Rich Winkel writes:

> According to Stathis Papaioannou:
> > Given that even in case (c) doctors were completely wrong, the way we test 
> > new treatments now is more stringent. However, evidence is still evidence, 
> > including evidence of past failures from medical history, which must be 
> > included in any risk/benefit analysis. You can criticise someone for making 
> > a 
> > decision without fair consideration of all the evidence, but you can't
> > criticise him if he does.
> Actually we can and often do.  The question is one of insight into
> one's own ignorance.  Suppose a child is run over by a car which
> is driven at high speed through a residential neighborhood.  The
> question of the driver's guilt isn't determined by his knowledge
> or ignorance that the child was about to run into the street, but
> by his lack of insight and prudent adaptation to his own ignorance
> of same.  In this case prudent adaptation = driving at a safe speed.

Why would you not include the well-known fact that driving at high speed 
is more likely to kill someone as "evidence"? If the driver honestly did not 
this, say due to having an intellectual disability, then he would have 
responsibility for the accident.

> Medicine is not like astronomy. Given the self-healing properties
> of adaptive systems, doing nothing is often the best course of
> "action."  The precautionary principle applies.  

Astronomy does not really have an ethical dimension to it, but most other 
do. Discovering that cyanide kills people is science; deciding to poison your 
with cyanide to collect on the insurance is intimately tied up with the 
science, but it 
is not itself in the domain of science. 

As for doing nothing often being the best course of action, that's certainly 
true, and 
it *is* a question that can be analysed scientifically, which is the point of 
controlled drug trials. 
> The human mind, especially, is capable of "healing" itself (i.e.
> finding a new stable equilibrium) in most circumstances without the
> aid or hinderance of drugs or lobotomies or electroshock or drilling
> holes in the skull to release demons.  Of course it often takes
> time and a change of environment, but what's the alternative?  To
> chemically or physically intervene in a self-organizing neural
> system is like trying to program a computer with a soldering iron,
> based on the observation that computer programs run on electricity.
> Ignorance is unavoidable.  The question is whether one adapts to one's
> own ignorance so as to do no harm.

You are suggesting that certain treatments believed to be helpful for mental 
illness by the medical profession are not in fact helpful. You may be right, 
the history of medicine is full of enthusiastically promoted treatments that we 
know are useless or harmful. However, this is no argument against the 
method in medicine or any other field: we can only go on our best evidence.

Stathis Papaioannou
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