[p2p-research] shots in the dark/p2p article

[Paul D. Fernhout]

Tomas Rawlings wrote:
>  My concenrn for things like 
> this is they bleed into to well documented denialism, of which one of 
> the most potent exposes I have read of late is Gen Goldacre on AIDS 
> denialism... 
> http://www.wired.co.uk/wired-magazine/archive/2009/06/start/the-man-who-sold-out-medicine.aspx 

 From that article: "The alternative-therapy industry is worth billions of 
pounds and the techniques used to market it are very familiar: buzzwords 
like “natural” and “holistic”, distortions of trial data, the denigration of 
mainstream medicine, conspiracy theories involving the pharmaceutical 
industry, and so on. They are indulged because they seem harmless, and tend 
to target the “worried well”. But what would happen if we took these 
sleights of hand and transplanted them out of our Western context, into a 
situation where medicines can literally mean living or dying?"

I don't know enough about the focus there on AIDS and various treatments to 
comment on that.

But, echoing Michel's theme of a diversity of issues, here is another item 
recently in the non-mainstream news, so I don't know how true it is, but 
this is as an example of what that article suggests is bad in that case but 
actually may work in *some* cases:
"Successful Use of Homeopathy In Over 2.5 Million People Reported From Cuba"
http://homeopathyresource.wordpress.com/2009/01/01/successful-use-of-homeopathy-in-over-5-million-people-reported-from-cuba/
"""
Part of the reason for this is that the high cost of vaccination prevents 
putting but the most at-risk populations (ie children, pregnant women, 
elderly) on vaccination. The cost of such limited vaccination is about 
US$3,000.000.
   But in Aug 2007, Finlay put approximately [2,500,000] people (yes! 5 
million doses!) in 2 provinces on homoepathic nosode prophylaxis at the cost 
of about only US$ 200,000.
   That figure represents the entire population of the 2 provinces. The 
prophylaxis consisted of 2 single doses about 2 weeks apart. Included in the 
dose was the Lepto nosode + some Bach flower remedies to address the mental 
distress of the disaster situation.
   How very amazing it was to watch this presentation being made. Up to the 
point, the presenters were showing us graph after graph of the usual rise of 
the epidemic, year after year, even with the use of allopathic vaccination. 
Each year the graphs would edge higher and higher towards the year-end, 
reaching up to the thousands of infected.
   But this time, within 2 weeks after Aug 2007, the rising lines literally 
dropped off the chart to ZERO-Ten infections only! Yes. Near-zero 
infections, zero deaths from leptospirosis after Aug 2007. And in 2008, no 
deaths, infections less than 10 a month.
"""

Still, I'll believe it more if I see more evidence. But, clearly, there are 
alternatives to mainstream medicine, and the parts of mainstream medicine 
that work are often based on refining herbs and such. So, as Michel 
suggests, there is a diversity of issues here. And personally, when 
homeopathic (infinitely diluted) medicines work, I tend to suspect it is 
about the extra things that are added, like in this case, Bach flowers, or 
in other cases, silver as a preservative.

Even doctors will say they are often told the first day of medical school 
that 50% of what they are taught will be obsolete or proven wrong within ten 
years. Of course, the problem is, no one knows which 50%. :-)

As is said here:
   "With Drugs Scarce, Cuba Tries Natural Cures"
   http://www.latinamericanstudies.org/cuba/cures.htm
"""
But alternative medicine has many supporters in Cuba. "Natural medicine is 
less toxic and has a medical basis. The most important thing is that it has 
  application," said Juventino Acosta, director of the clinic here in 
Matanzas, a port city 60 miles east of Havana. "We do not accept anything 
that does not have a scientific basis."
"""

Doctors in practice often say weaselly things like "there is no evidence for 
danger" when what they should say is, "there was no funding for studies to 
show danger because that might interfere with profits of someone".

We need more money to study lots of alternatives as a society. But the money 
goes to other things (war, expensive health interventions, compulsory 
schooling for an 19th century factory economy, etc.).

As much as I've always like the "scientific method" as an idea (even 
ignoring in practice that's not how most scientists work), the fact is, 
science and politics and economics are interwoven.
   http://www.disciplined-minds.com/
"In this riveting book about the world of professional work, Jeff Schmidt 
demonstrates that the workplace is a battleground for the very identity of 
the individual, as is graduate school, where professionals are trained. He 
shows that professional work is inherently political, and that professionals 
are hired to subordinate their own vision and maintain strict “ideological 
discipline.”"

Peer-to-Peer at least gets around some of that. But you are right to be 
skeptical. We need to build better institutions that still adhere to some 
notion of rigorous testing and peer review while somehow are able to get 
around this other block of conflict-of-interest and political hiring. I 
don't know formally how to do that.

