Gulf War Syndrome - Cover Sheet

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Author - Eimad Houry (Summer 1997); John Shepherd (Fall 1997)

Case PurposeThis case allows students to apply their growing skills to a socially, politically, and scientifically complex case. We begin examining the motives of various players and by talking about where science and scientific attitudes about data can play a role. We consider information from several WWW sources as well as from the mainstream medical ‘archive’ and focus on careful evaluation of the quality of information from peer-reviewed and internet sources. As we evaluate conspiracy theories, we make assumptions and logical connections explicit. Finally, the students are asked to come to a composite interpretation of all the information we have considered.

Relation to Texts This case can work well toward the end of the semester. It requires analysis of political and psychological issues. The epidemiological studies from the primary allow have simple enough designs that students are able to see the roles of comparison groups and confounding factors. It is a good place to make connections back to Ziman’s discussions of logic (CH2), perception (CH 5), the fit between theory and experiment CH 2) extracting signal from noise (CH 3). There are obvious contrasts in the clarity (and rigor) of the sources and we used this to discuss the role of peer review (consensus building and skeptical constructive criticism).

Description of Case Materials The case consists of the following readings:

  1. January 1998 PBS resources are described on the Users Notes Page
  2. Personal testimonies, letters and talks by people who talk about the horror of the situation. These are on the World Wide Web.
  3. Two readings that carefully outline a rationale that justifies veteran suspicions about their diseases and treatment. These are on the World Wide Web.
  4. A set of two August 1996 reports from the New England Journal of Medicine showing no difference in hospitalization rates and mortality between Gulf War vets and comparison groups. An editorial from NEJM summarizes and interprets the articles. A web article talks about the power of suggestion from the media and from lawyers.
  5. A set of four January 1997 reports from the Journal of the American Medical Association identifies syndromes of Gulf War vet symptoms, relates them to neurological dysfunction, and associates them with exposures to chemical warfare prophylactic pills and insect repellent.
  6. A set of letters that argue about the validity of the Jan 1997 JAMA articles.

Case Use Each set of readings is the basis of a day’s class discussion. On the final day, the student groups are asked to come to a consensus about the validity of veterans’ claims. The last day of the case is a panel forum in which each of the three student groups is assigned a particular perspective to represent: veterans, medical researchers, Department of Defense, congressional politicians. The congressional panel must decide what should be done.

Partial Reference List