From: lady@uhunix.uhcc.Hawaii.Edu (Lee Lady)
Subject: Re: On pre-scientific traditions of medicine (was: Use of term allopath)
Followup-To: sci.med
Summary: Support of establishment medicine as a cultist attitude.  
Organization: University of Hawaii (Mathematics Dept)
Distribution: sci
Date: Sat, 15 Aug 1992 02:51:16 GMT

In article <1887@snap> paj@uk.co.gec-mrc (Paul Johnson) writes:
>In article <713106779.F00005@blkcat.UUCP> John.Willis@p123.f349.n109.z1.fidonet.org (John Willis) writes:
>
>
>[Allegation that western medicine is tantamount to a religion]
>
>This is a straw man argument.  The key phrase is "seems to work".
>Western medicine has the double-blind trial to find out if something
>actually does work.  If a therapy (whether alternative or not) cannot
>produce an effect in a double-blind trial then it does not work.
>Period.
>
>On the other hand if it does work then scientists get to work trying
>to figure out how, and pretty soon they have an answer.
>
>The reason for the dichotomy between explainable, scientific cures and
>quackery is that so far no alternative treatments have
>demonstrated an effect in double blind trials.  I am sorry but science
>actually does have a very good model of how the universe works, and if
>a treatment does not even vaguely fit this model then its a pretty
>good clue that it won't work.
>
>Your religion argument falls over at this point.  Western medicine is
>a science, not a religion.

I don't think any reasonable person could deny that western medicine is a
science, or call it a religion.  However, I do think that the attitudes
of many of its supporters, especially here in sci.med, have a cultist
flavor to them.  

By cultist I mean:  the dogmatic assertion of certain beliefs without any
supporting justification or with minimal justification, especially in a
loud slow tone of voice, and the conviction that anyone who would
disagree with any of these beliefs would have to be simply stupid.
("Haven't you been LISTENING to what I've been saying?")  

And by cultist I mean:  The automatic rejection of all alternatives.  And
the tendancy of the believer to quickly slip over into dishonest
arguments:  ad hominem attacks, begging the question, use of slanted
language, use of ridicule or abuse as a substitute for evidence and
reason.  Even though the believer is well enough educated to know
better.  

Opponents of alternative medicine here start out with the claim that the
use of double-blind controlled trials is better than any other
methodology.  They don't say "Double blind controlled trials are more
effective in excluding the placebo effect and cases of spontaneous
remission than any other methodology," which is something many people
could agree with.  But they say BETTER, as if such trials were superior
in respect to every possible criterion, which is certainly not the case.
(For instance, they are certainly not "better" in the sense of being
quicker or cheaper.)  

But okay.  Agreed, double-blind controlled trials are a very good
methodology.  But now comes the logical flim-flam.  From saying that
the establishment methodology is "better" opponents of alternative
therapies jump to the implication -- the non-sequitur -- that other
methods of testing are NO GOOD AT ALL!  

And then comes the dishonest use of slanted words:  Approaches which
haven't been tested in the approved manner are labelled "unproven" or
"untested."  Giving the connotation that these approaches have just
been dreamed up by some people who have never even tried them out.  My
God, who would want to use something that hasn't even been tested?

These arguments support a cultist attitude toward establishment medicine,
making it impossible for outsiders to break in, because the approved
methodology is a big bucks methodology and the only approaches that can
raise the ante are those with some sort of academic/institutional funding
or remedies that some corporation has some hope of making a bundle on.
(It's like saying:  "Our school doesn't discriminate.  Anyone can get
in who passes our admissions test.  We charge $10,000 for the test.)

And then from the opponents of alternative approaches comes the sleaziest
argument of all, often not quite overtly stated, but definitely implied:
The implication that because the supporters of an alternative approach
have, for whatever reason, not run tests using the approved methodology,
that therefore their approach is not capable of passing such tests.
("Obviously you're not good enough for our school because you never took
the admissions test.")  

>...actually does work.  If a therapy (whether alternative or not) cannot
>produce an effect in a double-blind trial then it does not work.
>Period.

(As if all the alternative therapies that are discussed here had failed
to produce effects in double-blind trials.  Whereas in fact I believe
that none of them have undergone such trials.  Which may justify
skepticism, but certainly not the assertion that such a therapy "does not
work.  Period.") 

I think the point that many people in this discussion don't realize is
that this big bucks system of testing serves the alternative
practitioners as well as it does the establishment.  If accupuncture, for
instance, were tested using the approved methodology and found worthy,
then it would be absorbed into the mainstream.  It would be taught in
medical schools and people like the present practitioners couldn't offer
it anymore because that would amount to practicing medicine without a
license.  (And furthermore, let's face it, a lot of the alternative
approaches would fail such tests and then there would be definitive
proof that they're no good, instead of just a lot of hot air being
exchanged on usenet without any factual basis.)

Everyone involve has disincentives for actually putting alternative
therapies to the test using the approved procedures.  The only group
the present system doesn't serve is the general public.

--

Imagination is more important than knowledge.  -- Einstein 

lady@uhunix.uhcc.hawaii.edu         lady@uhunix.bitnet