A Call For Medical Nihilism - To Do Nothing Is Also Good Medicine

[yerrag]

Truth. When you enter one of those facilities, no matter how good your insurance, they try to get you or your relatives to sign your house up as collateral. Then they'll make sure they need it.

I used to visit these homes when I was in the US. I feel sorry for the residents there. They are on drug cocktails and on food restriction. The twilight years, and living in misery. I was going to get old one day too. I decided to leave the US while I still can. There are better ways to live out the end of our days.

Sad thing is the Philippines apes the US, and it gets to be like it over time. Perhaps Taiwan is better, as TCM is also used and the health insurance system pays for it as well. And costs are low.

 

[tankasnowgod]

Actually, the oath (in its original form) is almost gone at this point and majority of new doctors think it burdens them precisely because it focuses on the patient. About 20% of new doctors are not taking any oath at all and the rest are taking heavily modified "modern" versions, which usually leave out the part of "do no harm".
Millennial physicians opting out of the Hippocratic Oath in favor of alternatives: A poll conducted by Medscape shows the popularity of the Hippocratic Oath, an optional vow to uphold certain ethical standards, is waning in favor of alternative oaths, or no oath at all.
"...Medscape has surveyed more than 2,600 physicians and 134 medical students since last November on the subject, finding stark differences in opinions of the oath based on age. For example, 70 percent of physicians ages 65 and older said the Hippocratic Oath was very meaningful to them, compared to 39 percent of physicians under age 34. And 64 percent of physicians ages 65 and older reported they recited the Hippocratic Oath in its original form, compared to 39 percent of physicians under age 34. However, the poll indicates roughly similar proportions of physicians and medical students are still taking some form of oath. Only slightly more medical students reported taking no oath at all (19 percent) compared to physicians ages 65 and older (17 percent) and physicians 34 and younger (14 percent). Instead, younger physicians and medical students appear to be more split among alternative pledges. Medical students and millennial physicians under age 34 are much more likely to recite an oath written by medical school faculty (19 percent and 17 percent, respectively) than their older counterparts over age 65 (4 percent). Similarly, the Declaration of Geneva — a modern revision of the Hippocratic Oath adopted by the General Assembly of the World Medical Association after World War II — and the oath by Louis Lasagna, MD, a clinically renowned pharmacology expert who penned his own revision in 1964, have started to gain momentum among younger physicians and medical students, according to the poll. Younger physicians may have less faith in the Hippocratic Oath, which has a patient focus, because they feel it no longer holds in today's healthcare environment in which many needs compete for their attention. According to the poll, only 12 percent of physicians under age 34 said they were always able to put patients first, compared to 40 percent of physicians age 65 and older. Many younger physicians also indicated they felt the oath's patient focus added to burnout. Forty-seven percent of physicians ages 34 and under felt the oath contributes to burnout compared to 27 percent of those over age 65, according to the report.

https://gizmodo.com/doctors-aren-t-actually-bound-by-the-hippocratic-oath-1465044222
"...Although ancient, swearing the oath was not used as a rite of passage at medical schools until 1508, when the University of Wittenberg first administered it. By 1804, it had been incorporated into the graduation ceremony of the medical school in Montpellier, France. However, it was still not commonly administered, and by the early 20th century, not even 20% of U.S. medical schools included the oath as part of their commencement ceremonies."

I guess this isn't really all that surprising. I've heard that other professions, such as CPAs, Accountants, and Lawyers, actually take an oath to the system (or an entity like the IRS), and not to the supposed clients that they represent. I wonder if I could find a copy of the more modern oath. I wouldn't be surprised if doctors now take an oath to the system as well, or an entity like the FDA or the state boards.

 

[haidut]

I guess this isn't really all that surprising. I've heard that other professions, such as CPAs, Accountants, and Lawyers, actually take an oath to the system (or an entity like the IRS), and not to the supposed clients that they represent. I wonder if I could find a copy of the more modern oath. I wouldn't be surprised if doctors now take an oath to the system as well, or an entity like the FDA or the state boards.

