Monday 6 September 2010

The decline of medicine refutes modernity

When people are asked about the success of modernity, they usually refer first to medicine.

I mean that when people are asked to evaluate life in the modern world compared with life at any historical period, the most frequent justification for preferring modern times is medicine.

The benefits of medical progress are primal and self-justifying in a way which can only be matched by breakthroughs in food supply and shelter. But, for moderns, medical progress is the epitome of 'progress' - probably because it represents the most direct relief of suffering.

Medical progress is the number one test case for modernity.


I have even heard the whole thing boiled down to immunization and antibiotics, or to 'anaesthesia' - the existence of which are said to justify modernity against history; as in 'how would you like to live in a world without '*'.

In other words, a growing ability of modern medicine to prevent and cure many diseases (diseases which previously shortened life and caused great suffering on a huge scale - or to abolish pain) is taken to be the strongest evidence of progress, the clearest achievement of civilization in the post-industrial revolution era.

Consequently, the major, least controversial benefit that 'Western' civilization can bring to the undeveloped world has for many decades been said to be medicine.

This is hardly controversial nowadays - what the Third World supposedly needs more than anything in the world is good health care.


Rather than to critique the validity of this argument, I simply want to point out that since medical progress *is* the major validation of modernity, the failure of medical progress is the most powerful refutation of modernity.

I have previously written about the failure of medical progress from the mid-twentieth century, and that for half a century we have been living through a medical research bubble -

Yet the failure of medical research, defined as above, is stark: in broad terms we have not disovered any new classes either of antibiotics or pain killers for many decades.

Just think about the shocking magnitude of this *failure* of modernity: for decades people have been going on and on about the wonders and triumphs of medical progress, its importance - yet our civilization has failed to sustain this progress.

The failure to sustain medical progress is the most significant failure of modernity.


The reason we have failed to sustain medical progress are doubtless manyfold, but in essence I think it is because modernity has chosen bureaucratic expansion above creative individual discovery.

We prefer process over results - consequently we have a truly massive and expanding medical research process with zero or negative results.


It is not just medical research that has collapsed, but the whole practice of medicine.

As I look around medicine it is my impression that doctors know less, can do less, have less spirit, less sense of vocation (or none at all), are less able, make fewer breakthroughs, suffer greater losses of knowledge, have poorer judgment, do worse science, are less honest and have more wrong ideas than they did a generation ago.

And of course, doctors are increasingly managed by ignorant and spiteful time-servers, replaced with inferior professionals and by protocols, and denigrated.

This despite - or rather because - medicine as a social system has expanded by about an order of magnitude (c. tenfold)


Medicine has declined substantially and continues to fall apart.

The only reason that this decline is not blazingly obvious is the massive and continuing expansion of dishonesty: hype, spin, adevrtizing, public relations, propaganda...

In the UK government run NHS, they are not even *trying* to improve things any more - real medical progress has been abandoned.

Instead, efforts go into re-defining medicine and thereby re-defining progress in medicine: subordinating medicine to political and commercial goals, unrelenting information manipulation and media stunts.


So, if the primary benefit of modernity is going-going and will soon be gone - then what price modernity?

What is to justify modernity when medical progress is recognized as having stopped? And then decline becomes impossible to disguise?

When we lose the ability to prevent and treat infections, reliably to provide painless surgery and relief of suffering?

When we fail even to use basic hygeine in hospitals? (In the UK, hospital infections by antibiotic resistant germs are now so common that people are rationally beginning to avoid hospital in the same way our ancestors did.)

When we have lost the remnants of medical capability, then even medical knowledge?


What happens then is that modernity is refuted. Progress will be seen to have stopped, to have been a sham.

And modernity will be refuted not merely abstractly and intellectually, but in a way which is apparent to anyone - in terms of death and suffering.


dearieme said...

Bruce Charlton said...

@dearieme - My attitude is that probably both sides are wrong in this dispute - although medical science is now so corrupt that it will never be possible to know the truth about this.

ab said...

"In the UK, hospital infections by antibiotic resistant germs are now so common that people are rationally beginning to avoid hospital in the same way our ancestors did."

This is an example of retrogression, where the new problems society is creating can't be solved quickly enough ...

In Canada, births usually happen in the same building (hospital) as various other medical procedures - it makes little sense as far as I can tell, as hospitals are one of the most disease-filled places one can go to.

dearieme said...

I watched the Panorama on this - an utter waste of half an hour. We got the fatuous journalism of "she took the pill and then she had a heart attack"; an interview with an American medic of a strangely untrustworthy mien; and someone from the BMJ declaring something-or-other to be "unacceptable". Hopeless.

Pennsylvania HSA said...

I would like to think that most of medical science is still above board. Perhaps a different kind of regulation is needed.

Xamuel said...

We might have made more progress if we hadn't shot ourselves in the foot, and then in the other foot, and then in the face, over the whole stem cells thing.

Bruce Charlton said...

@Xamuel - indeed, but stem cells would never have become the fad they did unless for the corruption of medical research.

BTW 'shooting yourself in the foot' originally had the meaning of being something deliberate - done on the battlefiled to get a 'Blighty wound' and be sent home from the frontline with a moderate wound. If such self-injury was believed to be deliberate, I believe it could lead to very severe punishment.