* Diseases evolve, so today's vaccinations may not work against tomorrow's illnesses, and even when they are effective, other diseases may take the same ecological space (thus the proliferation of new vaccinations, while the old ones remain on the schedule just in case),
Diseases evolve, it's true, but on what timescale? Put another way, how many novel infectious diseases have developed since the dawn of vaccination? A few, but not enough to render vaccination ineffective, as you're suggesting. It's also not true that old vaccines remain just in case--were you vaccinated for smallpox? I wasn't. Also, the application of ecological concepts to infectious disease is not always warranted. In your case, I don't think humans represent an ecological niche that viruses are competing for traction in--it's more apt to compare humans to Australia, and infectious diseases to rabbits, an animal with no natural predators in Australia.
* It is not clear just how many pathogens a human immune system can be sensitized to without collapsing,
You and everyone else have been exposed to so many potential pathogens it's ridiculous--look in a virology textbook sometime. Vaccinating for a few is a drop in the bucket. It's important to distinguish between something that you don't know and something that science doesn't know. I'm not blaming you for not being a card-carrying immunologist, but at least respect the fact that there are a lot of very smart people who know a lot more about the immune system than you seem to think they do.
* The previous way many people developed immunity was by extended nursing and low levels of infections in populations, where the mother's immune system scanned for threats and passed antibodies onto children to help them deal with threats, conferring life long immunity. Vaccines break this cycle of "software" memory. Pediatricians promote shots but when was the last time you heard one recommend nursing to age three or four like most of humanity has done historically?
Nursing does not convey antibodies forever, and even if it did, the main reason for prolonged nursing has historically been birth control. People like sex. The flaw in your understanding of infectious disease is that people evolved living in small groups, largely isolated from each other. If one of those groups got wiped out, as they did all the time, it wasn't a big deal. With air travel, humanity is now lumped into one huge group. We can't rely on the old strategies any more. The book "Guns, Germs, and Steel" talks a lot about this, and I highly recommend it. One of the main points of that book, and others, is that infectious disease is one of the top two or three factors shaping the history of humanity.
Modern vaccination schedules entail approaching 200 different batches of produced materials to be injected in a person's lifetime (if you include annual flu shots, and assume booster shots on a decade schedule) each of which bypass the body's normal mechanisms for developing immunity for many infectious disease (general first response in the tonsils, moving from there).
Bypass the body's normal mechanisms? I'm sorry, that's simply not correct. You seem like an intelligent person, but if you want to be informed about the issues, you should read a real intro immunology textbook, like Janeway's "Immunobiology." It has lots of good illustrations and is very readable.
I sympathize with your situation, but there are a few medical/scientific facts you should know. First, febrile seizures (caused by fevers) are common in children, and while they appear dramatic, they're usually not that big of a deal. I used to see them all the time in the peds ER, and they're usually triggered by the common cold. It's common for children to react to vaccines with cold-like symptoms. The second thing is that as I'm sure you're aware, the data is pretty clear that MMR and other vaccines do not increase the risk of autism. However, there is likely something more subtle going on--the current thinking among many neuroscientists and psychiatrists is that the onset of autism is triggered by a stressful event. Epidemiological studies show that vaccines do not increase risk of autism, but they may serve as this triggering event. However, the data suggest that those children would have become autistic anyway, except it would have been another event that triggered it later on. I agree with you that autism is a serious thing, but childhood diseases are also very serious, and most people have forgotten how serious they are simply because vaccines have been so effective. It's true that the recommended vaccines have increased over the past 30 years, but there are also vaccines that are relatively safe and effective that are not administered to everyone, like smallpox and hepatitis A. This is because they fail the risk/benefit ratio test. No one thinks that vaccines are 100% safe, just safer than not vaccinating. Given your exposure to autism, I understand your apprehension toward vaccines. Personally, I've worked in an inner city peds ER, where I've seen some kids get really sick because they weren't vaccinated, and I'm going to make sure my kids get all the vaccines.
I worked for a number of years doing research, including bioengineering, mechanical engineering, electrical engineering, and computer science. The work that I did for the bioengineering department was actually on searching for better models of the biomechanics of the heart. We knew, rather precisely, how the mechanics worked at the small scale (ion channels, all that) and how it worked at the large scale (EKGs and all that) but it was the middle ground that was very difficult to do with any degree of precision. Simulating a single cell was a numerically intensive excercise -- simulating large numbers of cells had to be done with different approximation methods. A new approach that could better simulate a heart beat (more accurately or more quickly) would be worthy of a paper in this field. From what I can understand of what you're saying, you consider this type of work to be emblematic of the work scientists do. Some might call it "engineering" (building a better mousetrap), but they're two sides to the same coin in my opinion.
In the past, I've done computational modeling of the nervous system, the biophysics of which are actually pretty similar, but I've always thought that cardiac physiology was really cool, especially mechanisms of bifurcation to flutter and fibrillation states. But yes, I think that what you're describing is much more typical of "real" science.
The trouble is, it's difficult to say that the scientific method is being used in this circumstance. Certainly progress is being made, but progress can be made by a number of different methods, not just the scientific method. Did the people making the Luo-Rudy model of the heart start by stating a hypothesis? Testing it? Gathering evidence? Testing the hypothesis against the evidence? Of course not. They build a box that they'd run data through, and tried to get it to match the behavior of a real heart. Over the process of refinement over 10 years, Luo and Rudy came out with iteratively refined versions that worked "better" (for some definition of better).
This is science, but this isn't the scientific method. I've been trying to stick to examples where some version of the scientific method would actually be used, not the practice of science in general, which uses methods other than the scientific method to produce results.
I think we're getting closer to understanding each other on this, and I think there's a lot of semantics getting in the way. I would argue that if you think about it a little abstractly, each current iteration of the Luo-Rudy model WAS the hypothesis, and the data they were testing it against had already been collected. I guess this is somewhat similar to what Kuhn said. But I think this a totally valid example of the scientific method, and I think what you're calling the scientific method is really just a special case of that. The thing is, we both agree that the vast majority of science done doesn't follow the "Scientific Method (TM)" in the sense that you're describing. Where we disagree is that you say that this actually means that most science doesn't follow the scientific method, while I'm saying that the "Scientific Method" you (and many philosophers) are describing is an over-simplified, too-narrow example of the real thing. It's not wrong, but it's only one special case. A few years ago, people in biological sciences were discussing "hypothesis-driven vs. discovery-driven" models. Hypothesis-driven is when experiments are hard enough to do that you have to plan each one carefully in advance, while "discovery-driven" (or data-driven) is a result of the high-throughput technologies enabling experimentalists to vacuum up data faster than they can analyze it. But that's really nothing new, it's just new to that particular field. Both are totally valid ways of doing things, and I would argue that both (to the extent that they're not a false dichotomy) are part of the scientific method. And of course, there are other approaches as well.
I agree with what you're saying, and I'd like to add that when you give a person blood, you're really giving them packed red blood cells, which are already "dead," as in they're enucleated cells not actively making new proteins or anything. So you don't need any kind of absolute specificity--it's not like "killing" the blood cells makes them somehow ineffective, so you could probably just gamma-irradiate the blood. I know that's already done under certain circumstances.
"Nothing is impossible! That's what being a scientist is all about!"
As a scientist, I think it's important to distinguish between things we know are possible but can't do, things we don't know if they're possible or not, and things we know are impossible. And there are plenty of things we know are impossible, not just with current technology, but with any technology. Technology can only get you so far, and it's important to understand when fundamental limitations are present. In this case, people aren't 1 mm thick, and if you irradiated them with enough light energy to penetrate all the way through, you would kill them. There are better ways to clear viruses out of people.
