This was a response to an argument, often voiced on this listserv, criticizing medical profession by citing examples of its asinine behavior.
>Not in any systematic way, no, if you look at its historical development.
That raises an interesting point: did medicine caused scientific research or the other way around, scientific research gave birth to medicine. You seem to argue against the former, and I tend to agree. Vested occupational interests often oppose scientific and technological progress, which they perceive as threat. Again, doctors are not an exception - the only question is whether they are more resistant to progress than other occupational groups. I personally do not think so, but can be swayed by relevant evidence.
I also tend to think that modern medicine was created by modern science, not the other way around. In other words, if it were not for progress in empirical research, our medicine would still be nothing more than sorcery. Doctors took adavantage of modern science to vasatly improve their professional commodity - and that improvemenet gave them a significant competitive advantage against quacks and healers.
However, the practice of medicine is still fraught with a great deal of bounded rationality and information asymmetry - and that creates a fertile grounds for social rituals designed to symbolically overcome this knowledge gap. It is those rituals that seem to irk the detractors of the medical profession so much.
>I'm confused here. Are you talking about "western medicine" as it
actually is,
>as an actually existing social reality, or as some sort of Platonic form,
See my comments above. Modern medicine depends to a significant degree on empirical science, but cannot get away from bounded rationality and social rituals it generates. So even if a doctor had perfect "platonic" knowledge, she would still depend on social rituals to implement that knowledge in practice for the simple reason that her patients do not know what she does. Thus, the concept of platonic medicine is self-contradictory.
What I was aiming at was the economics of medical practice rather than its scientific foundations. Social problems can be treated by alternative treatments, each one equally effective but having different externalities. I can prescribe drugs to sick people or I can improve living conditions, behavior, or diet to prevent people from becoming sick. However, it is the social and economic externalities of each treatment that play role in my decision making. If I think of a long-term health of my nation, I am unwilling or unable to commit much resources to health care, and I can afford to write-off people currently infected - I will certainly opt for prevention over treatment. If, on the other hand, I am focused on short-term goals, have sufficient resources on my disposal, and I am on friendly terms with doctors who stand to economically benefit from their professional practice - then treatment is my choice.
>Furthermore, the overprescription of antibiotics and creation of superbugs
is a
>scientific failing as much as a social one. The decision to prescribe common
>antibiotics for minor ailments is based on epidemiological and bateriological
>science, and if it turns out to create superbugs, then that's a failure of
the
>science which said it wouldn't. The idea that "western science" has
warned for
>years that superbugs were a danger just doesn't fit the facts.
>
Hindsight knowledge does not negate rationality of decision makers. If a medieval astronomer constructed a calendar based on the "movement of the sun" he did not act irrationally simply because from the hindsight we know that his assumption was incorrect. Ditto for antibiotics.
Another point - antibiotics did not create more resistant bugs. Rather, bugs evolutionally adapted to a new environemnt characterised by use of antibiotics. So blaming antibiotics for bugs is based on a false logic - it is like blaming better locks for more spohisticated crooks.
>The perfectly sensible case you're trying to make here is not helped by
>attacking positions that nobody actually holds.
So why are we contantly inundated by anecdotes how horrible doctors are and how sexy the alternative crowd is.
>I'm saving this for any future discussion of linguistics and literary
theory as
>an example of a sentence with three different types of scare-quote.
You can safely ignore the quotes. They were added merely to signify that concepts in questions often serve as mythologies for some folks.
wojtek