UUSOM Students Ask Why Professor was 1 of about 32 Med School Instructors Behind Flawed Amicus Brief

[loris]

Here’s an article on the situation.

Should medical faculty members be called out for endorsing flawed and misleading legal documents if they are presenting themselves to the Supreme Court as marriage experts/pediatric patient advocates and the only goal associated with drafting those documents is to directly influence the laws of the United States and impact the welfare of its citizens (their patients, both pediatric and adult)?

Some of the questions that were brought up in the recent Dr. Oz thread included whether it was appropriate for faculty members at medical schools to publicly endorse health products and medical advice that lacked supporting evidence, what (if any) action should be taken by their employers and colleagues if they regularly did so, and whether the behavior and ideas of those physicians be protected and encouraged. So on a related note, I saw an article recently about medical students at the University of Utah publicly questioning why one of their adjunct associate professors of pediatrics, Dr. Richard Farnsworth, was listed as one of the 100 contributors to the “Brief of Amicis Curiae: 100 Scholars of Marriage in Support of Respondents” which is an amicus brief presented to the Supreme Court concerning four cases that will determine the legality of same sex marriage in Ohio, Tennessee, Michigan, and Kentucky. A quick count of the names & positions listed in the appendix of the brief reveals that at least 32 of the 100 contributors are faculty members at various medical schools throughout the US.

I didn't have time to analyze the brief in depth, but I really don't think it would have made much of a difference if I had. After reading the introduction and summary, I looked through some of the data in the appendix, and during that very limited review, I noticed several serious flaws, logical errors, and data presented in a manner meant to mislead readers. I really can’t fathom how a number of professors from various research intuitions thought that the data analysis and arguments presented in this paper seemed sound enough to be publicly presented to the Supreme Court as a source of information. I’m kind of embarrassed for the professors who wrote this. I’ll post a few examples in the thread in order to keep this first post short.

Tl;dr: Here’s an article & the Amicus Brief it mentions; what are your thoughts?

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[Mad Jack]

I think students and alumni should lay into them for presenting flawed data in a Supreme Court case. It's pretty cut and dry from what I read of the report.

 

[loris]

A few examples of flawed/misleading data analysis that the authors used to support their main argument (i.e. the legalization of same-sex marriage leads to decreased rates of heterosexual marriage).

Authors’ Argument from the Summary (pg. 35)

“We also explain why, contrary to claims by amici Massachusetts et al., the available evidence demonstrates the seriousness of those risks. Indeed, in every U.S. jurisdiction for which such data are available, after the adoption of same-sex marriage the opposite-sex marriage rate declined by least five percent—in comparison to a national marriage rate that, in the past few years, has been fairly stable. And if a forced redefinition of marriage caused only a five percent permanent decline in U.S. opposite-sex marriage rates, under reasonable assumptions and over the next fertility cycle (30 years), that decline would result in nearly 1.3 million fewer women marrying. That would lead to an additional nearly 600,000 children born into nonmarital parenting situations, and nearly 900,000 more children aborted.”

Authors’ Data Analysis from Appendix (pg. 84)

“As noted above, all four SSM states with data on opposite-sex marriages through 2009 have experienced marked declines in the rate of opposite-sex marriages. Three of the states have never seen opposite-sex marriages rise to their pre-same-sex marriage level. One state (Massachusetts) saw an initial decline, then a fleeting increase, but then a further decline below pre-SSM levels. Over the entire period, Vermont experienced a 5.1% drop, Iowa a 9.2% decline, Connecticut a 7.3% decrease, and Massachusetts an 8.9% reduction in their respective opposite-sex marriage rates in the last year for which data are available, compared to the year just prior to adopting same-sex marriage. However, from 2009 (the first year of genderless marriage in Iowa and Vermont, and the second in Connecticut) until 2012, the marriage rate in the United States remained stable. 4”

