> Ever look up how respected skepticism is within the larger philosophical community?

I'm a little unclear on what point you're trying to make here. Can you clarify?

> I mean look at my pastebin post: http://pastebin.com/cniysd82

I took a look at your pastebin post. There are a lot of criticisms there of various kinds of bad practices, but not all of them have anything to do with whether the medicines actually work. For instance, the patent issue; while that's a fair issue in its own right, whether large pharmaceutical companies can prevent people from making generic equivalents by using patents does not affect whether the drug works or not. Or direct to consumer advertising; again, it may be a bad idea, but it doesn't have anything to do with whether the drugs actually work.

Many of the other criticisms here are fairly hypothetical. Yes, there are places where the system isn't ideal, where there's potential for the wrong incentives. There are places where it would be nice to do research that covered a broader spectrum. But that doesn't mean that it's all invalid. We live in an imperfect world. We should try to fight those cases when we can, try to get better results, but you shouldn't write off the entire industry merely because it's imperfect.

Here's another example. In the software industry, I see bad practices all the time. People not writing unit tests, not doing full regression tests, writing sloppy code that doesn't handle all of the error conditions, and so on. And yet, somehow, we manage to get by. Software generally works, it does what it says, it improves whatever it was setting out to improve. Sure, there are some big expensive failures you can point to. Sure, it would be nice if we did a better job at this, and should try to continue to fight for higher quality software. But just because there is some software imperfectly written doesn't mean that you should just write off the software industry.

> But does SBM actually address any of the criticism? Not a single point of it, because there is no defense; in fact, it's all coming from high-level 'insiders' in the medical community -- JAMA, NEJM, the IOM, etc.

Really? I just decided to take a look at SBM; I wasn't familiar with it before this thread, but decided to take a look at it. Here's an article on reducing prescriptions for elderly patients, because they may do more harm than good: http://www.sciencebasedmedicine.org/index.php/how-do-we-avoi... (addressing one of your concerns about differences in how medications effect the elderly). Or here's an example where they do address one of the concerns that you mention; they demonstrate that doctors actually are more skeptical of research funded by the pharmaceutical industry: http://www.sciencebasedmedicine.org/index.php/news-flash-doc....

> Instead they just spin it in order to trick people who are predisposed to have faith in modern medicine. (And I use the term faith, because if you're familiar with these issues then it's unmistakably clear that this is really what it is.)

You know, I do tend to be skeptical of pharmaceutical remedies, and so try to minimize them myself. But to say that you have to have faith to buy into modern medicine is a bit of a stretch. How do you explain ever increasing life expectancies? Clearly, there is something going right in modern medicine.

> What science-based medicine does (again, the blog, not the concept) is really no different than what the evangelical megachurches do, it's just dressed up in different language.

Citing actual scientific studies, which may be flawed in certain ways, is the same as merely preaching mythology from a 2000 year old book based on no science whatsoever? Remember, "science" is not some binary thing, where if there's one flaw, it's all false. It's a process, by which we attempt to come up with better models of the world, and try to reduce bias in the process. Sometimes there will still be some bias; you won't necessarily be able to eliminate it all. But that doesn't mean it's worthless.

There are definitely a lot of ways in which I wish that pharmaceutical research would be improved; but the fact that there are people now who are living perfectly normal lives while HIV positive with anti-retroviral therapies, when just 10 or 20 years ago they would have died of the same disease, leads me to believe that it's not all bad. I wish those drugs were cheaper, that they weren't so tied up with patents, and so on; but you know, I wish I had a pony too. To equate the research and development that went into such life-saving measures as equivalent to an evangelical megachurch is quite frankly ridiculous.