We are developing the social individualist meta-context for the future. From the very serious to the extremely frivolous... lets see what is on the mind of the Samizdata people.

Samizdata, derived from Samizdat /n. - a system of clandestine publication of banned literature in the USSR [Russ.,= self-publishing house]

Let the medical heretics speak. You don’t have to believe them, but let them speak.

Most people prefer experts, of course, especially when it comes to health care. As a surgeon myself, I can hardly object to that tendency. But a problem arises when some of those experts exert outsized influence over the opinions of other experts and thereby establish an orthodoxy enforced by a priesthood. If anyone, expert or otherwise, questions the orthodoxy, they commit heresy. The result is groupthink, which undermines the scientific process.

From Against Scientific Gatekeeping, an excellent, measured essay for Reason magazine by Jeffrey A. Singer. He draws on his own experience of changes in medical best practice during his career as a surgeon and also on the lessons of history:

The “germ theory” anticipated by Semmelweis did not take hold until the late 1880s. That helps explain why, in 1854, the public health establishment rebuffed the physician John Snow after he traced a London cholera epidemic to a water pump on Broad Street. Snow correctly suspected that water from the pump carried a pathogen that caused cholera.

Public health officials clung instead to the theory that the disease was carried by a miasma, or “bad air.” The British medical journal The Lancet published a brutal critique of Snow’s theory, and the General Board of Health determined that his idea was “scientifically unsound.” But after another outbreak of cholera in 1866, the public health establishment acknowledged the truth of Snow’s explanation. The incident validated the 19th century classical liberal philosopher Herbert Spencer’s warning that the public health establishment had come to represent entrenched political interests, distorting science and prolonging the cholera problem. “There is an evident inclination on the part of the medical profession to get itself organized after the fashion of the clericy,” he wrote in 1851’s Social Statics. “Surgeons and physicians are vigorously striving to erect a medical establishment akin to our religious one. Little do the public at large know how actively professional publications are agitating for state-appointed overseers of the public health.”

They got their wish.

15 comments to Let the medical heretics speak. You don’t have to believe them, but let them speak.

  • Saxinis Kion

    …Herbert Spencer’s warning that the public health establishment had come to represent entrenched political interests, distorting science…

    Sounds very much like the US Public Health environment I left last year after 17 years (Controller/CFO of PH NFP). I stayed as long as I did because they were financial and business illiterates. But Covid and CRT really lit the fire for me to move industry.

    Not a Rooskie bot.

  • Lee Moore

    Aaaaand, one more time :

    “Science is the belief in the ignorance of experts.” – Feynman

  • Revelation

    Let the heretics speak?

    OK. There is a distinct difference in IQ between races.

    That one normally gets the Banhammer.

  • Stephen J.

    The British medical journal The Lancet published a brutal critique of Snow’s theory, and the General Board of Health determined that his idea was “scientifically unsound.”

    They really were saying, “You know nothing, John Snow!”

  • Let the heretics speak?

    OK. There is a distinct difference in IQ between races.

    That one normally gets the Banhammer.

    Sure, but the problem with that debate is it does not mean what people think. Sadly, it is impossible to discuss IQ & race rationally on the internet (the very notion of IQ itself is wildly misunderstood & highly contentious). I know such discussions are possible in theory, and they should be, but they aren’t. If I have learned anything from 20 years of this blog, it can’t be done (gawd knows how many times it has been tried here).

  • Snorri Godhi

    I went there just to see whether peptic ulcers are discussed. Glad to see that they are; not because it’s an issue that affects me, but because it was a major issue within living memory, a time when medicine is supposed to have become scientific.

  • NickM

    IQ… Well, I had a gf at university who was a maths ace. She didn’t even manage a third in her physics degree. I’m marriaed to a professional translator who picks up languages (inc. “weird” stuff like Turkish and Maltese) whilst I’m stuck with very basic French and German but she can’t get maths much beyond arithmetic. These are just two examples I can think of many more…

    So, what does IQ mean? I would suggest it is utterly meaningless or at best an abstraction not disimilar to the idea of stats in RPGs like D&D where the stat “Dexterity” governs both the gymnastic abilities of an Elven archer and the craft skills of a Dwarven smith. Utter codswallop.

    Stephen J, You swine! You got in there before me! The Walk of Shame beckons 😉

  • Stephen J.

    Sorry, dude! Just happened to be rewatching Season 2 of GoT, so it came naturally to mind.

  • Fraser Orr

    I think it is important to put forward a contrary opinion. Science is brutal because it needs to be. For every Semmelweis and Snow, there a hundred Pons & Fleischmanns, or Duesbergs. Science is very hard, and getting good reliable results is very hard. And so it is necessary to be hyper skeptical, and brutally critical. And medical science? Probably the hardest of all because testing on people is VERY expensive, risk averse, and, because humans live so damn long, takes a long time to get great results.

    I’m not saying that I think the present science establishment is good. It has been utterly poisoned by the interference of government, and the biggest mistake we make is thinking that something like the FDA or the CDC are science establishments, when they are in fact government institutions. It might be populated by people with science degrees, but they are still civil servants before being scientists. (especially the higher up the greasy pole they climb.) And unfortunately the universities have also been largely sucked into the poisonous stream of government funding.

    However, outside of government science, the truth will out. Marshall and Warren, the discoverers of Helicobacter Pylori ended up with a Nobel Prize, and although Semmelweis might have died in madness, his legacy lives on in hospital scrub rooms today.

  • rhoda klapp

    Is public health medicine? Its greatest advances have been in the field of cleanliness. No doctor required. Is epidemiology medicine? No. The problem with medicine in the recent/current epidemic has been its failure to do its own job while interfering with others doing theirs. And the major part of that failure is doing nothing on a positive test but waiting for serious illness before action of any kind. It doesn’t matter which of the couple of dozen mooted early treatments they didn’t use which might have worked, the doctors, the medical establishment if you like, not only didn’t do anything, as a policy, but they acted to suppress any of their own who did. For reasons which were never explained.

  • Wigner’s Friend

    “But a problem arises when some of those experts exert outsized influence over the opinions of other experts and thereby establish an orthodoxy enforced by a priesthood. If anyone, expert or otherwise, questions the orthodoxy, they commit heresy. The result is groupthink, which undermines the scientific process.”

    About medical matters but much the same can be said about the climate and AGM (or whatever it is called today) experts.

  • JohnK

    Wigner:

    As always, follow the money.

  • Paul Marks

    Not “only” medical doctors but distinguished medical academics from many old universities (from Harvard, Yale, Princeton, Stamford, and leading British universities as well) were very critical of the lockdown policy, and were very critical of the systematic smearing of Early Treatment of Covid 19.

    The excuse for censorship used to be “lack of qualification” – that people without the “proper credentials” do not have the right to speak on a subject, but this soon collapsed into ANY dissenter being censored and-or smeared.

    And it is not limited to Covid – many other subjects, such as the DIE (Diversity, Inclusion and Equity) Agenda, and the theory that C02 emissions are a threat to the world, now have only one “correct” point of view – with dissent persecuted.

    Why are moving to an anti Freedom of Speech position – an anti Freedom of Speech (Freedom of Conscience) culture.

  • If anyone, expert or otherwise, questions the orthodoxy, they commit heresy. The result is groupthink, which undermines the scientific process.

    I agree so much that I sort-of object to the insufficient word ‘undermines’. 🙂 It simply is the reverse of the scientific process. The fact that dissenters were able to challenge it is the reason we trust (only) such science as survived that process – and of course do not and should not trust it so much as to ban the expression of dissent from it today.