There's three points I'd like to make in conclusion of this thread (which I've enjoyed, by the way -- the Philosophy of Science is a fun topic for me). It's obviously a huge topic, so I'd like to summarize what I'm trying to say:
I've enjoyed it too. I think if there's one final point that I am trying to make (over and over and over), it's that too much of philosophy of science is based on a caricature of science and the scientific method. I studied a fair amount of philosophy of science and philosophy of mind as an undergrad, and I neverfelt that the philosophers I met really understood how science works, or even what science is. Their arguments are based on the narrowest possible definition, a definition that simply does not describe what people called "scientists" do. Anyway, I think this is the primary source of our disagreements.
Different kinds of questions have different methods for appropriately answering them:
Question 1: Did Sally kiss Harry? Answered by an observation or self-reporting followed by a chain of word-of-mouth.
Question 2: Are Scrub Jays blue? Answered by an orthinologist going out and studying a number of Scrub Jays.
Question 3: Are men taller than women? Answered by statistical methods.
Question 4: Is 5 greater than 4? Answered by a rational claim without any empirical observations.
Question 5: Does ice cream cause polio? Answered incorrectly by establishing correlation, Answered correctly by establishing causation.
Question 6: Should people wear hats in church? Answered by religious debate from authority.
Question 7: Is murder wrong? Answered by a variety of ethical or religious arguments. Some people claim that "murder is wrong" is not a fact at all, but an opinion. Others claim it is a fact.
Question 8: Does adding fertilizer cause tomato plants to grow faster? Answered by every 8th grade science fair, using the traditional scientific method of hypothesis testing.
My point is that the scientific method, while indeed a powerful tool at arriving at truth, and useful in many situation, is not the only means of learning truth. Different questions have different ways that are appropriate for answering them. The scientific method is not the complete answer to epistemology.
I guess it all hinges on what you would call truth. The idea that anyone could call numbers 6 or 7 "truth" is baffling to me. Number 4 is a tautology, as are all true statements in math--the trick is in proving that they are. Answers to the rest are all reliably established only through scientific means. When it all comes down to it, I guess I do believe that the only things that can be said to be true or false are things that can be addressed scientifically, by which I mean through analysis of evidence.
Logical Positivism has gone through various incarnations over the last century, but the most strident version says that that which cannot be scientifically proven (via verification or falsifiability) is not worth considering. Other versions accept different sets of facts. "My fiancee loves me" is resistant to being put in a test tube, but we could perhaps look at evidence for it, like taking her word for it, or perhaps looking at a cake she baked for me.
The trouble of course, is that it really is a slippery slope from there to reports of people seeing ghosts (the original point of this Slashdot article). How can we accept my fiancee's word that she loves me, but not accept the fact that her friend saw a ghost when she was young? We can't start from the assumption that ghosts don't exist, since then we're just assuming our conclusions. Hence the strident version of Logical Positivism -- that which cannot be shown scientifically is not of interest.
I think this is getting at the core of (in my opinion) what your fundamental misunderstanding of what science is. You seem to think that there is some sort of sharp divide between "scientific" observations in test tubes, which somehow purport to be
How do you know? Right now, there's probably a huge number of people in your hospital that have diabetes. Our model for the underlying cause of diabetes has been shaken up several times within the last few years. How do you know we're not killing thousands of Americans every year out of our ignorance or errors?
I didn't intend to claim that medicine knows everything--what I meant is that certain basic aspects of medicine are fully understood, and if they weren't understood it would become obvious very rapidly. My example of the mechanics of blood flow illustrates that.
That's a major part of the problem -- the other is, as I mentioned, the fact that falsehoods are held to be true. The scientific is supposed to give us truth about the world, but the system must necessarily publish falsehoods.
What I'm saying is that the belief that every published result is even supposed to be correct is, in itself, a fundamental misunderstanding of the nature of the scientific method on your part. Like I said, bad science exists, and even good science can reach incorrect conclusions. The claim advocates of the scientific method would make is that incorrect results get rooted out over time, not that all published results are intrinsically correct the very first time.
But what is the alternative to the scientific method? You can gain empirical knowledge (sorted from most- to least-reliable) through: testing, observation, tradition, and word of mouth. Most scientifically minded people are able to work with the first two comfortably, but feel uncomfortable when dealing with the last two. But sometimes the only way you have of learning a fact is through word of mouth. Sarry might have kissed Harry and told you about it -- but you can't put them into a double-blind controlled experiment and replicate the results.
I think you're lumping a whole bunch of things together there. Tradition and word of mouth are means of communication, not means by which the facts were discovered. If Janet directly observed Harry kissing Sally then told me about it, that's totally different than if Janet "had a feeling" that Harry kissed Sally and told me. And salicylic acid (not aspirin, which is a derivatized form developed to have decreased gastric side effects) was not discovered through tradition, it was discovered through empirical observation by some culture of proto-scientists a long time ago, then passed down to us through tradition. Of course, the vast, vast majority of traditional medicine has been shown to be absolutely worthless, if not directly harmful, so using salicylic acid as an example of the wonders of tradition is a bit of the "file drawer" effect you mention.
Logical Positivism's fundamental axioms state: 1) That anything that isn't falsifiable isn't scientific. And 2) Anything that isn't scientific isn't worthy of being thought about. But many of the most important things in life are not falsifiable, and rather impossible to put in a test tube. There's more to life than what can be known scientifically, and there are more ways to know facts than through the scientific method.
It may turn out that I'm some form of "weak" logical positivist--I've forgotten a lot of my undergrad philosophy, and you'll have to help me--but my understanding is that the position is that any model that is fundamentally unfalsifiable isn't scientific, not simply models that can't be falsified with the evidence we have at hand. In other words, the only reason to believe something is based on evidence, and things about which evidence can fundamentally not be collected are not worth thinking about. Contrary to what you say, I think almost everything in life has evidence attached to it, with the possible exception of things like whether or not God exists, and almost every decision in life can and should be made based on application of rigorous logic to the evidence at hand. The human brain is optimized to be naturally good at this in evolutionarily relevant contexts, but it breaks down beyond that, which is the only reason why formalized science is necessary.
An example of this would be how people's health aliments are treated differently in different parts of the world. In rural China treatment is different than in NYC. (Is there a Western equivalent of a "hot blood" theory?) Treatment would be different in parts of Europe than in America also.
This is actually a perfect example of what I'm talking about. There probably was a Western equivalent of "hot blood" or whatever premodern Chinese theory you could come up with--it was probably "the black bile" or something like that. Treatment protocols differ slightly in different countries, but the underlying theoretical framework of modern medicine is the same everywhere in the world. If a person's blood pressure starts to drop, doctors everywhere immediately start to think hypovolemic shock vs. cardiogenic shock vs. distributed (e.g. septic) shock vs. obstructive shock, etc., and they base their management strategy on that. These are theoretical frameworks that are based in scientific knowledge of the underlying physiology. You can argue that the validity of these frameworks has not been "proven," the same way the round earth has not been proven, but it's a pointless agument.
An aside: as a medical scientist of East Asian descent, I find it somewhat offensive when modern medicine is referred to as "Western" medicine. Western countries do not have a monopoly on modern medicine, and scientists from other parts of the world have played significant roles in its development. Western countries have their own premodern medical traditions (e.g. the theory of the humours, blood-letting, chiropractic, homeopathy, etc.), and these are no different than any other culture's version.
My other post goes more in depth, but I think it's important to draw a distinction between science-as-practiced, and the scientific method. Science-as-practiced is imperfect because it doesn't always adhere to the standards of the scientific method.
I should restate what I said before: science is an extension of common sense. You are absolutely correct that the findings of science can be deeply counterintuitive, and you don't even have to go as far as string theory to see that. But by "common sense," I'm referring to the essential activity of the brain of any human, which is to generate internal models constrained by sensory input, then generate motor outputs consistent with those models. Science is an extension of this in that we build explicit models constrained by observations, then make decisions based on those models. The difference is that science has a higher standard of model testing than the human brain does.
