Critical thinking, media literacy, and ethics in science and clinical practice
Session context and setup
Instructor acknowledges midterm performance; high class average noted by Academic Affairs as unusually high
Final exam: covers entire course (including limited readings); broader context but not more difficult
If students score poorly, they can meet with instructor (Nilsa) to review
Attendance check conducted; total attendance number given later
Critical lens on science, media, and trust
Review of a Lancet correspondence (03/07/2020) commenting on COVID-19 origins
Lancet statement: supports scientists, public health, medical professionals in China; asserts natural origin of COVID-19 and rejects lab-leak theory
The speaker argues the piece is loaded with inflammatory language and functions as an appeal to faith in science
The article’s signatories include people connected to the Wuhan lab; many had potential conflicts of interest not declared
The format and the sign-on invitation (“We declare no competing interests” followed by “sign our letter online”) as a potential manipulation of scientific credibility; this is described as a “bulldozer effect” that undermines legitimate debate
The Lancet piece is criticized for relying on authority rather than open methodological critique; questions about the role of media format in shaping scientific consensus
Core definition: what it means to be a “man or woman of science”
A sophisticated consumer of research: knows where literature exists, can read and critique it, can separate legitimate from illegitimate findings, and can apply valid knowledge to patient care
Reference to Marshall McLuhan: “The medium is the message”; the Lancet correspondence as a medium affects how the message is perceived
Distinction between primary scientific submissions (rigorous peer review) and correspondence pieces in top journals (subject to review but less stringent)
Historical reflections on media and knowledge transmission
McLuhan’s idea tied to a Canadian journalist and media scholar
Patricia Goodson’s 2014 paper: “Questioning the HIVAIDS Hypothesis: Thirty Years of Dissent” (public health journalism)
Argues ongoing controversy about AIDS causation (HIV vs alternative factors)
Peer-reviewed in a reputable public health journal; later labeled as an “opinion” piece by editors due to controversy
2015: author attacked ad hominem; editor retracts the original article five years after publication
The retraction triggers increased attention and public debate due to high online views (e.g., 135{,}237 views)
Social media and misinformation dynamics
Facebook misinformation widely clicked; misinformation sometimes achieves more engagement than factual content
The editor’s retract and ensuing controversy illustrate clashes between peer review, editorial decisions, and public discourse
Learning to think critically about evidence and the risk of consensus bias
The transition from confident authority to ongoing scrutiny
John Ioannidis, Stanford professor: Why Most Public Research Findings Are False
Argues that most tested hypotheses do not hold; publication bias leads to a literature skewed toward positive results
If positive and negative evidence were published equally, most articles would report no findings
Publication bias and the “paradox of promising connections”
When three papers test a hypothesis, one may show a positive result; two show negative results but negative results are less likely to be published
Leads to literature that overstates evidence for a connection
The importance for scientists to distinguish data quality and replication credibility from journal prestige
Data literacy and inference in biomedical research
Diamond detector analogy (hypothetical): 99\% accuracy detector identifying diamonds among rocks
If two rocks trigger the detector, probability of both being true positives is no longer guaranteed; risk of false positives increases with more detections
Monty Hall-like switching logic is not universally applicable to scientific evidence; decision thresholds depend on context and prior probabilities
Bayer experience: among cancer drug discoveries, about 75\% of studies in top journals could not be replicated; internal corporate studies may be more reliable than publicly published university studies
Takeaway: even highly credentialed journals do not guarantee truth; clinicians must assess methods, replication, and real-world applicability
The pipe image, perception, and the line between fantasy and reality
The classic Magritte-style “This is not a pipe” exercise: 88\% believed the image to be a pipe; 12\% correctly identified it as a picture of a pipe
Implications for literacy: people readily internalize conventions, tropes, and media symbolism; reality is mediated by representation
The evolution from cave paintings to external data storage (The Square and the Tower; Neil Ferguson)
External storage gave rise to a learned class; literacy and access to information historically restricted to elites (Cognisphere)
The evolution of media and literacy in society
Three great transitions in media (James O’Donnell, Avatars of the Word):
Spoken word to written word (cuneiform, scrolls)
Scroll to codex (books) enabling tables of contents, dictionaries, encyclopedias
Internet and non-linear access to information (plus AI) transforming knowledge access and dissemination
Scrolls: limited length, heavy, linear access; difficult to search; learning severely constrained
Codex: more user-friendly, enable indexing and rapid lookup; helped build modern scholarship and literacy
The Cognisphere era versus universal digital access: contrast between elite knowledge networks and broad, unmediated information streams
The learned class, literacy, and social dynamics
Augustine and Jerome as early individuals who navigated knowledge networks; contrast with peasant literacy and limited access in medieval Europe
The shift from a world lit by fire to an age of information abundance
The internet’s impact on social dynamics: non-linear access to information changes how people seek, verify, and trust knowledge
Reading, comprehension, and the psychology of communication
Word shape reading: people can read a sentence even with jumbled internal letters if the first and last letters are in place; underscores the brain’s ability to reconstruct meaning from patterns
Email and emojis: paralinguistic cues matter; punctuation and visual cues help disambiguate meaning
The ethics of communication: how misreading or miscommunication can arise from format, typography, or missing context
The Stroop effect, cognitive dissonance, and practical implications
Stroop test: naming the font color of color words (e.g., the word “red” written in blue font) is harder when reading automatically interferes with color naming
Classic Stroop demonstration: reading is automatic; naming ink color requires suppressing reading tendency
Harvard study variant: using offensive words slows color naming even more; demonstrates cognitive interference and cognitive dissonance
Applications: advertisers exploit Stroop-like effects to capture attention; dentists and patients can experience perceptual dissonance in clinical settings
The Myths of the Digital Native and Multitasker: cognitive processing is sequential, not truly parallel; multitasking is rapid task-switching with a cognitive cost
Implications for students: deep focus yields higher-quality work; multitasking degrades performance
Advertising, ethics, and professional professional norms in dentistry
Advertising evolution in dentistry
Early era: strict norms against advertising; minimal listing in Yellow Pages; no depictions of anatomy
Advertising allowed to a degree; debates about professionalism and information quality
California Dental Association v. FTC case: FTC found that advertising restrictions harmed competition and deprived consumers of information; truthful and non-deceptive advertising would have been useful to consumers
The advertising debate in the context of professional ethics
Tension between professional identity and commercial incentives
The question: can advertising be a legitimate tool to inform patients, or does it erode professional credibility?