The lawyers taking an oath to the "system" is really sick IMO. Harvard Law School did a survey with lawyers a few years ago about jury nullification and most lawyers said they would absolutely NOT inform the jury about this completely legal and constitutionally enshrined option/right. Even if it would benefit their client. So, you can't really trust your lawyer to work in your best interest, and I suspect the same is (becoming) true of the doctors.

 

[pepsi]

The elderly in nursing homes are the cash cows of the medical/pharma blood suckers.

What they do is feed the old people in the home funded by tax powers government funded pension money is feed the old people including my grandparents the most malnourished, low calorie,canola oil diet and no wonder they have them on blood pressure medication and diabetes, dementia drugs and so on. These poor old people have such low blood sugar that they faint from bending over to tie their shoe lase hense why they all wear slip on shoes, and the family members believe its a medical issue to be solved by drugs... discusting world and their all in on blood sucking satin sporn.

I used to work in a nursing home and that is one thing that irritated me the most.
They gave the residents their 3 meals in the dining room with dinner being around 530 PM.
I worked the night shift. I cant remember how many residents would ask for snacks and coffee.
I would go to the nurses station and she would open up her drawer and hand me some crackers,
if there were any left. If not, sorry all out, now this person has to stay hungry the rest of the night.
No coffee. The only thing I would refill for them was their water pitchers. The lucky ones had family that brought them food to keep in
their rooms. I would just shake my head.

 

[InChristAlone]

The elderly in nursing homes are the cash cows of the medical/pharma blood suckers.

What they do is feed the old people in the home funded by tax powers government funded pension money is feed the old people including my grandparents the most malnourished, low calorie,canola oil diet and no wonder they have them on blood pressure medication and diabetes, dementia drugs and so on. These poor old people have such low blood sugar that they faint from bending over to tie their shoe lase hense why they all wear slip on shoes, and the family members believe its a medical issue to be solved by drugs... discusting world and their all in on blood sucking satin sporn.

Nursing homes are abominations. My Grandpa died peacefully in the care of family, he was always mobile up until his last days. But even elderly who can still care for themselves are on 20 pills a day. I wonder what will happen when they all die, the newer generations are not so sheepish and try to find other ways to stay healthy.

 

[thomas00]

As Hippocrates once said, “to do nothing is also a good remedy.”

I hope this Steganga fellow doesn't represent the current state of philosophy of science. I thought it was their job to come up with better approaches to science and critique lousy ones. This guy is just advocating for neglect instead of bad treatment.

All he seems to see is corruption in the orthodoxy and quackery in alternative circles. He obviously moves in small circles. I wonder how he would react to reading anything by Peat.

 

[yerrag]

Nursing homes are abominations. My Grandpa died peacefully in the care of family, he was always mobile up until his last days. But even elderly who can still care for themselves are on 20 pills a day. I wonder what will happen when they all die, the newer generations are not so sheepish and try to find other ways to stay healthy.

You think so? You and I, and most members of this forum, perhaps. But talk to people outside this circle, just your own circle alone, and they have no clue at all.

I've given up on helping people on my own circle as far as health is concerned. People trust pieces of paper and authority. They trust experts and specialists. And they are given bad advice, and they extremely thankful for it. They can't do their own research, and they can't think for themselves.

 

[burtlancast]

I've given up on helping people on my own circle as far as health is concerned. People trust pieces of paper and authority. They trust experts and specialists. And they are given bad advice, and they extremely thankful for it. They can't do their own research, and they can't think for themselves.

Correct.

And the reason for that is people made the assumption that the progresses in the technological field for the past 60 years must have also happened in the medical one.

You can't change their thinking, even more so if their disease is advanced and the doctors tell them the lies they want to hear.

 

[ecstatichamster]

Nobody wants to take responsibility for their health. It is too scary. And the better someone knows you, the less they will listen to you.

I don’t offer advice to my friends or family other than my wife who will listen to me on some issues.

 

[nbznj]

Why are you guys surprised that most drugs don’t work like magic pills?