About unique events: it's two separate issues whether events occur rarely, or are observed rarely. If they're observed rarely (like the Martian), you need to try to find a way to either observe them more frequently, or observe something other parameter that gives you the same information you need to constrain your model. You're partially correct in that difficulty observing something directly is problematic, but one of the main points of science is that you don't need direct observations to tell you what's going on, you need observations to constrain models of what's going on. In other words, observation of one martian gives constraints on the height distribution of martians, the same way measuring the size of doorways inside the pyramids constrains estimates of the height distribution of ancient Egyptians (even if we never found their remains).
2. About rejection of inexplicable events: I understand that you sincerely believe this to be true, but once again you describe Roentgen, a hero and pioneer who won all sorts of recognition. I work in neuroscience, where people publish results all the time with no mechanistic explanation--the reason why some are rejected and others not has to do with the reliability of those measurements. Experimental artifact is a fact of life, and the vast, vast majority of "inexplicable" results are simply wrong. To the non-expert eye the acceptance of some and not others might appear arbitrary, but it's based on our understanding of the reliability and potential pitfalls of the techniques used. Also, keep in mind what makes something "inexplicable." Your example describes observation of an entirely new phenomenon, which is not "inexplicable" at all, and I don't think those people have much trouble getting recognized. Truly "inexplicable" results are ones that appear to contradict the models that were constructed based on other results. Interpretation of those is a lot trickier, but we spend a lot of time thinking about them, and I simply don't think it's accurate to say that we dismiss them out of hand.
3. The examples of bias, politics, uncertainty, etc. that you're describing are accurate, but they're simply examples of bad science. The existence of bad science is not really an indictment of the scientific method per se, it's an example of what happens when people don't adhere closely enough to it. Clinical epidemiology research is a good example of where we know how to do the right science, but other factors don't allow us to. For example, it's never been "proven" that HIV causes AIDS. I know how to do that study: lock 1000 healthy people in cages, inject 500 of them with HIV and 500 with saline, and see what happens. The "problem," if you want to call it that, is that financial and ethical constraints prevent the scientific method from being rigorously applied. But I don't think you can blame the "scientific method" for that.
I think this is getting at the core of what we're actually discussing here. I think we both agree that science, as practiced today, is suboptimal in many ways. The difference is that you are arguing that this is a limitation of the scientific method, while I'm saying that these are examples of science-as-practiced not adhering to the standards of the scientific method.
5) This is also the problem of trust in science. The problem is not malice or fraud (though the case of the South Korean cloning guy shows this can happen) but that whereas you or I can understand that studies inherently have uncertainty in them, people go out there and make life or death decisions based on studies, thinking that something which is scientifically shown to be true means the same thing as something mathematically shown to be true.
The problem you're describing is the problem of scientific illiteracy in the public, which I agree is a huge problem. However, keep in mind that we make life and death decisions every single day based on scientific "proof," and we don't even think twice about it. I'm not worried th
To clarify, I'm not referring to the current state of scientific methodology, which is obviously imperfect and in many ways in a constant state of refinement. I'm talking about "science" in a more general sense, as the idea that we discover truth by making observations and formulating models that explain those observations, then making predictions about new observations and test them. That is "science," as opposed to religion, magical thinking, rhetoric, force of character, or whatever methods were used in the past to make stuff up and claim it was true. In other words, "science" is nothing but common sense.
I don't disagree with all of your points, but I disagree with the conclusion you seem to be drawing. You state all these things that you call limitations of science and the scientific method, but as a practicing scientist, I see them more as fundamental limitations of reality. In other words, I believe that science (in its ideal form) is not only the best method we've found so far, but the best method there could possibly be.
1. It's true that experiments are bad at dealing with rare events (I'm generalizing your statement by substituting rare for singular). The challenge, as a scientist, is to come up with a situation where you can study the same underlying phenomena in a system or regime where those rare events become more common. It's true that there are situations where this can be difficult or impossible, but saying that's a limitation of the scientific method is somewhat trivial. Science is dependent on observation, and you're saying that it doesn't work when you can't observe something. More on that below...
2. Trust is less of a problem in science than any other human activity because science builds cumulatively on science done before. Despite what you suggest, direct reproduction is actually not even close to being the primary mechanism for validating past results. The truth is that new experiments are based on models constrained by old experiments, even if the new experiment is not a direct duplication of the old experiment. For example, your computer wouldn't work if all those experiments on electrons and whatever done in the 1950s were wrong. So old results, at least the ones that matter, are tested and retested every day as the findings are incorporated into the models.
3. You seem to imply that it's possible to "prove" things in the real world, but I would argue that it simply is not, through science or any other method. You can prove things in math because math is all made up. Sevens don't actually "exist." Those of us who operate in reality don't have it quite so easy. The type of "proof" you're talking about is not only impossible, but more importantly, completely unnecessary. We risk our lives every day wearing shoes we can't prove won't explode, using keyboards we can't prove won't electrocute us, confident that gravity will not fail us and fling us off the face of the earth. The level of certainty science can provide is sufficient.
4. It is simply untrue that "heretics have always received rough treatment" in science. Look at Einstein, the most famous scientist of the 20th Century. Your example of the discovery of the role of H. pylori is more an indictment of the medical establishment, which at the time was very dogma-driven and insufficiently scientific in its thought (and remains so today). Also, those guys eventually won the Nobel, if you forget--hardly the Galileo treatment.
I think the biggest problem with your understanding of science is that you seem to think that the sole activity of science is in providing "facts" and studying "events." I would argue that the main activity of science is in creating models based on observations, then refining those models. You make a lot of the idea that science rejects unique events, but I would argue that the very idea of truly unique events is fundamentally incompatible with the model of the universe that science has provided (i.e. we're all made out of the same atoms, those atoms all move around according to the same rules, etc.). Science seeks not to collect random facts, but to discover the general underlying principles of reality (which you refer to as "the natural world," as if to imply there is another).
My understanding was that beta-lactam type antibiotics were not very effective against TB in vivo because those drugs kill the cells when they try to replicate, and TB replicates very, very slowly in humans. I'm not entirely convinced that beta-lactamase inhibitors alone are going to make beta-lactam drugs effective against TB.
Lots of things kill bacteria. For something to be an antibiotic, you have to be able to introduce large amounts of it to the human body without too much toxicity. Killing bacteria is easy--it's the second part that's hard.
The idea that each published paper is read only once is absurd. How many papers have you read, and how many have you written? I read at least 100 papers for every paper I publish, and I don't think I'm unusual in that regard.
The shots they give people who are exposed to rabies are not vaccines. Vaccines are antigens you give someone so that they will produce antibodies. In rabies, you're actually injecting antibodies purified from an animal that has been immunized against rabies.
While it may seem that non-coding portions of DNA simply serve as placeholders at our currently level of understanding, it is perhaps possible that these repeating sequences are part of a secondary code that serves a useful (but as yet unclear) function. IANAGeneticist, but I believe that the jury is still out on the concept of "junk DNA".
Non-coding DNA (including introns) has been known for many, many years to have important functions. The jury is not out on "junk DNA" because it is a meaningless, nonscientific term. It has been known for many years that some noncoding regions (e.g. promoters) have important roles, and others (e.g. pseudogenes) do not. Please refrain from making such authoritative statements when your knowledge is so out of date.
This appears to be the implicit and unsubstantiated assumption put forth by everyone defending the movie. That the U.S. health care system as a matter of course, sucks.
