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I actually read the paper on the deconstruction of evidence-based medicine, and I think I understood it, but I do not understand what the authors would suggest as an alternative. To me, EBM is pretty much the application of the scientific method to a field where there are a LOT of things that are not well understood. As a chemical engineer, I am both thrilled at the progress that has been made in understanding how life forms work, and horrified at how that information has been popularized and commodified to drive business and political attempts to control human behavior. Horrified, because there is so much uncertainty about the science of medicine, which is fundamentally all about some very, very complicated chemistry.

I am also aware that some “non-scientific” treatments do seem to have positive effects, which medical science cannot explain, and which the practitioners cannot explain in words that I understand – one of my sisters practiced something called “Alexander Technique”, which is very effective with some people in dealing with muscular-skeletal problems. No one really understands how these things work. Because they are not understood, and the results are not always predictable, they do not fit into the EBM paradigm, and are consigned to the bin for loony ideas which don’t actually hurt anyone, so are tolerated.

I think that this paper is trying to indict EBM for not considering these alternative medical methods. They use very weird language to do this, and their bottom line is that the scientific method should not be “privileged” over other methods of evaluating medical treatments. I don’t know what else they would propose, other than “feelz”, which makes no sense to me, but I am a white male engineer, so my feelz don’t count at all. My response would be that the scientific method is “privileged” because it works better/more often than the other methods, including feelz, interpreting bones cast on the ground, or prayer. I think that this is considered a racist statement.

I would just say that there is a lot of biology that we don’t understand, so if some things work for some people, without harming anyone, then they should not be forbidden. Whether they should be funded is a different question – I am not much in favor of increasing the medical budget to accommodate feelz, but one never knows when something useful will come out of a crazy idea. However, if implemented as described, the epistemological process described in this paper will tie us up in knots forever, trying to decide whether to do anything. But then, that is the goal of their whole enterprise – the extinction of Western thought.

I recommend starting one’s consideration of the Deconstruction… paper by re-reading Chip Morningstar’s far-less-famous-than-it-deserves essay “How To Deconstruct Almost Anything.” Once you understand Morningstar’s essay and master the techniques he describes, you will be well equipped to respond to such papers with all the respect they deserve. Not only that, you’ll also be able to couch your response in their own academic style, thus quintupling your effectiveness.

Xenophon,

Thanks for the link. I read this a long time ago (back in the 90s), and haven’t gone back to it since. It is good to read now, after 20 years, to see how this technique has infected our whole society. I am getting it from lawyers in government and businesses, and you could even say that it is a foundational concept for most advertising. Post-Trump politics is almost entirely postmodern, and the supporting soft sciences have been pretty badly corrupted. I was listening to the news about the Trump pull-out from the Paris Climate Accords last night, and almost all of the commentary was just clever words with no meaning or substance. Even something as “firmly grounded” as agriculture has been taken over by the “Organic” mystic forces movements.

I am not confident about ability to survive as a society, if the rot gets into engineering, and we lose the ability to grow food, transport stuff, and deal with water suppies and waste systems.

I guess I have just defined myself as an old man. Too old to take up post-modern discourse. I will just continue to write stuff like an engineer, and point out the idiocy of the elites in words that anyone can understand.

Once again, thanks for the memories.