Talk:Christine Maggiore/Archive 2

Archive 1

Archive 2

Offering help

Hello. My name is David Crowe, formerly going by an obscure IP address (due to my lack of knowledge of how Wikipedia works not any desire to be anonymous). I'm interested in getting the Christine Maggiore page accurate and factual to avoid an editing war. Much of the mainstream information posted is not correct, but it's very hard to add the correct information and then all the references if it gets taken down right away. I propose that we start at the top of the article and work down until we can agree on the content of every paragraph, removing everything that is controversial if we can't come to an agreement. I'm still trying to learn how the wikipedia codes for references work. So rather than take down stuff that doesn't have a reference it might be more productive to request one as, in every case, they do exist.

• Paragraph 1: "Christine Maggiore is an HIV-positive activist and...". I agree with the contents of this paragraph.
• Paragraph 2 has a number of problems. First of all, medication cannot be shown to prevent the transmission of HIV unless HIV has first been purified. Since HIV has never been purified, this is impossible. Medication has been shown to reduce the risk of finding fragments of DNA/RNA considered to be from HIV and to reduce the risk of finding antibodies believed to be from HIV. I cannot provide a reference for the statement that HIV has never been purified because I cannot prove a negative, but I request that someone provide a reference for purification of HIV. Obviously without purification it could not be known if HIV had been transmitted or not.

—Preceding unsigned comment added by DavidRCrowe (talk • contribs)

Thanks for bringing your comments to the talk page. I think the issue is one of reflecting a scientific consensus. There is a general scientific consensus (disputed by a small but vocal minority) that HIV has been purified, that it is the cause of AIDS, that HIV testing is accurate, etc. I will grab a reference on purification, although it will probably not satisfy you as I know one dissident camp disputes the methods by which HIV has been cultured. Deciding whether a scientific consensus is "right" or not is outside the scope of Wikipedia; the goal here is generally to reflect the majority view as the majority view, and to give it correspondingly more weight than views held by a small minority of scientists. That said, there is quite a bit about AIDS dissident arguments at AIDS reappraisal, and that page could be linked from here; however, re-fighting all of the arguments about whether HIV exists, is pathogenic, etc is outside the scope of this article. The relevant Wikipedia guidelines are WP:NPOV and the WP:NPOV/FAQ. These are my 2cents, and I will grab the reference you requested. There are not many editors on this page, but often with controversial issues it can be worth seeking outside input depending on how well we can figure out a compromise. Again, thanks for coming to the talk page. MastCell 04:56, 28 November 2006 (UTC)

I have removed the entire page. If anybody wants to work on a consensus page I am willing to help, but we cannot tolerate the publication of libellous material. Perhaps we can develop it on the sandbox instead. If not I will start uploading our material, ensuring that I have references for every statement that is made. DavidRCrowe 18:58, 28 November 2006 (UTC)

I think we all share a desire to avoid libeling anyone. However, can you specify which parts of the page you considered libellous? In general, your edit to the page could be considered a legal threat, which is frowned upon on Wikipedia. That said, again, if there is material you consider libellous, please specify your concerns, as I would definitely like any potentially untrue/defamatory material removed immediately. If you have other concerns about the content of the page or how it is presented, they are generally worked out here with gradual changes, rather than blanking the page entirely. If your objective is to replace the page, which was heavily sourced from the mainstream media, with "your material", then there's a very real problem here and I'd suggest reviewing the Neutral Point of View policy. MastCell 23:51, 28 November 2006 (UTC)

Deleting "Maggiore had not taken medication to reduce the risk of transmission of HIV to her daughter, as she does not believe that HIV causes AIDS. Eliza Jane had never been tested for HIV.[2] "

I have deleted "Maggiore had not taken medication to reduce the risk of transmission of HIV to her daughter, as she does not believe that HIV causes AIDS. Eliza Jane had never been tested for HIV.[2] " for several reasons:

1. This is not the reason that Christine did not take AZT.
2. There are an infinite number of things that Christine did not do, they cannot all be listed.
3. This obviously could not have been the immediate cause of death