It's not an implicit and unsubstantiated assumption. There is plenty of objective evidence backing up the deficiencies in the US health care system. First, last time I checked, we had over 40 million uninsured people. That alone is enough for me. I work with the health care system on a daily basis, and my opinion is that it is an embarrassment. When it works, it's the best health care system in the world. But when it doesn't work, the results are terrible. The problem is not that it doesn't work at all, but that it doesn't work consistently. In that sense, it is analogous to US high schools. The best US high schools are probably the best in the world, but it's hard to argue that our overall system is good when so many students are stuck in bad schools receiving low-quality education. On average, the quality of education received is lower here than in most of Europe, and the same holds true for health care as well.
Also, the issue of comparing our health care system vs. others, in my opinion, should not be about effectiveness, but about efficiency. Of course we have more MRI machines and airlift people more often--we spend twice as much money per patient as everyone else! Even if you don't believe that Canadian health care is better than American health care, studies comparing outcomes show that it's roughly comparable at HALF THE COST. How good would our system be if we were able to keep spending constant, but achieve that level of efficiency?
Our problems do not come from a "failure" to socialize medicine. When I was up in Canada, the news was that brain scanners were mostly going to places with powerful politicians. Quebec got an unfair share.
This statement reflects part of the reason why free market medicine is a disaster in the US--to the layperson, it sounds like more fancy technology is the marker of an effective medical system. It sounds reasonable on the surface. I've often heard people say that Canada's health care system is worse because they don't have very many MRI machines. However, they pay a lot less per patient than we do, and their outcomes are better by objective measures. The truth is that their system is better because they are able to prioritize spending on what counts, while the US wastes its money on expensive tests and machines because they're PROFITABLE. If a hospital gets an MRI machine, that's like having a gold mine in the basement. Billable procedures round the clock! It's true, getting an MRI is probably always marginally better than not getting an MRI, but if you take the $1000 or so that each scan costs, you could probably spend that money much more effectively. For example, by vaccinating 100 children.
Most medical care is not emergency, but rather falls into three categories:
- Proactive care (physicals, etc)
- Non-emergency illness (flu, strep throat, etc--treatable at doctor's office rather than ER)
- Treatment of chronic conditions (diabetes, high blood pressure, arthritis, etc)
These aspects of medical care can easily satisfy the requirements for market forces, at least as much as other markets.
It's not your argument that's flawed as much as your premise. The majority of health care is provided in hospitals, not outpatient clinics. Most people who believe strongly in free markets for medicine have interacted with the medical system primarily as an outpatient with minor medical issues, and I agree with them that the free market model does work well for certain aspects of outpatient medicine.
However, the majority of health care expense is racked up by extremely sick people in hospitals, and that's where free market ideals quickly lead to the fox guarding the henhouse. The fundamental problem, as I see it, is that no one has ever come up with a way to make providing better medical care more profitable than worse medical care. Consumers are not informed, and despite the torrent of information on sites like webmd, the never will be. Information is not the same as understanding. Measuring outcomes has been tried, but it simply leads to A) physicians and hospitals screening their patients, refusing to treat people who will pull their averages down, or B) hospitals that treat populations with lower socioeconomic status being unfairly given bad numbers, then labeled as "bad" hospitals, so their ER sits empty while the ER across town is so packed it refuses to accept new patients. When hospitals are run as businesses, they compete with each other, and it's the patients that suffer when incompatible computer systems prevent transfer of records (which is the rule, not the exception), and the new hospital is more than willing to charge $10k to redo a full diagnostic workup, since that's all billable.
"'The test was very hard,' the medical specialist said. 'Only 35 percent passed.' 'How did they grade it?' I asked. 'Multiple choice,' he said. 'They count the number right.' As a former mathematician, I immediately knew the test results were meaningless.
He/she must not have been a very good mathematician. They're assuming that the reason that only 35% passed is because each individual question was very hard, in which case their argument is correct. However, it's more likely that each question is relatively easy, but to pass you have to get almost all of them right. Since it's impossible to know which of these situations was the case based on what the doctor said, the former mathematician couldn't have known the test results were meaningless. In my experience taking the MCAT, med school tests, and USMLE licensing exams, they're usually composed of many easy questions, and you have to get almost all of them right. That sort of mimics what being a doctor is like, which is that most of the time the diagnosis and treatment is fairly straightforward, but the tolerance for mistakes is very, very low.
Ethanol does not neutralize methanol toxicity, as methanol itself is not all that toxic. It's that your body breaks methanol down into formic acid and formaldehyde, which are substantially more toxic--ethanol slows that breakdown, but only at doses that are likely much higher than what you find in a tomato. The issue is with dosage: your body can tolerate small amounts of methanol, just not large ones. Just because something is toxic in a large dose does not mean that small doses cause cumulative damage. If you extracted the caffeine from 365 cups of coffee and took it all at once, you would probably die, but if you drink one cup a day for a year you would be fine. The question to ask is how much aspartame does a person typically consume, and how much methanol is released?
I believe it's been shown that diets high in fruits and vegetables correlate to lower incidence of cancers due to the antioxidants and other nutrients in them.
I don't know the data very well, but as you said, there are many health benefits to eating a diet high in fruits and vegetables, so I'm not sure that the lower cancer risk could be attributed to antioxidant effects per se. As far as the bilirubin stuff goes, I think that the key thing there is realizing that iron deficiency is more widespread than previously thought, especially among people with certain diseases, such as GI diseases that inhibit iron absorption, or renal dialysis patients. Interestingly, it turns out that proton pump inhibitors like Prilosec, Prevacid, and Nexium that millions of people take for indigestion have been shown to inhibit absorption of dietary iron and B12. My girlfriend is on Prevacid, and she recently started taking oral iron supplements. It could be placebo effect, but she says that after two days she could feel her endurance at the gym increase noticeably. There have also been animal studies showing dramatic increases in exercise tolerance 10-14 hours after iron injection in animals that were iron-deficient. Of course, those effects might not be mediated by the heme oxygenase antioxidant pathway, but I think that's more dramatic than anything an oral antioxidant supplement could claim.
There are so many red flags there, I don't even know where to start. It's a review article in some no-name journal where all the authors have the same last name and work at a "center" that also shares the same name (presumably a tax write-off operated out of their basement). Of course, that doesn't automatically discount what they say, but they "indiscriminately" include all studies done on the topic (when they really should filter out the bad ones), and they include in vitro and animal studies as if those mean anything. Then they say that 15 out of 50 human studies show increased survival rates. Do the other 35 show decreased survival rates? Anyway, you get my point. I wouldn't be surprised if antioxidant supplements didn't make any difference one way or the other--the general consensus of the studies that have been coming out is that they just aren't all that effective in vivo. The future of antioxidant research will most likely be in stimulating the body's natural antioxidant systems, not trying to add artificial antioxidants. That is something that I think is much more interesting. Try looking up bilirubin and heme oxygenase in pubmed.
There are (at least) three problems with what you're saying:
1. I suspect you know this, but there are many types of tumors beyond mesotheliomas that are linked to environmental exposures, viral infections, hormonal states, and other things that have nothing to do with oxidative stress. Oxidative stress is just one small piece of the puzzle.
2. oxidative stress may be bad, but what does the evidence say about the efficacy of exogenous antioxidants in vivo? I'll give you a hint: they've been a big disappointment. Bonus question: what are the most important endogenous antioxidant systems in the human body, and which disorders affect them? hint: patients with Gilbert's syndrome have a five-fold lower risk of ischemic heart disease. I didn't learn that in med school biochemistry, and I bet you didn't either.
3. even if initiation of a cancer is tied to oxidative stress, it doesn't make any sense to think that antioxidants would be effective treatments for cancer that already exists. By giving antioxidants you would be making all the cells healthier, including the tumor cells. In fact, there have been studies demonstrating that you can ablate tumors by inducing oxidative stress locally while inhibiting the endogenous antioxidant systems of the tumor cells.
Don't get me wrong, I have great respect for clinicians, but you need to get on the critical thinking bandwagon.
