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-   -   Medicine as “a proven science” (http://hintsforums.macworld.com/showthread.php?t=85224)

CAlvarez 02-05-2008 12:30 PM

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We can't live without faith (i.e., trusting beyond what cannot be proven). It's impossible to do so. You'd drive yourself crazy trying to verify every little contingency of life without some degree of faith.
I have no faith in any of the things you mention. However I realize I can't test and control them so there's no point in trying. There is a reasonable risk involved that it probably won't kill me, so I choose to worry about things with higher risk.

wdympcf 02-05-2008 01:37 PM

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don't think that medicine is the science of healing; it's not. medicine is the science of destroying disease. all a doctor ever does is slice, zap, poison, irradiate, or clean out whatever it is she can see going wrong with your body
That's neither fair nor accurate! The practice of medicine is about treating illness - helping the body to overcome infection and injury. Sure, doctors can't magically heal you - but they help you along the way.

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A lot of medicine is applying the logical narrowing down of causes and effects like we would do when diagnosing what went wrong with a Mac, and we all know how complex a Mac already is to troubleshoot sometimes.
I couldn't agree more - and no one is calling any of the troubleshooting "experts" in this forum a hack or accusing them of suggesting quack remedies. Usually the troubleshooting advice is to try these 3 things, and report back if that doesn't work. The other approach is to have someone dump an error log on the forum and analyze those results. Well here's the news flash - the body only generates the most cryptic and unintelligible error logs imaginable, so cut physicians a little slack. They are trying to troubleshoot the most impossibly complex system without access to the original design documentation and reverse-engineered troubleshooting manuals.

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I think what folks tend to forget is that although Medicine is science-based, it's practice is still experimental.
Don't forget that science is an experimental process. A hypothesis that cannot be tested is not a valid hypothesis. And how do we test it? Through experiment.

The problem as I see it isn't with medicine, but rather with uninformed patients and profit-hungry businesses. The medical profession has a giant monkey on their back called the pharmaceutical industry. And history has repeatedly shown that the pharmaceutical industry is not out there for the greater good.

I don't watch TV very often (perhaps an hour or two a week), but when I do, I am always shocked at the number of pharmaceutical advertisements on TV. The pharmaceutical companies are trying to peddle their drugs directly to the end user through advertisement. What? So I can go into the doctor and ask them to prescribe me X brand of drug? Pharmaceutical companies are very savvy at advertising and marketing. They wouldn't be wasting millions (billions?) of dollars on advertising directly to the end user if it wasn't influencing their sales. Doesn't that suggest that people must be going to their doctor with preconceived notions about their diagnosis and cure?

"Ask your doctor about Lipitor"
"Ask your doctor about Cialis"
"Ask your doctor about Paxil"

Physicians have an obligation to try to remain objective against the onslaught of that marketing machine. But so too do the patients. As a general rule, I drink a glass or too of water for a headache and go to bed early. No Tylenol, Advil or Aspirin for me. Besides, scientific stats (not pharmaceutically backed studies) suggest that the majority of headaches are caused by improper hydration. I also try to avoid medication of any kind if it's not necessary. If I'm sick, but my body can fight it off on my own, then I let it do its job. However, if and when medicine has been necessary, I believe that medical science has served me well.

wdympcf 02-05-2008 02:20 PM

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Take these salt tablets, they prevent dehydration. Cut down on your salt, it raises high blood pressure. Wait, no it doesn't unless you already have a problem.

Don't eat butter, too much cholesterol... eat the margarine made from vegetable oil. No, wait, that's worse, go back to butter.

Take this med that works to keep cholesterol from absorbing in the intestine and lowers your bad cholesterol. No wait, study shows zero effect on the build up in your arteries and has no impact whatsoever on risk of heart attack, surgery, death, etc. Wait, it does lower your bad cholesterol numbers... but apparently that doesn't have anything to do with anything. More studies... keep taking the pill, they're only a buck and half a piece, even though we know there is zero proven benefit to taking them.

Don't eat fat, it has a bad effect on your heart. No, wait... no it doesn't but you should eat less anyway because of the calories.

Don't drink alcohol, it's bad for you in any quantity. No, wait... a couple three drinks a day for the average male actually has a beneficial effect on health. So, I figure six is about break even.

Don't eat apples with the wax sprayed on (Aylar) cause it causes cancer. No, wait, it doesn't.