Based on those reasons, the sentence is misplaced. DavidRCrowe 23:26, 30 November 2006 (UTC)

Localzuk -- Please provide a reference that the reason that Christine Maggiore did not take drugs to "prevent the transmission of HIV" was because she does not believe that HIV causes AIDS. Please provide a reference that drugs "prevent the transmission of HIV" (at best they reduce it). Please provide a reference that the transmission of HIV can be detected through references showing that the gold standard of HIV, virus purification has even been achieved. Please also summarize why this sentence belongs in a paragraph describing the circumstances of Eliza Jane's death. Note that this current wording strongly implies that Christine caused her daughter's death. I note that the inclusion of "potentially libellous" material is forbidden by Wiki rules. DavidRCrowe 23:45, 30 November 2006 (UTC)

I have explained the reasons on your user talk page. We are reporting what the source says - whether you believe what it says or not. The LA Times is a reliable source.-Localzuk^(talk) 00:04, 1 December 2006 (UTC)

Mr. Crowe is familiar with the fact that risk of vertical transmission from mother to child can be dramatically reduced if appropriate measures are taken. Let's quote "Mandatory HIV testing: Should screening in pregnancy be compulsory?", by David Crowe & Elyske Levinsky MD, from the Parkhurst Exchange Doctor’s Newsletter: "Highly effective antiretroviral drugs, elective cesarean section and formula feeding have been shown to reduce the mother-to-child spread of HIV from approximately 25% to less than 2%.". [1]. He's familiar with the facts. Questioning them here and asking for citations as though there's the remotest possibility that it's untrue is completely disingenuous. - Nunh-huh 00:35, 1 December 2006 (UTC)

To be fair, it seems that the quote above was from Dr Levinsky, a bioethicist, and not from Mr. Crowe - although that is an interesting source. The basic issue is that it seems User:DavidRCrowe wants to refight the issue of the existence of HIV, accuracy of HIV testing, etc - which is inappropriate for this page. A scientific consensus exists, reliable sources are aplenty on the transmissibility of HIV perinatally or in breast milk, and this needs to be reflected per the "Undue weight" portions of WP:NPOV. So-called "AIDS dissident" arguments are already probably given an undue amount of weight on their various pages on Wikipedia. This article should neutrally summarize what happened, including Maggiore's viewpoint and responses to criticism (which it does) - but the WP:NPOV policy does not mandate giving both sides "equal time" when one view is that of a small and shrinking minority and the other view has a broad scientific consensus behind it.

As far as references and the "gold standard", HIV has been isolated and cultured as early as 1984 (see PMID 6200936, PMID 6096718, PMID 6206563, PMID 2869262, etc). Since then, HIV has been repeatedly cultured to confirm the accuracy of antibody tests - see PMID 2298875, PMID 2046708, etc etc. I'm aware that some dissident groups quibble over the meaning of "purification", or try to claim that no one's ever actually "seen" or "purified" HIV. That's the view of an extreme minority. The fact remains that numerous respectable peer-reviewed journals (e.g. Science mag, Nature, etc etc) contain articles by virologists describing the isolation of HIV, and there's very broad scientific consensus that HIV has been adequately isolated, purified, and met all the relevant microbiologic gold standards. You don't have to agree, but such a broad, reliable-source-based scientific consensus needs to be acknowledged as such for Wikipedia purposes. MastCell 04:48, 1 December 2006 (UTC)

Pathologist, etc

I made a few changes for the following reasons. First, in the U.S. a "pathologist" is an M.D., whereas Al-Bayati is not an MD. Secondly, it is relevant that the person chosen by Maggiore to review the coroner's findings (and whose report argued that EJ did not die of AIDS/PCP) happens not to believe that HIV causes disease. I did remove the section on the reasons why Maggiore did not use antiretrovirals in pregnancy as it had been the subject of some controversy here. MastCell 01:34, 1 December 2006 (UTC)

Removing that information is a problem though - as it is a direct quote from the source. Why should it not be included?-Localzuk^(talk) 17:44, 1 December 2006 (UTC)

