Doctors are just like military dictators

There's a number of dangers in carrying an analogy too far. One situation may be analogous to another without being identical, or they may not in fact be analogous at all. Forgetting this principle can get you into a wee bit of trouble.

To formalize it a bit, just because you think "A" resembles "B", and "B" has property "P" does not mean that "A" also has property "P". It may be that "A" is not quite enough like "B" to share all of its properties.

But a weak analogy can't stop a weak but persistent mind. Dana Ullman, Hahnemann's cognitively-impaired bulldog, has given us a fantastically weak analogy with which he tries to delegitimize all of modern medicine (to be replaced by...what? That is his second logical fallacy: if "A" is bad, that does not mean "B" is better, a sort of non sequitur in which he asserts that modern medicine is bad and therefore magic is better).

Rather than drag you through a complete fisking of the piece, I'll lay it out for you: doctors live by a military model in which arbitrarily-defined "enemies" (diseases) are blasted indiscriminately causing grave collateral damage. He goes on to explain how dissenters are quashed by being labelled as (gasp!) "unscientific".

Some of his brilliant flashes of insight include this:

Doctors may even be able to go the next step and surgically remove a symptom or an obstructive agent, but the assumption that removing a single symptom or pathological agent will create health is both simplistic and incorrect.

In other words, removing an inflamed appendix doesn't create total health and is therefore irrelevant---this one's a "Nirvana fallacy": because medicine isn't perfect, it is therefore wrong in its entirety.

When trying to argue, poor Dana Ullman finds that every paper bag is a Tholian web. It should come as no surprise that a strong advocate of a religion like homeopathy would have difficulty constructing a logical argument; the acceptance of logical arguments would lead to the rejection of his religion, and for Ullman, that is clearly unacceptable.

To clarify it for Dana, who will likely stop by and say "hi", there is no "doctatorship" in health care, at least not in the way he means it. When we discover are errors is when we are at our best. Harmful and useless practices do become accepted, but eventually the science wins out, and we reject these practices. A reader recently pointed to the Vioxx controversy, and although I'm not in complete agreement as to the relative harm of Vioxx, the example is a good one. A drug with with potentially harmful effects was dishonestly marketed, the negative data buried. For a few years, we continued to prescribe it, believing the data to support its use, but eventually the weight of data overwhelmed us, and we abandoned the drug. This is a success, not a failure.

Homeopathy is an absurd, vitalist religion whose acceptance would require us to reject most of modern science. There is no finite (or infinite) number of fallacious analogies that can change this fact.

More like this

"...a weak analogy can't stop a weak but persistent mind..."

I love that.

What you are not getting, PAL, is that there is a special homeopathic logic. You take some logic, then you divide it in half. Then you do that again. And again. And again. Until finally you have 1/1028th of a logic.

Oh wait, maybe you are supposed to start with an ill-logic...

Thanks to the homeopaths for their concern and all, but I was pretty damned happy that removing my appendix stopped my symptoms of being deranged with pain and throwing up bile. Really. Getting rid of symptoms was fine with me. Preventing the symptoms of sepsis which I'd have likely been facing at any moment was pretty nice too.

Oh what a pile of steaming BS that article excreted.

However, I'm not one to take any therapeutic device or cure without skepticism. Not now, at least.

After having lived for 15+ years with the effects and after-effects of VBG, I'm all for investigation, by scientific methods, of surgical re-arrangements of the human gut. I really am thankful I did not have surgery similar to RNY.

But... aside from human testing of a surgical procedure without proper oversight, I wonder how homeopathy is going to help my hernia. (This despite the fact that the first surgery didn't work.)

While I've plenty of personal anecdotes that "prove" western medicine does not always work and perhaps causes problems that are as bad as it was intended to solve... there's no way I think homeopathy is better.

I say this knowing that if I'd taken homeopathy cures for obesity, I might be healthier now.