Don't eat meat cooked over an open flame... the burned spots are carcinogens. When asked what the researchers did with the steaks after cutting off a couple burned spots for testing, the answer was, "We ate them."
I wonder if you actually know the sources of these supposed studies? I would guess that you probably heard of these through the news media or by word of mouth through friends and acquaintances. I would also guess that you never went further and actually looked up the studies themselves (like most people) to see what the hypothesis, methodology, sample size, statistics and results were. Or how about who funded the study? Perhaps it is convenient to try to pin this on bad "medical science" or perhaps science in general, but I think most of the public does a very poor job of developing informed opinions.

For example, there is a recent study released citing that caffeine intake can double the risk of miscarriage in pregnant women. Now, I have always encouraged my wife to cut back on or eliminate coffee drinking while pregnant, so I was quite happy to read this news as it justified my stance on the issue. However, despite the fact that the study told me what I wanted to hear, there are several questions that I could ask about it.

The study was done on 1063 Kaiser Permanente member who were pregnant between 1996 and 1998. There are three things that immediately grab my attention here: 1. the study sample size is quite small, 2. the data is from 1996 to 1998 and the study is just coming out in 2008, and 3. the study was done on members of a specific HMO. All of these factors influence the validity of the claims being made. Why is the sample size so small? The larger the sample size, the more compelling the statistics become. Why wasn't more recent data being used? How well are people going to remember their caffeine habits 10 years ago? If the data was collected then, why is the study only being published now? What kind of demographics apply to members of the Kaiser Permanente HMO? Does this influence the miscarriage rate?

And all of this is only from reading the news media coverage of the study (not actually reading the study itself - this of course assumes that the media got the details right). Many of the answers to these questions may be contained in the details of the study - and if I truly wanted to spend the time, I could read it. Most people don't ask these questions in the first place, let alone take the time to research the answers. Then they complain - after taking the "result" at face value without questioning anything - when they are confronted with a new "result" that contradicts the previous result.

Do you know how many "scientific" studies cigarette companies have done to show that cigarettes are not addictive and do not cause cancer? Did you know that many of the studies showing that margarine is healthier than butter were financed by the companies that produced the margarine? And that many of the studies showing that butter is healthier than margarine were financed by dairy farmers' associations?

Learn to be skeptical, and don't trust "science" unless it comes from a scientific source and is performed like real science. Also, take the time to try to understand the implications of the results. I can't count the number of times I've gotten into a discussion with someone who is opposed to evolution and the "pseudo-science" it represents, only to discover midway through the conversation that they don't even have a proper grasp on what the theories on evolution are claiming. If you don't know what something is, how can you claim to believe it false (or true for that matter)?

aehurst 02-05-2008 03:24 PM

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Learn to be skeptical, and don't trust "science" unless it comes from a scientific source and is performed like real science.
That was sorta my point... one study, no matter how well done, does not make it science. I lived through the cholesterol things and made the changes on the doc's advice. The medication I referenced was last month and I am on that medication.... I did not stop taking it. Apples sprayed with Aylar were removed from the market. The items listed are real examples.

We seem to have arrived at the point that an increase/decrease in A resulted in a 6 percent increase in B in one study somehow computes to cause and effect and gets reported in the news just that way. That is nonsense. No doubt in many cases somebody had a federal grant and had to report something, needed a dissertation for a PhD, or had a particular outcome in mind when the project was designed.

I ignore all the advise in the paper/TV and let the family doc make the calls on those things (including alcohol and caffeine). He does keep up with all the literature/studies (professor of internal medicine at a local teaching hospital).

wdympcf 02-05-2008 04:23 PM

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The items listed are real examples.
I don't question the fact that they were all real examples (in fact, I remember hearing/reading about all of these at some point or other - except for the salt tablets, never heard that one). My point was merely that many people like to vilify science for their own misunderstandings or often the misunderstandings of others that they have then in turn blindly accepted as fact. And the media (newspapers, TV, internet) is often to blame for this misunderstanding.

A brilliant example of this was years ago when several newspapers reported that you could lose weight simply by increasing your consumption of ice cold water. The article went on to say that researchers had shown that by drinking x cups of ice cold water a day you could burn y calories because your body would lose energy to heating the water to body temperature. I'm not sure what researchers they talked to, but whoever they were, they were charlatans.