We’re trying to cure self made disease. We’re giving drugs trying to heal some completely alien race: the humanoid that is insanely sedentary, eats and drinks absolute trash and consumes or smokes weird substances, stresses the f**k out right from birth from EMFs to the office life, spends their free time glued to blue&white light screens, can’t sleep right, can’t socialize.

What are people thinking?

 

[haidut]

I hope this Steganga fellow doesn't represent the current state of philosophy of science. I thought it was their job to come up with better approaches to science and critique lousy ones. This guy is just advocating for neglect instead of bad treatment.

All he seems to see is corruption in the orthodoxy and quackery in alternative circles. He obviously moves in small circles. I wonder how he would react to reading anything by Peat.

As you can see from the entirety of the post, he mentions the "do nothing" in regards to treatment of many chronic disease. The cures are just not there. He most certainly embraces acute/ER medicine, aspirin, antiobiotics, insulin, etc. Basically, the life saving measures that work. He is saying everything else is pretty weak on evidence. I doubt that he would have been saying this if people were actually getting cured of diabetes, CVD, Alzheimer, etc.

 

[thomas00]

That's where his view is problematic.

Ray and others, including yourself, have demonstrated that there are treatments that are quite effective for a range of chronic problems. The studies are just being ignored and not included in the latest meta analysis that people like him refer to when they are evaluating the evidence, the treatments get rejected because they go against prevailing theories that become dogma.

And because he's unaware of them, they don't exist.

 

[tankasnowgod]

I hope this Steganga fellow doesn't represent the current state of philosophy of science. I thought it was their job to come up with better approaches to science and critique lousy ones. This guy is just advocating for neglect instead of bad treatment.

All he seems to see is corruption in the orthodoxy and quackery in alternative circles. He obviously moves in small circles. I wonder how he would react to reading anything by Peat.

Well, it might be neglect if we didn't all have functioning immune systems.

I would think Steganga would largely agree with Peat's work. In fact, Peat goes farther than Steganga in some instances. Peat is on record as saying he likely would not go to a "medical professional" for something like a broken bone, as he has seen breaks set well by farmers, and poorly by doctors.

 

[yerrag]

Well, it might be neglect if we didn't all have functioning immune systems.

I would think Steganga would largely agree with Peat's work. In fact, Peat goes farther than Steganga in some instances. Peat is on record as saying he likely would not go to a "medical professional" for something like a broken bone, as he has seen breaks set well by farmers, and poorly by doctors.

I second this.

If we have good metabolism, more likely we would have a fully functional immune system, and our body would be in good position to fix itself. If our body does encounter toxins and insults that interfere with normal bodily functions, it will adapt itself in order to survive. It may become suboptimal, but it's still going to find the optimal way to operate under suboptimal conditions.

A lot of modern medicine is geared these days towards interfering with our body's own wisdom. If you can tell the difference between supporting the body to heal by itself, and interfering with the body, I think you will be agreeing to the gist of Stegenga's thesis.

 

[steel_reserve]

Should I do something about my low blood pressure? Been that way my whole life.

 

[Overton]

Should I do something about my low blood pressure? Been that way my whole life.

Ray talked about pulse pressure (the difference btw the 2 numbers) as useful to understand your metabolic/thyroid state. <50 difference indicates a good metabolic/thyroid/glycogen state, while >70 difference indicates stressed state.

 

[AinmAnseo]

Ray talked about pulse pressure (the difference btw the 2 numbers) as useful to understand your metabolic/thyroid state. <50 difference indicates a good metabolic/thyroid/glycogen state, while >70 difference indicates stressed state.

Overton,​

Would you know where Peat said this?
Thanks.

