9 ms·

As ridiculous as these medical treatments sound to the modern ear, I wonder how people will look back on our "state of the art" 200 years from now.

andrewflnr 8y ago
Between the emergence of resistant bacterial strains and growing understanding of internal microbiomes, the future will not look kindly on our use of antibiotics. And of course, you don't need to go into the future to find people who look dimly on the state of the art in nutrition.
- refurb 8y ago
  Won’t look too kindly? The alternative to antibiotics in a lot of these cases is death. Not sure anyone would look at that “unkindly”.
  - Ensorceled 8y ago
    I believe the parent was thinking of our using antibiotics for things like increasing growth rates in livestock, hand soap marketing, and viral infections; but maybe your incredibly uncharitable interpretation is correct ...
  - andrewflnr 8y ago
    Sure, those specific cases are justified. A lot of others aren't. I guess in the context of blood-letting it wasn't clear I meant they would look unkindly on our policy as a whole, rather than on using them at all.
- Mediterraneo10 8y ago
  While overprescription of antibiotics to human patients has been a problem, I think that the antibiotics usage that the future will really look back on unkindly is the massive use of antibiotics in the livestock industry. Wastewater from that is a major contribution to bacterial resistance.
  - wwweston 8y ago
    You don't even have to go into the future to find unkind looks here. Operators making the decision to use ABX the way they're used in livestock are morally guilty of negligent homicide whether or not it meets a legal standard. It's unconscionable at this point to treat them as just another industrial input.
    - Filligree 8y ago
      A family friend, who's a farmer, made the decision not to use antibiotics in feed. He then went bankrupt. He claims that was why. Whether or not it is, in his specific case, this is a coordination problem. Using antibiotics this way has to be outlawed, because any farmer who unilaterally chooses not to use it is leaving money on the table. In an efficient market, that leads to bankruptcy.
- philwelch 8y ago
  > the future will not look kindly on our use of antibiotics It's entirely likely that we use too many antibiotics, but antibiotics have also saved all of us from unbelievable levels of pain and suffering. I had an ear infection once, and the pain was unbearable. I went to the doctor, who quipped, "if we leave it alone, eventually it'll just burst the eardrum and drain out." And then she prescribed me some antibiotics. And that's not even the worst situation that calls for antibiotics. It's not like my life was in danger.
melling 8y ago
200 years? How about in 50 years? Heart attacks and cancers will be detected early and easily treatable. The idea of chemotherapy will seem barbaric.
- williamdclt 8y ago
  To be fair chemotherapy does sound barbaric already today, but it's one of the few things we know that kind of works
  - tcj_phx 8y ago
    Otto Warburg figured out a lot about cancer. Unfortunately he was a jew in Nazi Germany, and his insights were mostly forgotten when the “bad genes” theory of cancer took hold of the medical profession. There was a semi-recent NY Times article about the resurgence of Warburg’s metabolic theory of cancer. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4493566/#!po=5.91398 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4493566/#!po=5.... > but it's one of the few things we know that kind of works Chemotherapy as a treatment for cancer is one of many pseudo-scientific medical practices commonly used by conventional medical practitioners. Edit: link to NY Times article on Warburg: https://www.nytimes.com/2016/05/15/magazine/warburg-effect-an-old-idea-revived-starve-cancer-to-death.html https://www.nytimes.com/2016/05/15/magazine/warburg-effect-a...
- bonzini 8y ago
  Chemotherapy sucks, but it works and is scientifically sound.
  - codr4 8y ago
    Works short term but wrecks your immune system long term, which means you will get sick from something else and no one can be blamed. Have you actually seen someone on chemo? Scientifically sound is not the first thing that comes into my mind. There's even a decent amount of objective research out there these days showing exactly this so there are really no excuses for clinging to these delusions any more.
all_blue_chucks 8y ago
In 20 years time it will seem barbaric that doctors used to treat us without even looking at our DNA.
- dan-robertson 8y ago
  That’s a bit like saying it’s barbaric that in the 18th century doctors never ever sent blood off to be tested (or looked at under a microscope). We can’t really expect doctors to do things that aren’t really very possible (yes dna sequencing is somewhat possible today but the results aren’t necessarily very useful and far too little is known about the interaction of different genes with each other and medicine for it to be useful)
  - philipov 8y ago
    I am sure that's exactly the point the GP is making.
simonh 8y ago
At least we know our established treatments generally do actually improve outcomes rather than worsen them. Establishing that as a criteria for adopting a new treatment was a real step forward.
- TheOtherHobbes 8y ago
  Generally, sometimes. Medical research consistently has issues with independence and reproducibility. One example of many: https://www.bmj.com/content/360/bmj.k1073 https://www.bmj.com/content/360/bmj.k1073 It's not that the principle of peer review is wrong, it's just very hard to apply it fairly and objectively when money - huge sums of money - are involved.
- Dove 8y ago
  I don't think that's really true. https://www.theatlantic.com/health/archive/2017/02/when-evidence-says-no-but-doctors-say-yes/517368/ https://www.theatlantic.com/health/archive/2017/02/when-evid...
  - simonh 8y ago
    You do not think that established medical treatments generally improve outcomes? What do you do if you think you have a medical problem? Where do you go for help? Obviously there are mistakes made and some unnecessary or counterproductive treatments are given in some cases. We’re talking about a massive endeavour involving millions of practitioners across the world. But claiming that in general this activity is not beneficial seems a big claim to make based on a single article on an issue with seemingly specific scope.
    - nickodell 8y ago
      >You do not think that established medical treatments generally improve outcomes? That's not what the linked article claims. The linked article claims that there are specific procedures that do not help in specific situations, yet these procedures continue to be done in those situations. This is totally compatible with the claim that medical care improves outcomes on average.
wallflower 8y ago
> McCoy: What’s the matter with you? > Patient: Kidney... dialysis. > McCoy: Dialysis?! What is this? The Dark Ages? Here! You swallow that and if you have any more problems, just call me!
- KSteffensen 8y ago
  Star Trek had just the right amount of childish optimism to work well as critique of the current state of affairs.