The reason this was initially accepted by the media and reported was because the reporters did not understand the difference between a calorie as used in physics and a calorie as used in medicine/nutrition. The difference between the two is a factor of 1000. Thus, the amount of energy consumed by drinking a cup of ice water is actually 1000 times smaller than what the researchers were claiming. I wound up having to sit down and explain this to my sister-in-law and mother-in-law for half-an-hour in order to convince them that this report was utter junk. Of course, I could have just let them drown themselves in ice cold water while trying to lose weight - but that wouldn't make me a very good brother/son -in-law!

Had the media been interested in publishing scientific results they would have done their due diligence and checked their facts before disseminating this garbage! True science exists and gives us valuable insight into the inner workings of our universe (both outer and inner), but as always, you have to sift out some of the garbage that masquerades as science in order to find it.

J Christopher 02-05-2008 06:21 PM

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Originally Posted by wdympcf (Post 448596)
Do you know how many "scientific" studies cigarette companies have done to show that cigarettes are not addictive and do not cause cancer?

And now the same tactics of the Tobacco Institute are being used by energy companies and global warming deniers to obfuscate the facts in an attempt to create public debate on an issue on which real scientists have already reached a consensus based on evidence. Public debate has no place in the matter. It's like debating whether grass is a plant or an animal. Even if people can be convinced that grass is an animal, it doesn't change the fact that grass is a plant.

tw 02-05-2008 07:17 PM

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Originally Posted by wdympcf (Post 448590)
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Originally Posted by tw
...don't think that medicine is the science of healing; it's not. medicine is the science of destroying disease. all a doctor ever does is slice, zap, poison, irradiate, or clean out whatever it is she can see going wrong with your body

That's neither fair nor accurate! The practice of medicine is about treating illness - helping the body to overcome infection and injury. Sure, doctors can't magically heal you - but they help you along the way.

oh, I think it's both fair and accurate, and not all that different from what you said. all I was trying to do was point out that doctors lie somewhere between 'medical messiahs' and cold, bloodless scientists. and think about it - 'treating illness' really means 'treating people by attacking illness' doesn't it?

no insult intended to doctors, who do marvelous work. I'm just trying to put things in perspective.

Phil St. Romain 02-05-2008 07:22 PM

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Originally Posted by J Christopher (Post 448657)
And now the same tactics of the Tobacco Institute are being used by energy companies and global warming deniers to obfuscate the facts in an attempt to create public debate on an issue on which real scientists have already reached a consensus based on evidence. . .

Not so fast on the global warming issue, at least the human contribution to it. Apparently, there are a lot of "real scientists" who have serious qualms about how the public discussion of that topic has been going. Maybe "global warming" deserves it own thread, however.

wdympcf 02-05-2008 08:13 PM

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cold, bloodless scientists
Ouch....

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And now the same tactics of the Tobacco Institute are being used by energy companies and global warming deniers to obfuscate the facts in an attempt to create public debate on an issue on which real scientists have already reached a consensus based on evidence. Public debate has no place in the matter. It's like debating whether grass is a plant or an animal. Even if people can be convinced that grass is an animal, it doesn't change the fact that grass is a plant.
Not to appear to flip sides here, but you should be very careful about lumping science and fact together. Very few things in science are fact. The strongest conclusions in science are usually labeled as laws (still not fact, as laws can and have been refuted), the next strongest as theories, then hypotheses, etc.

To say that public debate has no place in the matter is to encourage people to be irresponsible and not to think for themselves - exactly what I was cautioning against above! You should question everything that comes from science. There are many scientific theories that have been modified or flat out disproved over time, and global warming may well be one of them. I happen to believe in global warming and the human contribution to it, but not necessarily to the extent that Gore predicts. After all, I heard global warming predictions when I was growing up that suggested that the California coast should have been flooded by now.

tw 02-05-2008 08:29 PM

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Originally Posted by wdympcf (Post 448692)
Ouch....

lol - sorry. I was just thinking of that notorious (though possibly mythical) "the operation was a success, but the patient died" quote. :D

J Christopher 02-05-2008 11:37 PM

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Originally Posted by Phil St. Romain (Post 448675)
Not so fast on the global warming issue, at least the human contribution to it. Apparently, there are a lot of "real scientists" who have serious qualms about how the public discussion of that topic has been going. Maybe "global warming" deserves it own thread, however.

A few hundred isn't much compared to several thousands. A closer examination of some of those signatories will expose them as hired guns for special interest.

A couple examples (Notice how the credentials of the second example are misrepresented by the report in the Senate report.

