9 ms·

"Do you know what they call 'alternative medicine' that's been proved to work? Medicine." - Tim Minchin, Storm, 2008. Should you trust an authority? That is a

"Do you know what they call 'alternative medicine' that's been proved to work? Medicine." - Tim Minchin, Storm, 2008. Should you trust an authority? That is always a personal decision. I try not to, but I will listen to someone with credentials and give weight to their knowledge and experience. Online randoms describing an "alternative" are not challenging authority or bypassing it: no matter how they try to frame it, they are trying on the mantle of authority itself, but with no foundation. Your assertion that "policy makers" are systematically withholding "solid information about your body" is paranoid nonsense. If you want to go study the systems of your body, all the world's medical information is publicly available. There's a reason a medical degree takes seven years or more, however: the body of knowledge is vast and interconnected. It's not withheld, it's just a much greater challenge than many of us are willing to undertake. Online forums may be a source of good advice and anecdotal suggestions, but they also give false hope to the desperate, and thereby open the window to perpetuating snake oil and quackery and delusional magical thinking. At their worst, this amounts to conducting uncontrolled medical experiments on other human beings who are only willing because they are desperate - and that's close to evil in my book.

Mz 9y ago
Your assertion that "policy makers" are systematically withholding "solid information about your body" is paranoid nonsense. I said nothing of the sort. Both of the replies to me seem to be reading in enormous amounts of bs that isn't in my remark at all. Patients being informed about their condition is not all about people promoting snake oil. For some conditions, the patients themselves are often better informed than general MDs. Only actual specialists in the condition really know more and going to a general MD with no experience in their specific condition sometimes has catastrophic (even deadly) results.
- inopinatus 9y ago
  You said everything of that sort. If that was not your intent, then perhaps in future you might say what you mean, rather than defending the vendors of false hope and perpetuating the extremely harmful myth that one can treat oneself. As in this: > patients themselves are often better informed than general MDs No, that is a gross overgeneralisation and not true of any condition. A few patients may have slightly better information in one dimension of their condition than a GP. Presuming otherwise is foolhardy arrogance that misses the profound interconnectedness and subtle complexity of body systems. And this is especially the case with endocrine and immune systems. Patients should be as informed as possible, yes, because this is always a benefit to one's treatment. Crossing the line into "I-know-better"-land is arrogance and idiocy.
  - joools 9y ago
    The problem for me is that currently the choice is between accept definitions of "authority" as it is decided for you, or "you've crossed into arrogance and idiocy." And the consequences ultimately are most severe for the patient, who has more skin in the game, literally, than the provider. I'm not talking about quack authority figures, though, either. Let's say, for example, that you, as a patient, have been reading the literature on inflammatory systems and have become convinced that some immunology PhD has a very convincing scientific case that's been made for some etiology and treatment. Why should you, as the patient, have to get the approval of a physician to go through with it? It might be a good idea to consult with people of different backgrounds, to get competing opinions, but what if the medical literature has already done that? What if you ultimately disagree? What if the experts disagree? My experience is that GPs do not always know better, because there is just too much to keep track of. Patients are the ones whose condition is most salient to them, and they're the ones who are spending the most time on it. Honestly, I think the best solution to alternative medicine is to just deregulate the whole thing, so people don't have the excuse of regulatory capture for a particular decision. When there's nothing "alternative" anymore, and everything is just alternatives, everything is medicine, just good or bad.
    - inopinatus 9y ago
      If it's a matter of degree, then here's my take on your remark. Your comment has not merely crossed the line into "I-know-better"-land, it is days into that territory, is lost without a map, is desperately looking for water and shelter, but is still having terrible trouble admitting to itself that it might have made a horrible mistake. > Let's say, for example, that you, as a patient, have been reading the literature on inflammatory systems and have become convinced that Uh-oh. > PhD has a very convincing scientific case That is the point where your physician had to stifle a giggle, I'm afraid. > Why should you, as the patient, have to get the approval of a physician to go through with it You don't. If you can perform the procedure on yourself, it's perfectly legal.
