Lies in the name of God are still lies

Let’s be honest, we all lie, and we lie a lot.

It’s ok, we’re all friends here.  You can admit it – lying is a regular part of everyday social cohesion.  We don’t call it lying, we call it tact, but it’s still lying.

Like when we automatically say to the mother of a newborn baby, “Oh, your baby’s adorable”.  Sure, most of them are, but there are some newborns that, shall we say, need to grow into their features.

Or when a patient walks in and asks, “Hey, have you lost some weight?!”  No, I’ve actually gained five kilos, but thanks for your flattery.

Even some of the most brutally honest people still figure out they have to lie at some point.  My children, for example.  They have absolutely no diplomacy filter between their brains and their mouths, “Aw, Dad … you stink”, or “Dad, you’re really fat.  You need to exercise.”  But when their butt’s on the line, things change, “I only ate one biscuit …”, or, “He started it …”.

Adults are no better.  Sometimes when things are important enough to us, we bend the truth to fit our world-view.  It’s often subconscious, though confirmation bias of our opinions can also be overt.

Sometimes we’re right, sometimes we’re wrong, and sometimes there is no right or wrong, but our beliefs shape our interpretation of the world, and the language and actions that stem from them.  And most of the time, it doesn’t really matter.
“Chocolate is the nicest flavour of ice-cream”.
“Beer is better than cider.”
“The Broncos shouldn’t have lost the NRL Grand Final.”
“Holden’s are better than Ford’s at Bathurst.”
“Donald Trump is a great guy.” **

Hey, if you think Donald Trump is a great guy, then you’re welcome to your opinion.  It ultimately makes no difference, if you like Trump, or I like vanilla ice-cream, or if you’re a ‘Ford guy’.

Though what about when someone in the public sphere lies, or allows their opinion to shape their version of truth?  Is ‘a little white lie’ ever truly acceptable?

For example, is it justifiable if news reporters lie about themselves or their motives to get to the truth of a story?  For example, in an article written as an ethical primer for journalism students at Indiana University, Henry McNulty recalled an expose he was part of in which reporters posed as couples trying to get into the local real estate market.  The investigation exposed some inherent racial prejudice amongst the realtors, and eventually lead to the state governor ordering a formal investigation into real estate discrimination.

While he noted that the investigation had noble goals and positive outcomes for the community, he also concluded that the end should never justify the means.
“Credibility is our most important asset.  And if we deceive people in order to do our job, we’ve compromised that credibility before a word is written”, he said.

In recent times, the Safe School’s program has come under intense scrutiny.  For those not familiar with it, the Safe Schools program was touted by its supporters as an evidence-based anti-bullying program for mid-late primary school students, although its primary agenda appears to be in promoting the Lesbian-Gay-Bisexual-Transgender (LGBT) lifestyle and ideology.  Or as one commentator put it, “In reality, the debate is between those who support the right to childhood and children’s bodily dignity, the right to an education that educates, not indoctrinates, versus those who believe Marxist activism constitutes sound school curriculum.”

A post came up on my Facebook feed in the last couple of days, titled, “Gender Ideology Harms Children”.  It was published by the American College of Pediatricians, which sounds like an official body, except that the American Academy of Pediatrics is the peak body of paediatricians in America. Then the style of language of the statement was inconsistent with that used by most peak bodies – this statement by the American College of Pediatricians was very strongly partisan.  I couldn’t help but wonder who the American College of Pediatricians actually were.

As it turns out, the American College of Pediatricians are a group that promote a very conservative agenda under the guise of official medical and scientific opinion.

In their core values, they state that their college:
“A: Recognizes that there are absolutes and scientific truths that transcend relative social considerations of the day.
B: Recognizes that good medical science cannot exist in a moral vacuum and pledges to promote such science.”

I’m all for good science, but one has to wonder if they’re going about it the right way, because while they declare their pledge to scientific truth, their next core value is essentially an opinion:
“C: Recognizes the fundamental mother-father family unit, within the context of marriage, to be the optimal setting for the development and nurturing of children and pledges to promote this unit.”

As much as I agree with and share most of their values, their pledge to opinion-based science is somewhat duplicitous, because opinion-based science isn’t absolute truth, it’s still a version of truth relative to their values and presumptions.

The irony hasn’t escaped some of the colleges critics, who have highlighted some of the factual errors and bad science that inevitably occurs when one tries to fit scientific findings into a set of values rather than drawing conclusions from the science.

In fairness, I’m not saying that the LGBT community is faultless either.  I’m sure that an in-depth study of their sources would find some over-zealous misinterpretations of scientific data as well.

My point is that we tend to look for information that suits our own pre-conceived notions, and the Christian community can get itself into trouble by doing this.  Christian lobby groups and church leaders need to be wary selectively accepting ‘scientific’ information that conforms to their world-view.  They need to, in all diligence, ensure that the data they cite really does support their position, not cherry-pick or over-extrapolate.  Otherwise they’re no better than the moral relativists on the other side of the political spectrum, or journalists who would justify mistruth to achieve a higher goal, or my eleven-year-old denying his biscuit binge.