Slashdot Mirror
* Diseases evolve, so today's vaccinations may not work against tomorrow's illnesses, and even when they are effective, other diseases may take the same ecological space (thus the proliferation of new vaccinations, while the old ones remain on the schedule just in case),
Diseases evolve, it's true, but on what timescale? Put another way, how many novel infectious diseases have developed since the dawn of vaccination? A few, but not enough to render vaccination ineffective, as you're suggesting. It's also not true that old vaccines remain just in case--were you vaccinated for smallpox? I wasn't. Also, the application of ecological concepts to infectious disease is not always warranted. In your case, I don't think humans represent an ecological niche that viruses are competing for traction in--it's more apt to compare humans to Australia, and infectious diseases to rabbits, an animal with no natural predators in Australia.
* It is not clear just how many pathogens a human immune system can be sensitized to without collapsing,
You and everyone else have been exposed to so many potential pathogens it's ridiculous--look in a virology textbook sometime. Vaccinating for a few is a drop in the bucket. It's important to distinguish between something that you don't know and something that science doesn't know. I'm not blaming you for not being a card-carrying immunologist, but at least respect the fact that there are a lot of very smart people who know a lot more about the immune system than you seem to think they do.
* The previous way many people developed immunity was by extended nursing and low levels of infections in populations, where the mother's immune system scanned for threats and passed antibodies onto children to help them deal with threats, conferring life long immunity. Vaccines break this cycle of "software" memory. Pediatricians promote shots but when was the last time you heard one recommend nursing to age three or four like most of humanity has done historically?
Nursing does not convey antibodies forever, and even if it did, the main reason for prolonged nursing has historically been birth control. People like sex. The flaw in your understanding of infectious disease is that people evolved living in small groups, largely isolated from each other. If one of those groups got wiped out, as they did all the time, it wasn't a big deal. With air travel, humanity is now lumped into one huge group. We can't rely on the old strategies any more. The book "Guns, Germs, and Steel" talks a lot about this, and I highly recommend it. One of the main points of that book, and others, is that infectious disease is one of the top two or three factors shaping the history of humanity.
Modern vaccination schedules entail approaching 200 different batches of produced materials to be injected in a person's lifetime (if you include annual flu shots, and assume booster shots on a decade schedule) each of which bypass the body's normal mechanisms for developing immunity for many infectious disease (general first response in the tonsils, moving from there).
Bypass the body's normal mechanisms? I'm sorry, that's simply not correct. You seem like an intelligent person, but if you want to be informed about the issues, you should read a real intro immunology textbook, like Janeway's "Immunobiology." It has lots of good illustrations and is very readable.
I sympathize with your situation, but there are a few medical/scientific facts you should know. First, febrile seizures (caused by fevers) are common in children, and while they appear dramatic, they're usually not that big of a deal. I used to see them all the time in the peds ER, and they're usually triggered by the common cold. It's common for children to react to vaccines with cold-like symptoms. The second thing is that as I'm sure you're aware, the data is pretty clear that MMR and other vaccines do not increase the risk of autism. However, there is likely something more subtle going on--the current thinking among many neuroscientists and psychiatrists is that the onset of autism is triggered by a stressful event. Epidemiological studies show that vaccines do not increase risk of autism, but they may serve as this triggering event. However, the data suggest that those children would have become autistic anyway, except it would have been another event that triggered it later on. I agree with you that autism is a serious thing, but childhood diseases are also very serious, and most people have forgotten how serious they are simply because vaccines have been so effective. It's true that the recommended vaccines have increased over the past 30 years, but there are also vaccines that are relatively safe and effective that are not administered to everyone, like smallpox and hepatitis A. This is because they fail the risk/benefit ratio test. No one thinks that vaccines are 100% safe, just safer than not vaccinating. Given your exposure to autism, I understand your apprehension toward vaccines. Personally, I've worked in an inner city peds ER, where I've seen some kids get really sick because they weren't vaccinated, and I'm going to make sure my kids get all the vaccines.
I worked for a number of years doing research, including bioengineering, mechanical engineering, electrical engineering, and computer science. The work that I did for the bioengineering department was actually on searching for better models of the biomechanics of the heart. We knew, rather precisely, how the mechanics worked at the small scale (ion channels, all that) and how it worked at the large scale (EKGs and all that) but it was the middle ground that was very difficult to do with any degree of precision. Simulating a single cell was a numerically intensive excercise -- simulating large numbers of cells had to be done with different approximation methods. A new approach that could better simulate a heart beat (more accurately or more quickly) would be worthy of a paper in this field. From what I can understand of what you're saying, you consider this type of work to be emblematic of the work scientists do. Some might call it "engineering" (building a better mousetrap), but they're two sides to the same coin in my opinion.
In the past, I've done computational modeling of the nervous system, the biophysics of which are actually pretty similar, but I've always thought that cardiac physiology was really cool, especially mechanisms of bifurcation to flutter and fibrillation states. But yes, I think that what you're describing is much more typical of "real" science.
The trouble is, it's difficult to say that the scientific method is being used in this circumstance. Certainly progress is being made, but progress can be made by a number of different methods, not just the scientific method. Did the people making the Luo-Rudy model of the heart start by stating a hypothesis? Testing it? Gathering evidence? Testing the hypothesis against the evidence? Of course not. They build a box that they'd run data through, and tried to get it to match the behavior of a real heart. Over the process of refinement over 10 years, Luo and Rudy came out with iteratively refined versions that worked "better" (for some definition of better).
This is science, but this isn't the scientific method. I've been trying to stick to examples where some version of the scientific method would actually be used, not the practice of science in general, which uses methods other than the scientific method to produce results.
I think we're getting closer to understanding each other on this, and I think there's a lot of semantics getting in the way. I would argue that if you think about it a little abstractly, each current iteration of the Luo-Rudy model WAS the hypothesis, and the data they were testing it against had already been collected. I guess this is somewhat similar to what Kuhn said. But I think this a totally valid example of the scientific method, and I think what you're calling the scientific method is really just a special case of that. The thing is, we both agree that the vast majority of science done doesn't follow the "Scientific Method (TM)" in the sense that you're describing. Where we disagree is that you say that this actually means that most science doesn't follow the scientific method, while I'm saying that the "Scientific Method" you (and many philosophers) are describing is an over-simplified, too-narrow example of the real thing. It's not wrong, but it's only one special case. A few years ago, people in biological sciences were discussing "hypothesis-driven vs. discovery-driven" models. Hypothesis-driven is when experiments are hard enough to do that you have to plan each one carefully in advance, while "discovery-driven" (or data-driven) is a result of the high-throughput technologies enabling experimentalists to vacuum up data faster than they can analyze it. But that's really nothing new, it's just new to that particular field. Both are totally valid ways of doing things, and I would argue that both (to the extent that they're not a false dichotomy) are part of the scientific method. And of course, there are other approaches as well.
But this experiment i
I agree with what you're saying, and I'd like to add that when you give a person blood, you're really giving them packed red blood cells, which are already "dead," as in they're enucleated cells not actively making new proteins or anything. So you don't need any kind of absolute specificity--it's not like "killing" the blood cells makes them somehow ineffective, so you could probably just gamma-irradiate the blood. I know that's already done under certain circumstances.
"Nothing is impossible! That's what being a scientist is all about!"
As a scientist, I think it's important to distinguish between things we know are possible but can't do, things we don't know if they're possible or not, and things we know are impossible. And there are plenty of things we know are impossible, not just with current technology, but with any technology. Technology can only get you so far, and it's important to understand when fundamental limitations are present. In this case, people aren't 1 mm thick, and if you irradiated them with enough light energy to penetrate all the way through, you would kill them. There are better ways to clear viruses out of people.