andrewflnr 8y ago

Between the emergence of resistant bacterial strains and growing understanding of internal microbiomes, the future will not look kindly on our use of antibiotics. And of course, you don't need to go into the future to find people who look dimly on the state of the art in nutrition.

refurb 8y ago
Won’t look too kindly? The alternative to antibiotics in a lot of these cases is death. Not sure anyone would look at that “unkindly”.
- Ensorceled 8y ago
  I believe the parent was thinking of our using antibiotics for things like increasing growth rates in livestock, hand soap marketing, and viral infections; but maybe your incredibly uncharitable interpretation is correct ...
- andrewflnr 8y ago
  Sure, those specific cases are justified. A lot of others aren't. I guess in the context of blood-letting it wasn't clear I meant they would look unkindly on our policy as a whole, rather than on using them at all.
Mediterraneo10 8y ago
While overprescription of antibiotics to human patients has been a problem, I think that the antibiotics usage that the future will really look back on unkindly is the massive use of antibiotics in the livestock industry. Wastewater from that is a major contribution to bacterial resistance.
- wwweston 8y ago
  You don't even have to go into the future to find unkind looks here. Operators making the decision to use ABX the way they're used in livestock are morally guilty of negligent homicide whether or not it meets a legal standard. It's unconscionable at this point to treat them as just another industrial input.
  - Filligree 8y ago
    A family friend, who's a farmer, made the decision not to use antibiotics in feed. He then went bankrupt. He claims that was why. Whether or not it is, in his specific case, this is a coordination problem. Using antibiotics this way has to be outlawed, because any farmer who unilaterally chooses not to use it is leaving money on the table. In an efficient market, that leads to bankruptcy.
philwelch 8y ago
> the future will not look kindly on our use of antibiotics It's entirely likely that we use too many antibiotics, but antibiotics have also saved all of us from unbelievable levels of pain and suffering. I had an ear infection once, and the pain was unbearable. I went to the doctor, who quipped, "if we leave it alone, eventually it'll just burst the eardrum and drain out." And then she prescribed me some antibiotics. And that's not even the worst situation that calls for antibiotics. It's not like my life was in danger.