First off, look at this CDC list of state marriage rates. You could pick many states where the marriage rate was declining while same-sex marriage was still illegal (and thus all marriages reported in the state were heterosexual). The state rates are also going to be skewed because they include destination weddings which is why some states like Hawaii and Nevada (all those drunken Las Vegas weddings in a chapel with an Elvis impersonator) have really high rates like 35.1 in 2012 compared to the national rate of 6.8. Also note that marriage rate has been declining nationally for years (other CDC list); a massive, isolated decline didn't just appear after the first legal same-sex marriage. Even if it had, correlation does not equal causation (e.g. autism diagnosis rate and vaccines). The authors found the percent change in the heterosexual marriage rate between the year before SSM was legalized and the last year of available data for four states. They then compared these changes to the percent change in the national rate from 2009 to 2012. Note that they named the years (SSM Year 1, Y2, Y3, etc.) and didn't include any dates in the chart which makes it impossible to construct a mental timeline without outside resources and see if there are any trends shared by states and the nation as a whole.

This is the Chart with Dates and a Row for the National Rate:
VT: 7.9(2008); 7.5(2009)
IA: 6.5(2008); 6.1(2009); 6.1(2010); 6.0(2011); 6.2(2012); 5.9(2013)
CT: 5.5(2007); 5.2(2008); 5.1(2009)
MA: 5.6(2003); 5.5(2004); 5.8(2005); 5.7(2006); 5.6(2007); 5.3(2008); 5.1(2009); 5.2(2010); 5.2(2011); 5.3(2012); 5.1(2013)
US: 7.7(2003); 7.8(2004); 7.6(2005); 7.5(2006); 7.3(2007); 7.1(2008); 6.8(2009); 6.8(2010); 6.8(2011); 6.8(2012)

So when they were comparing percentages and drawing conclusions, THIS is what they were looking at:
VT: 2008-2009 percent change in rate= -5.1%
IA: 2008-2013 percent change in rate = -9.2%
CT: 2007-2009 percent change in rate = -7.3%
MA: 2003-2013 percent change in rate = -8.9%
US: 2009-2012 percent change in rate = 0.0%
....and you can't really compare these to the US rates from 2009-2012.

Soo…the longest time periods have the greatest changes in rate…out of curiosity, what do the state and national percent changes look like for the following time ranges?
2008-2012: US(-4.2%); VT(N/A); IA(-4.6%); CT(N/A); MA(0.0%)
2003-2012: US(-12%); VT(N/A); IA(N/A); CT(N/A); MA(-5.4%)

The same “mislead-by-cherry-picking-data” BS showed up when they went over divorce statistics too (pg 99). Despite the fact the 2012 CDC marriage and divorce data was available and they used it in the marriage rate section, they claimed that although the divorce data was available at the time, it was still provisional so they didn't include it in their divorce rate chart. In reality, every year of data, not just the latest year, is considered provisional (e.g. the 2002 rate was posted years ago and updated as recently as 01/14/2015 to 8.0); the authors probably just didn't want to use it because it weakens their argument. They also probably did not list the national rate data for the same reason.

Chart 27a Divorce Rate per 1,000 Population Trends WITHOUT 2012 Data:
MA: 2.5(2003), 2.5(2010), 2.7(2011) = Net increase from year prior to SSM
CT: 3.4(2007), 2.9(2010), 3.1(2011) = Net decrease from year prior to SSM
IA: 2.6 (2008), 2.4(2010), 2.4(2011) = Net decrease from year prior to SSM
VT: 3.6(2008), 3.8(2010), 3.6(2011) = No net change from year prior to SSM
NH: 3.7(2009), 3.8(2010), 3.8(2011) = Net increase from year prior to SSM
DC: 2.7(2009), 2.8(2010), 2.9(2011) = Net increase from year prior to SSM
NY: 2.9(2011), 2.9(2010), 2.9(2011) = No net change from year prior to SSM