There's three points I'd like to make in conclusion of this thread (which I've enjoyed, by the way -- the Philosophy of Science is a fun topic for me). It's obviously a huge topic, so I'd like to summarize what I'm trying to say:
I've enjoyed it too. I think if there's one final point that I am trying to make (over and over and over), it's that too much of philosophy of science is based on a caricature of science and the scientific method. I studied a fair amount of philosophy of science and philosophy of mind as an undergrad, and I neverfelt that the philosophers I met really understood how science works, or even what science is. Their arguments are based on the narrowest possible definition, a definition that simply does not describe what people called "scientists" do. Anyway, I think this is the primary source of our disagreements.
Different kinds of questions have different methods for appropriately answering them:
Question 1: Did Sally kiss Harry? Answered by an observation or self-reporting followed by a chain of word-of-mouth.
Question 2: Are Scrub Jays blue? Answered by an orthinologist going out and studying a number of Scrub Jays.
Question 3: Are men taller than women? Answered by statistical methods.
Question 4: Is 5 greater than 4? Answered by a rational claim without any empirical observations.
Question 5: Does ice cream cause polio? Answered incorrectly by establishing correlation, Answered correctly by establishing causation.
Question 6: Should people wear hats in church? Answered by religious debate from authority.
Question 7: Is murder wrong? Answered by a variety of ethical or religious arguments. Some people claim that "murder is wrong" is not a fact at all, but an opinion. Others claim it is a fact.
Question 8: Does adding fertilizer cause tomato plants to grow faster? Answered by every 8th grade science fair, using the traditional scientific method of hypothesis testing.
My point is that the scientific method, while indeed a powerful tool at arriving at truth, and useful in many situation, is not the only means of learning truth. Different questions have different ways that are appropriate for answering them. The scientific method is not the complete answer to epistemology.
I guess it all hinges on what you would call truth. The idea that anyone could call numbers 6 or 7 "truth" is baffling to me. Number 4 is a tautology, as are all true statements in math--the trick is in proving that they are. Answers to the rest are all reliably established only through scientific means. When it all comes down to it, I guess I do believe that the only things that can be said to be true or false are things that can be addressed scientifically, by which I mean through analysis of evidence.
Logical Positivism has gone through various incarnations over the last century, but the most strident version says that that which cannot be scientifically proven (via verification or falsifiability) is not worth considering. Other versions accept different sets of facts. "My fiancee loves me" is resistant to being put in a test tube, but we could perhaps look at evidence for it, like taking her word for it, or perhaps looking at a cake she baked for me.
The trouble of course, is that it really is a slippery slope from there to reports of people seeing ghosts (the original point of this Slashdot article). How can we accept my fiancee's word that she loves me, but not accept the fact that her friend saw a ghost when she was young? We can't start from the assumption that ghosts don't exist, since then we're just assuming our conclusions. Hence the strident version of Logical Positivism -- that which cannot be shown scientifically is not of interest.
I think this is getting at the core of (in my opinion) what your fundamental misunderstanding of what science is. You seem to think that there is some sort of sharp divide between "scientific" observations in test tubes, which somehow purport to be
How do you know? Right now, there's probably a huge number of people in your hospital that have diabetes. Our model for the underlying cause of diabetes has been shaken up several times within the last few years. How do you know we're not killing thousands of Americans every year out of our ignorance or errors?
I didn't intend to claim that medicine knows everything--what I meant is that certain basic aspects of medicine are fully understood, and if they weren't understood it would become obvious very rapidly. My example of the mechanics of blood flow illustrates that.
That's a major part of the problem -- the other is, as I mentioned, the fact that falsehoods are held to be true. The scientific is supposed to give us truth about the world, but the system must necessarily publish falsehoods.
What I'm saying is that the belief that every published result is even supposed to be correct is, in itself, a fundamental misunderstanding of the nature of the scientific method on your part. Like I said, bad science exists, and even good science can reach incorrect conclusions. The claim advocates of the scientific method would make is that incorrect results get rooted out over time, not that all published results are intrinsically correct the very first time.
But what is the alternative to the scientific method? You can gain empirical knowledge (sorted from most- to least-reliable) through: testing, observation, tradition, and word of mouth. Most scientifically minded people are able to work with the first two comfortably, but feel uncomfortable when dealing with the last two. But sometimes the only way you have of learning a fact is through word of mouth. Sarry might have kissed Harry and told you about it -- but you can't put them into a double-blind controlled experiment and replicate the results.
I think you're lumping a whole bunch of things together there. Tradition and word of mouth are means of communication, not means by which the facts were discovered. If Janet directly observed Harry kissing Sally then told me about it, that's totally different than if Janet "had a feeling" that Harry kissed Sally and told me. And salicylic acid (not aspirin, which is a derivatized form developed to have decreased gastric side effects) was not discovered through tradition, it was discovered through empirical observation by some culture of proto-scientists a long time ago, then passed down to us through tradition. Of course, the vast, vast majority of traditional medicine has been shown to be absolutely worthless, if not directly harmful, so using salicylic acid as an example of the wonders of tradition is a bit of the "file drawer" effect you mention.
Logical Positivism's fundamental axioms state: 1) That anything that isn't falsifiable isn't scientific. And 2) Anything that isn't scientific isn't worthy of being thought about. But many of the most important things in life are not falsifiable, and rather impossible to put in a test tube. There's more to life than what can be known scientifically, and there are more ways to know facts than through the scientific method.
It may turn out that I'm some form of "weak" logical positivist--I've forgotten a lot of my undergrad philosophy, and you'll have to help me--but my understanding is that the position is that any model that is fundamentally unfalsifiable isn't scientific, not simply models that can't be falsified with the evidence we have at hand. In other words, the only reason to believe something is based on evidence, and things about which evidence can fundamentally not be collected are not worth thinking about. Contrary to what you say, I think almost everything in life has evidence attached to it, with the possible exception of things like whether or not God exists, and almost every decision in life can and should be made based on application of rigorous logic to the evidence at hand. The human brain is optimized to be naturally good at this in evolutionarily relevant contexts, but it breaks down beyond that, which is the only reason why formalized science is necessary.
An example of this would be how people's health aliments are treated differently in different parts of the world. In rural China treatment is different than in NYC. (Is there a Western equivalent of a "hot blood" theory?) Treatment would be different in parts of Europe than in America also.
This is actually a perfect example of what I'm talking about. There probably was a Western equivalent of "hot blood" or whatever premodern Chinese theory you could come up with--it was probably "the black bile" or something like that. Treatment protocols differ slightly in different countries, but the underlying theoretical framework of modern medicine is the same everywhere in the world. If a person's blood pressure starts to drop, doctors everywhere immediately start to think hypovolemic shock vs. cardiogenic shock vs. distributed (e.g. septic) shock vs. obstructive shock, etc., and they base their management strategy on that. These are theoretical frameworks that are based in scientific knowledge of the underlying physiology. You can argue that the validity of these frameworks has not been "proven," the same way the round earth has not been proven, but it's a pointless agument.
An aside: as a medical scientist of East Asian descent, I find it somewhat offensive when modern medicine is referred to as "Western" medicine. Western countries do not have a monopoly on modern medicine, and scientists from other parts of the world have played significant roles in its development. Western countries have their own premodern medical traditions (e.g. the theory of the humours, blood-letting, chiropractic, homeopathy, etc.), and these are no different than any other culture's version.
My other post goes more in depth, but I think it's important to draw a distinction between science-as-practiced, and the scientific method. Science-as-practiced is imperfect because it doesn't always adhere to the standards of the scientific method.
I should restate what I said before: science is an extension of common sense. You are absolutely correct that the findings of science can be deeply counterintuitive, and you don't even have to go as far as string theory to see that. But by "common sense," I'm referring to the essential activity of the brain of any human, which is to generate internal models constrained by sensory input, then generate motor outputs consistent with those models. Science is an extension of this in that we build explicit models constrained by observations, then make decisions based on those models. The difference is that science has a higher standard of model testing than the human brain does.
