Doubting, confirming, and the placebo effect

         f) Doubting Confirmed Truths:  It is the duty of science to periodically doubt its own confirmed truths and to subject them to re-examination whenever new data conflicts with old findings.  As a result of this periodic self-monitoring, old truths continue to become refined over time. 

         Indeed, newer studies have now confirmed that lowering cholesterol protects against heart attacks mainly if the lowering affects the LDL (Low Density Lipoprotein) cholesterol fraction.  If the lowering affects the HDL (High Density Lipoprotein) cholesterol fraction, it may indeed encourage heart attacks.  Moreover, the same degree of lowering, when achieved by different types of medications, does not provide the same degree of protection, which means that the choice of medicine is as important as is the degree of lowering.

         Recent studies have also confirmed that lowering blood pressure does protect against strokes.  However, they also revealed that not all blood-pressure-lowering medicines perform equally in all races and under all conditions, even when they achieve the same degree of lowering.  Consequently, using certain medicines for certain races or under certain conditions does influence the stroke-protection rate.

         Other revolutionary studies have now confirmed that ulcers are not due to high stomach acid; rather, they are due to a specific bacterial infection with an organism called Helicobacter pylori.  Consequently, the current treatment of ulcers no longer depends on long-term anti-acid medicines.  Ulcers are now curable with a short course of complex antibiotics.

         As Oscar Wilde (1854-1900) stated in Act I of his 1895 play, The Importance of Being Earnest, “The truth is rarely pure and never simple.”

         g) The Placebo Effect:  Which, translated from Latin means ‘I shall please’ is the delight of all those who cannot stand the exacting scrutiny of science.  It turns out that the placebo effect is a most powerful healing potion especially for non-life-threatening, self-limited, or otherwise self-healing disorders.  The power of belief in ‘alternative therapies’, which is an all inclusive term for therapies unsanctioned by scientific scrutiny, produces enough healing stories to sustain their popularity in spite of their abject lack of published, scientific evidence and sometimes in spite of strong scientific evidence to the contrary. 

         Another feature common to practitioners of ‘alternative therapies’ is their un-openness or unwillingness to self examine or doubt the scientific validity of their own practices and also their rejection of scientific evidence when it goes against their therapeutic ideas. The high prevalence of such misconstrued beliefs lead the British philosopher A. C. Grayling (1949-    ) to explain in his book, What Is Good, that “The durability of unscientific views might be variously explained, but one main historical reason is that most people are naturally superstitious and insufficiently reflective.”

         In his book, The Mystery of Things, A. C. Grayling observes that, “Science is a minority sport.  It requires skills that are neither within everyone’s reach nor to everyone’s taste.  It requires a facility in mathematics and an imaginative ability to see the world in unexpected and often counter-intuitive ways.  It also requires endless patience, and the lack of dogmatism.  The scientific mentality is almost exactly the opposite of the belief mentality.  Science is open, skeptical, and eager to submit its tentative claims to test.  Belief is dogmatic, final, closed, knows all the answers, and dismisses as ignorant anyone who asserts otherwise.  If the two mentalities resemble each other in any respect, it is in their wonderment in the face of the universe.”

         Consequently, given that the placebo effect is powerful, pervasive, and as much a part of human nature as breath and speech, it is perfectly reasonable to harness it in the service of healing as long as it causes no harm.  Surely, all those who profess the art of healing should at least agree on the sound directive of ‘primum non nocere,’ which means, first do no harm.