Trusting the Establishment: Examples and Underlying Reasoning

In a followup to Friday's post entitled Trusting Data, Part 2: Evidence on Both Sides, I present a worthwhile article from Newsweek's Sharon Begley about the fickleness of organized medicine.

If you follow the news about health research, you risk whiplash. First garlic lowers bad cholesterol, then—after more study—it doesn’t. Hormone replacement reduces the risk of heart disease in postmenopausal women, until a huge study finds that it doesn’t (and that it raises the risk of breast cancer to boot). Eating a big breakfast cuts your total daily calories, or not—as a study released last week finds. Yet even if biomedical research can be a fickle guide, we rely on it.

But what if wrong answers aren’t the exception but the rule? More and more scholars who scrutinize health research are now making that claim. It isn’t just an individual study here and there that’s flawed, they charge. Instead, the very framework of medical investigation may be off-kilter, leading time and again to findings that are at best unproved and at worst dangerously wrong. The result is a system that leads patients and physicians astray—spurring often costly regimens that won’t help and may even harm you.

She cites numerous medical controversies where popular opinion changed rapidly, with each side producing data ultimately flawed in some major respect. I had not read Mrs. Begely's article when I wrote mine on Friday, yet it perfectly mirrors what I had stated - that biases inherent to research should caution us from fully accepting the relevant wisdom.

While Begley does a great job of presenting the problem, she largely ignores the underlying motivations and reasoning behind such an unfortunate situation. I have previously considered the liberal ideology undergirding much of nutritional scholarship. For a quick refresher, think reformed hippies eager to adopt Eastern and South American mysticism as manifested through ethnic cuisine as well as undermine the palpable connection between meat eating and manhood. One could also consider the intellectual smugness, as a class issue, alluded to in this quote:

Biostatistician Steven Goodman of Johns Hopkins, who worries that the most-research-is-wrong claim “could promote an unhealthy skepticism about medical research, which is being used to fuel anti-science fervor.”

Perhaps I'll consider that in a future post. I have also mostly ignored the big money interests pushing the debate in whatever direction the drug companies decide. As Begley notes, the 40 billion dollar statin industry is built out of whole cloth, creating a problem where none exists then disseminating drugs that do nothing to thwart it. Everyone has heard the cliche that "money is the root of all evil" and despite its banality, it explains so much of how humans and their institutions operate. The drug companies have colluded with academic and medical establishments to create a wholly opaque system of faulty scholarship. This three headed monster is essentially impenetrable to the average intellect, making the general public susceptible to whatever snake-oil they decide to champion next.

Yet what solution exists for the small government, pro-capitalism conservatives? We understand the trade-offs inherent to any productive system and perhaps we begrudgingly accept this behemoth in order to maintain societal and economic freedom. Unfortunately, I don't see a viable solution, a situation exacerbated by a government that promotes the same tripe. Further, as I've covered before, our society now believes credentials are the only indication of authority. As a result, almost everyone will reject any justified medical iconoclast as an eccentric and ignorant crank.

We're stuck in a rut, a big, fat one full of death.