You're right about this being the wrong thread for an in depth discussion of global warming. At any rate, I've not heard any arguments from the side of the deniers that have not been well debunked.

J Christopher 02-05-2008 11:50 PM

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Originally Posted by wdympcf (Post 448692)
Not to appear to flip sides here, but you should be very careful about lumping science and fact together. Very few things in science are fact. The strongest conclusions in science are usually labeled as laws (still not fact, as laws can and have been refuted), the next strongest as theories, then hypotheses, etc.

True, few things in science are known as absolute facts. Still, when science finds itself wrong, such as when we realized the earth was not spherical or that Newton got gravity wrong, it typically revises the theories rather than abandon them. We still often model the earth as a sphere, and we still often use Newton's model of gravity.

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To say that public debate has no place in the matter is to encourage people to be irresponsible and not to think for themselves - exactly what I was cautioning against above! You should question everything that comes from science.
Public debate has no place in science. Science is about experiment and observation, with a healthy portion of maths thrown in for credibility's sake. Absolutely science should continually question their conclusions. But that questioning should be done in a scientific manner. Once the scientific method is abandoned, it's no longer science. Debate is not science.

CAlvarez 02-06-2008 01:04 AM

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I've not heard any arguments from the side of the deniers that have not been well debunked.
I've not heard any arguments from the side of the sky-is-falling crowd that have not been well debunked either. This is why debate is important, but the debate is to be based on science, not public perception or opinion.

aehurst 02-06-2008 08:08 AM

I was told by a physician that a full 75 percent of the patients he sees would be just fine without any medical intervention whatsoever. In these instances, he just tries to relieve symptoms while the body heals itself. There is value in relieving symptoms, too.

cwtnospam 02-06-2008 08:27 AM

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Originally Posted by CAlvarez (Post 448741)
I've not heard any arguments from the side of the sky-is-falling crowd that have not been well debunked either.

Really? I've never even heard a reasonable response to this:
1. Put enough force on anything and it's position will change.
2. Over the last 150 years, humans have been putting enormous force on the environment, so its position(s) must change over time. That applies not only to the weather, but the environment's effects on our health and healthcare system as well.

Phil St. Romain 02-06-2008 10:24 AM

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Originally Posted by J Christopher (Post 448728)
A few hundred isn't much compared to several thousands. A closer examination of some of those signatories will expose them as hired guns for special interest.

Same goes for the U.N. Climate panel. Bringing up "affiliations" is irrelevant, however. In science, one goes by explanation that is supported by evidence, and so long as one can offer explanation in that manner, it's still science. When you go outside that context, it's about ideology, and there's plenty of that on both sides.

I'll start a new thread and we'll see how it goes. Let's keep the focus here more on the thread topic.

J Christopher 02-06-2008 11:45 AM

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Originally Posted by Phil St. Romain (Post 448829)
Same goes for the U.N. Climate panel. Bringing up "affiliations" is irrelevant, however.

Oh yeah? Exactly what industry do those panel members represent?

Bringing up affiliations is absolutely relevant. Why don't the deniers publish anything in peer reviewed scientific journals such as Nature? If they have science on their side, that would be the logical place to present their position.

Phil St. Romain 02-06-2008 11:52 AM

J. Christopher, I've started a thread on global warming so I'll discuss the issue with you there, if you decide to participate.

wdympcf 02-06-2008 02:08 PM

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Public debate has no place in science. Science is about experiment and observation, with a healthy portion of maths thrown in for credibility's sake. Absolutely science should continually question their conclusions. But that questioning should be done in a scientific manner. Once the scientific method is abandoned, it's no longer science. Debate is not science.
Just to clarify, I was never once indicating that public debate has any place in science. I said public debate does have a place in the matter! "The matter" being decisions made based on the evidence presented by science. Scientists do not run our respective countries - politicians do. And they are directly and indirectly influenced by the public (of which scientists are members, but not a majority). Thus it is the public's responsibility to attempt to discern truth from scientific findings and reports (which often involves public debate of the validity of various findings) and attempt to guide politicians to act on what are perceived to be the real issues.

wdympcf 02-06-2008 02:09 PM

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1. Put enough force on anything and it's position will change.
2. Over the last 150 years, humans have been putting enormous force on the environment, so its position(s) must change over time. That applies not only to the weather, but the environment's effects on our health and healthcare system as well.
That is a philosophical argument, not a scientific argument!


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