Evidence trumps hunches in medicine - and in theology

The most popular item on the TIME magazine Web site at the moment is a survey of how evidence-based medicine is starting to displace doctors' hunches. The article implicitly illustrates how (to use religious language) we're far better off when we give priority to the reality that God actually wrought, rather than clinging to our limited conceptions of that reality. To paraphrase the Rev. Barbara Brown Taylor's definition of 'faith,' it's a Very Good Thing to remain open to the truth, no matter what the truth turns out to be.

Excerpt:

Increasingly, doctors seeking to provide their patients with the best possible care are exploring what is known as evidence-based medicine--a hard, cold, empirical look at what works, what doesn't and how to distinguish between the two. It's not enough to prove that a particular blood test or CT scan really spots cancer, for example. You also need to know whether early detection of that cancer would make a difference in your ability to respond to treatment or it merely means that you would die at the same point but learn about your illness earlier than you would have without the test.

Evidence-based medicine, which uses volumes of studies and show-me skepticism to answer such questions, is now being taught--with varying degrees of success--at every medical school in North America. It has been extraordinarily successful in shooting down some of the most cherished beliefs in health care, like the idea that long-term hormone-replacement therapy would help prevent heart disease in women. And it has clearly saved lives. Many doctors used to give anti-arrhythmia drugs to everyone who experienced irregular heartbeats after a heart attack because severely irregular beats could rapidly prove fatal. But then came the results of a randomized trial showing that patients with only mildly irregular heartbeats were more likely to die if given the anti-arrhythmia medication than their untreated counterparts were. Doctors now prescribe more judiciously, though treatment still saves lives in the case of severe arrhythmias.

[...]  Physicians who encouraged their female patients to take hormone-replacement therapy to prevent heart problems later on were practicing a kind of evidence-based medicine, since the best available evidence at the time--observational studies and the like--suggested a benefit. Of course, when a randomized controlled trial showed otherwise, the advice changed. Even at that, the case is not entirely closed. Some researchers now believe there may be a window of opportunity right around the years of menopause during which hormone-replacement therapy could help the heart. Proving that would, naturally, require another study.

All the same, few people deny that the trend in medicine is increasingly to be guided, if not governed, by the data--an idea that is spreading to other fields as well. Evidence-based practice is now being taught in nursing, general education and even philanthropy, thanks to the influence of the Bill and Melinda Gates Foundation, a results-based group if ever there was one. You could see even the political fights over global warming as the birth pangs of the new practice of evidence-based policy.

Christine Gorman, Are Doctors Just Playing Hunches? in TIME, Feb. 15, 2007

Comments

[Wayne]

DC,
Thanks for pointing out this excellent article. Just as to be effective, medicine needs to be open to evidence-based correction, so too does religion. One of the disturbing trends in the debate about religion and science is the position of some that science and religion occupy non-intersecting realms so the rules of one sphere don't apply to other. It seems to me that rules of scientific evidence could certainly be useful in examining many religious beliefs. For example: if science were to find that the DNA of Jesus actually existed on the Shroud of Turin, would religious believers say, "Oh, we don't care about that. Our beliefs have nothing to do with evidence." No way. In the same way, if bones were found in an ossuary in Jerusalem that matched the DNA of Jesus, might this not have some effect on the beliefs of a large number of Christians?

Many like me think that an evidence-based religion is sorely needed. Certainly people can appeal to "the evidence of their changed hearts" and the moral law to justify their religious beliefs, but that has to be weighed along with the evidence of evolution, anthropology, psychology and many other fields of scientific endeavor.

Sadly, I think the modern truce between science and religion is more of an effort to save irrational belief from the glaring light of science than any effort to save science from religion. And many religious believers will claim that "true" faith is defined by belief against all evidence. Or as Mark Twain once put it that "faith is believing what you know for a fact ain't so."

[bls]

"Or as Mark Twain once put it that "faith is believing what you know for a fact ain't so.""

But that's not true at all. Nobody knows, or can know, "for a fact" whether or not there's a God; nobody knows or can know "for a fact" whether or not there's an afterlife. D.C. has faith in both, however. Are you saying that he already knows they don't exist? I don't think that's true.

But I'm wondering why, when it comes to religion, the evidence of thousands of years is so often ignored or sneered at. The evidence says that religion - belief in God - is something quite deep and persistent in the human psyche; it says that liturgical action (whether religious or, as in D.C.'s last post, military, or "other") also persists and has deep meaning to human beings. I always wonder why atheists who purport to be scientists don't find this curious, and ask questions about it? Rather, like Dawkins and others, they find it childish and silly - but that says something about them, I think. They are religious atheists, actually; they hold their beliefs with as firm a grip as any fundamentalist.

Why don't they ever think to ask about people like St. Francis, for instance, whose whole life was a testament to his faith, and who is admired by religious and non-religious people alike? What about the social activism of the Quakers? What about people like Albert Schweitzer and Dietrich Bonhoeffer? What about the Sisters of St. Mary, who died caring for victims of yellow fever? What about Dr. Martin Luther King? Why don't atheists who scorn religious faith investigate what makes such people tick?

