Saturday, April 18, 2009

A Duty Of Care .. A response to MacDoctor's Egotism.

MacDoctor struck a nerve.

... until such time as medical practitioners are trained in research methodology and statistics and have the ability to critically assay research ... and read the stuff prior to 'selling' it as a 'treatment of choice' ... and enable and demand independent (not drug company) research with control groups prior to the widespread implementation of treatments - rather than claim that such research cannot occur because it involves with holding a 'treatment of choice' and as such is unethical, then the moral high ground you purport to inhabit is simply 'puffery.'

Perhaps, 'spare the rod and medicate the child' (the 'educational drugs'), are a good example of this.

There are so many medical treatments for which the underlying research does not stand up to rigorous scrutiny, cost benefit analyses (i.e. benefit versus harm) are more often than not lacking.

How would most medical practitioners know whether they were causing harm or not?
Certainly studies looking at reliability of diagnoses have not revealed figures worthy of celebration, and this without considering validity.

Is this situation of greater concern than that which you describe?
I would have thought so.

4 comments:

ZenTiger said...

I'm not sure it was Egotism driving MacDoctor's comment, but I agree with the points of your post.

mojo said...

Egotism?
The ability to disassociate and pass judgement on others, be it colleagues or other,who are but functioning from the same 'well-intentioned' knowledge base as themselves ... who somehow perceive all their own professional actions to be 'mainstream and socially acceptable.'
Egotism? Elitism?

macdoctor said...

Mojo: Interesting that you consider a principled stand to be egotistic. I suspect that you have every doctor neatly pigeon-holed as a raving egotist. This is called prejudice. It is a form of egotism.

Your point that much that we consider to be "true" in medicine is dubious is perfectly true. Many so-called statistical analyses of clinical trials are deeply flawed. This does not undermine the fact that we still have a duty to care for our patients to the best of our current knowledge. For this reason, I have made a great deal of effort to understand statistical analysis and research methodology, so forgive me if I get slightly tetchy when I get criticism such as yours.

I do not " medicate" children. Ever.

You are correct in asserting that many medical "treatments" do not stand up to rigorous scrutiny. However, I should point out that the bulk of medical treatment is well attested and clearly works, despite your allegations to the contrary.

I am uncertain whether your cynical view of medicine is coming from a naturalistic bent or an objectivist one. Looking at your site I would suspect the latter. If so, logic would suggest that doctors do considerably more good that you would admit. it is likely, therefore, that there is a serious flaw in your arguments.

From a purely rational perspective.

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