The “Profit with Honor” concept by Daniel Yankelovich
An ethics ladder: staying within the law is easy; the harder part is passing the “smell test” (perceived integrity)
Higher ethical standard: stewardship ethics or CSR (corporate social responsibility) or a credo
The Ritz-Carlton credo as a model of ethical practice
Mission statement: care and comfort of guests are the highest mission; personal service; warm, refined ambiance; anticipates unexpressed needs
Emphasizes authenticity, consistency, and trust across all levels of the organization
Practical takeaway: ethics in professional practice requires aligning inner values with actions and organizational culture; creating a clear mission statement helps guide behavior and decision-making
Consent, ethics, and medical history
Nazi doctors and moral lessons
Nuremberg trials: physicians had the highest conviction rate among professionals implicated in human experimentation
Forcible sterilization programs in Nazi Germany; medical establishment exceeded state quotas
Tuskegee Syphilis Study (1932–1972)
400 African American men with syphilis; no treatment provided to observe the natural history
Support for continuing the study from some professional bodies; ethical critiques and eventual exposure
Plutonium injections at UCSF (1945–1947)
Patients injected with plutonium without written consent; potential cancer risks; lack of informed consent
Informed consent today
The evolution from minimal oral “consent” to formal documented consent with risks, benefits, and alternatives
The ongoing ethical obligation to protect patients and respect autonomy
Ethics, legality, and morality: definitions and overlaps
Key distinctions and overlaps:
Legality: what the state permits or prohibits; has a monopoly on lawful violence; laws can change over time
Morality: normative judgments about good and bad behavior within a culture or subculture
Ethics: study and application of what is right and wrong within a professional or societal context; prescriptive norms
Intersections and differences
Something can be illegal but not immoral or unethical (e.g., minor traffic violations)
Something can be immoral but not illegal or unethical (depending on religious or cultural contexts)
Something can be unethical but not illegal (e.g., professional advertising violations)
Ethics in dentistry
Professional ethics governed by organizations (e.g., ADA, American College of Dentists) with prescriptive norms and standards
Joining different organizations may involve different ethical codes (e.g., Uniform Code of Military Justice for military service; different standards for civilian practice vs. military)
The role of choice in ethics
Values are often set within existing structural possibilities and reasons; individuals choose among established options rather than creating new ones from scratch
The dynamics of professional culture, advertising, and self-presentation
Advertising evolution and professional reputation
Old norms limited advertising but allowed some informational content; shift toward more public-facing marketing in some contexts
The social psychology of professional image
The idea that “those who know do not tell; those who tell do not know” (a caution about professional knowledge and how it is communicated)
The ethics of professional representation
The importance of honest, transparent communication and avoiding misrepresentation or manipulation
Concluding notes and upcoming topics
Preview of forthcoming discussion: how thinking patterns influence patient decision-making
Announcement of guest speakers: Barbarie Vartanian (inspirational figure) and Scott Kellerman (retired physician turned humanitarian in Uganda)
Gary Parker (Mercy Ship, oral surgeon) as another inspirational case study; his work in global health and surgical care
Emphasis on consent, autonomy, and ethical practice in real-world clinical contexts
Reminder of the broader themes: critical thinking, media literacy, evidence evaluation, and ethical practice in healthcare
Quick reference to key numbers and symbols from the lecture (for exam-ready recall)
03/07/2020: Lancet correspondence date
50{,}000: number of wet markets in China (context for COVID-19 origin discussion)
1: Wuhan Institute of Virology (context for lab-leak discussions)
135{,}237 views: views for Patricia Goodson’s HIV/AIDS paper (as reported)
0.01 (p = 0.01): significance level in a hypothetical detector analogy (diamond analogy)
0.05: typical significance threshold in biomedical research (5\%)
0.75: 75\% of cancer drug studies could not be replicated (Bayer case citation)
0.99 (99\%) or 0.88 (88\%)/: detector accuracy and survey responses in related examples
101 rocks: initial rock field example for decision under uncertainty
2 rocks: illustration of two-detection scenario in the analogy
0.5 (50\%): midpoint in probability when considering two detections
Final reminder
The overarching goal is to cultivate men and women of science: sophisticated consumers of research who can discern credible evidence, understand the role of media, and apply ethical principles to patient care
Stay engaged with class discussions, attend guest sessions, and integrate ethical reasoning with clinical decision-making