One critic of the American College of Pediatricians wrote something very incisive in the title of his blog, “Lies in the name of God are still lies.”

It’s a fair call.  Misleading with the best of intentions is still misleading.  We may have the best of intentions, and feel justified in picking the science that conforms to our world-view.

Even so, God called us to speak the truth, because Jesus was the way, truth and life, and it’s the truth that sets us free.  And our credibility is our witness.  If we deceive people in order to do our job, we’ve compromised that witness before a word is written.

That’s the honest truth.

** The opinions expressed here do not necessarily represent those of the authors, and are for illustrative purposes only … except the bit about the Broncos … but the rest is just illustrative. 

Should pregnant women still take antidepressants if they’re depressed? – SSRI’s and the risk of autism

As is my usual habit, I sat down tonight to do something useful and wound up flicking though Facebook instead.  Procrastination … avoidance behaviour … yeah, probably.  But at least this time it turned out to be rather useful procrastination, because I came across a science news story on Science Daily about a study linking the use of anti-depressants in pregnancy with an 87% increased risk of autism.

Actually, this is old news.  Other studies have linked the use of some anti-depressants with an increased risk of autism, such as Rai et al in 2013 [1].

The latest study to come out used data from a collaboration called the Quebec Pregnancy Cohort and studied 145,456 children between the time of their conception up to age ten.  In total, 1,045 children in that cohort were diagnosed with autism of some form, which sounds like a lot, but it was only 0.72%, which is actually lower than the currently accepted prevalence of autism in the community of 1%.

What the researchers got excited about was the risk of developing autism if the mother took an antidepressant medication at least at one time during her pregnancy.  Controlling for other variables like the age, wealth, and other health of the mothers, a woman who took an anti-depressant during pregnancy had a 1.87 times greater chance that her baby would end up with ASD, compared to women who did not take an anti-depressant [2].

An 87% increase sounds like an awful lot.  In fact, it sounds like another reason why anti-depressants should be condemned … right?

Well, like all medical research, you’ve got to consider it all in context.

First, you’ve always got to remember that correlation doesn’t always equal causation.  In this particular study, there was a large number of women being followed, and their children were followed for a long enough time to capture all of the likely diagnoses.  So that’s a strength.  They also tried to control for a large number of variable when calculating the risk of anti-depressants, which also adds more weight to the numbers.

Although the numbers are strong, studies like these can’t prove that one thing causes another, merely that they’re somehow linked.  It might be that taking anti-depressants causes the brain changes of autism in the foetus, but this sort of study can’t prove that.

Even if the relationship between anti-depressants and ASD was cause-and-effect, what’s the absolute risk?  Given the numbers in the study, probably pretty small.  With a generous assumption that ten percent of the study population was taking anti-depressants, the increase in the absolute risk of a women taking anti-depressants having a child with ASD is about 0.5%.  Or, there would be one extra case of autism for every 171 that took anti-depressants.

Hmmm … when you think of it that way, it doesn’t sound as bad.

You also have to consider the increase in risk to women and their offspring when they have depression that remains untreated, or in women that stop their anti-depressant medications.  There is some evidence that babies born to women with untreated depression are at risk of prematurity, low birth weight, and growth restriction in the womb, as well as higher impulsivity, poor social interaction, and behavioural, emotional and learning difficulties.  For the mother, pregnant women with depression are more at risk of developing postpartum depression and suicidality, as well as pregnancy complications such as preeclampsia, and an increase in high-risk health behaviour such as smoking, drug and alcohol abuse, and poor nutrition.  Women who discontinued their antidepressant therapy relapsed significantly more frequently compared with women who maintained their antidepressant use throughout pregnancy (five times the rate) [3].

So the take home messages:

  1. Yes, there’s good evidence that taking anti-depressants in pregnancy is linked to an increased risk of a child developing autism.
  2. But the overall risk is still small. There is one extra case of autism for every 171 women who take anti-depressants through their pregnancy.
  3. And this should always be balanced out by the risks to the mother and child by not adequately treating depression through pregnancy.
  4. If you are pregnant or you would like to become pregnant, and you are taking anti-depressants, do not stop them suddenly. Talk to your GP, OBGYN or psychiatrist and work out a plan that’s best for you and your baby.

References

[1]       Rai D, Lee BK, Dalman C, Golding J, Lewis G, Magnusson C. Parental depression, maternal antidepressant use during pregnancy, and risk of autism spectrum disorders: population based case-control study. Bmj 2013;346:f2059.
[2]       Boukhris T, Sheehy O, Mottron L, Bérard A. Antidepressant use during pregnancy and the risk of autism spectrum disorder in children. JAMA Pediatrics 2015:1-8.
[3]       Chan J, Natekar A, Einarson A, Koren G. Risks of untreated depression in pregnancy. Can Fam Physician 2014 Mar;60(3):242-3.