liability? Intentional torts? At first blush, it may sound fairly easy, but I would disagree. It is one thing to use Zoom for a dozen students, but it is an entirely different animal to teach 50 or more students via Zoom? Last spring for instance, I had the pleasure to teach at a neighboring law school. When we started the semester with in-person teaching, the students were a joy, and for me, it was teaching as usual. However, when the pandemic hit, it was a challenge to teach over 100 students with up to five separate Zoom pages in each class setting? I simply could not effectively tell who or how many were listening? How many were engaged? Then when the school changed the course's grading to pass/fail, that challenge only grew. As we tend to do, I adjusted. I taught the best I could under the circumstances--holding extra sessions, extra reviews, and even sharing my class notes for every class. But the question remained: was it enough?

While I look forward to your reactions, I believe Zoom works in some settings: small classes with upper-level students. I do not believe it works well with large classes, such as with our first-year curriculum. Perhaps the vaccine(s) will make the above moot? I nonetheless believe much more research and discussion is needed, especially if we are to stay apart for a longer period than we first expected. 

Mary Davis Named Sole Dean Finalist at Kentucky Law

Interim dean Mary Davis has been named the only finalist candidate in the University of Kentucky's internal search for a new law school dean.