 

[Rinse & rePeat]

To my greatest surprise, I stumbled upon yet another article in the Scientific American (SCIAM) that looked completely out of place in that publication. After all, SCIAM was (and continues to be) a bastion of official medicine and its articles often read more like drug company brochures than discussions on serious scientific matters. Yet, here it is below - an article reviewing a book calling for all but the abandoning most of medicine as we know it. If Ivan Illich is looking upon this world from somewhere, he is probably laughing and waving his book "Medical Nemesis" in our faces.
According to the author modern medicine's limited utility can be summarized in a single sentence - i.e. surgery for trauma, aspirin for headache, antibiotics for infections, and insulin for diabetes. That is pretty much the sum total of interventions for which there is irrefutable evidence of benefit. Everything else is either wishful thinking or pharma-sponsored fraud. As far as the increased lifespan seen in the 20th century, for which medicine takes ALL the credit? It was likely not due to vaccines (and even antibiotics) but to improved standard of living, sanitation, and nutrition. Btw, doctors are in on the scam too, it is not just greedy Big Pharma or corrupt FDA killing us by the millions. Doctors are fully complicit in the so-called "disease mongering", which creates an endless supply of patients for themselves and drug companies. Maybe Hippocrates was spot on when he said that (and I'd add "more often than not") "to do nothing is also a good remedy". Considering there was no organized medicine in his time, I would paraphrase this to match the modern times better as "to do nothing is also good medicine".

FDA Depends on Industry Funding; Money Comes with “Strings Attached”
Is Medicine Overrated?

"...In Medical Nihilism, published by Oxford University Press, Stegenga presents a devastating critique of medicine. Most treatments, he argues, do not work very well, and many do more harm than good. Therefore we should “have little confidence in medical interventions” and resort to them much more sparingly. This is what Stegenga means by medical nihilism. I learned about Medical Nihilism from economist Russ Roberts, who recently interviewed Stegenga on the popular podcast EconTalk. Skepticism toward medicine, sometimes called “therapeutic nihilism,” was once widespread, even among physicians, Stegenga notes. In 1860 Oliver Wendell Holmes, dean of Harvard Medical School, wrote that “if the whole materia medica, as now used, could be sunk to the bottom of the sea, it would be all the better for mankind—and all the worse for the fishes.”

"...Such cynicism faded with the advent of anesthesia, antiseptic surgical techniques, vaccines and truly effective treatments, notably antibiotics for infectious disease and insulin for diabetes. Stegenga calls these latter two “magic bullets,” a phrase coined by physician/chemist Paul Ehrlich to describe treatments that target the cause of a disease without disrupting the body’s healthy functions."

"...Researchers have labored mightily to find more magic bullets, but they remain rare. For example, imatinib, brand name Gleevec, is “an especially effective treatment” for one type of leukemia, Stegenga says. But Gleevec has “severe adverse effects, including nausea, headaches, severe cardiac failure and delayed growth in children.” Most other forms of cancer, as well as heart disease, Parkinson’s, Alzheimer’s, arthritis, schizophrenia and bipolar disorder, lack cures or reliable treatments. Many “widely consumed” medications are “barely effective and have many harmful side effects,” Stegenga writes. Examples include drugs for high cholesterol, hypertension, type-two diabetes and depression. Stegenga warns readers not to stop taking prescribed medications without medical supervision, because abrupt cessation can be risky. But our health will improve and our costs shrink, Stegenga contends, if we resort to treatments much less often. As Hippocrates once said, “to do nothing is also a good remedy.”

"...There is no place I would rather be after a serious accident than in an intensive care unit. For a headache, aspirin; for many infections, antibiotics; for some diabetics, insulin—there are a handful of truly amazing medical intervention, many discovered between seventy and ninety years ago. However, by most measures of medical consumption—number of patients, number of dollars, number of prescriptions—the most commonly employed interventions, especially those introduced in recent decades, provide compelling warrant for medical nihilism."

"...The core of Stegenga’s book is his critique of clinical trials. Everybody wants positive results. Patients are desperate to be cured and prone to the placebo effect. Journals are eager to publish good medical news, journals and mass media to publicize it and the public to read it. Researchers can gain grants, glory and tenure by showing that a treatment works. Most importantly, biomedical firms, which sponsor the bulk of research, can earn billions from a single approved drug, like Prozac. John Ioannidis, a Stanford statistician who has exposed flaws in the scientific literature and whom Stegenga cites repeatedly, contends that “conflicts of interest abound” in medical research. Most clinical research, Ioannidis asserted bluntly in 2016, “is not useful,” meaning it does not “make a difference for health and disease outcomes.”

