[extropy-chat] Are vaccinations useless?
hal at finney.org
Tue Mar 14 20:54:52 UTC 2006
The excerpt I posted from the "Economics of Health Care" textbook
yesterday was intended to confirm the point that the consensus in the
field is that medical practice played a small or even insignificant role.
The book goes on to discuss an area where there is genuine controversy,
namely the relative contributions of public health measures such as
improved sanitation, quarantines, and standards for the safety and
handling of food, versus the role of improved nutrition. Both seem to
have played a part but some researchers emphasize nutrition and others
give more credit to public health efforts.
A counter-argument to the nutrition theory is that rich people and
royalty always had plenty of food, but they have always gotten just as
sick as everyone else. Pro-nutritionists fire back that although they had
plenty of calories, their diets were unhealthy by present day standards.
The role of nutrition might then be seen as not so much in how much
people eat, but in what they eat. In particular the introduction of two
American foods, corn and potatoes, is cited as improving the quality of
protein in English diets in this time frame.
Overall, the book makes it clear that this is all still very much in
dispute and the decline in mortality post 1750 must be considered a
puzzle at this time.
Samantha keeps demanding to know what is the alternative hypothesis.
But you shouldn't need an alternative to decide that your existing
hypothesis is contradicted by the data. Sometimes the fact is that
you have to admit that you just don't know. You shouldn't cling to a
contradicted theory just because you don't have something better.
Several commenters here have noted with relief that the evidence I have
presented does not seem to reject the role of medical and scientific
research in improving longevity. I don't know that it necessarily
confirms it, either, though. As I said, it is really still a mystery
what effects played a predominant role. From what I have read it is
possible that improved knowledge of germs and contagion has helped make
health measures more effective. OTOH Robin has citations to research
indicating, for example, that improved water supplies don't help.
I've only spent a few hours studying this; he has spent years.
In any case, I don't think we can justify a feeling of relief even if it
does turn out that medical knowledge has helped. Go back to the strong
claim that "medicine", defined as services delivered by doctors, has
played an insignificant role in extending life. Redefining medicine to
include washing your hands doesn't make this uncomfortable fact go away.
Reset your mind to the state it was in a few days or weeks ago and I think
you will find that this claim sounds completely insane. Russell compared
our discussion to those who insist we never landed on the moon.
Look at Robin's paper, "Fear of Death and Muddled Thinking: It Is So Much
Worse Than You Think," <http://hanson.gmu.edu/feardie.pdf>. He really
lays it on the line there. Most people's heads will explode when they
The two excerpts I posted yesterday both offered reasons why vaccination
and antibiotics are thought to have been of relatively little benefit.
Disease rates were falling even before the introduction of these measures.
Even though they arguably helped, disease rates were generally so low
by the time they were introduced that their enhancement of longevity
was marginal at best. And in many cases, the rate of decline of disease
rates barely changed when these treatments were introduced.
Bearing in mind Robin's paper on "muddled thinking", how do you want
to react to these facts? Do you want to accept them, to accept the
expert consensus? Or will you refuse to believe it? Are you thinking
rationally, or emotionally? Which way do you want to think?
And the real sticking point Robin raises is this: even if you find this
convincing, as I do, will you change your habits? Will you stop going
to the doctor, and even harder, stop taking your kids or loved ones?
That's a hard decision! I can feel my mind squirming, going into "excuse
mode". That's what I call it when you don't want to accept the reality of
something and you are searching for reasons to disbelieve. It's a very
specific and noticeable mental state, if you pay attention. Frankly I
suspect that many posters here have been spending time in excuse mode.
Pay attention to your own thoughts and see if you can feel it happening.
More information about the extropy-chat