About unique events: it's two separate issues whether events occur rarely, or are observed rarely. If they're observed rarely (like the Martian), you need to try to find a way to either observe them more frequently, or observe something other parameter that gives you the same information you need to constrain your model. You're partially correct in that difficulty observing something directly is problematic, but one of the main points of science is that you don't need direct observations to tell you what's going on, you need observations to constrain models of what's going on. In other words, observation of one martian gives constraints on the height distribution of martians, the same way measuring the size of doorways inside the pyramids constrains estimates of the height distribution of ancient Egyptians (even if we never found their remains).
2. About rejection of inexplicable events: I understand that you sincerely believe this to be true, but once again you describe Roentgen, a hero and pioneer who won all sorts of recognition. I work in neuroscience, where people publish results all the time with no mechanistic explanation--the reason why some are rejected and others not has to do with the reliability of those measurements. Experimental artifact is a fact of life, and the vast, vast majority of "inexplicable" results are simply wrong. To the non-expert eye the acceptance of some and not others might appear arbitrary, but it's based on our understanding of the reliability and potential pitfalls of the techniques used. Also, keep in mind what makes something "inexplicable." Your example describes observation of an entirely new phenomenon, which is not "inexplicable" at all, and I don't think those people have much trouble getting recognized. Truly "inexplicable" results are ones that appear to contradict the models that were constructed based on other results. Interpretation of those is a lot trickier, but we spend a lot of time thinking about them, and I simply don't think it's accurate to say that we dismiss them out of hand.
3. The examples of bias, politics, uncertainty, etc. that you're describing are accurate, but they're simply examples of bad science. The existence of bad science is not really an indictment of the scientific method per se, it's an example of what happens when people don't adhere closely enough to it. Clinical epidemiology research is a good example of where we know how to do the right science, but other factors don't allow us to. For example, it's never been "proven" that HIV causes AIDS. I know how to do that study: lock 1000 healthy people in cages, inject 500 of them with HIV and 500 with saline, and see what happens. The "problem," if you want to call it that, is that financial and ethical constraints prevent the scientific method from being rigorously applied. But I don't think you can blame the "scientific method" for that.
I think this is getting at the core of what we're actually discussing here. I think we both agree that science, as practiced today, is suboptimal in many ways. The difference is that you are arguing that this is a limitation of the scientific method, while I'm saying that these are examples of science-as-practiced not adhering to the standards of the scientific method.
5) This is also the problem of trust in science. The problem is not malice or fraud (though the case of the South Korean cloning guy shows this can happen) but that whereas you or I can understand that studies inherently have uncertainty in them, people go out there and make life or death decisions based on studies, thinking that something which is scientifically shown to be true means the same thing as something mathematically shown to be true.
The problem you're describing is the problem of scientific illiteracy in the public, which I agree is a huge problem. However, keep in mind that we make life and death decisions every single day based on scientific "proof," and we don't even think twice about it. I'm not worried th
To clarify, I'm not referring to the current state of scientific methodology, which is obviously imperfect and in many ways in a constant state of refinement. I'm talking about "science" in a more general sense, as the idea that we discover truth by making observations and formulating models that explain those observations, then making predictions about new observations and test them. That is "science," as opposed to religion, magical thinking, rhetoric, force of character, or whatever methods were used in the past to make stuff up and claim it was true. In other words, "science" is nothing but common sense.
I don't disagree with all of your points, but I disagree with the conclusion you seem to be drawing. You state all these things that you call limitations of science and the scientific method, but as a practicing scientist, I see them more as fundamental limitations of reality. In other words, I believe that science (in its ideal form) is not only the best method we've found so far, but the best method there could possibly be.
1. It's true that experiments are bad at dealing with rare events (I'm generalizing your statement by substituting rare for singular). The challenge, as a scientist, is to come up with a situation where you can study the same underlying phenomena in a system or regime where those rare events become more common. It's true that there are situations where this can be difficult or impossible, but saying that's a limitation of the scientific method is somewhat trivial. Science is dependent on observation, and you're saying that it doesn't work when you can't observe something. More on that below...
2. Trust is less of a problem in science than any other human activity because science builds cumulatively on science done before. Despite what you suggest, direct reproduction is actually not even close to being the primary mechanism for validating past results. The truth is that new experiments are based on models constrained by old experiments, even if the new experiment is not a direct duplication of the old experiment. For example, your computer wouldn't work if all those experiments on electrons and whatever done in the 1950s were wrong. So old results, at least the ones that matter, are tested and retested every day as the findings are incorporated into the models.
3. You seem to imply that it's possible to "prove" things in the real world, but I would argue that it simply is not, through science or any other method. You can prove things in math because math is all made up. Sevens don't actually "exist." Those of us who operate in reality don't have it quite so easy. The type of "proof" you're talking about is not only impossible, but more importantly, completely unnecessary. We risk our lives every day wearing shoes we can't prove won't explode, using keyboards we can't prove won't electrocute us, confident that gravity will not fail us and fling us off the face of the earth. The level of certainty science can provide is sufficient.
4. It is simply untrue that "heretics have always received rough treatment" in science. Look at Einstein, the most famous scientist of the 20th Century. Your example of the discovery of the role of H. pylori is more an indictment of the medical establishment, which at the time was very dogma-driven and insufficiently scientific in its thought (and remains so today). Also, those guys eventually won the Nobel, if you forget--hardly the Galileo treatment.
I think the biggest problem with your understanding of science is that you seem to think that the sole activity of science is in providing "facts" and studying "events." I would argue that the main activity of science is in creating models based on observations, then refining those models. You make a lot of the idea that science rejects unique events, but I would argue that the very idea of truly unique events is fundamentally incompatible with the model of the universe that science has provided (i.e. we're all made out of the same atoms, those atoms all move around according to the same rules, etc.). Science seeks not to collect random facts, but to discover the general underlying principles of reality (which you refer to as "the natural world," as if to imply there is another).
My understanding was that beta-lactam type antibiotics were not very effective against TB in vivo because those drugs kill the cells when they try to replicate, and TB replicates very, very slowly in humans. I'm not entirely convinced that beta-lactamase inhibitors alone are going to make beta-lactam drugs effective against TB.
Lots of things kill bacteria. For something to be an antibiotic, you have to be able to introduce large amounts of it to the human body without too much toxicity. Killing bacteria is easy--it's the second part that's hard.
The idea that each published paper is read only once is absurd. How many papers have you read, and how many have you written? I read at least 100 papers for every paper I publish, and I don't think I'm unusual in that regard.
The shots they give people who are exposed to rabies are not vaccines. Vaccines are antigens you give someone so that they will produce antibodies. In rabies, you're actually injecting antibodies purified from an animal that has been immunized against rabies.
While it may seem that non-coding portions of DNA simply serve as placeholders at our currently level of understanding, it is perhaps possible that these repeating sequences are part of a secondary code that serves a useful (but as yet unclear) function. IANAGeneticist, but I believe that the jury is still out on the concept of "junk DNA".
Non-coding DNA (including introns) has been known for many, many years to have important functions. The jury is not out on "junk DNA" because it is a meaningless, nonscientific term. It has been known for many years that some noncoding regions (e.g. promoters) have important roles, and others (e.g. pseudogenes) do not. Please refrain from making such authoritative statements when your knowledge is so out of date.
This appears to be the implicit and unsubstantiated assumption put forth by everyone defending the movie. That the U.S. health care system as a matter of course, sucks.
