During the 20th century, physics, chemistry, and biology lead to an explosion of innovation and discovery in medicine, giving us such things as antibiotics, radiography, and genetic analysis.
But that legacy is very much at stake as medicine has gravitated from the “sciences” and more to the “social sciences.” This radical framework first emerged in the early 1990s and was heavily influenced by a “postmodernism,” which Britannica defines as a philosophy “characterized by broad skepticism, subjectivism, or relativism: a general suspicion or reason.”
Medicine is not so much a strict discipline of science but increasingly a means to advance certain ideologies or promote activism. It is not unusual to hear the term “social production of disease.” The late, prescient noble laureate in physics Richard Feynman referenced this trend more than two decades ago when he called the social sciences “pseudoscience.”
“Stress” as a Cause of Illness
Medicine rooted in social science often resorts to blaming an unspecified pathology on “stress”. The danger of this “stress” model of disease has been severely underestimated.
An illustrative example is the once–long-time practice of blaming peptic ulcers on “stress” rather than the microorganism H. Pylori. This idea was met with intense skepticism by the medical community, even a decade after its original publication. Ultimately, it required the co-discoverer of the link between H. Pylori and peptic ulcers, Australian physician Barry Marshall, to willingly infect himself with H. Pylori to convince others of the validity of his claim. Though Marshal’s singular act was merely anecdotal evidence, it seems the H. Pylori model of peptic ulcers was not fully accepted until this wild PR stunt caught the attention of the media.
This “stress as a cause of disease” prevails today, with baseless claims that “structural racism” is the cause of poor health outcomes or that poor health may be the result of stress one feels from perceptions of sexism. “Debt and financial” stress can lead to problems with mental health, more than perhaps a chemical imbalance in the brain.
Statistics Can Lead Medicine Astray
Theoretical biologist Stuart Kauffman has pointed out that statistical relationships among components in medicine can lead down a blind alley. Statistics could show, for example, the heart exists solely to fill space between the lungs.
Statistics is also not a science; it is a tool to identify whether data are significant or not. It cannot say anything about methodology or experimental design. Yet clinicians are never given formal education in raw statistics and do not understand probability.
Regardless, physicians make clinical decisions based solely on “statistics” and “probability,” with little regard to the underlying mechanistic relationships between the variables that they are operating on. To put it in Kaufman’s terms, this is like making clinical decisions on the idea that the heart exists to add weight to the chest and not to pump blood.
To give one example of many: several respected physicians do not believe that proton pump inhibitors (PPIs), drugs used to treat heartburn and ulcers, increase the risk of contracting the superbug Clostridium difficile (C. Diff). Part of this reasoning is that “the probability is low,” completely ignoring the fact that the C. Diff grows at an optimum pH of 6, which is within the pH range of stomach acid for patients taking PPIs.
Similar reasoning is starting to emerge in the treatment of obesity. Thanks to the rising influence of the social sciences in medicine, obesity is now looked at through the lens of psychology. The U.S. Centers for Disease Control and Prevention acknowledges the existence of “body shaming.” There is some belief that obesity is not a health problem and that “fat people can be as healthy as thin people.” But these arguments are based on mindless use of statistics and willful ignorance of the underlying pathophysiology of metabolic syndrome. The purpose of scientific experimental design is to provide a distinction between causation and correlation, in the mind of the anti-science postmodernists, correlation supersedes causation.
Science is and has always been non-authoritarian. There is no “king of science” or other major authoritative body to tell others what to think. What is “real” is the scientific method, its reliance on a body of ideas to create a sound hypothesis and testing those results through replication.
When the social sciences can turn medicine into subjectivism, it becomes an authoritative venture. How else to explain the censorship of clinical discussion and evidence relating to early treatment protocols for COVID-19?
The public should be cognizant of the growing influence of social science in medicine and demand that medicine sticks to its scientific roots. Teaching our next generation of healthcare providers the importance of the scientific method and its underlying principles and conceptual frameworks is a good place to start. Let physics, chemistry, and biology make even bigger leaps for the 21st century.
Editor’s note: The writer of this article, a prospective medical school student, wishes to remain anonymous.