Why good medicine requires materialism

I don’t like to repost, but Steve Novella has some great pieces up right now, and this is directly related. –PalMD

s I’ve clearly demonstrated in earlier posts, I’m no philosopher. But I am a doctor, and, I believe, a good one at that, and I find some of this talk about “non-materialist” perspectives in science to be frankly disturbing, and not a little dangerous.

To catch you up on things, consider reading one of Steve Novella’s best posts ever over at Neurologica. While you are there, you can also follow his debate with neurosurgeon Michael Egnor, the latest guru of mind-body dualism.

To sum up (remember, IANAP), most of us science-y types hold to a materialist view of reality, that is, reality is all there is. This reality is susceptible to the investigations of science. Non-materialists and mind-body dualists hold that there is also a “non-material” reality. What exactly this might be, and how one might observe or measure it is never specified. Instead, they usually use a god-of-the-gaps argument, whereby any gaps in scientific understanding are automatically ascribed to the supernatural. The proof of the supernatural is stated is a lack of disproof of the supernatural.

Personally, I have no problem with people believing in God, Satan, fairies, or the Flying Spaghetti Monster (may we all be touched by His Noodley Appendages). What I have a problem with is people applying these beliefs to science and medicine.

Non-scientific medical practices, such as homeopathy, faith-healing, and reiki state various claims of efficacy and of mechanism of action. They can never prove these, but ask us to take their word, and the word of their clients. Once again, if someone takes communion and feels closer to their God, it’s none of my business. But if someone is claiming to affect the health of an individual by invoking supernatural powers, this is immoral and harmful

The point is simple: if reiki manipulates unseen, unmeasurable forces by unseen and unmeasurable means, creating solely subjective individual results, then reiki (and practices like it) is completely irrelevant to health. What matters in medicine is results, and results that cannot be observed and measured do not, for all practical purposes, exist.

We can measure the effect of beta blockers on a population of heart attack survivors. We can compare the number of subsequent heart attacks in those who do and do not receive the drug. We can come up with a scientifically valid explanation for the results, and we can replicate them.

None of the cult medicine practices that are so popular can do this. Their effects are either unmeasurable by definition (show me a qi), or when we try to measure the results of their application, results in aggregate are no better than by chance alone.

In all this discussion about naturopathy over the last week or so, what has been left out is that it doesn’t matter if naturopaths consider what they do to be “medicine-plus”—the plus is irrelevant because it cannot be measured or observed reliably. Unless and until it can, forget the “plus”. It’s only a dream.