Debate on Medical Ethics

From an online debate on

rhonda741 wrote:

Let’s look at a few FACTS:

The NUMBER ONE KILLER in America is NOT heart disease or high blood pressure, but Iatragenic Disease, commonly known as Medical errors. The number of people who die EVERY DAY from medical related incidence or error is the equivalent to 6 (SIX) jumbo jets crashing and killing everyone aboard. THAT Happens EVERY DAY! That is outrageous!

Where are you getting these numbers? You seem to be saying that there are some 800,000 iatrogenic (sic) deaths in the US every year. (I am assuming that by “America” you mean the US, right? It seems to be a habit in this country to conflate the two, to the disgust of the many other inhabitants of the continent.) This would indeed put it in the number one slot, but with a total of around 2,400,000 deaths a year, of which some 1,400,000 are attributed to heart disease and cancer, it seems unlikely that your number is correct. 

But beyond the accuracy of the numbers, if you are going to use this as an argument for staying away from doctors, you would have to show that a significant number of these deaths would not have occurred had the person not sought medical attention

rhonda741 wrote:

The NUMBER ONE suggestion a medical makes is to take tests, and more tests, and more tests, and then prescribe a drug that they

1. own stock in the producing pharmaceutical company of

2. receive kick-backs & benefits for perscribing x # of _______ within a designated time frame

3. KNOW that the drug will not “cure” anything, but instead create issues that will require more drugs to compensate for the bad side affects of this new drug, which MAY kill the person because their system will not handle the side affects mentioned in pica 4 print on the label inside the box

In any profession, or for that matter any grouping of people at all, you will find some who are dishonest, some who are criminal, some who are honest but deluded, and some who are both sincere and skillful, among many other categories. You will also find that the percentages of these categories are pretty constant in all walks of life, including the “alternative” health business. Your suggestion that all, or even a large proportion, of doctors act as you have described does not look like cynicism, but an extreme form of prejudice. Yes, I am sure that there are doctors who are as you describe, but I am equally sure that they form a tiny minority of the profession. (Nitpicking point: a pica is 12 points, so you described 48-point type, which would be readable at six feet or so!)

rhonda741 wrote:

The Number TWO suggestion by REAL medical doctors is to cut an organ out (for $72,000 +) that will provide a little relief but shorten the expected life span of the individual mutilated by the “expertise” of the surgeon who performs barbaric atrocities to the human body for a “fee” which pays a portion of his malpractice insurance.

Again, surgeons are fallible and sometimes dishonest, but the same applies here. In addition, some forms of surgery are unquestionably beneficial (I hope you would not go to an Upper Cervical pracitioner to treat an attack of appendicitis). And there are plenty of malpractice attorneys ready to pounce on any surgeon who even makes an honest mistake, let alone indulges in the kind of behavior you describe. (That malpractice insurance you mention creates a very tempting deep pocket!)

rhonda741 wrote:

IF YOU WANT to know the truth and really help people, then read the reports of these people who have tried alternative approaches to health and gotten over their debilitating illnesses. Their desire is to help others without expecting a financial gain or showing their excellent knowledge base. Shame on you for putting down members on this group who do not have an agenda or need to perform to your arrogant responses.

No agenda? You are pushing Upper Cervical care. Is this not a profit-making business too? Are you saying that this is the one business that contains no dishonest, greedy or deluded practitioners? I would be astonished.

rhonda741 wrote:

Of course, the Upper Cervical doctor, according to your qualifications is not a REAL DOCTOR because he does not TEST, REMOVE organs or prescribe drugs). That means he is NOT a MD or DO, doesn’t it? Montel goes on to say his MS disappeared after his atlas was corrected. How many modern REAL doctors have patients that say that? We have unlimited testimonies from people saying the same thing on our site.