I guess it seemed the wording was getting cumbersome... but in retrospect, as it is from the source and sheds light on the situation, perhaps it should go back in. I don't feel strongly about it - if you'd like to re-add it, go for it. MastCell 17:47, 1 December 2006 (UTC)

"AIDS dissident"

Also, per User:DavidRCrowe's edit summary, since when is "AIDS dissident" a "pejorative" term? I don't go out of my way to offend, and I prefer to call people by the terms they choose for themselves, but I've been told by actual AIDS dissidents that this is the term they choose to describe their views. After all, "dissident" is hardly pejorative - it calls to mind the bravery and conscience of Soviet-era dissidents. Many "dissident" websites use this phrase as self-description - the idea that it's pejorative is new to me, but I'm open to using other terminology (within reason) if User:DavidRCrowe will suggest it. MastCell 04:55, 1 December 2006 (UTC)

Pap smear results

There's a general misconception about how Pap smear results work that had made its way into the article. The Pap smear is a screening (not diagnostic) test with a relatively high false-negative rate - hence it needs to be repeated yearly, although cervical cancer takes years to develop, to make sure abnormalities are picked up. A worrisome Pap finding should lead to more accurate/invasive testing (e.g. colposcopy). If you have an abnormal Pap, but keep repeating the test, it may "turn negative" - but that may very well be a false-negative, given the test's relatively low sensitivity.

The confusion may arise from women who have an "abnormal" Pap, are told to come back in 3-6 months, and then have a normal one. These women have a finding of atypical squamous cells of uncertain significance (ASCUS), or a "grade 1" abnormality. Maggiore stated that she had a "grade 3 Pap smear with cervical dysplasia", which presumably corresponds to high-grade squamous intraepithelial neoplasia (HGSIL). With a finding of HGSIL, the reassurance value of subsequent normal Paps is low, and the general medical recommendation for someone with HGSIL would be immediate colposcopy. For a reference, see the 2001 Consensus Guidelines for management of abnormal Pap results (PMID 11966387). Again, I'm not trying to offer medical advice, and I don't have any familiarity with or access to anyone's medical records, so this isn't intended to be a diagnosis or treatment recommendation. However, I do think it's important not to give a generally wrong impression in the article; medical guidelines state that if someone has a significant abnormality on a Pap (LGSIL or HGSIL), repeating the test is generally not recommended and may provide false reassurance. MastCell 18:11, 1 December 2006 (UTC)

Primary vs secondary sources

<Moved from User Talk:MastCell> I have replaced the references. I'm willing to discuss a major reduction in the scope of the paragraph, but including a reference to a tertiary source does not illustrate the complexity of the reasoning that mothers must go through regarding these decisions, and ignores the significant financial conflicts of interest of many of the members of the panel (e.g. the recent Vioxx scandal, where a highly conflict FDA panel allowed Vioxx back on the market). —The preceding unsigned comment was added by DavidRCrowe (talk • contribs).

OK, about the edit by DavidRCrowe which inserted a litany of primary studies - please review Wikipedia's guidelies on the use of reliable sources and, specifically, examples of reliables sources for scientific questions. Secondary sources are, in fact, preferred over primary sources, and David's edit is a good example of the reasoning behind this policy. Lengthy citations of primary studies are both difficult for a lay reader to assimilate, and there is the risk of cherry-picking, selective citation, and/or original interpretations of the research (all of which David's edit exemplifies). The NIH recommendations are a valid secondary source for summarizing the data on mother-to-child HIV transmission. In fact, they recognize that there are "known and unknown" harms associated with AZT use, and they actually support Maggiore in that they say that although AZT is recommended, the final, informed decision should be made by the mother in a "noncoercive" environment - i.e. there is no generically "right" or "wrong" answer. I quoted the above for the sake of balance. Again, this is not the place to fight a debate about what should be recommended to pregnant mothers. It's an article on Christine Maggiore. It's relevant to note the official medical guidelines (and it doesn't get more official than the NIH) in a neutral way, from a secondary source. It's also relevant to note that Maggiore disagrees with them - but not to get into a selective rehash of a dozen primary studies. MastCell 18:46, 5 December 2006 (UTC)