Chart 27a Divorce Rate per 1,000 Population Trends WITH 2012 Data and National Rate:
US: 3.8(2003), 3.6(2007), 3.5(2008), 3.5(2009), 3.6(2010), 3.6(2011), 3.4(2012) = Net Decrease from ‘03
MA: 2.5(2003); 2.5(2010); 2.7(2011); 2.7(2012) = Net increase from year prior to SSM; Rates Below US rate
CT: 3.4(2007); 2.9(2010); 3.1(2011); 2.7(2012) = Net decrease from year prior to SSM; Rates Below US rate
IA: 2.6(2008); 2.4(2010); 2.4(2011); 2.2(2012) = Net decrease from year prior to SSM; Rates Below US rate
VT: 3.6(2008); 3.8(2010); 3.6(2011); 3.5(2012) = Net decrease from year prior to SSM; Above US rate
NH: 3.7(2009); 3.8(2010); 3.8(2011); 3.6(2012) = Net decrease from year prior to SSM; Above US rate
DC: 2.7(2009); 2.8(2010); 2.9(2011); 2.9(2012) = Net increase from year prior to SSM; Rates Below US rate
NY: 2.9(2011); 2.9(2010); 2.9(2011); 2.9(2012) = No net change from year prior to SSM; Rates Below US rate

 

[Mad Jack]

I will be impatiently waiting for their appeal to bring back privateers to reduce global warming.

 

[Psai]

wtf is with that scale why is the x axis backwards

 

[ERK123]

wtf is with that scale why is the x axis backwards

So the data can be presented in chronological order

 

[Tired]

...

 

[loris]

Well, in case anyone is curious, here is the full list of the 33 medical amici organized by state and their 36 affiliated institutions. Everything here is listed in the appendix of the publicly available amicus brief which they prepared for the Supreme Court and willingly attached their names to; I just organized the information and corrected names if they didn't use their medical school's official name. Just FYI, some of these instructors hold other positions that have a broader scope than the one listed in the brief; for example, one Adjunct Professor in Pediatrics is also the Dean, Designated Institutional Official, and Chief Executive Officer of the San Antonio Uniformed Services Health Education Consortium in San Antonio.

AL
University of Alabama School of Medicine - Huntsville (1)

Field, Dr. Scott - Adjunct Faculty in Pediatrics​

AZ
University of Arizona College of Medicine (2)

Bouvier, Dr. Joseph - Clinical Assistant Professor of Child Health (Pediatrics) and Emergency Medicine
Liu, Dr. Paul - Clinical Assistant Professor of Pediatrics​

FL
University of Florida College of Medicine (1)

Benton, Dr. Thomas B.B. - Adjunct Faculty in Pediatrics​

University of Miami Miller School of Medicine (1)

Vizcarrondo, Dr. Felipe E. - Associate Professor (voluntary)​

Florida State University College of Medicine (1)

Wilson, Jr., Dr. Robert - Clerkship Co-Director of Pediatrics​

GA
Medical College of Georgia (3)

Mansfield, Dr. Richard - Clinical Associate Professor of Pediatrics - (Affiliated with two institutions)
Miller, Dr. Jerry A. - Clinical Professor of Pediatrics
Zanga, Dr. Joseph - Clinical Professor of Pediatrics - (Affiliated with three institutions)​

Mercer University School of Medicine (1)

Zanga, Dr. Joseph - Professor of Pediatrics - (Affiliated with three institutions)​

IL
University of Illinois College of Medicine at Rockford (1)

Baptist, Dr. Errol C. - Clinical Professor of Pediatrics​

University of Illinois College of Medicine at Urbana-Champaign (1)

Morton, Dr. Charles - Clinical Professor of Pediatrics​

Loyola University Chicago Stritch School of Medicine (1)

Keen, Dr. Mary - Clinical Associate Professor​

MN
University of Minnesota Medical School – Twin Cities (2)

Bateman, Dr. Michael - Assistant Professor of Pediatrics
Olson, Dr. Ross - Assistant Professor of Pediatrics (retired)​

University of Minnesota Medical School – Duluth (1)

Lim, Dr. Paul - Adjunct Professor of Surgery​

MS
University of Mississippi School of Medicine (1)

