One of the frequent complaints I hear about science-based medicine is that it is dangerous. Of course, it’s true—so is riding in a train, but it sure beats walking. And that’s the danger of this particular fallacy—yes, medicine is a sharp tool, but it’s also an effective tool, so we must use it properly. And this is where the tools of evidence- and science-based medicine can give us a hand.
The potential harms of modern medicine must be approached carefully. If they are ignored or approached in an ineffective way, we’ll miss an opportunity to save lives. This comment from my other blog is typical:
You asked if so-called traditional Chinese medicine has ever eradicated any diseases. Well, yes. It pretty much eradicated one that is in epidemic numbers in the U.S. and most of the developed world: Iatrogenic disease.
This is wrong is so many ways. The definition of “iatrogenic” is difficult. The traditional definition is “adverse effects of medical treatment or advice.” I suppose one could broaden this to include failure to give proper advice, as inaction by a physician has similar consequences to action, but perhaps that is a discussion for another day.
The way in which this is truly wrong is the false dichotomy. Yes, medical errors would be reduced to zero if we didn’t treat people, but the consequences would be rather dramatic. Our goal should not be to abandon modern medicine because it sometimes causes harm. Our goal is to reduce iatrogenic illness in a science-based way.
Strangely enough, this is being done. A recent study in the New England Journal of Medicine (effectively discussed here) described a study in which surgical checklists reduced errors. This study was based on earlier work by Peter Provonost of Johns Hopkins, the subject of a terrific piece in the New Yorker. (Related commentary here.)