      - maxerickson 9y ago
        Did they edit their comment to say "treatment" instead of "procedure"? Because there's lots of things that fall under treatment that have pretty effective legal gatekeeping around them.
joools 9y ago
I kind of share your perspective, but to be honest, my theory about the appeal of the communities you're referencing is that people are not in control over their care, so they do what they can to achieve it. They're stripped of it by medical regulation and lack of choice over who to go to. So they're forced to go to some alternative, totally outside the system, to get any kind of traction in personal autonomy. The choice, at least in the US, is (1) traditional, science-based medicine delivered in an oppressively regulated system, full of monopolies, regulatory capture, patriarchical, patronizing attitudes, and restrictions on how you care for yourself, or (2) untested, unscientific, but free approaches to care where you are the active driver. This is a bit of an oversimplification, but not much. It's absolutely no surprise to me that we have so many problems with lack of engagement in preventative self-care when the entire system revolves around deference to authority. Your question "should you trust an authority?" is a bit misguided, because in the end, if you say no, what choices do you have? Expertise in the medical system is based on hoop-jumping and guilds as much as actual rigor of argument and expertise.
tomhoward 9y ago
> "Do you know what they call 'alternative medicine' that's been proved to work? Medicine." - Tim Minchin, Storm, 2008 I've been a big fan of Tim Minchin's, and thanks to living in one of the cities where he built much of his early fame, I've seen and enjoyed much of his work. But I feel like a form of Godwin's Law should apply to this quote. It's been done to death, it contributes nothing of value to the discussions in which it is cited, it minimises and trivialises the horrible predicament of people (like myself) who experience illnesses that mainstream medicine can't/won't recognise or treat, and serves only to promote a sense of smugness among people who think they have mainstream medical science on their side. The point that people sharing this quote don't understand is this: For mainstream medical science to 'prove' something to work, it requires huge commercial and/or political incentives to do the research. If a pharmaceutical company or research institution can't reasonably expect a study to result in the development of a drug that can yield hundreds of millions or billions of dollars, it doesn't get done. That leads to a vast gap between what has been "proved to work" and what can actually work for people who take matters into their own hands, as I've done very successfully. It's notable that all the comments here seeking to refute Mz's comment are doing so by exaggerating or outright misquoting what she said.
- inopinatus 9y ago
  On the contrary, I shared this quote having full knowledge of the cost and complexity and political barriers, having both studied the industry academically and being personally close to medical practitioners engaged in the research and implementation of new treatments. I think all suggestion of "alternative remedies" is dangerous, since it opens the door to those preying on desperation to sell false hope. I have an active dislike of the phrase, because it fails to capture just how harmful they can be, and how rarely they are actual remedies. "Unproven interventions" might be a better name. More precisely, they also serve to mask those treatments deserving of more research that might actually have some potential, because such signal is lost in the torrential noise of snake oil and quackery. I join your criticism of the externalities in the US market-led system that incentivise research into drugs of symptomatic relief rather than cures. Nevertheless I believe that is a short-term systemic malfunction, and in any event is not a severe problem elsewhere where drug pricing is regulated. Large amounts of money and time are routinely allocated around the world for fundamental research into many difficult and poorly understood conditions. Pointing out that medicine can't treat everything is fine, because if it could we wouldn't need more research. But claiming the research doesn't get done, that's simply untrue.
dang 9y ago
We detached this subthread from https://news.ycombinator.com/item?id=14896531 https://news.ycombinator.com/item?id=14896531 and marked it off-topic.