Nowicki, Dr. Michael J. - Professor of Pediatrics​

NC
Wake Forest School of Medicine (1)

Matthews, Dr. Randolph - Clinical Assistant Professor of Pediatrics​

NY
State University of New York at Buffalo School of Medicine and Biomedical Sciences (1)

Yates, Dr. Ferdinand D. - Professor of Clinical Pediatrics​

Hofstra North Shore-LIJ School of Medicine (1)

Zaso, Dr. John - Clinical Assistant Professor of Pediatrics​

OH
The Ohio State University College of Medicine (1)

Hoffman, Dr. Robert P. - Professor of Pediatrics​

PA
Perelman School of Medicine at the University of Pennsylvania (1)

Carlson, Jr., Dr. Alfred J. - Associate Faculty in Pediatrics​

The Commonwealth Medical College (1)

Gombosi, Dr. Russell - Adjunct Professor of Pediatrics​

University of Pittsburgh School of Medicine (1)

Kaleida, Dr. Phillip H. - Formerly Professor of Pediatrics (Retired 2014)​

Philadelphia College of Osteopathic Medicine (1)

Zanga, Dr. Joseph - Clinical Professor of Pediatrics - (Affiliated with three institutions)​

SC
AnMed Health Oglesby Center (1)

Bradford, Dr. Nathan F. - Associate Professor of Family Medicine​

TN
East Tennessee State University James H. Quillen College of Medicine (1)

Pearson, Dr. James M. - Assistant Clinical Professor​

University of Tennessee College of Medicine (1)

Wheless, Dr. James W. - Professor and Chief of Pediatric Neurology​

TX
University of Texas Health Science Center at San Antonio (1)

Jones, Dr. Woodson S. - Adjunct Professor of Pediatrics​

Texas Tech University Health Sciences Center School of Medicine (1)

Lacy, Dr. Mark D. - Associate Professor of Medicine​

Texas Tech Paul L. Foster School of Medicine (1)

Smith, Dr. Christine Z. - Assistant Professor of Pediatrics​

University of Texas-Arlington?
(The college of nursing? I don’t think that there is a UT Arlington medical school. There is no entry for this individual in the current UT Arlington faculty directory & no entry seen on a few randomly picked archived versions of the faculty directory web page through 2011.)

McGehee, Dr. Frank T. - Clinical Instructor in Pediatrics​

UT
University of Utah School of Medicine (1)

Farnsworth, Dr. Richard Y. - Adjunct Associate Professor of Pediatrics​

VA
Virginia College of Osteopathic Medicine (1)

Mansfield, Dr. Richard - Assistant Professor of Pediatrics - (Affiliated with two institutions)​

Virginia Commonwealth University School of Medicine (1)

Shaw, Dr. Bill - Assistant Professor of Pediatrics​

East Virginia Medical School (1)

Shelton, Dr. Jean - Associate Professor of Pediatrics​

 

[loris]

Also just for comparison, here is another brief composed in part by several medical organizations that is supporting the opposite position as the 100 amici scholars in the same Supreme Court case.

Brief of the American Psychological Association, Kentucky Psychological Association, Ohio Psychological Association, American Psychiatric Association, American Academy of Pediatrics, American Association for Marriage and Family Therapy, Michigan Association for Marriage and Family Therapy, National Association of Social Workers, National Association of Social Workers Tennessee Chapter, National Association of Social Workers Michigan Chapter, National Association of Social Workers Kentucky Chapter, National Association of Social Workers Ohio Chapter, American Psychoanalytic Association, American Academy of Family Physicians, and American Medical Association as Amici Curiae in Support of Petitioners
(Summary & Full Text)

 

[loris]

A few more examples from the appendix: Incorrect calculations without an easy to check source for the data, incorrect calculations with listed sources, misleading data presentation, etc.