What defines a “real” doctor is not how he or she sets about diagnosing and treating patients, it is the education and certification that he or she has undergone. “Real” doctors regularly report patients that recover for no discernible reason; no doubt you are familiar with the placebo effect, for instance. This is why medical science is very circumspect about ascribing causes to either illnesses or cures; it takes very careful study and statistical analysis to determine what is really true. Whatever your opinion of the scientific method and the value of anecdotal evidence, you would do well to read Carl Sagan’s book “A Demon-Haunted World (Science as a Candle in the Dark)” which describes many beliefs that were once widely held among even intelligent people that even you would now acknowledge to be mistaken.

So could we not perhaps conduct this discussion on a more intelligent level, and leave out the blanket condemnations of an entire profession, and the unsupported and highly questionable statistics? I am sure that Upper Cervical care has its place as a treatment modality, and in the hands of a skillful practitioner can be helpful in some cases where regular medicine has failed, but I am equally sure that it is not a panacea that will cure all ills, and that there are UC practitioners who are dishonest and greedy and venal in about the same proportion as in all other professions.

Scientific Studies

From an online debate on

ThePhiant wrote:

as you probably know, any study or data can be used to prove anybody’s point. bunching a number of study’s together and coming to a conclusion is always subjective. having said that my main point is that generalizations however subject-ive they may be, don’t mean a thing in the real world. Your partner in life or at work is more than likely the opposite of what those studies are telling you. Just because your studies say you are just as good at math as boys, that doesn’t imply that YOU are good at math. In the real world we are dealing with individuals, not statistics. Talk about YOUR experience,

Now wait a minute here. You may have your own views about the value of scientific study, but what you say is simply not true. Studies cannot legitimately be used to support any point of view, and they are certainly not subjective. In fact studies are very carefully designed to be objective, and where this is not possible, this fact is pointed out. A properly presented study includes an estimate of confidence; the authors’ estimate of likelihood that their conclusions are correct. Science includes in its procedures mechanisms for the discovery of error, and acknowledges that some error will always be present. 

And what exactly do you mean by the “real world?” Is your world any more real than that of thousands of dedicated and hard-working scientists (plus, of course, the normal admixture of charlatans, thieves and cheats; a minority in this as in most pursuits)? To say that generalizations mean nothing is wrong; they are valuable evidence, and to simply dismiss them as valueless is a waste of a precious resource, knowledge. Certainly a study incompletely reported can be used to support a point of view contrary to its true meaning, but this is true of any piece of infomation. It is up to the consumer to decide what is good information and what is bad. Go and read the underlying data and make up you own mind.

As for the contention that “your partner in life or at work is more than likely the opposite of what those studies are telling you”: since the precise purpose of studies is estimating likelihoods, by definition you cannot be more likely to contravene the generalization than follow it.

ThePhiant wrote:

Since when is a study’ objective? Do you mean to say that studies are chosen at random. Studies are chosen to prove or disprove something, and the way to go about is to test certain variables that are CHOSEN not objectively but subjectively. Just like the 11 blind men studying an elephant. They can and want to see only what is in front of them, subjectively. Antioxidants were supposed to be a lifesaver, turns out they actually can shorten someone’s life. Which scientist do you believe?

I will respond, not because I hope to persuade you of anything, but because I think it is important to supply the contrary point of view for others who might be reading this.

Scientific studies, in order to claim that designation, must conform to certain criteria. Among them are the requirements that both the initial assumptions and the methodology used are incorporated as part of the report. These results are studied by others, who are free to critique them. 

Yes, many studies are commissioned by interested parties hoping to prove something, but this does not always succeed; many studies go the other way. Yes, this often results in the suppression of those particular studies, and that is unfortunate, but is part and parcel of the capitalist system. I do not believe that there is a significant number of studies that are falsified for financial gain. Scientific hoaxes have certainly happened, but generally in important cases a lot of scrutiny is brought to bear, and it is hard to sustain a lie. There is a great deal of rivalry in science, and there are a great many scientists who are genuinely motivated by a search for verifiable and useful truths. They are constantly checking each others’ work in hopes of finding errors.

