Srini RamaKrishnan wrote on 2/2/19 9:06 AM February 2, 2019:
I don't think I'm qualified to make sense of all the medical literature,
but here's what is obvious to me.
Science is fundamentally about healthy disagreement and debate over the
truth until it is conclusively found with no room for argument.
I don't think such certainty is ever the provenance of science. Even
after we think we know what's going on, some Einstein can come along
with a more descriptive model.
A lot of medical practices become universal before they have been
rigorously tested. We can't make good risk/benefit analyses of medical
interventions if we don't have good data, and it takes many decades of
general use before longterm data is available.
If you have any questions (and I have many) about public health
vaccination practices, there are many who dismiss your concerns out of
hand, because any issues with vaccines make a person an ignorant
anti-vaxxer.
Similarly there are kids who get polio solely because of the vaccine,
Vaccine-derived
polioviruses (VDPVs).
Kids get polio from the live, attenuated oral polio vaccine. They don't
get it from the killed, injected vaccine.
There is good evidence that the OPV provides better and longer-lasting
immunity than the IPV. The current US vaccine schedule requires the IPV,
and the OPV is no longer available.
I wonder whether this is a good thing. Sure, polio is rare now, but what
happens if there's an epidemic and huge swathes of the population are no
longer immune to polio?
My concern about many of the vaccines against the childhood diseases
have to do with the fact that the vaccines are worse at conferring
immunity than the disease. Thus, we now have a pool of adults who are
susceptible to measles (I'm likely in that demographic), rubella,
chicken pox, mumps, etc.
I fear that we are setting the stage for some truly devastating
epidemics. When the crowd diseases first hit populations, they decimated
them. Over time, we domesticated the diseases (as it were). Their
virulence decreases and they became nuisances for children rather than
epidemics that killed substantial portions of the adult population.
So now we vaccinate against those disease, conferring temporary partial
immunity on the population. Perhaps eradicating these diseases is a
mistake and we would do better keep them endemic and try to reduce their
virulence, as we are attempting to do with bed nets and malaria.
One of the advantages to endemic childhood diseases is that adults whose
immunity might be waning are re-exposed to them many times over the
course of their lives, thus refreshing and strengthening their immune
responses to the organism.
I've wondered whether the current shingles epidemic in young adults is a
side effect of vaccination against chicken pox.
Vaccination and pesticides have a lot in common. In both cases, we're
trying to eradicate organisms we don't like instead of learning to live
with them.
When that boomerang comes back, it can give us a nasty clout on the head.
No one disputes this, but now it becomes a
philosophical question whether even one victim is one too many. Guess which
side the drug companies are on?
Medical treatments typically come with a business agenda. Should we
trust that our health rates higher than the profit motive for the
pharmaceutical and medical tech industries?
Such open questions are routinely brushed under the carpet, and that raises
the question - what is the role of profit motive and wanting to be seen to
be doing something? It should be discussed with more seriousness than I see
currently.
Yes, I agree.
Instead what I do see is a lot of hoarse rhetoric from those living in the
majority consensus reality.
And a lot of discrediting the loyal opposition.
Undoubtedly some good continues to come from drug companies and medical
research,
I'd go further and say that modern medicine indisputably saves and
improves many lives. There is a lot of great research and practices in
amidst the scientism.
it's not all bad, but there's an air of confidence that's
unearned. They are not doing anything about wellness, they don't even cure
diseases most of the time, only dealing with eradicating symptoms.
This is a bit too dismissive of medical care that helps many people stay
well a lot longer.
My husband was diagnosed with pre-diabetes and some other worrying signs
that his high-simple-carb diet was affecting his health. His doctor
encouraged him to change his diet. He has lost weight, his blood sugar
is in the normal range, and his blood pressure has dropped
significantly. The doctor could have given him pills to manage all of
that, but the HMO we belong to values wellness over pharmaceutical profits.
I know quite a few older adults whose lives are better because their
doctors have recommended lifestyle changes that have improved their
overall health and functional mobility.
Putting down traditional medicine as alternative is also definitely kind of
majoritarianism that is aided by the rich pharma giants. Which is a tragedy
because they actually were developed in ages when profit motive was absent.
Traditional medicine is mixed bag, too. Some of it is quackery, some of
it is harmful, some of it works quite well. There's been a lot of
research to help separate the wheat (i.e. certain herbs) from the chaff
(i.e. homeopathy). I would no more take Chinese herbs without looking at
the research than I would take a pill from the pharmacy without reading
up on it.
Science must also look seriously at the idea that there's no such thing as
objective reality, as I outlined in earlier messages. Limiting precision is
what enables objective reality.
A little humility goes a long way. Godel, Heisenberg, Turing/Church, and
others have proved that there are limits to human understanding and
delineated some of them quite clearly. It would be helpful for
scientists to know not only what they don't know, but also what they
can't know.
It seems like we're in a golden age of hubris, particularly when it
comes to computability. We know that many things aren't computable and
yet the current generation of programmers arrogantly believes that
computers will be able to figure everything out and run society
perfectly. They just throw enough (finite, discrete) linear
transformations at it and call it a day.
What if the problems aren't amenable to finite, discrete solutions? What
if you need a continuous, analog system instead?
What if we're asking the wrong questions? Won't we get the wrong answers?
--hmm
