Evidence Based Medicine / Part I

The innate human resistance to evidence

       Given the intuitive readiness of human nature to believe in gut feelings, handed down beliefs, popular and fashionable ideas, rumors, and hear say, it’s most natural for us to reject scientific evidence when we perceive it as counterintuitive or against our belief systems.  This conflict between ‘myth’ and ‘intellect’ is as old as humanity and goes on today as much as it did in ancient times.  But instead of gods, we now believe in vitamins, herbs, supplements, and natural remedies.  Indeed, we only have changed the objects of our beliefs but have neither learned to question nor to examine them critically.  Skepticism and evidence based scrutiny of cultural beliefs is not part of human nature; it cannot be naturally acquired but it may be cultivated and nurtured with time and maturity.    

         Ever since the days of the Stoics and Socrates, sages and philosophers have ruthlessly lashed out against us, well deserving Homo sapiens, with myriad sayings such as:

         “The unexamined life is not worth living.”
             
Socrates (469BC-399 BC) Plato’s Dialogues, Apology
         “Common sense is not so common.”
                  Voltaire (1694-1778) in Dictionnaire Philoosophique.

         “Common sense is judgment without reflection, which is shared          by an entire class, a people, a nation, or the whole human race.”
                  Giovanni Battista Vico (1668-1744)

         “The only means of strengthening one’s intelligence is to make          up one’s mind about nothing—to let the mind be a thoroughfare          for all thoughts.”
                  John Keats  (1795-1821)
         “All true knowledge contradicts common sense.”

                  Mandell Creighton (1834-1901)
         “Knowledge shrinks as wisdom grows.”
                  Alfred North Whitehead (1861-1947)

            Currently, we are being cajoled, seduced, and assailed by advertisements, the media, magazines, books, testimonials from friends or strangers, the Internet, and expert advice from non-experts—all with the common aim of inducing us to ‘buy’ something that either runs contrary to scientific evidence or has no scientific evidence to back up its wild and wonderful claims. Thomas Hobbs (1588-1679) was prescient when he said: “If I had read as much as other men, I would know as little.”

            Furthermore, if our beliefs are challenged by published evidence, we tend to reject the evidence without diligent consideration.  History abounds with examples of our inability to yield to scientific truths.  When Galileo proclaimed that Copernicus was correct in that earth rotated around the sun, his proclamation offended the Roman Catholic Church, which held to the geocentric, Aristotelian view that the sun rotated around the earth.  In 1632, Pope Urban VIII referred Galileo’s case to the Roman Inquisition, which forced Galileo to recant, banned his book, Dialogue Concerning the Two Chief World Systems, and placed him under house arrest until he died in 1641.  This cruel ‘Christian’ verdict was not ratified until 1822, one-hundred-and-eighty-one years after that scientific truth was first promulgated.                        

            The battle between science and myth is the ever-present battle between truth and tradition, whose battlefields continue to be the gullible minds of humanity.  Such are the dictates of our natures and that’s how we have been wired and programmed; the only thing we have done over time is traded our ancient myths for modern ones.

            But, living up to our species’ name, Homo sapiens or ‘wise man’ is our solemn duty, for as Quintin Hogg (1854-1903) stated, “Whatever else may be shaken, there are some facts established beyond warring; for virtue is better than vice, truth is better than falsehood, kindness than brutality.  These, like love, never fail.”  It is only with this spirit in mind that I present some pertinent scientific truths about the discipline of medicine of today.

            The medical professions, although held to higher standards, are not immune to corruption, nor are the purported, paramedical ‘healers’ that abound.  Human nature has always had a strong proclivity for shortcuts and it is this particular trait that nourishes the multiplying, paramedical systems.  The shorter the courses of study, the shallower their required levels of evidence, and the less labor intensive they are, the more attractive they become to those who wish to circumvent the unforgiving hardships of scientific studies.
         
        


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