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The Argument for Medical Nihilism

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Suppose you have just been diagnosed with a rare illness. You go to your doctor and they put you through a series of tests. In the end, they recommend that you take a new drug — wonderzene — that has recently been approved by the FDA following several successful trials. How confident should you be that this drug will improve your condition?You might think that this question cannot be answered in the abstract. It has to be assessed on a case by case basis. What is the survival rate for your particular illness? What is its underlying pathophysiology? What does the drug do? How successful were these trials? And in many ways you would be right. Your confidence in the success of the treatment does depend on the empirical facts. But that’s not all it depends on. It also depends on assumptions that medical scientists make about the nature of your illness and on the institutional framework in which the scientific evidence concerning the illness and its treatment is produced, interpreted and communicated to patients like you. When you think about these other aspects of the medical scientific process, it might be the case that you should very sceptical about the prospects of your treatment being a success. This could be true irrespective of the exact nature of the drug in question and the evidence concerning its effectiveness.That is the gist of the argument put forward by Jacob Stegenga in his provocative book Medical Nihilism. The book argues for an extreme form of scepticism about the effectiveness of medical interventions, specifically pharmaceutical interventions (although Stegenga intends his thesis to have broader significance). The book is a real tour-de-force in applied philosophy, examining in detail the methods and practices of modern medical science and highlighting their many flaws. It is eye-opening and disheartening, though not particularly surprising to anyone who has been paying attention to the major scandals in scientific research for the past 20 years.I. . .

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News source: Philosophical Disquisitions

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