Authors’ Data Analysis (Brief pg. 15a; PDF pg. 87)

Furthermore, similar to the findings out of the Netherlands where the country’s Bible Belt and less religious areas experienced different effects from adopting same-sex marriage, with the less religious areas suffering significant declines in marriage rates, a similar pattern is unfolding in Massachusetts. There the more religious counties saw their marriage rate drop from 6.2 to 6.0 (a 3.3% decline), whereas the less religious counties saw their marriage rate reduce from 11.6 to 9.6 (a 16.8% decline).5 <CHART> […] 5 Data were obtained from the state of Massachusetts.

Data from Chart: “Marriage Rate Per 1000” for both “More Religious Counties” and “Less Religious Counties” during the “Year before SSM (2003)” and “Last Year of Data (2010)”
Less Religious Counties: 2003 (11.6), 2010 (9.6)
More Religious Counties: 2003 (6.2), 2010 (6.0)

• The calculated percent change for the given values is not the percent change listed by the authors. There is no easy way to confirm what the true values are supposed to be, because the only information the authors provided about the source of the data was that it was “obtained from the state of Massachusetts” and it looks like you would have to contact the Registry of Vital Records and Statistics and personally request marriage data from the state for research purposes.
• There is no information on how the religiousness of the counties was determined or how many/which of MA’s 14 counties where assigned to each group. Given the variation in population of MA's counties, county marriage rates could potentially be skewed by something as simple as a few popular wedding venues in a county with a relatively small population. For reference, here is MA’s population by county in the 2010 US Census: Nantucket (10,172), Dukes (16,535), Franklin (71,372), Berkshire (131,219), Hampshire (158,080), Barnstable (215,888), Hampden (463,490), Plymouth (494,919), Bristol (548,285), Norfolk (670,850), Suffolk (722,023), Essex (743,159), Worchester (798,542), Middlesex (1,503,085).
• Although they included a graph, it only shows two data points (2003 & 2010) for each group, and the years of data between those points is missing which makes it impossible to see how the rates may have fluctuated during that time. Pre-same sex marriage rate data beyond 2003 from the two groups is also missing so there’s no way to know what the trends were before SSM and there is also no data past 2010.
• There isn't much info about this data or an easily accessible source so I have the following questions: Does the data in this chart only include heterosexual marriages or does it include both same and opposite sex marriages? In the previous section of the appendix, the authors had been given access to Massachusetts’s annual statewide heterosexual marriage rate data from 2003 to 2014; was that data also available by county and is this data from the same data set? If so, did MA stop collecting marriage data by county and only continue to collect statewide data from 2010 to 2014, or did the authors just choose to list 2010 as the last available year of data for this section?

Authors’ Data Analysis (Brief pg. 16a; PDF pg. 88)

Other western nations that have adopted same-sex marriage have also seen subsequent declines in their marriage rates. Perhaps the most notable is Spain, which in the nine-year period before adopting same-sex marriage saw marriage rates increase, and in the nine years after has seen opposite-sex marriage rates plummet by 36%.6 <CHART “Spain: Before & After Adopting Genderless Marriage”> […] 6 Data on Spanish marriages from Instituto Nacional de Estadistica, and on Spanish population from the World Bank. Data available through 2013.

• The percent change provided by the authors does not match the marriage rates listed on the website of the Instituto Nacional de Estadistica, the authors’ source. Same sex marriage was legalized in 2005 in Spain. According to a marriage rate table on the website, the 2004 rate was 5.000307 marriages per 1000 population and the 2013 rate was 3.315288 so the calculated percent change from the year before legalization to 2013 isn't the reported -36%. The authors also listed the World Bank's data on the Spanish population as one of their sources which doesn't make sense unless they decided to generate their own marriage rates or something and then used those to calculate the percent change. I don't really know what they did here.
• The authors’ phrasing and the “Year of Change” line on the accompanying chart imply that the marriage rate in Spain was only increasing until same-sex marriage was legalized in 2005 and then it plummeted dramatically. In general, the Spanish marriage rates have been decreasing since the 1970’s with a few rises and falls in between. Choosing to display 10 years on either side of SSM legalization masked this, because the rate was falling from 1989 until 1996, the first year displayed on the chart, and then it increased from 1996 until 2000 when it started to fall again, eased up a little bit, and then continued to decline until 2013. Full data below.