So it would seem extreme to simply reject all scientific studies categorically as unreliable. In a previous post you commented that “bunching a number of study’s together and coming to a conclusion is always subjective”, but i would submit that the more studies agree on a subject the more likely they can be relied on. One study might be a good indicator, especially if its methodology passes scrutiny; five studies that show similar results show a strong likelihood of truth.

Let’s face it; studies are like hamburgers and television sets and cars; some are very good and some are very bad. Most are in the acceptable range. Unlike hamburgers and television sets and cars, however, the way they are constructed can be examined by the user because the map is part of the product.

This, as I see it, is the case for the defense of science; no doubt there are other points that would be helpful, but someone else will have to supply them.

ThePhiant wrote:

Unfortunately you are not supplying the contrary point but actually, you are extrapolating my point that science is not as reliable as it pertains to be. Good science, bad science?  Science is only as good as the next study who proves otherwise. Case in point; antioxidants! btw; I have neither hamburgers, nor tv’s nor cars in my life to examine

Well, as I said, I had no ambition to persuade you from your views; I can see that you twist whatever input you receive to feed your preconceptions. If I am correctly understanding your somewhat idiosyncratic way of using words (extrapolating, pertains?) then once again you state the exact opposite of the case. Since scientific studies include estimates of the likelihood of error, scientific studies are in fact pretty much as reliable as they claim to be!

Maybe you are confusing the studies themselves with the way they are used by people who do not necessarily even understand them, and are all too often willing to omit whatever parts do not suit their arguments.

I know it can be confusing when studies show that something that has been previously thought to be useful also has dangers under some circumstances (antioxidants, for instance). That is where clear thought and judgment come in; my own observation is that pretty much everything in life has a medicinal dose and a toxic dose, and it is up to the consumer to determine from the information provided what those doses are.

Making sense of these kinds of complex issues, where conflicting evidence needs to be properly weighed and evaluated, is greatly facilitated by the use of critical thinking skills. Critical thinking was developed for exactly this purpose; to provide a tool for examining controversial questions and coming to the conclusions that are best supported by the available evidence. Critical thinking does not tell you the answer, any more than a good sharp knife makes you a good cook. If the evidence in fact supports your point of view, then you can use critical thinking to establish that fact. As it is, even though you may in fact be correct about some of your conclusions, your ways of arguing them, and your insistence on making statements that are at the very least highly misleading, do more to conceal that possibility than to reveal it.

I think at this point that I have said pretty much everything I have to say on the subject, and for me at least this discussion is reaching its toxic dose!

Science vs Intuitive Understanding

From an online discussion on

claire ossenbeck wrote:

Every time there is a major earthquake, they come out with some statement that says their clues to understanding have been tossed on the heap and they pretty much have to start anew. Before the North Ridge quake they believed that the faults were not connected to each other. I read this in a science mag. Then after the quake they find that omg, they are connected, quite! Ok, now here am I for years now, an absolute nobody, thinking to myself (purely intuitively) I think that they are connected because it’s just common sense to me and it feels right. It may not have been based on the science of the day, but if science does not understand that which it cannot measure or prove, and is needing to continuously upgrade itself, then where’s the proof that I’m wrong?

Among the many non-experts who thought about earthquakes, and had an intuitive understanding about some aspect of the subject, a certain number thought as you did, and were eventually proved to have been right. However I am sure that there were many who had some other intuitive insight that did not turn out to be right. Which one should we have followed?  Back then, when they had it wrong and you had it right, what would you have had them do?

Should they have said to themselves (and to us) “Claire is quite sure that it is this way, and we should change our views to conform with hers!”? Clearly not, since there are myriad Claires, and they do not all have the same intuitive understanding, yet they are all equally certain.

What they did was what science does: continue to study the matter with as open a mind as they could manage (they are, after all, human, and prone to human weaknesses) and when they accumulated evidence that they were wrong, they changed their views and told us that they had been wrong, and now understood things to work differently than they had thought. Do you ever stop to consider how rare and courageous an act that is, to admit that you have been wrong? Yet that is what science does regularly, as better tests are devised and new theories tested and knowledge is more widely disseminated by communications technology improvements.

