Some people on this forum seems to think there are two groups, "pro-surgery" and "anti-surgery." These terms are misused so often that they are meaningless.
"Pro-surgery" is often used incorrectly to mean a position that is against conservative treatments. In fact nobody is against conservative treatments THAT WORK. That last bit is the critical part. People who are realistic about the evidence case often end up with surgery but it isn't because they think surgery is great. It is because there is no conservation treatment that can help them.
So a parent that agrees to fusion for her child is not "pro-surgery" but rather accepting the evidence that there is no alternative to surgery.
"Pro-surgery" is also often used to refer to people "giving up" on the notion of conservative treatments or not giving them a chance in the first place. Here is where a keen eye and feel for the evidence case can inform a person or parent about whether a conservative treatment is worthwhile to try and how much cajoling is ethical in the case of a child. This area can be grey. One way to clear it up is to state exactly what is known and not known. Even a teenager can make a rational decision if given an honest rendition of the fact case as balanced against hope.
Everyone is "anti-surgery" in the sense that nobody would want it if it wasn't necessary. This term is often applied to people trying conservative treatments in the hope of avoiding surgery (kids wearing bracing or doing PT, etc.). People in this group still have a option because they don't need surgery now and so can try conservative treatments. They are probably not philosophically opposed to surgery but just being rational in trying to avoid it if possible.
There are a few parents who are "anti-surgery" in the strict sense of having a child who surgeons agree would benefit from surgery but still refuses it. They are philosophically opposed to spinal fusion no matter the consequences of refusing treatment for their child. Those cases are thankfully rare. I have a hypothesis that these parents are convinced that if something went wrong that they could never forgive themselves. That is a legitimate concern that must be balanced against negative consequences to their child from not having surgery. The parents should get counseling to help them figure out the risk/reward situation for their child and themselves.
I think these terms are not helpful because they are misused, misunderstood, and mainly emotion-driven as opposed to rationality-driven. And indeed almost all of the uses of these terms comes from the emotion-driven crowd. When we see that, it is a good sign that it isn't helpful.
"Pro-surgery" is often used incorrectly to mean a position that is against conservative treatments. In fact nobody is against conservative treatments THAT WORK. That last bit is the critical part. People who are realistic about the evidence case often end up with surgery but it isn't because they think surgery is great. It is because there is no conservation treatment that can help them.
So a parent that agrees to fusion for her child is not "pro-surgery" but rather accepting the evidence that there is no alternative to surgery.
"Pro-surgery" is also often used to refer to people "giving up" on the notion of conservative treatments or not giving them a chance in the first place. Here is where a keen eye and feel for the evidence case can inform a person or parent about whether a conservative treatment is worthwhile to try and how much cajoling is ethical in the case of a child. This area can be grey. One way to clear it up is to state exactly what is known and not known. Even a teenager can make a rational decision if given an honest rendition of the fact case as balanced against hope.
Everyone is "anti-surgery" in the sense that nobody would want it if it wasn't necessary. This term is often applied to people trying conservative treatments in the hope of avoiding surgery (kids wearing bracing or doing PT, etc.). People in this group still have a option because they don't need surgery now and so can try conservative treatments. They are probably not philosophically opposed to surgery but just being rational in trying to avoid it if possible.
There are a few parents who are "anti-surgery" in the strict sense of having a child who surgeons agree would benefit from surgery but still refuses it. They are philosophically opposed to spinal fusion no matter the consequences of refusing treatment for their child. Those cases are thankfully rare. I have a hypothesis that these parents are convinced that if something went wrong that they could never forgive themselves. That is a legitimate concern that must be balanced against negative consequences to their child from not having surgery. The parents should get counseling to help them figure out the risk/reward situation for their child and themselves.
I think these terms are not helpful because they are misused, misunderstood, and mainly emotion-driven as opposed to rationality-driven. And indeed almost all of the uses of these terms comes from the emotion-driven crowd. When we see that, it is a good sign that it isn't helpful.
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