Spanish Marriage Rates from 1990 to 2013: 2013(3.315288); 2012(3.562002); 2011(3.460354); 2010(3.624914); 2009(3.783012); 2008(4.246771); 2007(4.483309); 2006(4.640094); 2005(4.756610); 2004(5.000307); 2003(4.988052); 2002(5.058720); 2001(5.065292); 2000(5.327542); 1999(5.166976); 1998(5.164232); 1997(4.917847); 1996(4.872495); 1995(5.050983); 1994(5.038897); 1993(5.102939); 1992(5.531049); 1991(5.565845); 1990(5.639062); 1989(5.673385); 1988(5.620225); 1987(5.553933); 1986(5.369165); 1985(5.171486); 1984(5.135517); 1983(5.127731); 1982(5.072436); 1981(5.326344); 1980(5.855664); 1979(6.574780); 1978(6.944868); 1977(7.127590); 1976(7.181786)

 

[supermario21]

Looks like the PC'ers have moved on from trying to take down Dr. Oz to this guy. This stuff will likely take years to find out one way or the other. What's going to happen when there are surrogate babies and other artificial means of conception involving gay couples and a divorce happens? There are plenty of issues here.

 

[loris]

Looks like the PC'ers have moved on from trying to take down Dr. Oz to this guy. This stuff will likely take years to find out one way or the other. What's going to happen when there are surrogate babies and other artificial means of conception involving gay couples and a divorce happens? There are plenty of issues here.

I think you may be missing the main problem presented in this thread. It’s not about being PC; it’s about scientific integrity and acting in a way that can harm others for no reason. I’m not trying to “take someone down,” because of their opinions. I take issue with individuals who misrepresent facts in order to support their own agenda in a legal document that was presented to the Supreme Court as a source of information in a court case that involves the laws of four states. Also this situation involves at least 33 medical faculty members from schools across the country, not just one medical school instructor from Utah; Richard Farnsworth MD was just the only one who has been asked to explain the science and methodology behind the brief so far.

Theoretically the Supreme Court should be responsible enough to fact check all of their information and they shouldn't quote amicus briefs directly in their arguments, but historically that has not been the case. On several occasions the Supreme Court has used and quoted inaccurate information from amicus briefs in their decisions. This article has a list of several examples that were brought up in the paper “The Trouble with Amicus Facts” by William and Mary College of Law professor Allison Orr Larsen.
Here are the first two of the seven examples listed in the news article:

• “1. An unverifiable source: In Caperton v. AT Massey Coal — a 2009 case in which the Court said the constitution required a state judge to recuse himself due to a "probability of bias" given his deep financial ties to one of the parties — Chief Justice John Roberts argued in his dissent that the judge's participation in the case did not violate Due Process. He argued that there were "numerous examples of judicial elections in which independent expenditures backfired and hurt the candidate’s campaign." The chief's evidence? An amicus brief citing a law review article, which cited an email from a state judge that was not publicly available.”

• “2. No source at all: In a 2012 decision in Florence v. Board of Chosen Freeholders, Justice Anthony Kennedy wrote for a 5-4 majority that prison strip-searches were constitutional even in the absence of evidence that the person was carrying contraband. Kennedy argued, among other things, that the number of gang fights in prisons was rising. For his evidence, Kennedy cited an amicus brief by a policeman's association that made the assertion without citing a source.”

Attorney Gene Schaerr, the legal counsel for the amici of this 100 scholars brief, represented the state of Utah as an Assistant Attorney General in 10th Circuit Court of Appeals during Utah's failed attempt to maintain a ban on same sex marriage. He is also the former law clerk of Associate Justice Antonin Scalia which means that the judges may be more inclined to trust and be persuaded by the brief that Schaerr has submitted. If that happens, then a decision that will be made by June 30th that affects the populations of four states would be based on flawed and misleading scientific methodology. That is what concerns me.