"Who needs evidence based medicine?"

[greyl]

Spotted by www.neuralgourmet.com . Reads like a Colbert skit. Check out all the links:

Gene Expression mentions what has to be the most frightening article in a "medical" journal I've ever read. So, if you want to dip your toes into the waters of post-modern medicine, you surely won't want to miss "Deconstructing The Evidence-Based Discourse In Health Sciences: Truth, Power And Fascism" {PDF} in the latest edition of the International Journal of Evidence-Based Healthcare. With such revolutionary ideas as these who can deny the essential fascistic nature of modern medicine (bolding mine):

snip>Those who are wedded to the idea of 'evidence' in the health sciences maintain what is essentially a Newtonian, mechanistic world view: they tend to believe that reality is objective, which is to say that it exists, 'out there', absolutely independent of the human observer, and of the observer's intentions and observations. They fondly point to 'facts', while they are forced to dismiss 'values' as somehow unscientific. >snip

"It's time we overthrew our evidence based overlords! Viva la revolution! Now who's with me?"

http://www.neuralgourmet.com/2006/08/16/who_needs_evidence_based_medicine

edit: fixed bolding

[Celebration]

1. interesting, but not frightening

Here are some interesting observations by a NASA person--

http://www.grc.nasa.gov/WWW/K-12/Numbers/Math/Mathematical_Thinking/observer.htm

The Observer in Modern Physics
Some Personal Speculations
The phenomena of the cosmos require an observer in order to be learned about and understood by us. The observer can take many forms, for example:
1. A person watching amoeba through a microscope
2. A person watching an ocean sunset
3. A spacecraft monitoring a distant asteroid (and transmitting data to earth)
4. A person conducting an experiment in a laboratory

The ideal observer is one who causes no unnecessary perturbations to the system being observed. An observation made by such an observer is called an objective observation. In our school physics and chemistry, we routinely assume that our observations are objective.

But reality seldom, if ever, provides us with ideals. The real observer always causes an unnecessary perturbation of some kind. Scientists must remain alert in their efforts to minimize the magnitudes of these perturbations. The extent to which they succeed determines the level of confidence they can claim in their results and, therefore, the certainty they can expect in their knowledge of things.

.....................snip....................

Let us ask a simple question: When you look up at night and "see" a star, what is "really" going on? A Newtonian philosopher might answer that you are "really seeing" the star, since, in Newtonian physics, the speed of light is reckoned as being infinite. An Einsteinian philosopher, on the other hand, would answer that you are seeing the star as it was in a past epoch, since light travels with finite velocity and therefore takes time to cross the gulf of space between the star and your eye. To see the star "as it is right now" has no meaning since there exists no means for making such an observation.

A quantum philosopher would answer that you are not seeing the star at all. The star sets up a condition that extends throughout space and time-an electromagnetic field. What you "see" as a star, is actually the result of a quantum interaction between the local field and the retina of your eye. Energy is being absorbed from the field by your eye, and the local field is being modified as a result. You can interpret your observation as pertaining to a distant object if you wish, or concentrate strictly on local field effects.

[trotsky]

2. Holy crap, that's disturbing.

One of the hallmarks of science is the ability to accept evidence that shows your position to be false. Falsifiability is at the core of every scientific principle. What people like this are saying is that it doesn't matter how much evidence you present to the contrary, there will always be special, secret, hidden, undetectable evidence that DOES support them, and you will never convince them they're wrong.

To those who embrace this worldview, how do you refine it? What can convince you that something you believe is wrong?

[Odin2005]

3. The Postemodernist infection is spreading.

The Postmodernist philosphers are the people who made is OK in respectable intellectual circles to attack science as "dogma." A few moths ago a DU poster went on some rant attacking "dogmatic positivism" when I attacked some luddite position taken by a poster, it is very disturbing.

[Trillo]

4. Double-plusgood!

Thanks for the pointer to the article.

My first impression of the article's thrust was as satire, but on the first thorough read through changed my mind. There appear to be many logical points made, one inference that I drew was that EBHS proponents espouse a flawed reasoning when in their sales effort they allegedly state that EBM reduces cost: anyone who's been paying attention knows that as EBHS has come to prominence, the exact opposite has happened, medicine has become much more expensive, not less.

The authors appear to also make the point.

From the journal article, linked on Gene Expressions's page:

Moreover, we must ask whether EBHS serves a state or governmental function, where ready-made and convenient ‘goals-and-targets’ can be used to justify cuts to healthcare funding.

I am amazed at the generalized difficulties in access for the reading of journals and scientific articles. Once, in my early days of the Internet, probably the early 90s, I found a reference to a medical journal article I wanted to read, but couldn't find online. I physically went to the UCSD medical library, a 15-minute drive then another long walk because of parking issues, figuring that they'd have a copy of the article. They did, but I was disappointed to find that they had a rule at the time that only gave either students access to the journals. I wasn't a student, so I wasted time, money, and gas. I have no idea whether this rule is still in effect, but as a California taxpayer, it torqued me more than a little bit given that it's a public research university supported in part by taxes I've paid to California.

Along with Deleuze and Guattari,1 we understand such fascist logic as a desire to order, hierarchise, control, repress, direct and impose limits. Fascism is one of the many faces of totalitarianism – the total subjection of humanity to the political imperatives of systems whose concerns are of their own production.25 In light of our argument, fascism is not too strong a word because the exclusion of knowledge ensembles relies on a process that is saturated by ideology and intolerance regarding other ways of knowing. The process at play here is one that operates hand-in-hand with powerful political or ‘power’ structures and that gears and sustains scientific assertions in the same direction: that of the dominant ideology. Unfortunately, the nature of this scientific fascism makes it attractive to all of us – the subjected.
In Foucault’s words:

the major enemy, the strategic adversary is fascism. . . . And not only historical fascism, the fascism of Hitler and Mussolini – which was able to mobilize and use the desire of the masses so effectively – but also the fascism in us all, in our heads and in our everyday behavior, the fascism that causes us to love power, to desire the very thing that dominates and exploits us. (p. xiii)1

Fascism does not originate solely from the outside; it is a will within us to desire, although often unwittingly, a life of domination.1 Such a ‘lovable’ fascism requires little more than the promise of success (grants, publications, awards, recognition, etc.) within its system to get us to participate wholeheartedly.25 Perhaps it is time to think about governing structures that impose their imperatives (academic, scientific, political, economic) on academics and researchers, and to ask ourselves what drives us to love fascist and exclusionary structures.

excerpt to PDF file linked by Gene Expression