It's not an implicit and unsubstantiated assumption. There is plenty of objective evidence backing up the deficiencies in the US health care system. First, last time I checked, we had over 40 million uninsured people. That alone is enough for me. I work with the health care system on a daily basis, and my opinion is that it is an embarrassment. When it works, it's the best health care system in the world. But when it doesn't work, the results are terrible. The problem is not that it doesn't work at all, but that it doesn't work consistently. In that sense, it is analogous to US high schools. The best US high schools are probably the best in the world, but it's hard to argue that our overall system is good when so many students are stuck in bad schools receiving low-quality education. On average, the quality of education received is lower here than in most of Europe, and the same holds true for health care as well.
Also, the issue of comparing our health care system vs. others, in my opinion, should not be about effectiveness, but about efficiency. Of course we have more MRI machines and airlift people more often--we spend twice as much money per patient as everyone else! Even if you don't believe that Canadian health care is better than American health care, studies comparing outcomes show that it's roughly comparable at HALF THE COST. How good would our system be if we were able to keep spending constant, but achieve that level of efficiency?
Our problems do not come from a "failure" to socialize medicine. When I was up in Canada, the news was that brain scanners were mostly going to places with powerful politicians. Quebec got an unfair share.
This statement reflects part of the reason why free market medicine is a disaster in the US--to the layperson, it sounds like more fancy technology is the marker of an effective medical system. It sounds reasonable on the surface. I've often heard people say that Canada's health care system is worse because they don't have very many MRI machines. However, they pay a lot less per patient than we do, and their outcomes are better by objective measures. The truth is that their system is better because they are able to prioritize spending on what counts, while the US wastes its money on expensive tests and machines because they're PROFITABLE. If a hospital gets an MRI machine, that's like having a gold mine in the basement. Billable procedures round the clock! It's true, getting an MRI is probably always marginally better than not getting an MRI, but if you take the $1000 or so that each scan costs, you could probably spend that money much more effectively. For example, by vaccinating 100 children.
Most medical care is not emergency, but rather falls into three categories:
- Proactive care (physicals, etc)
- Non-emergency illness (flu, strep throat, etc--treatable at doctor's office rather than ER)
- Treatment of chronic conditions (diabetes, high blood pressure, arthritis, etc)
These aspects of medical care can easily satisfy the requirements for market forces, at least as much as other markets.
It's not your argument that's flawed as much as your premise. The majority of health care is provided in hospitals, not outpatient clinics. Most people who believe strongly in free markets for medicine have interacted with the medical system primarily as an outpatient with minor medical issues, and I agree with them that the free market model does work well for certain aspects of outpatient medicine.
However, the majority of health care expense is racked up by extremely sick people in hospitals, and that's where free market ideals quickly lead to the fox guarding the henhouse. The fundamental problem, as I see it, is that no one has ever come up with a way to make providing better medical care more profitable than worse medical care. Consumers are not informed, and despite the torrent of information on sites like webmd, the never will be. Information is not the same as understanding. Measuring outcomes has been tried, but it simply leads to A) physicians and hospitals screening their patients, refusing to treat people who will pull their averages down, or B) hospitals that treat populations with lower socioeconomic status being unfairly given bad numbers, then labeled as "bad" hospitals, so their ER sits empty while the ER across town is so packed it refuses to accept new patients. When hospitals are run as businesses, they compete with each other, and it's the patients that suffer when incompatible computer systems prevent transfer of records (which is the rule, not the exception), and the new hospital is more than willing to charge $10k to redo a full diagnostic workup, since that's all billable.
"'The test was very hard,' the medical specialist said. 'Only 35 percent passed.' 'How did they grade it?' I asked. 'Multiple choice,' he said. 'They count the number right.' As a former mathematician, I immediately knew the test results were meaningless.
He/she must not have been a very good mathematician. They're assuming that the reason that only 35% passed is because each individual question was very hard, in which case their argument is correct. However, it's more likely that each question is relatively easy, but to pass you have to get almost all of them right. Since it's impossible to know which of these situations was the case based on what the doctor said, the former mathematician couldn't have known the test results were meaningless. In my experience taking the MCAT, med school tests, and USMLE licensing exams, they're usually composed of many easy questions, and you have to get almost all of them right. That sort of mimics what being a doctor is like, which is that most of the time the diagnosis and treatment is fairly straightforward, but the tolerance for mistakes is very, very low.
Ethanol does not neutralize methanol toxicity, as methanol itself is not all that toxic. It's that your body breaks methanol down into formic acid and formaldehyde, which are substantially more toxic--ethanol slows that breakdown, but only at doses that are likely much higher than what you find in a tomato. The issue is with dosage: your body can tolerate small amounts of methanol, just not large ones. Just because something is toxic in a large dose does not mean that small doses cause cumulative damage. If you extracted the caffeine from 365 cups of coffee and took it all at once, you would probably die, but if you drink one cup a day for a year you would be fine. The question to ask is how much aspartame does a person typically consume, and how much methanol is released?
I believe it's been shown that diets high in fruits and vegetables correlate to lower incidence of cancers due to the antioxidants and other nutrients in them.
I don't know the data very well, but as you said, there are many health benefits to eating a diet high in fruits and vegetables, so I'm not sure that the lower cancer risk could be attributed to antioxidant effects per se. As far as the bilirubin stuff goes, I think that the key thing there is realizing that iron deficiency is more widespread than previously thought, especially among people with certain diseases, such as GI diseases that inhibit iron absorption, or renal dialysis patients. Interestingly, it turns out that proton pump inhibitors like Prilosec, Prevacid, and Nexium that millions of people take for indigestion have been shown to inhibit absorption of dietary iron and B12. My girlfriend is on Prevacid, and she recently started taking oral iron supplements. It could be placebo effect, but she says that after two days she could feel her endurance at the gym increase noticeably. There have also been animal studies showing dramatic increases in exercise tolerance 10-14 hours after iron injection in animals that were iron-deficient. Of course, those effects might not be mediated by the heme oxygenase antioxidant pathway, but I think that's more dramatic than anything an oral antioxidant supplement could claim.
There are so many red flags there, I don't even know where to start. It's a review article in some no-name journal where all the authors have the same last name and work at a "center" that also shares the same name (presumably a tax write-off operated out of their basement). Of course, that doesn't automatically discount what they say, but they "indiscriminately" include all studies done on the topic (when they really should filter out the bad ones), and they include in vitro and animal studies as if those mean anything. Then they say that 15 out of 50 human studies show increased survival rates. Do the other 35 show decreased survival rates? Anyway, you get my point. I wouldn't be surprised if antioxidant supplements didn't make any difference one way or the other--the general consensus of the studies that have been coming out is that they just aren't all that effective in vivo. The future of antioxidant research will most likely be in stimulating the body's natural antioxidant systems, not trying to add artificial antioxidants. That is something that I think is much more interesting. Try looking up bilirubin and heme oxygenase in pubmed.
There are (at least) three problems with what you're saying:
1. I suspect you know this, but there are many types of tumors beyond mesotheliomas that are linked to environmental exposures, viral infections, hormonal states, and other things that have nothing to do with oxidative stress. Oxidative stress is just one small piece of the puzzle.
2. oxidative stress may be bad, but what does the evidence say about the efficacy of exogenous antioxidants in vivo? I'll give you a hint: they've been a big disappointment. Bonus question: what are the most important endogenous antioxidant systems in the human body, and which disorders affect them? hint: patients with Gilbert's syndrome have a five-fold lower risk of ischemic heart disease. I didn't learn that in med school biochemistry, and I bet you didn't either.
3. even if initiation of a cancer is tied to oxidative stress, it doesn't make any sense to think that antioxidants would be effective treatments for cancer that already exists. By giving antioxidants you would be making all the cells healthier, including the tumor cells. In fact, there have been studies demonstrating that you can ablate tumors by inducing oxidative stress locally while inhibiting the endogenous antioxidant systems of the tumor cells.
Don't get me wrong, I have great respect for clinicians, but you need to get on the critical thinking bandwagon.