I don’t know about needing to read it. The relevant point is its existence, the details of arguments might be amusing but hardly informative. It’s not a paper about medicine, it’s a paper about fighting oppression.
And actually, if there’s this widespread attitude in medicine that only PCRTs and long-held-expert-opinion matter, and every other form of evidence should be discounted in the name of science, then maybe what they conceive of as ‘science’ is acting oppressively.
PCRTs rock for solidity, but they are hella blunt tool.
long-held-expert-opinion also rocks, but it does not come from PCRTs!
Anecdotes and clever ideas are tricky-as-all-hell, but that doesn’t mean you should ignore them.
I don’t suppose you’ve read that wretched paper and can summarise it?
Blah blah microfascism blah legitimacy of truth blah Cochrane hierarchy blah Jacques Derrida blah hegemonic discourses blah subjugated knowledge blah 20th century totalitarianism blah Orwell’s totalitarian vision blah we must resist the totalitarian program blah blah blah.
Money quote: “Those who are wedded to the idea of ‘evidence’ in the health sciences maintain what is essentially a Newtonian, mechanistic world view: they tend to believe that reality is objective, which is to say that it exists, ‘out there’...”
They likely don’t make a good case for their opposition to the focus of objectivity, but the focus on objectivity is not without problems.
On example would be placebo-controlled drugs, in standard trials it doesn’t matter whether people who they get a placebo or an active drug know what they are getting because that’s subjective knowledge. The thing that matters is whether an objective third-party thinks the experiement tried to control for placebo.
As far as microfascism goes, the law that’s in effect that forbids me from healing other people was passed under Hitler.
On example would be placebo-controlled drugs, in standard trials it doesn’t matter whether people who they get a placebo or an active drug know what they are getting because that’s subjective knowledge. The thing that matters is whether an objective third-party thinks the experiement tried to control for placebo.
Sense make not.
Double-blind trials are double-blind for a reason. And subjective knowledge can certain affect objective outcomes, that’s not an issue.
As far as microfascism goes, the law that’s in effect that forbids me from healing other people was passed under Hitler.
We know from Rabkin et al’s paper How blind is blind? Assessment of patient and doctor medication guesses in a placebo-controlled trial of imipramine and phenelzine. that particpants in drug trials often know whether or not they get the active drug.
Standard protocols for double-blinding don’t effectively prevent the participants from knowing whether they get a placebo or the real drug. Yet there little interst of people running studies to ask the participants of their trials whether they know what they are getting.
OK, but how does that lead to “the focus on objectivity is not without problems”?
Badly run trials are evidence for the proposition that some trials are badly run, not for the proposition that focusing on objective results is problematic.
It’s not about badly run trials in the sense that trials are not run according to the gold standard. The issue is that taking active pills frequently feels different than taking sugar pills even when both pills look the same way. That’s information that patients can use to know whether they are on the active drug.
In a world where people would sincerely care about whether trials actually prevent the participants from knowing the questions that Rabkin’s asks would be routine questions in every trial.
Asking patients whether they think they got the drug or placebo, is querying for subjective knowledge. That’s a “way of knowing” that yields knowledge but that’s not practiced. A “way of knowing” that the paper you linked would predict to be neglected.
I don’t know about needing to read it. The relevant point is its existence, the details of arguments might be amusing but hardly informative. It’s not a paper about medicine, it’s a paper about fighting oppression.
And actually, if there’s this widespread attitude in medicine that only PCRTs and long-held-expert-opinion matter, and every other form of evidence should be discounted in the name of science, then maybe what they conceive of as ‘science’ is acting oppressively.
PCRTs rock for solidity, but they are hella blunt tool.
long-held-expert-opinion also rocks, but it does not come from PCRTs!
Anecdotes and clever ideas are tricky-as-all-hell, but that doesn’t mean you should ignore them.
I don’t suppose you’ve read that wretched paper and can summarise it?
I’ve paged through the paper.
Blah blah microfascism blah legitimacy of truth blah Cochrane hierarchy blah Jacques Derrida blah hegemonic discourses blah subjugated knowledge blah 20th century totalitarianism blah Orwell’s totalitarian vision blah we must resist the totalitarian program blah blah blah.
Money quote: “Those who are wedded to the idea of ‘evidence’ in the health sciences maintain what is essentially a Newtonian, mechanistic world view: they tend to believe that reality is objective, which is to say that it exists, ‘out there’...”
They likely don’t make a good case for their opposition to the focus of objectivity, but the focus on objectivity is not without problems.
On example would be placebo-controlled drugs, in standard trials it doesn’t matter whether people who they get a placebo or an active drug know what they are getting because that’s subjective knowledge. The thing that matters is whether an objective third-party thinks the experiement tried to control for placebo.
As far as microfascism goes, the law that’s in effect that forbids me from healing other people was passed under Hitler.
Sense make not.
Double-blind trials are double-blind for a reason. And subjective knowledge can certain affect objective outcomes, that’s not an issue.
...and so what?
We know from Rabkin et al’s paper
How blind is blind? Assessment of patient and doctor medication guesses in a placebo-controlled trial of imipramine and phenelzine.that particpants in drug trials often know whether or not they get the active drug.Standard protocols for double-blinding don’t effectively prevent the participants from knowing whether they get a placebo or the real drug. Yet there little interst of people running studies to ask the participants of their trials whether they know what they are getting.
OK, but how does that lead to “the focus on objectivity is not without problems”?
Badly run trials are evidence for the proposition that some trials are badly run, not for the proposition that focusing on objective results is problematic.
It’s not about badly run trials in the sense that trials are not run according to the gold standard. The issue is that taking active pills frequently feels different than taking sugar pills even when both pills look the same way. That’s information that patients can use to know whether they are on the active drug.
In a world where people would sincerely care about whether trials actually prevent the participants from knowing the questions that Rabkin’s asks would be routine questions in every trial.
Asking patients whether they think they got the drug or placebo, is querying for subjective knowledge. That’s a “way of knowing” that yields knowledge but that’s not practiced. A “way of knowing” that the paper you linked would predict to be neglected.
Thanks, maybe I’ll save it until after I’m dead.