Over at sciencebasedmedicine.com, Mark Crislip has a great post on the history of medical advances. First, go read it. WAIT! Don’t forget to come back and read the rest of my post! OK, you can go now.
Good. Welcome back.
There was some talk a while back about “the end of science“. That was an interesting but ultimately fatally-flawed hypothesis.
Then Ben Stein decided that science isn’t over, it’s just evil. EEEEVILLLL!!!11!!
This is also, needless to say, a flawed hypothesis.
In the article you just read at sciencebasedmedicine.com, Dr. Crislip describes the progress made in preserving human life over the last several centuries. This led one commenter to opine:
What has happened to medical progress? It isn’t simple anymore, and the ever increasing complexity does not seem to have much of a payoff.
And that’s why I question some of the mainstream assumptions that I believe have been blocking progress. CAM is still very young and inexperienced. You can’t expect it to make miraculous discoveries over night, when mainstream medical science is proceeding at a sloth’s pace, if at all.
We need more CAM research funding, not less.
There are several problems with these common misconceptions. Medical progress is doing quite well. We did a great job with the whole public health thing. That was a real revolution in human health. It keeps the majority of us alive long enough to deal with other things, like having families, inventing the internal combustion engine, inventing the replacement for the internal combustion engine. It also allows us to worry about other illnesses, and to make profound medical discoveries. For example, the victory against cholera that Dr. Crislip talked about required no understanding of microbiology. The fight against other diseases requires a somewhat more sophisticated knowledge set.
Using HIV as an example, epidemiologists did a great job figuring out what the mystery disease was and how it was spreading. Fortuitously, microbiology and genetics were making incredible strides at the same time, and were able to characterize the pathogen and understand how it works. Finally, medical science, using evidence-based techniques, found effective treatments.
Science is a technique, not a set of data. Science can’t “know everything” because science and knowledge are non-equivalent. The better question than “is science over” (which it can never be, since it is a tool) is, “do we know all there is to know”. The answer to that has to be “no”. There are always more things to learn—just because one of them isn’t “gravity” or “relativity” doesn’t mean that what is left isn’t “knowledge”.
This is simply another attempt by modern medical Luddites to claim that “other ways of knowing” are somehow more valid than science. Of course, they also tacitly acknowledge that knowledge hasn’t ended. So really, they are simply arguing that science isn’t the best way of gaining knowledge, and that only the knowledge that they have accumulated by other means is legitimate.
Sometimes, medicine is referred to derisively as an “art” rather than science. It is both, but we have to make clear where the line is. The science of medicine is in knowing and choosing evidence-based therapies. The art is in knowing how to talk to patients and to guide them in the direction of health. The end of science is an invalid statement. The limit of knowledge is unlikely to be seen in our lifetimes.