Where Western medicine fails, is in its being so sure that something works without proof... and that whether it works for its intended purpose (weight loss) it does not assess the side effects (muscle loss, hair loss, weakness, inability to digest enough nutrients to sustain life, etc...)

Western medicine has some absolutely fantastic successes to sustain it -- and science is the best way. However, there is a tendency in Western medicine to overlook it's failures and to keep prescribing methods that do not live up to its ideals.

What is Western medicine verses Eastern medicine?

I thought we just had a collection of treatments with variable degrees of evidence in support of their risk-v-benefit.

Hey, unrelated, but how's the diet coming? Random supportive strangers want to know.

@titmouse

There is medicine and then there are a "set of practices which cannot be tested, refuse to be tested, or consistently fail tests" (Dawkins). I reject Eastern vs. Western medicine.

I assume that the "Western" medicine of which Dana writes includes medical systems that originated in Germany. ;)

Ullman's particular strain of crazy has nothing to recommend it, but he's hardly alone in employing the metaphor (not analogy...) of "medicine as war." Every time you see a reference to medicine's therapeutic armamentarium there's a nod in the direction of that metaphor.

As an aside, metaphors can often be turned on their heads. Consider how military dictators have frequently claimed that their actions are undertaken to promote the health of the polity.

By bob koepp (not verified) on 13 Nov 2009 #permalink

Hold it a minute, I'm getting confused! East, west and never the twain shall meet!Seriously, lately I've noticed that woo-centric proselytizers have been labelling EBM/SBM as either "traditional" medecine- ((I had thought that that was *their* province, like Traditional Chinese Medecine or traditional herbal "therapy" (sic))) or as "orthodox" medecine, which conjures images of Yiddish-speakers dressed in black or of onion-domed churches with triple crosses.I think that they want to make themselves sound *moderne*- new, on the cutting edge as opposed to that "old",*traditional* sciency un-imaginative medecine.

By Denice Walter (not verified) on 13 Nov 2009 #permalink

As someone with an Asian parent, I LOATHE the Eastern/Western "distinction." To me, it is a very subtle form of racism that continues to draw a line between two groups, even if one group is saying the other is better. We're all people, we're all flawed, there are smarter people and there are dumber people, everywhere. Woo flourishes everywhere, alas, but all my Asian relatives use modern medicine, FWIW.

You have to admire the chutzpah of a homoeopath alluding to the lack of evidence for the WMDs in Iraq.

Wait, I think I'm onto something. Ullman presumably drinks water to stay hydrated. Guess who else did that? That's right - Hitler. Do you know what else Hitler and Ullman have in common? They both have TWO arms! It must be a conspiracy.

so, based on the evidence, Dr Pal has two hands, and I have two hands, ergo I must be Dr Pal !
There's a logical fallacy in there, if you look for it.
:-)

Diane, you are completely correct, and there's not much subtle about the racism inherent in labelling such things eastern/western medicine. The first time I heard it, it confused me completely, because I'd always heard of homeopathy as a 'western' thing, whereas almost all of my 'eastern' relatives were doctors, and thus perscribing more sensible things.

[at the risk of sounding completely loony and loosing all credibility: It Is A Sphere. There is no 'east' or 'west']

"Doctors may even be able to go the next step and surgically remove a symptom or an obstructive agent, but the assumption that removing a single symptom or pathological agent will create health is both simplistic and incorrect"

=

"In other words, removing an inflamed appendix doesn't create total health and is therefore irrelevant"

Not exactly the idea he wanted to convey...

Is it possible for me to reword these as "treating the symptom is good but treating the underlying causes is much better" For example: treating an STD is good but educating the patient to stop risky behavior is better? I don't think he meant to say that an appendectomy is irrelevant. That's putting words in his mouth.

For the record I may be a fan of chinese medicine, but not of homeopathy.

By Philip Tan-Gatue, MD (not verified) on 18 Nov 2009 #permalink