You know how the Lefties always seem to fall on their faces and beg for the alligator to eat them last instead of just un-aliving the damn thing? Well, here's one who has been at the back of the line for many, many years and is finally getting his turn,
The Father of Evidence Based Medicine doesn't like how the evidence is going, so he's denouncing science and raging on about Lefty sacred cows instead.
While the western world is making an about-face on the medical scandal that is pediatric gender transition, Canada — thanks to people like Guyatt — remains under the spell of radical gender ideologues whose sole remaining currency is intimidation. Do what we say, or we will ruin your reputation, too.
What Guyatt and his colleagues are essentially saying is this: forget about the low-quality evidence, and instead allow the "autonomy of patients and their advocates" to overrule the science. "The high respect for autonomy becomes particularly important when the certainty of the evidence is low or very low. In such circumstances, clinicians should work with patients to ensure that care reflects the experience, goals and priorities of those needing care — that is, their values and preferences," they wrote.
That's the thing about begging the alligator to let you be at the back of the line. Eventually, the line moves forward and your turn comes. Chomp.
On a broader scale, this is a big reason Canada is as fucked as it is these days. People in positions of authority, people with all the credentials and awards and etc., the people who guide public policy, do not have the strength of their own convictions. This is one guy at one institution, knuckling under to the mob on one issue and thereby calling his entire body of work into question. Which makes you wonder, how often does this happen and we don't hear about it? And the answer seems to be almost every fucking time.
Another example far from medicine, Eddison Motors. TL/DR, Eddison Motors is a celebrated greenie company that is trying to make hybrid diesel/electric logging trucks. Exactly what the #Lieberals say they want. Electric trucks. Well, except that the federal government regulators have decided that because of an obscure (and stupid) regulation that nobody knew about before some inspector opened the rule book and combed through it, Eddison is not allowed to use the engine they have designed the system around. And the reason is because that engine has not received the correct designation from federal regulators because it is a -generator- engine. Not a -truck- engine. So you can use the engine to drive a generator, but not if it is attached to a truck. Even though it is -identical- in most respects to the truck version.
So nobody in government can be assed to move their fingers on the keyboard and approve the engine for Eddison Motors, because... well, no reason really, they just won't do it. And you did not hear about this flagrant, abject, horrifying stupidity in the Canadian media, you heard about it on some obscure blog run by the cranky old Phantom. I heard about it on YouTube, because I'm a weird old gearhead that watches truck videos.
Gordon Guyatt says never mind the evidence, even though he's Evidence-Based Man. (Canadian Medicine Fall of Fame!) Eddison Motors can't get an engine approved, even though they're a Green darling running on government grants and doing everything the #Lieberal government says they want. Now do mining. Or forestry, or home construction, or widget manufacturing, immigration, trucking, or literally any other topic you can think of, and if you just brush away the decay on top, you will find a coward begging to be eaten last.
And that is why Canada sucks. No one with two dollars to rub together and a single functioning brain cell would invest a dime here.