Mz 9y ago

Your assertion that "policy makers" are systematically withholding "solid information about your body" is paranoid nonsense. I said nothing of the sort. Both of the replies to me seem to be reading in enormous amounts of bs that isn't in my remark at all. Patients being informed about their condition is not all about people promoting snake oil. For some conditions, the patients themselves are often better informed than general MDs. Only actual specialists in the condition really know more and going to a general MD with no experience in their specific condition sometimes has catastrophic (even deadly) results.

inopinatus 9y ago
You said everything of that sort. If that was not your intent, then perhaps in future you might say what you mean, rather than defending the vendors of false hope and perpetuating the extremely harmful myth that one can treat oneself. As in this: > patients themselves are often better informed than general MDs No, that is a gross overgeneralisation and not true of any condition. A few patients may have slightly better information in one dimension of their condition than a GP. Presuming otherwise is foolhardy arrogance that misses the profound interconnectedness and subtle complexity of body systems. And this is especially the case with endocrine and immune systems. Patients should be as informed as possible, yes, because this is always a benefit to one's treatment. Crossing the line into "I-know-better"-land is arrogance and idiocy.
- joools 9y ago
  The problem for me is that currently the choice is between accept definitions of "authority" as it is decided for you, or "you've crossed into arrogance and idiocy." And the consequences ultimately are most severe for the patient, who has more skin in the game, literally, than the provider. I'm not talking about quack authority figures, though, either. Let's say, for example, that you, as a patient, have been reading the literature on inflammatory systems and have become convinced that some immunology PhD has a very convincing scientific case that's been made for some etiology and treatment. Why should you, as the patient, have to get the approval of a physician to go through with it? It might be a good idea to consult with people of different backgrounds, to get competing opinions, but what if the medical literature has already done that? What if you ultimately disagree? What if the experts disagree? My experience is that GPs do not always know better, because there is just too much to keep track of. Patients are the ones whose condition is most salient to them, and they're the ones who are spending the most time on it. Honestly, I think the best solution to alternative medicine is to just deregulate the whole thing, so people don't have the excuse of regulatory capture for a particular decision. When there's nothing "alternative" anymore, and everything is just alternatives, everything is medicine, just good or bad.
  - inopinatus 9y ago
    If it's a matter of degree, then here's my take on your remark. Your comment has not merely crossed the line into "I-know-better"-land, it is days into that territory, is lost without a map, is desperately looking for water and shelter, but is still having terrible trouble admitting to itself that it might have made a horrible mistake. > Let's say, for example, that you, as a patient, have been reading the literature on inflammatory systems and have become convinced that Uh-oh. > PhD has a very convincing scientific case That is the point where your physician had to stifle a giggle, I'm afraid. > Why should you, as the patient, have to get the approval of a physician to go through with it You don't. If you can perform the procedure on yourself, it's perfectly legal.
    - maxerickson 9y ago
      Did they edit their comment to say "treatment" instead of "procedure"? Because there's lots of things that fall under treatment that have pretty effective legal gatekeeping around them.

joools 9y ago

I kind of share your perspective, but to be honest, my theory about the appeal of the communities you're referencing is that people are not in control over their care, so they do what they can to achieve it. They're stripped of it by medical regulation and lack of choice over who to go to. So they're forced to go to some alternative, totally outside the system, to get any kind of traction in personal autonomy. The choice, at least in the US, is (1) traditional, science-based medicine delivered in an oppressively regulated system, full of monopolies, regulatory capture, patriarchical, patronizing attitudes, and restrictions on how you care for yourself, or (2) untested, unscientific, but free approaches to care where you are the active driver. This is a bit of an oversimplification, but not much. It's absolutely no surprise to me that we have so many problems with lack of engagement in preventative self-care when the entire system revolves around deference to authority. Your question "should you trust an authority?" is a bit misguided, because in the end, if you say no, what choices do you have? Expertise in the medical system is based on hoop-jumping and guilds as much as actual rigor of argument and expertise.

tomhoward 9y ago

> "Do you know what they call 'alternative medicine' that's been proved to work? Medicine." - Tim Minchin, Storm, 2008 I've been a big fan of Tim Minchin's, and thanks to living in one of the cities where he built much of his early fame, I've seen and enjoyed much of his work. But I feel like a form of Godwin's Law should apply to this quote. It's been done to death, it contributes nothing of value to the discussions in which it is cited, it minimises and trivialises the horrible predicament of people (like myself) who experience illnesses that mainstream medicine can't/won't recognise or treat, and serves only to promote a sense of smugness among people who think they have mainstream medical science on their side. The point that people sharing this quote don't understand is this: For mainstream medical science to 'prove' something to work, it requires huge commercial and/or political incentives to do the research. If a pharmaceutical company or research institution can't reasonably expect a study to result in the development of a drug that can yield hundreds of millions or billions of dollars, it doesn't get done. That leads to a vast gap between what has been "proved to work" and what can actually work for people who take matters into their own hands, as I've done very successfully. It's notable that all the comments here seeking to refute Mz's comment are doing so by exaggerating or outright misquoting what she said.

inopinatus 9y ago
On the contrary, I shared this quote having full knowledge of the cost and complexity and political barriers, having both studied the industry academically and being personally close to medical practitioners engaged in the research and implementation of new treatments. I think all suggestion of "alternative remedies" is dangerous, since it opens the door to those preying on desperation to sell false hope. I have an active dislike of the phrase, because it fails to capture just how harmful they can be, and how rarely they are actual remedies. "Unproven interventions" might be a better name. More precisely, they also serve to mask those treatments deserving of more research that might actually have some potential, because such signal is lost in the torrential noise of snake oil and quackery. I join your criticism of the externalities in the US market-led system that incentivise research into drugs of symptomatic relief rather than cures. Nevertheless I believe that is a short-term systemic malfunction, and in any event is not a severe problem elsewhere where drug pricing is regulated. Large amounts of money and time are routinely allocated around the world for fundamental research into many difficult and poorly understood conditions. Pointing out that medicine can't treat everything is fine, because if it could we wouldn't need more research. But claiming the research doesn't get done, that's simply untrue.

dang 9y ago

We detached this subthread from https://news.ycombinator.com/item?id=14896531 https://news.ycombinator.com/item?id=14896531 and marked it off-topic.