"...Researchers eager for positive results can engage in p-hacking, which involves formulating hypotheses and finding data to support them after a study is carried out. P-hacking is a form of cherry-picking, which allows researchers to attribute significance to what may be random correlations. One way to prevent p-hacking is to make researchers pre-register studies and spell out hypotheses and methods in advance."

"...Stegenga accuses the FDA, which has close ties to industry, of setting the bar too low in approving drugs. He quotes a senior FDA epidemiologist complaining that the agency “consistently overrated the benefits of the drugs it approved and rejected, downplayed or ignored the safety problems.”

"...Stegenga faults physicians and drug companies for expanding their markets by inventing disorders and pathologizing common conditions. He calls this practice “disease-mongering.” Dubious disorders include restless leg syndrome, erectile dysfunction, premenstrual dysphoric disorder, halitosis, male balding, attention deficit hyperactivity disorder, osteoporosis and social anxiety disorder."

"...Although he focuses on treatments, Stegenga disparages tests, too. A staple of preventive care is that screening asymptomatic people for disease leads to earlier diagnosis and better outcomes. Unfortunately, Stegenga writes, screening can lead to “false positive diagnoses, overdiagnosis and overtreatment.” (Overdiagnosis occurs when a test detects a small tumor or other anomaly that if left alone would never cause harm.)A 2015 review examined popular tests for four major killers: cancer, heart disease, diabetes and respiratory disorders. The study found that few screening methods reduced disease-specific mortality and none reduced all-cause mortality. The authors conclude that “expectations of major benefits in mortality from screening need to be cautiously tempered.”

"...Modern medicine gets too much credit for boosting average life spans, according to Stegenga. He cites evidence compiled by scholar/physician Thomas McKeown in the 1970s that increased longevity results less from vaccines, antibiotics and other medical advances than from improved standards of living, nutrition, water treatment and sanitation. McKeown’s work remains influential in spite of criticism. Moreover, health-care providers routinely violate the Hippocratic decree to do no harm. A 2013 study estimated that more than 400,000 “preventable hospital-caused deaths” occur in the U.S. every year, and as many as 8 million patients suffer “serious harm.”

Every part of this post is empowering! It really deflates the fear that one might have going their own route in taking care of themselves.

 

[David PS]

Overton,​

Would you know where Peat said this?
Thanks.

This is the text that eventually answers your question. The audio clip mentioned that the pulse pressure should be no more than 50 points difference, and a high pulse pressure (greater than 50) could be a sign of a low thyroid function. It's important to note that pulse pressure alone is not a definitive indicator of thyroid health or other conditions, and it should be considered alongside other clinical findings and symptoms.


“…And in less than an hour, their blood showed almost no T3, the active hormone. And if a person is healthy, as soon as they catch their breath and rest for a day, their T3 is right back where it should be. But if there's anything wrong with their diet, just that moderate amount of exercise every day can push your thyroid lower and lower. And one of the ways that you might see a bad effect of a low pulse is if the distance between the top and the bottom blood pressure is very great.”

https://raypeatinterviews.s3.us-east-005.backblazeb2.com/orn-140101-nutrition-2.mp3

 

[AinmAnseo]

This is the text that eventually answers your question. The audio clip mentioned that the pulse pressure should be no more than 50 points difference, and a high pulse pressure (greater than 50) could be a sign of a low thyroid function. It's important to note that pulse pressure alone is not a definitive indicator of thyroid health or other conditions, and it should be considered alongside other clinical findings and symptoms.


“…And in less than an hour, their blood showed almost no T3, the active hormone. And if a person is healthy, as soon as they catch their breath and rest for a day, their T3 is right back where it should be. But if there's anything wrong with their diet, just that moderate amount of exercise every day can push your thyroid lower and lower. And one of the ways that you might see a bad effect of a low pulse is if the distance between the top and the bottom blood pressure is very great.”

https://raypeatinterviews.s3.us-east-005.backblazeb2.com/orn-140101-nutrition-2.mp3

David,
Thanks.