Friday, January 20, 2006

More on alternative medicine and falsifiability,Karl Popper and Andrew Weil

Two medical bloggers have recently disagreed a bit regarding integrative medicine or alternative medicine. We speak of the art and the science of medicine. The philosopher of science, Karl Popper, was very interested in the question of what separated science from pseudo-science . His well read essay on this issue can be found here.
It should be part of any handouts given in a medical school course in evidence based medicine.This is particularly important now given the prevalence of pseudo-scientific alternative medical disciplines given inappropriate implicit validation by various medical schools. Popper's formulation is that science as opposed to pseudoscience is stated in such a way that the proposals can be tested and thereby falsified.This is way Popper put it:
"Every good scientific theory is a prohibition:it forbids certain things to hapen.The more a theory forbids,the better it is....A theory which is not refutable by any conceivable event is non-scientific.Irrefutability is not a virtue of a theory but a vice....Every genuine test of a theory is an attempt to falsify it, or to refute it.testability is falsifiability...One can sum up all this by saying the criterion of the scientific status of a theory is it falsifiability, or refutability,or testability."There are elements of what passes for alternative medicine that can be tested. We can even do a randomized trial for some as we could to see if this or that proposed ancient medication did what its advocates claim it does.
Now, lets see if we can think of a way to test, for example, the Qijong proposition of sound and posture being able to cleanse and recharge the internal organs of stagnant energy.Perhaps we could devise experiments of delivering sounds to patients and then measuring the stagnant energy of organs.Wait, how can we measure stagnant energy when no one know what that even means ?Well, you get the point.
So why did the title mention Dr. Andrew Weil? (let me give a plug to Arnold Relman's essay about Weil.) He is being featured at a meeting sponsored by AMA on medical communication.The AMA can invite whomever they want to a conference but I question the appropriateness of inviting folks who advocate non-scientific alternative medicine.Does that not give Weil an implicit endorsement? I will , of course, have to admit Weil has been very successful at communicating whatever it is he is selling and it is a conference on communication but could they have not found someone who is skilled at selling science and scientific thinking?

1 comment:

Anonymous said...

At least with Andrew Weil's products you at least have something to hold in your hand and most of them cost less than a single office call. I can't tell you how many times I have left a physician's office with no more information than when I arrived there. Physicians charge anywhere from $85-$150 for an office call in my area and that usually lasts 10-15 minutes and ends with the latest pharmaceutical sample and a perscription for a medication that in essence gives me three more minor diseases.