You might enjoy the attached commentary: a) provocative, b) combines insight and gross oversimplification, c) several accurate and inaccurate statements, d) the very definition of slippery slope, and e) reinforces (unintentionally) why we should consider two of the 20th Century’s most exhilarating and prescient intellects – Isaiah Berlin and Eric Hoffer (just my opinion).
Part of me is surprised the JAMA editors published Dr. Miller’s piece,…..most of me pleased they did. Dr. Miller will receive praise and criticism, sometimes the hallmark of insight,…..or “airing what needs to be aired”.
Keep forefront the distinction between scientific method versus scientism. This dissimilitude, when not recognized, explains a fulsome share of history’s conflict, particularly since the Enlightenment. History is chock-full of intellectuals and scientists making this mistake, an error not unique to John Q. Public. Dr. Miller regrettably blurs the separation,…..but all of us in healthcare are guilty of such from time-to-time.
Some of my highest IQ friends and colleagues harbor the most moonstruck of beliefs,…..they assuredly would say “So do you Joe.” The best we can do is gaze reflectively in the mirror – “Am I being reasonable? Compassionate? Honest? Responsible?”
Isaiah Berlin’s contributions to intellectual integrity, perhaps our pre-eminent philosopher of ideas, cannot be summarized briefly,…..but a core contribution is IB’s thesis regarding Mankind’s principle miscalculation/delusion: 1) there exists an absolutely true and objective explanation to every entity in Nature and human activity, 2) we can reach that truth if we just keep persisting, and 3) all the truths for all the entities and activities will be consistent with each other. #1-2-3 are “True, except in the real world.”
You might think “That’s obvious.”,..…but IB’s error-thesis has/is/will be denied, over and over and over,……and healthcare is a prime exemplar,…..suffering results.
Eric Hoffer’s True Believer addresses similar misconceptions and is a nominee for “Top Ten Under-appreciated Books” of the 20th Century. His personal story is inspiring, heroic. There is a beautiful abstract sculpture honoring his legacy at Fisherman’s Wharf in San Francisco, Skygate,…..easy to walk right by without much notice, like his work.
Joe Kaempf, MD
District VIII Oregon Representative
Portland, OR
Volume 12, Number 47