It's not actually an argument against "duh" RCTs. It's an argument against clinical medicine being fixated on RCTs as the one-and-only form of evidence that ca

It's not actually an argument against "duh" RCTs. It's an argument against clinical medicine being fixated on RCTs as the one-and-only form of evidence that can be taken seriously, even when - as you note - the Bayesian prior for such a situation is extremely high. This happens more often in the field than many people might think.