melling 8y ago

200 years? How about in 50 years? Heart attacks and cancers will be detected early and easily treatable. The idea of chemotherapy will seem barbaric.

williamdclt 8y ago
To be fair chemotherapy does sound barbaric already today, but it's one of the few things we know that kind of works
- tcj_phx 8y ago
  Otto Warburg figured out a lot about cancer. Unfortunately he was a jew in Nazi Germany, and his insights were mostly forgotten when the “bad genes” theory of cancer took hold of the medical profession. There was a semi-recent NY Times article about the resurgence of Warburg’s metabolic theory of cancer. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4493566/#!po=5.91398 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4493566/#!po=5.... > but it's one of the few things we know that kind of works Chemotherapy as a treatment for cancer is one of many pseudo-scientific medical practices commonly used by conventional medical practitioners. Edit: link to NY Times article on Warburg: https://www.nytimes.com/2016/05/15/magazine/warburg-effect-an-old-idea-revived-starve-cancer-to-death.html https://www.nytimes.com/2016/05/15/magazine/warburg-effect-a...
bonzini 8y ago
Chemotherapy sucks, but it works and is scientifically sound.
- codr4 8y ago
  Works short term but wrecks your immune system long term, which means you will get sick from something else and no one can be blamed. Have you actually seen someone on chemo? Scientifically sound is not the first thing that comes into my mind. There's even a decent amount of objective research out there these days showing exactly this so there are really no excuses for clinging to these delusions any more.

all_blue_chucks 8y ago

In 20 years time it will seem barbaric that doctors used to treat us without even looking at our DNA.

dan-robertson 8y ago
That’s a bit like saying it’s barbaric that in the 18th century doctors never ever sent blood off to be tested (or looked at under a microscope). We can’t really expect doctors to do things that aren’t really very possible (yes dna sequencing is somewhat possible today but the results aren’t necessarily very useful and far too little is known about the interaction of different genes with each other and medicine for it to be useful)
- philipov 8y ago
  I am sure that's exactly the point the GP is making.

simonh 8y ago

At least we know our established treatments generally do actually improve outcomes rather than worsen them. Establishing that as a criteria for adopting a new treatment was a real step forward.

TheOtherHobbes 8y ago
Generally, sometimes. Medical research consistently has issues with independence and reproducibility. One example of many: https://www.bmj.com/content/360/bmj.k1073 https://www.bmj.com/content/360/bmj.k1073 It's not that the principle of peer review is wrong, it's just very hard to apply it fairly and objectively when money - huge sums of money - are involved.
Dove 8y ago
I don't think that's really true. https://www.theatlantic.com/health/archive/2017/02/when-evidence-says-no-but-doctors-say-yes/517368/ https://www.theatlantic.com/health/archive/2017/02/when-evid...
- simonh 8y ago
  You do not think that established medical treatments generally improve outcomes? What do you do if you think you have a medical problem? Where do you go for help? Obviously there are mistakes made and some unnecessary or counterproductive treatments are given in some cases. We’re talking about a massive endeavour involving millions of practitioners across the world. But claiming that in general this activity is not beneficial seems a big claim to make based on a single article on an issue with seemingly specific scope.
  - nickodell 8y ago
    >You do not think that established medical treatments generally improve outcomes? That's not what the linked article claims. The linked article claims that there are specific procedures that do not help in specific situations, yet these procedures continue to be done in those situations. This is totally compatible with the claim that medical care improves outcomes on average.

wallflower 8y ago

> McCoy: What’s the matter with you? > Patient: Kidney... dialysis. > McCoy: Dialysis?! What is this? The Dark Ages? Here! You swallow that and if you have any more problems, just call me!

KSteffensen 8y ago
Star Trek had just the right amount of childish optimism to work well as critique of the current state of affairs.