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What’s a “Claim” in Health Care?

In health care, claims often involve a more self-serving assertion

updated (first published 2012)ARCHIVEDArchived pages are rarely or never updated. Most featured articles on PainScience.com are updated regularly over the years, but not archived pages.
by Paul Ingraham, Vancouver, Canadabio
I am a science writer and a former Registered Massage Therapist with a decade of experience treating tough pain cases. I was the Assistant Editor of ScienceBasedMedicine.org for several years. I’ve written hundreds of articles and several books, and I’m known for readable but heavily referenced analysis, with a touch of sass. I am a runner and ultimate player. • more about memore about PainScience.com

A “claim” is any unverified assertion. But not all claims are created equal. Some claims matter more than others, and some are more dubious. In health care and health science, the stakes are high and many claims involve a lot of strikingly self-serving assertions (like “my Awesome Treatment Method™ will cure you”). If a claim could be used as a bullet-point in a sales pitch, it’s more claim-y. If it makes you (or your profession) look better, it’s more claim-y. And the claim-ier the claim, the more it needs to be backed up.

No one ever uses the word “claim” to describe their own beliefs and sales pitches, of course. It’s vocabulary for critical thinking and skepticism specifically. It identifies something often not discussed at all, and the sole point of this (tiny) article is to emphasize the kind of claim — a special sense of the word — spawned by the thorny ethical challenges of selling care to sick, hurt people. Vulnerable people. People suffering from aches and pains that are amazingly poorly understood for this late date in history.

All claims need critical appraisal and independent verification, of course, but it’s much more important when it has more claim-stink and people’s health depends on it. Sagan’s classic idea that “extraordinary claims require extraordinary evidence” is not just about exotic and/or extremely implausible claims like “aliens abducted me!” or “lake monsters are real” or “I have a machine that produces more energy than it requires, defying the laws of thermodynamics!” Really? Prove it! No one has trouble seeing those kinds of claims for what they are.

But the extraordinariness of claims is, in spirit, also about more mundane but profitable claims, such as “this nutritional supplement will reduce your knee pain” or “vibrating your tissues with sound waves will accelerate your tendon healing.” These are much more common hazards than truly exotic and extreme stuff, especially in health care. They are less obvious and yet more ethically problematic than many other common types of claims.

What can be asserted without proof can be dismissed without proof.

Christopher Hitchens