4 ms·

> If they valued and were capable of reasoning about the science, they would not be “proponents” — they'd recognize the current scientific understanding (no kno

> If they valued and were capable of reasoning about the science, they would not be “proponents” — they'd recognize the current scientific understanding (no known mechanism or benefits, significant side-effects) and wait for a solid study before recommending anything. The the standard of "we should not perform treatments with known side effects if there is no solid study proving the mechanism and benefits of that intervention" is unreasonably strict. Proning (laying the patient on their stomach appears to improve oxygenation and improve outcomes) was suspected to be helpful by May of 2020. However, even by December of 2020 there were not any large randomized controlled trials proving this. Proning has risks (like "unplanned extubation" i.e. the breathing tube coming out when it shouldn't). Should we have foregone that treatment because there was no proof of either efficacy or mechanism, and there were significant risks associated with the treatment? I personally don't think ivermectin is terribly likely to be effective, but the more general statement of "nobody who is capable of reasoning about science would be a proponent of an unproven treatment that has risks" is wrong.

acdha 5y ago
That's exactly the kind of reason why I included “no known method”: proning was not a previously unknown concept, it clearly changes a known problem, and the risks are manageable. Remdesivir and other antivirals were similarly reasonable to try since they had a plausible method of being effective, as did the steroid treatments which have been so useful for controlling inflammation. Now, nobody is saying that we can't _try_ new things but note also that I was referring to “proponents” — not just people who are willing to try something but who are actively advocating it as an effective treatment. The vast, vast majority of those people are not running experiments or even medical professionals who might possibly have some relevant prior experience suggesting it was worth trying. I'm not opposed to research but I think there's a substantial ethical line to cross when you switch from being open to the possibility of something working to running around telling everyone that it works so well they should avoid a safe, cheap, and highly effective vaccine.

acdha 5y ago

That's exactly the kind of reason why I included “no known method”: proning was not a previously unknown concept, it clearly changes a known problem, and the risks are manageable. Remdesivir and other antivirals were similarly reasonable to try since they had a plausible method of being effective, as did the steroid treatments which have been so useful for controlling inflammation. Now, nobody is saying that we can't _try_ new things but note also that I was referring to “proponents” — not just people who are willing to try something but who are actively advocating it as an effective treatment. The vast, vast majority of those people are not running experiments or even medical professionals who might possibly have some relevant prior experience suggesting it was worth trying. I'm not opposed to research but I think there's a substantial ethical line to cross when you switch from being open to the possibility of something working to running around telling everyone that it works so well they should avoid a safe, cheap, and highly effective vaccine.