I think that perhaps you are under a false impression of what “science” is saying. If you had had the opportunity to talk to a reputable earthquake specialist at the time when the accepted view disagreed with your intuitive sense of what was the truth, he or she would probably have said something like “Well, that is a possibility, and may indeed be true, however the information we have right now seems to indicate otherwise.” Under appropriate circumstances the response might be “Well, what you propose is not impossible, but it has been studied so much with so much agreement that we consider the likelihood very low.” Even then they may turn out to have been mistaken; in almost no case will a reputable and honest scientist claim to know for certain that anything is either definitely right or definitely wrong. However, it is not up to science to prove that you are wrong; if they had to do that for every theory that came along, they would not have time for anything else. If you want to have your theory adopted it is up to you to provide the evidence, not just the assertion, that you are right.

As in all pursuits, there are individual scientists who care more about their ego or reputation than about the truth, but this is not true of science or scientists in general, any more than it is true of doctors or engineers in general, or of medicine or engineering as professions. You are of course quite free to believe that your theory is true and the accepted one false, just as I am sure there were earthquake scientists who also disagreed. Nobody was or is trying to stop you believing that. The difference is that the views of “science” (as opposed to the views of individual scientists) represents the distilled knowledge, tested and verified, of many people who have studied the matter. Even then as we have seen, they can be wrong. However, unlike people whose views rest solely on faith (and are therefore not really interested in evidence), when presented with new information that checks out, science will change its views. 

So if occasionally science comes around to a point of view you already held, you are allowed a smile of satisfaction, and even a modest boast, but at the same time it is always salutary to remember the ideas you had that did not turn out to be supported by the evidence after all. 

What is Science?

Science is not a profession, it is a method, an algorithm. An orderly set of instructions which when correctly applied yield the best possible approximation to a reliable and repeatable truth.  It will also yield the degree of certitude of that truth as well as the degree of likely variance. 

Science does not answer the question “What course should we take?” Science answers the question “If we take thus and such a course, what is the range of possible outcomes, and what is the probability of any given outcome?” There are many areas that science has no tools to tackle, which means that it is not the right method of approaching that problem. This is not a weakness of science any more than it is a weakness of a hammer that it cannot cut a straight line. 

The process goes something like this. You have a flash of inspiration. You figure out ways of testing it by trying to disprove it. You try to eliminate all the other possible causes that could account for your results. You try it under as many different conditions as you can think of.

Only when you have thoroughly tested the limits of your hypothesis can you justify any confidence in it. Then comes the real test. In order to pass scientific muster you must show how you arrived at your conclusion in sufficient detail to allow others to replicate your findings. If a significant proportion of them succeed in doing so, then and only then can you claim to have arrived at a verifiable truth.

You can be an inventor without being a scientist; as long as what you invent works well enough to be beneficial in the world you can even get rich that way. You can make scientific discoveries with out being a scientist, but someone will have to do the science to prove it, it does not have to be the discoverer. The vast majority of scientists never discover anything new or propose an original hypothesis, they dedicate their lives to testing the ideas of others. Sometimes they are motivated by the desire to find mistakes in accepted hypotheses. No matter, they are all valuable to the project of Science itself, which is the search for ever more reliable truth. 

Pure science barely exists in the world today. So much is known about the nature of the physical world at such a deep level, that advancing the frontiers of knowledge involves prolonged immersion on the subject even to understand the remaining problems, and then very expensive gadgets like CERN to test their theories. The days of hobbyist scientists discovering new materials are long gone, and such research is now done by corporations for their own use and profit. They are not specifically interested in advancing knowledge, but in making money. If they can make more money by suppressing knowledge, they will happily do so.

