From a recent issue of NEJM, “The Pediatrician’s Lament“, with Abstract, “With U.S. politics threatening to erase the gains of science, reduce access to vaccines, and undermine their vast public health benefit, what is a conscientious pediatrician to do?” (Thanks to A Physician for the tip.)
The plaint is clearly hersterical. Erase the gains of science? What could that mean? A federal law forbidding use of imaginary numbers? Ban people from using the Periodic Table of the Elements? Let’s see. The article opens:
“It’s your fault!” the renowned infectious disease attending told the cluster of students and residents. In the late 1990s, the varicella vaccine was relatively new, and uptake was disappointingly low. “You pediatricians,” he went on, “must correct your wording. Instead of telling parents their child is due for the MMR vaccine and then half-heartedly offering the varicella vaccine, you should include it with the same declarative certainty: ‘Your child is due for varicella and MMR vaccines.’”
Take careful note of the “must correct your wording” and “declarative certainty.”
The lady author goes on to say of herself, “I consider the high immunization rate in my patient panel to be one of my greatest professional accomplishments” because of its benefits. Some of which, it is easy for us to acknowledge, are genuine.
Yet the emphasis on “correct wording” and “declarative certainty”, especially where there is none, is Science Bullying, even if you agree with the bully that having a varicella (chicken pox) vax, or any vaccine, is “right for you”, as the commercials tell us.
The lady author admits “Much of pediatrics advice is more cultural wisdom than science. Does it matter whether an infant consumes green vegetables before orange ones? Unlikely. Some of what we do (antibiotics for acute otitis media) is probably of limited benefit.”
Cultural wisdom is a fine thing, and should be cherished, and even deferred to in many cases. But passing off the uncertain as if it were certain leads to bad decisions, and is scientism—even if only good decisions are made.
The decisions, good or bad, are not necessarily on the part of doctors. Some, like this doctor, take as their metric of success numbers of procedures administered. She is clearly successful in those lights.
But those patients won’t see it as a success in which they are given a drug that turns out to do nothing, like those antibiotics, or, worse, causes harm itself, like myocarditis for the vex given to at-almost-zero-risk kids in the covid panic. “Given” is a weak word here, standing in for the bellicose braying and bullying of Experts in the panic.
A doctor has no right to tell you what is best for you, or what you should do. A doctor who thinks she has this right because science is on her side has committed the scientism fallacy. Science does not take sides. Knowing the rate of heat transfer between two different metals, say, gives no insight into which drugs should be forced into the kiddies.
A doctor should assess your child and say here are the potential benefits and potential risks, weighted by whatever uncertainty is appropriate with the proposed treatment and your child’s biology and circumstance. You incorporate that information, add to it whatever is important to you and yours, and then you make the decision. Adding shot notches to the belt of a doctor may even be one of the items you view as critical—though it is hard for me to see how.
Now, having said all that, I realize the uselessness of my argument for the majority. They don’t want to be bothered by the distinction between real science and moral decisions. Scientism to the masses is just as fascinating a fallacy as affirming the consequent. Most want—would need be too strong a word?—to be told what to do.
For doctors to reject the temptation to dictate in these circumstances would require superhuman powers of moral concentration. Which, all experience proves, most do not have. Certainly the lady author here does not. I suppose the best compromise would be to require all doctors to spout “Past performance is no guarantee of future success” or similar verbiage along with their orders. Those warnings are always ignored by the masses anyway.
But they are not ignored for those with eyes to see.
Like I said, now that woke is somewhat ebbing, utilitarianism will rise (blog/Substack). Scientism is a form of utilitarianism. So we’re going to see a lot more of it.
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Vaccine Bullying may ALSO be Scientism (and I strongly agree it is), but it is CERTAINLY still Bullying… and as such completely wrong and totally unacceptable.
The whole vaccine industry and accompanying “accepted wisdom” is a pack of lies built on a foundation of lies told by professional liars and repeated by the uninformed. Which makes Vaccine Bullying all the worse offense.
Thanks, yet again, for boldly telling the truth through the lens of real science.
One day an insurance company sent me an insulting and threatening letter, on the basis I had failed to do something they really wanted me to do (settle a claim). I had already done, many months previously, what they wanted me to do.
But anyway I called the 0800 number, figuring what the hell it's their dime. The guy who answered explained to me that the company has a policy, they send two reminder letters (they had not arrived at this point) and if the target doesn't do what they want then the computer sends out the insulting and threatening letter. "It's just company policy" he said, word for word, as if this justified their threats and insults.
"Oh" says I, "well, I have a policy too. When you insult and threaten me for no reason but your possession of false information about me, then I get fucking pissed off and I burn down your office buildings!"
All this is to say that it's not only the scientismists that live by some principle or other they consider beneficial.