Razib Khan One-stop-shopping for all of my content

January 1, 2012

“Doctors don’t cure nothing”

Filed under: Causation,Correlation,Culture,False Positives,Medicine,science — Razib Khan @ 2:00 pm

NSFW


As I observed before, modern medicine is subject to some of the same statistical issues as social science in its tendency to put unwarranted spotlight on preferred false positive results. Trials and Errors – Why Science Is Failing Us:

This doesn’t mean that nothing can be known or that every causal story is equally problematic. Some explanations clearly work better than others, which is why, thanks largely to improvements in public health, the average lifespan in the developed world continues to increase. (According to the Centers for Disease Control and Prevention, things like clean water and improved sanitation—and not necessarily advances in medical technology—accounted for at least 25 of the more than 30 years added to the lifespan of Americans during the 20th century.) Although our reliance on statistical correlations has strict constraints—which limit modern research—those correlations have still managed to identify many essential risk factors, such as smoking and bad diets.


I need to look at the difference between mortality and morbidity here. The two are clearly related, but if modern medicine has decreased morbidity, then it is still worthwhile to a greater extent than simple life expectancy calculations might indicate. But the reality is that the more and more I look at modern medicine the more worried I get that the age old heuristics and biases which allowed medicine to flourish as a form of counterproductive psychotherapy up until the early 20th century are now coming back to the fore. The issue here is less the profession of medicine, as the incentives and impulses which drive the need for a “cure” from the demand side.

All this brings to mind a passage from the book Religion Explained:

E. E. Evans-Pritchard is famous for his classic account of the religious notions and beliefs of the Zande people of Sudan…one day the roof of a mud house collapses in the village…People promptly explain the incident in terms of witchardcraft…Evans-Pritchard points out to this interlocutors that termintes had undermined the mud house and there was nothing particularly mysterious in its collapse. But people are not interested in this aspect of the situation. As they point out…they know perfectly that termites gnaw at the pillars of mud houses and that decrepit structures are bound to cave in at some point. What they want to find out is why the roof collapsed at the precise time when so-and-so was sitting undernearth it rather than before or after that. This is where witchcraft provides a good explanation.

With all due respect to modern scientifically trained physicians, but the demands that their patients are now making upon them in terms of curing diseases whose causal roots are less than clear are transforming them into latter-day shamans. As it was, it will be?

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