Science has among its practitioners a certain number of liars, a certain number of fools, honestly deluded people and some outright criminals. This statement could be said equally truthfully of lawyers, bankers, mechanics, wealthy people and pretty much anyone else. These are categories that people in general fall into in similar proportions throughout the population regardless of what station in life they occupy. The vast majority of people are honest and well intentioned. There is absolutely no reason to suppose that scientists have a greater propensity for dishonesty than the general public.

How do we know what we know?

Every decision is taken in the context of countless conditions. The number of possible reverberations that might result from any significant life decision is infinite, and the possibilities usually range from total success to utter failure. When you also count in the potential effects on others, and their probable reactions, trying to figure it all out logically is an impossibility and often leads to complete inability to make any decision at all. There are two possible kinds of response to this situation. Some declare that you just can never think it through and must rely on some kind of intuition or “direct knowing” or some such. This is just giving up, and the likelihood of making anything close to the optimal decision is no greater than plain chance. This is not much of a problem in the personal sphere where your actions will affect only a limited number of people, but in the public sphere it just is not good enough. If we are to make laws that everyone must obey and decisions that will affect everyone (and to live in a society we must do that) we owe it to them to base those laws and decisions on the most reliable basis possible.

This raises one of the most fundamental philosophical questions: “How do we know what we know?”  The reason this question is so important is because the only way we can justify society’s abridgment of citizens’ freedom is if we can be morally certain that there is a strong and valid reason for it. There is no such thing as absolute certainty about anything, but in order to balance a societal need against the citizen’s freedom of action we need to know at the very least four things: what is the degree of harm being avoided; what is the severity of the restriction on freedom; what is the likelihood of the harm occurring; and how certain are we that the danger is real? 

There are countless examples in history of measures being taken to counter a perceived danger that turned out in the end never to have been a danger at all. The Cold War was largely based on a gross overestimation of the capabilities and hostile intent of the USSR. 9/11 precipitated a series of government actions the echoes and aftershocks of which are still roiling the world (and inconveniencing the traveler) in 2017, which have cost us untold lives and treasure, and virtually none of them, I would be willing to bet, had any effect whatever upon the likelihood of another such event. So clearly it is vitally important to know what degree of credibility to give to any given piece of information.

We must recognize just how difficult it is to be certain of something. Things which seem self-evidently true turn out to be completely false. Things that seem quite obviously to be caused by a particular circumstance turn out to be caused by something quite different. We give great weight to our own personal experience, and the experiences of our friends and acquaintances, forgetting that we and they may very well not be typical of the world at large.

Fortunately this problem is not new. People have been thinking about it for centuries, and have come up with various solutions. Religion, in all of its varieties, is one solution. God will tell us what is right and what is wrong, and it is not up to us mere mortals to inquire into such matters. The difficulty with this solution is that there is by definition no way to verify the truth of what God says. You just have to have faith that it is true. Unfortunately we cannot even verify convincingly that such a concept as God even exists, and still less can we be certain that any alleged communication fro that source is even genuine, to say nothing of the impossibility of verifying its correct meaning. If your personal experience runs counter to what God says in any aspect at all, the whole edifice is then suspect, and you are left with no certainty.

Then there is folk knowledge, also known as old wives tales. Here we are on much more solid ground, as these remedies do represent accumulated experience and often study. The difficulty here is again the issue of verification. Too often old ideas persist long past the time when the original impulse for them is forgotten.

We might have direct personal experience of the matter, or perhaps have access to the combined experiences of others. Unfortunately this may be a poor basis upon which to draw a reliable conclusion. There may be something untypical about you and your acquaintances that make your experience quite different from that of others.  

We may have a very strong intuitive flash that something is true. It just seems so right, answers so many questions, it just has to be true, right? Well, maybe. Certainly it could be true; many famous scientific discoveries came about through just such flashes of inspiration. But we do not hear the countless stories of the flashes of inspiration that turned out to be just plain wrong. The intuitive inspiration is just the start of the process. The real work is in testing the hypothesis to verify that it is in fact correct. Or more accurately to assess its degree of certitude. 

Fortunately we have at our disposal the best tool ever invented by the mind of man for this purpose, and that tool is Science.