In the first paragraph he says:
Repair of the physical body is erroneously equated with healing. Never mind whether it is capable of true healing; it doesn’t even understand the meaning of the concept.
Well, mending a broken leg, easing an arthritic shoulder or freeing the urinary tract of a painful bacterial infection may not be “true healing” in Malerba’s mind but to my mind having these ailments treated by ‘materialistic Western’ doctors is far better than continuing to suffer them.
It is a closed belief system that does not allow innovation or new ideas.
In fact the whole history of evidence based medicine (EBM) is one of innovation and new ideas, else doctors would still be treating their patients with leeches, purgings and bloodletting.
Medical science takes a materialistic stand in opposition to the non-physical; it is predicated upon a denial of the relevance of spirit. The irony here is that the church of medicine assumes the authority and function of a religious system but refuses to account for the role that the spiritual dimension plays in human health.
It would appear that it is Malerba who is taking a religious viewpoint here and his accusation of materialism is saying that ‘Western’ medicine is antireligious.
Like any good faith, the church of medicine stands on the authority of its sacred texts. The randomized double-blinded placebo-controlled trial is the gold standard that assures the purity of church doctrine.
There are good reasons why modern medicine insists on randomised, double-blinded controlled trials. The first is that the human mind can have an effect on symptoms – particularly pain. The simple fact of receiving attention and medication – even if it is a useless sugar-pill – can result in symtoms easing. Hence the need for a control arm; some patients receive the medication being tested and some receive a placebo and the difference in performance between the two arms of the trial is that due to the medication under test. Incidently, placebos are used only when there is no current treatment. The usual practice is to use the best currently available treatment as a control.
Hence we see that medical trials take account of the effect of the mind on the body and hence are not the mechanistic affairs that Malerba claims.
All of us humans can fool ourselves and see what we want to see. Hence in medical trials, the people administering the medication do not know which patients are receiving the medication under test and which the control to eliminate concious or unconcious bias. Hence bouble-blinded. The researchers do not get to choose which patients go into which arm – unscrupulous researchers might be tempted to put those most likely to recover in the test arm and those least likely in the control arm to make the medication seem better than it really is. Instead, patients are assigned randomly by computer. Hence randomised.
This is why randomised double-blinded controlled trials are held up as the gold standard. Quite right too, I would not want Big Pharma or anyone using treatments that have not been subject to rigorous testing.
As with many effective religious systems, ritual and symbol are often employed to inspire belief and reinforce the faith of congregants. The medical church has its white coats, green scrubs, and stethoscopes, those ubiquitous symbols of the medical priesthood. And we mustn’t forget the ritual washing of hands to ward off evil germs in spite of what basic science teaches us, which is that excessively antiseptic practices contribute to the development of microbial mutations, which in turn lead to increasing resistance to antimicrobial drugs. Such practices don’t strike me as very rational — or scientific.
All I can say about the “ubiquitous symbols of the medical priesthood” is that many alt.med types, particularly homeopaths, are fond of imitating them. And is he seriously suggesting that surgeons should cease washing their hands before operating? It has been known since Joseph Lister’s time that dirty handed surgeons transferred infections between patients.
Lister also noticed that midwife-delivered babies had a lower mortality rate than surgeon-delivered babies, correctly attributing this difference to the fact that midwives tended to wash their hands more often than surgeons, and that surgeons often would go directly from one surgery, such as draining an abscess, to delivering a baby. He instructed surgeons under his responsibility to wear clean gloves and wash their hands before and after operations with 5% carbolic acid solutions. Instruments were also washed in the same solution and assistants sprayed the solution in the operating theatre. One of his additional suggestions was to stop using porous natural materials in manufacturing the handles of medical instruments
Since asepsis is based on the notion that conclusions should be tested by observation then I would say that it most certainly is scientific:
Initial Observations Mid-wife delivered babies have better survival rates than surgeon delivered babies. Mid-wives wash their hands more than do surgeons.
Hypothesis There is a causal link between hand-washing and improved mortality.
Test Make surgeons wash their hands before operating also.
Result Mortality rates of surgeon delivered babies improved
Conclusion Asepsis improves survival rates.
At this point, Lister’s conclusions were a purely empirical conclusion but Pasteur’s germ-theory of disease put them – and the practices he advocated – on a sound theoretical footing.
So much for the notion that medicine rejects new ideas and empirical results, and is unscientific. What about the allegation of ‘scientism’?
“Scientism” is a term that has been applied to Western science’s tendency to consider itself as the only valid way of describing reality and acquiring knowledge. Far from objective science, it is riddled with a self-imposed form of materialistic and mechanistic bias. When it inappropriately and clumsily attempts to impose its restricted worldview upon domains where it has no business meddling, it can no longer be considered legitimate science that is practiced with an awareness of its boundaries.
Whether or not scientific inquiry, ie testing ideas by experiment and/or observation, has limits as a tool for acquiring knowledge is a philosophical can of worms that I do not proposde to open now. It is, however, a perfectly valid means of deciding what medical treatments should be used. Certainly a damn sight better than just making shit up like Hahneman did – deciding that “like cures like” and diluting something made it stronger without a shred of evidence to support it.
If you want to see anger and resistance to criticism, incidently, go look at some of my older posts and see what homeopaths, scenar enthusiasts and xocai chocolate peddlers have to say when I have the temerity to examine their ideas and money-making schemes.