Other people don't know either. Here is one explanation for the corruption 
of "peer review" in academia, by the Vice Provost of Caltech (Dr. David 
Goodstein), related to how academia stopped its exponential growth in the 
1970s while still continuing to produce a vast number of PhDs as if it would 
keep growing exponentially:
   http://www.its.caltech.edu/~dg/crunch_art.html
"""
  Peer review is usually quite a good way to identify valid science. Of 
course, a referee will occasionally fail to appreciate a truly visionary or 
revolutionary idea, but by and large, peer review works pretty well so long 
as scientific validity is the only issue at stake. However, it is not at all 
suited to arbitrate an intense competition for research funds or for 
editorial space in prestigious journals. There are many reasons for this, 
not the least being the fact that the referees have an obvious conflict of 
interest, since they are themselves competitors for the same resources. This 
point seems to be another one of those relativistic anomalies, obvious to 
any outside observer, but invisible to those of us who are falling into the 
black hole. It would take impossibly high ethical standards for referees to 
avoid taking advantage of their privileged anonymity to advance their own 
interests, but as time goes on, more and more referees have their ethical 
standards eroded as a consequence of having themselves been victimized by 
unfair reviews when they were authors. Peer review is thus one among many 
examples of practices that were well suited to the time of exponential 
expansion, but will become increasingly dysfunctional in the difficult 
future we face.
   We must find a radically different social structure to organize research 
and education in science after The Big Crunch. That is not meant to be an 
exhortation. It is meant simply to be a statement of a fact known to be true 
with mathematical certainty, if science is to survive at all. The new 
structure will come about by evolution rather than design, because, for one 
thing, neither I nor anyone else has the faintest idea of what it will turn 
out to be, and for another, even if we did know where we are going to end 
up, we scientists have never been very good at guiding our own destiny. Only 
this much is sure: the era of exponential expansion will be replaced by an 
era of constraint. Because it will be unplanned, the transition is likely to 
be messy and painful for the participants. In fact, as we have seen, it 
already is. Ignoring the pain for the moment, however, I would like to look 
ahead and speculate on some conditions that must be met if science is to 
have a future as well as a past.
"""

So, reforming the very nature of science education and science 
communications and science funding is a big challenge that some in academia 
recognize.

A book on cognitive dissonance in decision making that explains how Dr. 
Goodstein's observation could be true, that even the best academics can go 
down a slippery slope of fraud one step at a time (same as police start to 
plant evidence for some people where they think it is extremely justified 
and then end up planting it for everyone):
   "Mistakes Were Made (But Not by Me): Why We Justify Foolish Beliefs, Bad 
Decisions, and Hurtful Acts"
   http://www.amazon.com/Mistakes-Were-Made-But-Not/dp/0151010986

By the way, this is hard for me to believe, but yesterday this search result 
had only 261,000 matches, but now has 920,000.
http://www.google.com/search?hl=en&q=vaccine+conflict+of+interest
"Results 1 - 10 of about 920,000 for vaccine conflict of interest. (0.12 
seconds)"

Hope I'm not making another mistake in tracking that value. Wonder what it 
will be next week? Or maybe it is just some funky Google variation?

But even the variation on that search has leaped up from 383,00:
http://www.google.com/search?hl=en&source=hp&q=vaccines+conflict+of+interest
"Results 1 - 10 of about 1,270,000 for vaccines conflict of interest. (0.35 
seconds)"

Anyway, I think Michel is right overall. There is some deep peer-to-peer 
issue here. It is even implied in the phrase "peer review". But it may take 
a lot to fix this deep, deep interwoven set of problems that Goodstein and 
Schmidt and others (Gatto, etc.) point out.

And on medicine specifically, these issues go way back to the 1970s:
   "Book: Limits to Medicine. Medical Nemesis: The Expropriation of Health"
  http://www.bmj.com/cgi/content/citation/324/7342/923

Two comments from reviewers:
   "Medical Nemesis" by Ivan Illich"
http://www.amazon.com/Limits-Medicine-Medical-Nemesis-Expropriation/dp/0714529931
"""
This highly referenced text, orginially written in the late 70's, outlines a 
well presented documentation of why medicine has not positively impacted 
modern life. Illich argues that iatrogenic illness is far more common than 
we realize. It's a must read for anyone intersted in the evolution of our 
views on "disease" and what constitutes health!
"""

and:
"""
Ilyich wrote this a generation-plus ago, yet his messages resonate today. We 
have depersonalized our lives in so many ways, by bringing the industrial 
model into realms that were meant for emotion, feeling, and art. The influx 
of industry-thought into medicine has torn the sensitive heart from many 
care-givers and patients alike. His text is a bit lengthy and is repetitive 
in spots, and can be challenged on the facts in others. Overall, his 
concerns about the choices we have made socially and medically remain valid.
"""

So, there are some deep issues here, and they have been recognized for 
decades but not acted on. I wonder if the combination of the swine flu 
issue, in the middle of a debate about health care in the USA, and in the 
context of some other trends like p2p on the internet, is causing some sort 
of upheaval of social consciousness on this theme?

--Paul Fernhout
http://www.pdfernhout.net/