First, he ignores that even under current circumstances a lot of people die from quackry (and in fact, the example he uses of Steve Jobs is arguably an example since he used various ineffective alternative medicines until it was too late)
Steve Jobs sought out quackery. You seem to be confused by what is meant by quackery here:
The entire thrust of our medical regulatory system, from the Flexner Report to today, is the belief that it’s better for 1000 patients to die of neglect, than 1 from quackery. Until this irrational fear of quack medicine is cured, there will be no real progress in the field.
People who die because they rely on alternative medicine aren’t going to be helped in the slightest by an additional six or five or four sigmas of certainty within the walled garden of our medical regulatory system. Medical malpractice and incompetence also is not the correct meaning of “death by quackery” in the above text. Death by quackery quite clearly refers to death caused as deaths caused by experimental treatments figuring out what the hell is happening.
You indeed miss a far better reason to criticize Moldbug here. A good reason for Moldbug being wrong is that even with those expensive six sigmas of certainty many people end up distrusting established medicine enough to seek alternatives. If you reduce the sigmas of certainty, more people will wander into the wild weeds outside the garden. These people seem more likely to be hurt than not.
Not only that, even controlling for these people, the six sigma’s of certainty might also be buying us placebo for the masses. But this is easy to overestimate, since it is easy to forget how very ignorant people really are. They accept the “doctor’s orders” and trust them with their lives not because the doctor is right or extremely likely to be right but because he is high status and it is expected of people to follow “doctor’s orders”. The reasons doctors are high status in our society has little to do with them being good at what they do. Doctors have been respected in the West for a long time and not so ancient is a time when it is plausible to argue that they killed more people than they saved. The truth of that last questions matters far less than the fact that it can be raised at all! Leaving aside doctors in particular it seems a near human universal that healers or at least one class of healers is high status regardless of their efficacy.
Nevertheless, today I believe doctors save many more than they kill. I want doctors to treat me, and I want them to become much better at treating me. And if there’s no better choice, I will cheerfully pay the price of more people turning to quackery, because I won’t do it myself.
Steve Jobs sought out quackery. You seem to be confused by what is meant by quackery here:
People who die because they rely on alternative medicine aren’t going to be helped in the slightest by an additional six or five or four sigmas of certainty within the walled garden of our medical regulatory system. Medical malpractice and incompetence also is not the correct meaning of “death by quackery” in the above text. Death by quackery quite clearly refers to death caused as deaths caused by experimental treatments figuring out what the hell is happening.
You indeed miss a far better reason to criticize Moldbug here. A good reason for Moldbug being wrong is that even with those expensive six sigmas of certainty many people end up distrusting established medicine enough to seek alternatives. If you reduce the sigmas of certainty, more people will wander into the wild weeds outside the garden. These people seem more likely to be hurt than not.
Not only that, even controlling for these people, the six sigma’s of certainty might also be buying us placebo for the masses. But this is easy to overestimate, since it is easy to forget how very ignorant people really are. They accept the “doctor’s orders” and trust them with their lives not because the doctor is right or extremely likely to be right but because he is high status and it is expected of people to follow “doctor’s orders”. The reasons doctors are high status in our society has little to do with them being good at what they do. Doctors have been respected in the West for a long time and not so ancient is a time when it is plausible to argue that they killed more people than they saved. The truth of that last questions matters far less than the fact that it can be raised at all! Leaving aside doctors in particular it seems a near human universal that healers or at least one class of healers is high status regardless of their efficacy.
Nevertheless, today I believe doctors save many more than they kill. I want doctors to treat me, and I want them to become much better at treating me. And if there’s no better choice, I will cheerfully pay the price of more people turning to quackery, because I won’t do it myself.