Skepticism about science and medicine

In search of disinterested science

Public (lack of) sound knowledge about medical matters

Posted by Henry Bauer on 2014/10/27

This is a scientific age, and medicine (among other things) is now based on science. And science, of course, is self-correcting.

At least that’s what the conventional wisdom is, the Zeitgeist, the common shibboleths, and what the slew of public pundits keeps repeating.

The truth, of course, is quite otherwise. We’re in a Science Bubble [1] in which conflicts of interest, commercial interests, and bureaucracy throughout official institutions and “grass-roots” organizations make it less and less likely that genuine scientific knowledge influences our policies and practices.

The media do not do their job as a Fourth Estate that might help to keep the other Estates honest, they are simply mouthpieces helping to inflate and sustain the Science Bubble.

Evidence for these assertions:
Over the last few decades, and especially the last one, there has been a spate of informed criticism of present-day drug-besotted medical practice, in dozens of books and many more articles, from prominent insiders and from competent and well informed observers [2].
But the public media have failed to bring awareness of these critiques to the general public. And when they do make some reference to bits of it, they fail to emphasize the conclusions or to draw attention to the wider context of the Big Picture.

Case in point:
For years, informed insiders and observers have pointed out that much routine “screening” has done far more harm than good, by leading to unnecessary and damaging “preventive” “treatment” for people who did not need it.
Shannon Brownlee pointed this out at least 5 years ago in relation to mammography screening against breast cancer [3]; and Brownlee practices what she preaches:
“I don’t get mammograms. I don’t do mammograms. Now, I may do a mammogram or two in my 60s when it looks like the benefit is greatest, but I don’t do mammograms. And it’s . . . because I am more worried about being harmed by unnecessary treatment. I’m very worried about being harmed by unnecessary treatment by overdiagnosis.” [4]
Peter Gøtzsche published a book about it in 2012 [5], as authoritative as one might wish since Gøtzsche heads the Nordic Cochrane Center — the Cochrane Collaboration  being an independent group whose raison d’être is literature reviews and meta-analyses to determine whether actual practices do or do not live up to claims and expectations.

But what does the public learn from the popular media?
In 2014, for example, THIS WEEK (ABC TV, 26 October 2014) mentioned, as supposedly current news, that there’s controversy over the benefits of routine mammography screening.

I mentioned this to a good friend who happens to be a statistician/probabilist. He had worked at the University of Michigan some 40 years ago in a group that reported already then that annual mammograms did more harm than good.

Long gone are the days when Mike Wallace on 60 Minutes programs, to the occasional bemusement and sometimes dismay of sponsors, advertisers, and executives, would actually call a spade a spade (or a bloody shovel, as Aussies would say).

When the Science Bubble finally bursts, it will do far more damage than the defective air-bags and other things that the media are currently obsessing over and describing as world-shattering risks. Much is wrong with present-day medical practice, scores of books have been written about that, but the popular media seem ignorant of it and continue to disseminate misleading and damaging material.

——————————————-
[1] The Science Bubble, Edgescience #17, February 2014, 3-6
[2] What’s Wrong with Present-Day Medicine
[3] Cancer screening: Doing more harm than good?, Reader’s Digest, April 2009
[4] Diane Rehm show, “Debate over the benefits of routine mammograms”, 12 December 2012
[5] Mammography Screening: Truth. Lies and Controversy, Radcliffe, 2012

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6 Responses to “Public (lack of) sound knowledge about medical matters”

  1. Carol S said

    Nice one, Henry. 🙂

  2. dondeg said

    Hi Henry

    Just found your blog. I’m over at http://dondeg.wordpress.com/. You are of course cordially invited to pop in and see my rants.

    re your above post. It seems not only has the media quit doing it’s job, but so have the scientists. Science is supposed to be self-policing. It is supposed to prune away bad ideas before they even make it out into places of application. Instead, one sees the opposite: they vie for position in this squalid system. They see their job to make the next “miracle drug”, the next “gold standard of treatment”.

    I see in my day to day work a kind of intellectual ADD (attention deficit disorder) that is similar to contemporary politics. A mistake is made. It is swept under the rug and forgotten. There is no backward looking analysis, just a forward movement that constantly dissociates itself from the past, both immediate past and long-term past. For example, in my field, a theory will arise: “Excess nitric oxide kills the cells”. A whole flurry of activity will occur. Many papers are published studying this in cell cultures and animals. Millions in grants are given out. People make their reputations. It may or may not make it to clinical trials. If it does, the clinical trials inevitably fail. Then a new theory arises: “apoptosis kills the cells”, and the whole cycle repeats. No one looks back. No one tries to understand the constant failures.

    It is such a bizarre sociological phenomena. Even given all my reading in STS, I don’t have words or concepts to describe it.

    Anyway, as usual, I am just underlying your point. Great to find your blog, Henry and I look forward to reading it regularly.

    All my best,

    Don

    • Henry Bauer said

      dondeg:

      Thanks, Don, appreciated. Jack Good used to say, “The urgent drives out the important”. Research has become such a cutthroat, hothouse affair, people are too busy to think, results have to be achieved AND PUBLISHED quickly, and there’s no reward for stepping back and trying to see whether the trees actually say anything useful about the forest….
      I was just reading Allen Frances’s Saving Normal, he has lots of examples in chapters about past, present, and future fads in psychiatry

  3. I’m not sure if this is the most appropriate entry under which to comment about vaccines, but it’s close enough. I came across this story this morning via Twitter, about a mother whose seven kids all contracted whooping cough:

    http://www.rawstory.com/rs/2015/04/anti-vaxx-mom-abandons-movement-after-all-seven-her-of-her-kids-get-whooping-cough/

    This quote got me thinking:

    “We had vaccinated our first three children on an alternative schedule and our youngest four weren’t vaccinated at all”

    Well, I’m not entirely sure what that means. Did the first three kids have whooping cough vaccines or not, I wonder? Does this mean she didn’t finish the course?

    You know, I had a flu last year that lasted for weeks, though I was never bed-bound. I had two days where I had one coughing fit each day where I thought I was going to vomit. They lasted just minutes. And stringy mucus is something I put up with now and then for no reason anyway (could be a minor genetic thing).

    So, did I have whooping cough as well as the flu? I don’t know. Did I rush to the doctor? No – they wouldn’t do anything anyway. But then again, that was when lots of people in Melbourne had this strain of flu, and it could have just had superficial resemblance to whooping cough. And I’m an adult – maybe kids can’t handle these things.

    I wonder: are people not really thinking through their stance on this, or is this over-thinking on my part?

    • Henry Bauer said

      Karim D. Ghantous:

      Single cases are impossible to analyze conclusively without a huge amount of specific information.

      I think refusing ALL vaccines goes against the evidence, but I think it makes much sense to space out vaccination of babies instead of giving multiple ones at the same time. And there’s good reason, excellent reason, to avoid recently invented vaccines like Gardasil.

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