Our December 2006 JOMS offers our readers two more Controversies, led by our Clinical Controversies Section Editor, Felice O’Ryan, on subjects affecting our daily practice and the direction of the specialty; the elective removal of third molars and pathways to training in oral and maxillofacial surgery. John Langdon and A. Thomas Indresano square off on the training of oral and maxillofacial surgeons while Louis Rafetto and C. Michael Hill offer their interpretation of the evidence supporting the removal of asymptomatic third molars. Both of these controversies remain at the core of the identity of American oral and maxillofacial surgery. The outcome of these controversies will identify our specialty in the future.
Rather than reprise the complicated conglomeration of views expressed on these subjects, these authors’ contributions will speak for themselves. Instead, in this editorial, I ask the reader to examine how you read controversies. What notions do you and other JOMS readers bring to bear in examining controversies? Does hearing the other side influence your opinion? Does the writing of a controversy illuminate issues or simply polarize positions towards an “either/or” approach to the problem? Do well-defined positions create the ability to formulate a workable middle ground or do they obviate the controversy by the declaration of a “winner?” Indeed, must there be a winner? Do those with opposing views identify themselves as just good debaters, or are they intractable opponents on a high stakes playing field of ideas?
To read controversies well, consider the myriad factors that generate controversy and how it is debated.
Know Your Authors
Life experiences, cultural factors, individual professional lives, societal context, and political allegiances play important roles in the formulation of opinion. In this month’s Controversies it is no accident that the authors present from the perspective of different health care systems, Great Britain and the United States, from differing societies, and different professional experience.
Know Your Own Prism of Perception
What preconceived notions do you carry when you consider a controversy? To understand yourself, you must identify where your interests lie. All individuals are naturally motivated by what is best for them and those who depend upon them for their health and well-being. Such concerns affect the prism through which a controversy is examined and decided upon.
Examine the Quality of Evidence
The scientific basis presented to form the opinions in the controversy will determine the outcome of the argument in the long run. Hard evidence permits firmly held belief. The softer the evidence, the more nuanced the belief, and the more room for opinion based upon extraneous needs.
Examine the Decorum of the Advocates
Does the speaker or writer respect opposing views and understand their basis? After all, it would not be a controversy unless rational people could conceivably hold opposing views on the subject.
If the author uses sharp language or ad hominem attacks, the author may be only supported by soft evidence to support their opinion or they are trying to misdirect the reader from the crux of the argument.
Imagine the View of an Unbiased Observer
Imagine how a disinterested third party would see the controversy. Would they wonder what all the strider is for, since both sides sound so reasonable? Would they simply seek what would benefit the general welfare of all?
And Then Decide
Making up your mind after reading controversies is really quite simple. First, determine the facts by summarizing the scientific basis of the controversy. Examine the effects of potential solutions to the problems identified. Formulate what you perceive is best for ourselves, our neighbors, and our world, and base your opinion on that.
Advocate that course; yet always listen to the other side. And change your mind when you should. Facts that do not fit your lexicon are pearls to be considered. Others’ opinions and information can reveal an improved future course of action. Sometimes the opposition is your best friend.
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