Skepticism about science and medicine

In search of disinterested science

Posts Tagged ‘David Healy’

Speaking Truth to Big Pharma Power

Posted by Henry Bauer on 2017/03/18

Some time ago I recommended the newsletter of Mad in America, a diligent and reliable commentary on the flaws of modern psychiatric medicine.

A recent issue had links to a superb series of articles by David Healy, a psychiatrist who has spoken truth to Big Pharma and to the conventional (lack of) wisdom, at considerable personal cost. Healy also founded a website with information about dru side effects, RxRisk:
Tweeting While Psychiatry Burns
Tweeting while Medicine Burns (Psychopharmacology Part 2)
Burn Baby Burn (Psychopharmacology Part 3)

Also useful in this newsletter, link to a report of a meta-analysis confirming the Minimal Effectiveness and High Risk of SSRIs

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Posted in conflicts of interest, medical practices, politics and science, prescription drugs, science is not truth, scientific culture, scientists are human | Tagged: , , | Leave a Comment »

What to believe? Science is a red herring and a wild-goose chase

Posted by Henry Bauer on 2016/07/24

To be certain about things is reassuring. It allows feelings of safety, security.

For knowledge, for understanding the world, humankind seems to have turned at first to what could be inferred from the spirits of things — the spirits associated with or inherent in everything: in mountains, in trees, in bodies of water. The spirits could be understood, at least partly, because they were similar to people in having emotions and desires.

Eventually — quite recently, only a few thousand years ago — the plurality and hierarchies of spirits and gods yielded to monotheistic religions in most parts of the world. Even more recently, and only in the most powerfully developed countries, religion yielded to science.

That is to say, traditional religion yielded to scientism, the religion of science. Even the monotheistic gods have emotions and desires, but science doesn’t. So knowledge became entirely impersonal, at least in principle.

Nowadays, then, for real certainty we look to science. “Scientific” stands for unquestionably true. Science is the gatekeeper of truth. “Science” and “scientific” are mediators of being certain, being sure about something.

Consequently, a great deal of arguing to-and-fro has to do with whether something is scientific:
Does it emerge from use of the scientific method?
Is it reproducible?
Is it falsifiable?

And if a claim doesn’t satisfy those criteria or equivalent ones then it’s dismissed as not scientific, or as pseudo-science, or as just plain not to be believed.

That’s an indirect way of judging believability, and arguments about whether something is scientific can be and have been highly abstract, complicated, and sophisticated as technical philosophical discourse tends to be.

Instead, why not go directly at the issues of certainty and truth and just ask, what does it take to be justifiably and reliably certain about something?

In any case, although we use science as mediator of certain truth, we’ve also learned that contemporary scientific knowledge and understanding really isn’t always reliably true. Even when an explanation has been based on tangible evidence, and withstood challenges and tests — if it’s properly scientific, in other words — we’ve learned that it may be misleading. Scientific progress with periodic scientific revolutions has continually revealed flaws, deficiencies, errors, in what were for a time the most widely and fully accepted scientific theories.

If something has always happened in the past, can we be certain that it always will happen in the future? We’ve learned that we cannot be quite certain.

When an explanation has always worked in the past, can we be certain that it always will work in the future? We’ve learned that we cannot be quite certain.

When tangible things are sub-divided into their ultimate components, those turned out to be nothing like objects accessible to direct human observation. They do not fit our concepts of particles or energy, although many of their reactions can be calculated using sometimes particle equations and sometimes wave equations. They behave sometimes as though they were locatable, delimited in space-time, and at other times appear to be “non-local”, not so delimited.

In other words, we’ve learned that we cannot get certain and humanly comprehensible understanding of everything about the whole of the natural world. It’s surely time to accept that, that human beings will never attain complete certainty.

That could be liberating. It would make more feasible pragmatic, non-ideological communication and cooperative action — if only we could be rid of the ideologues: the true believers in a religion, including the true believers in scientism, the religion of science. Anyone who claims complete certainty has insufficient warrant for that claim. The world and its behaviors can be known only within degrees of probability. Instead of arguing about whether something is scientific or whether it is true, we ought to be discussing plausibility, likelihood, utility, risk.

Instead of dismissing as pseudo-science the claims that Loch Ness Monsters are real animals, we should be content to say, “Feel free to believe that if the evidence seems to you sufficiently convincing. For my part, I’ll wait until someone shows me an actual specimen or an indubitable bit of one”. And similarly with yetis and other cryptids, and with UFOs, and with all other anomalous or Fortean reports or claims.

Instead of arguing over being for or against vaccination, we should ask for the statistical data of harm possibly caused by each specific vaccine. For instance, since in many countries the chance of becoming infected by polio is less than the risk of contracting polio from the oral vaccine. perhaps official sources might be less dogmatic about enforcing use of that particular vaccine (“Polio vaccines now the #1 cause of polio paralysis”; “Oral polio vaccine-associated paralysis in a child despite previous immunization with inactivated virus”; “Bill Gates’ polio vaccine program caused 47,500 cases of paralysis death“).

And so on. For every drug and every treatment, we should demand that the Food and Drug Administration require data on NNT and NNH — NNT: the number of patients needed to be treated in order that 1 patient benefit, compared with NNH: the number of patients who must receive a drug in order to have 1 patient experience harm [How (not) to measure the efficacy of drugs].  That would go a long way to decreasing the number of people nowadays being killed by prescription drugs, which are the 3rd or 4th leading cause of death in First-World countries (Peter C. Gøtzsche, Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted

Healthcare [Radcliffe, 2013]; David Healy, Pharmageddon [University of California Press, 2012]).

We need more data and less dogmatism.

 

 

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Public health and individual health

Posted by Henry Bauer on 2014/09/19

Recent posts about vaccines point to an inevitable conflict between public policy and individual autonomy. The risk can be greatly diminished of epidemics capable of sickening and even killing many people, but the price is the induced sickness and even death of a few individuals.

One anecdote in the NOVA program featured a lad who was crippled by polio contracted through vaccination by the oral polio vaccine. Despite his own sad experience, he was shown supporting the principle and practice of vaccination nevertheless. “Only” 2 or 3 in a million people experience this misfortune. An “expert” pointed out that as a result of this unfortunate case, it was realized that the less dangerous injected vaccine should supplant the oral one, “showing that the system worked”. He also mentioned that since the only cases of polio reported for many years had been those actually caused by the oral vaccine, clearly more attention ought to have been paid to making the vaccine as safe as possible. In other words, the system did NOT work — it took some personal tragedies for the system to do something that rationality could have foreseen the need for.

Yet no matter how well “the system” might work, the fundamental conflict remains: some unknown number of individuals, albeit a small number, will be harmed by actions that (are believed to) decrease risk for a large number of others. “Are believed to” to emphasize that one cannot in fact know that risk is being decreased in the case of diseases that have essentially disappeared in developed countries: If the risk of polio in the USA is 1 in a million from vaccination, what is the risk — if not vaccinated — of actually getting polio from an infected traveler from some other country? The cited experience of many years indicates that risk to be less than 1 in a million. Not vaccinating against polio may be less risky than vaccinating, apparently?

That point is easy enough to see when it comes to vaccines. Perhaps surprising, though, is that the same point applies to the use of clinical trials in the developing of drugs. Clinical trials can only gauge average effects, and it is far from obvious that all individuals should be treated according to such average results. This issue is argued in great detail in David Healy’s Pharmageddon (University of California Press, 2012).  For a short discussion, see my just-published “Clinical trials with surrogate outcomes have brought bad medicine(s)” .

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