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Residual Confounding

Who doesn't love a good turn of phrase? Or a term that is both suggestive and unknowable, at the same time? Or a reference that is simply mind-boggling? Like, "residual confounding". Maybe it's the name of a band I hadn't previously heard about?

On November 16, 2018 the Chicago Tribune newspaper published a piece in its "Perspectives" section that was written by a chief fellow in the oncology unit at Northwestern Memorial Hospital, in which the author discussed at length what he felt to be residual confounding that undermined or called into question, the conclusion of a study that had been printed a month earlier by JAMA Internal Medicine--a prestigious medical publication that is part of a series of peer-reviewed journals.

The journals are promoted on the JAMA websites as, "insightful opinions of leading scholars on a diverse range of medical issues"--except, apparently, when they are impacted by residual confounding, which is a fancy medical term for what one who is of Russian descent might refer to as "kompremat ".

To his abiding credit, the author concluded the article with the observation that, "medical science is rarely black and white, and anyone claiming something is proven to be 100 percent good, all the time, may be motivated by some bias or career incentive". Residual confounding (or what lawyers might refer to as "unconscious bias") lurks around every corner, challenging our common sense of things.

As one of my prior Managing Partners used to say with absolute certainty: "If you can't measure it, you can't manage it". Pithy wisdom, and pretty compelling unless it is offered as wisdom that is, "100 percent [correct] all the time". Which, of course, it is not.

I freely acknowledge that my enthusiastic embrace of mindfulness and meditation as a material benefit for the legal profession, is colored by residual confounding. I'll even go one step further and concede that my unconscious bias is really, quite conscious. I would also suggest that my advocacy is grounded in the common sense knowledge that my belief is more likely true, than not true --a standard that most lawyers understand and accept.

Legal truths-- like medical truths-- are rarely black and white. That's simply not representative of the world in which we live. And it's not a standard that the legal profession should insist upon in deciding whether to encourage mindfulness and meditation as tools to be included in the lawyer well-being toolkit.

The concept of mindfulness and the practice of meditation may be confounding for many of us lawyers (as well as many others), but that doesn't mean that the benefits and the application of those practices are not more likely to be helpful, than not.

Let's listen to our own common sense, and stop investing so much in scientific certainty or management bon mots that are--unavoidably-- compromised by residual confounding!




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