August 25, 2005
The ethical dilemma of faith healing - 2
There were some very thought provoking comments (some of them sent privately) in response to my posting on the ethics of faith healing. In one of the comments, Erin made a very telling observation that I've been thinking about and which prompted me to revisit the topic.
Those of us who do not believe in a god who intervenes in daily life tend to think of faith healing (if it works at all) as purely a placebo effect whose success depends on people believing that there is something real going on. As I said before, I have a real problem with how to deal with this.
On the one hand, the rationalist/skeptic in me wants to actively debunk all faith healers as, at worst, cynical con artists who are preying on the gullible for monetary gain or for fame and glory, or at best as self-deluding people who genuinely believe that they have some sort of gift. Even if a few people are of the latter kind, allowing them to propagate the belief that faith can heal allows the charlatans amongst them a greater chance of swindling others.
On the other hand, the humanist in me wants to keep out of the issue since I don't want to jeopardize the chances of a "cure" for a few people, even if it is placebo induced.
In these types of discussions, we tend to contrast the placebo effect (which is based on an illusion) with the effects produce by modern medicine, which is assumed to be based on science and is thus real. But Erin points out that the medicine-as-science versus placebo-as-quackery distinction isn't as clear-cut as one might imagine.
On the third floor of Allen building (where my office is) is the Dittrick Medical History Museum. It consists of just two rooms but contains enough devices and descriptions of past treatments to make me glad that we live in the current age. If one goes back in medical history, one finds all kinds of treatments that were once fully endorsed by the medical establishment and are now discredited. Some of them (such as bleeding using leeches) are pretty bizarre. The museum is free and open 10:00 am-4:30 pm Monday through Friday, and well worth a quick visit.
So what are we to make of these past treatments? Based on current science, we have no reason now to think that they should work, so any success they had must have been due to the placebo effect. But since the medical establishment believed in those treatments then, they must also have been considered science at that time. One assumes that the physicians of that time recommended these treatments with complete sincerity and achieved some "cures". What distinguishes them from the sincere faith healers of the current times?
Can we maintain the distinction between science and the placebo? Some argue that we cannot. I have heard it said that: "The history of medicine is the history of the placebo." This may be a little strong but it has enough truth in it to be disquieting. What if current medical treatments are also placebos? It could be that a few generations from now, people will marvel that bodies were once cut open with sharp knives or that strong chemicals were introduced into the bloodstream, all in the name of medicine-as-science.
One way to get around the problem is to think that past generations of medical scientists were simply wrong and that we are fortunate to happen to live in an era when science has come into its own, producing real cures, and that our current successful treatments are permanent. Some science triumphalists extend this argument across the board, arguing that current scientific knowledge, unlike that of its predecessors, is right in its essentials and that all that awaits us in the future are minor improvements, tinkering at the boundaries.
I am always a little wary of assuming that we live in a special time in history, whether it is a high point (as asserted by the science triumphalists) or an especially low point (as asserted by those Christian fundamentalists who think the country has gone to the dogs and want to return it to a previous era by putting religious symbols in the public sphere and overthrowing evolutionary theory). While changes have undoubtedly occurred and in some cases for the better, we may not be too different from our predecessors in our ability to distinguish good science from bad, or science from non-science.
One thing that has definitely improved is our research protocol methods. At least with double-blind clinical trials, we can have some confidence that some of the medical treatments we use are truly beneficial. But that still does not solve our problem of the ethics of faith healing and whether we should try and debunk them, whether the practitioners are sincere or not.
That's the trouble with true ethical dilemmas. There is no obvious right answer.
POST SCRIPT 1
Tom Tomorrow spells out how supporters of the Iraq war avoid reality.
POST SCRIPT 2