Doubt – Part Three
20 May 1747 – I took twelve scurvey patients aboard the HMS Salisbury at sea, cases similar as I could have them,….gave two a quart of cider,….two 25 gutts of elixir vitriol,….two vinegar,….two sea water,….two orange and lemon,….two nutmeg,……and given each day. Consequence was the most sudden good perceived from the use of orange and lemon.
Captain James Lind
What a person calls moral judgment is merely their desire to generalize, and so make available for others those values he or she has come to choose.
C Wright Mills
Philosophy, tho’ it cannot produce a different world to wander, makes us act as if we were different beings from others,….at least makes us frame to ourselves, tho’ we cannot execute, rules of conduct different from those set to us by Nature.
David Hume
Perak et al provide yet more evidence that there is nothing in healthcare that exceeds the paramountcy of ensuring the health of the pregnant woman. Pregnant woman well-being = fetus well-being = child well-being = family well-being = civilized society. Maybe epitomizing C Wright Mills above, but we’ll stick with it.
The nocebo effect – unpleasant side effects from a placebo or sham Rx – is real. Yet more evidence of the public’s general skepticism of science and healthcare. What do we call it when we see this in parents of hospitalized infants or children? Nocebo-by-proxy?
Despite James Lind’s careful observations above (and subsequently duplicated by others), it took the British Navy over 50 years to make citrus juices compulsory for seafaring. Take home lesson for us all: well-executed QI projects, scoping reports, RCTs, systematic reviews, and meta-analyses sit on our desks awaiting our careful reading,…..or easily available online.
Joe Kaempf, MD
District VIII Oregon Representative
Portland, OR
Volume 13, Number 9