They are very close-minded, if you ask me.

Bls,
I think Bertrand Russell answered the question about "knowing for a fact that God exists." It's very difficult to prove a negative, but we can look at the evidence to give us some degree of reliability in our conclusions. Does the Loch Ness monster exist? Well, we have seen some fuzzy photos, but other than that it's difficult to affirm its existence given our current knowledge of evolution and the types of fauna that currently exist in lakes.

The thousands of years of "evidence" for religion is limited to reports of the experiences of generations of people. I don't believe it is sneered at, but must be taken in the context of the knowledge available to those reporting their experiences. When people lacked the medical knowledge to understand epilepsy they attributed it to demons. When people lacked the knowledge of neurology and psychiatry, they attributed foreign voices in their head to deities or devils (e.g. Joan of Arc).

The fact that religion has persisted in the human psyche for centuries says nothing about the existence of God, any more than the voodoo cultures of certain islands says something about the existence of magic.

I have read Dawkins and he does indeed pay tribute to St. Francis and Albert Schweitzer and others who were motivated by compassion. But again, human compassion does not lead inexorably to the existence of God. If their belief in God motivated them to act with compassion, then we can acknowledge that, but the fact that a belief is useful does not mean that it is, in fact, true.

The religious instinct of compassion has certainly proved useful to humans, but other religious instincts such as exclusivity (well documented in the Hebrew scriptures) have lead to outright genocide and other horrors unimaginable and will continue to until more evidence-based religion gains enough traction in the world to stop it.

[bls]

"The fact that religion has persisted in the human psyche for centuries says nothing about the existence of God...."

That's right, it doesn't. I'm not trying to prove the existence of God, something I've already said can't be proved. I don't understand why people get stuck on this question; there's no possibility of it being resolved, so let's move on.

I'm asking why scientists regard religion in the way that they do: with contempt, rather than with curiosity. Why aren't they interested in why it's been around so long, and in what it's about? It exists; it's a fact. Why is it that people have such trouble accepting reality on this topic?

And after a century of "horrors unimaginable" - the worst in human history, in fact - coming out of explicitly atheist ideology, I would think it's obvious that "horrors unimaginable" will exist with or without religion - and also that religion's claims of human sinfulness are proved true, and optimistic views of human progress proved false.

[bls]

(Anyway, I wasn't talking about "the religious instinct of compassion," either.

I was talking about something in the Christian faith, in particular, that inspires people to give up everything they have in order to step into the unknown and reach out to help the poor and marginalized and oppressed. What is it that is found in Christianity that impels this sort of totalizing self-giving behavior? Why isn't this of interest to the anti-religionists?

BTW, in survey after survey, it's been found that, at least in the United States, religious people - whether conservative or liberal politically - give far more to charity than the non-religious.)

[Wayne]

bls,
I'm detecting some all-or-nothing thinking . I haven't seen much evidence that all scientists wake up each day with their first thought being "where I can find some Christians to ridicule?" All scientist don't regard religion as absurdity, just some. I don't think that people like Dawkins, Harris or Dennett just woke up one morning and decided to stick it to religious people just to be bullies. Rather I think they are genuinely concerned as human beings about some of the ghastly side-effects of certain religious world-views and, as scientists, with understanding how religion evolved into its present forms.

One thing I think is necessary here is to debunk the tired canard that "atheism was responsible for millions of death in the 20th century." No one ever killed anyone because of their personal non-belief in God. It's a non-sequitur: "I don't believe in God; therefore I think I'll kill you".

What does flow logically is the following chain of reasoning that has been used through the centuries and continues to be used to this very day:
1. According to my holy book, you are violating the will of God.
2. My holy book says you deserve death.
3. I will act as God's glorious agent and kill you.

About, the 20th century: it is more true to say that socio-pathy killed millions of people in the 20th century and some of the socio-paths who were behind the killings espoused an atheist ideology. Atheist ideology does not inexorably lead to killings any more than a religious one does. There are millions of atheists in China, Europe and the US. Do we see mass murdering and mayhem committed by them?

And if the relative merits of religious world views are scored by body counts, as soon as Iran launches their nuke at Israel in the name of Allah, the score will even out quite quickly.

On a more conciliatory note: certainly some religious world-views have been good for the world. The religious world-view espoused by Einstein comes to mind. But circling back to DC's original topic, what needs to challenged forcefully is irrational world-views. Because irrationality is the common element in all ideologies that lead to murder, mayhem and a host of human ills.

[bls]

Matter of fact, you're the one engaged in "all or nothing" thinking. I've never, anywhere, said "all" scientists did anything. I simply wondered why scientists show contempt for religion rather than being curious about it. Surely you're not going to deny that many scientists do show contempt for religion? I can find a hundred examples in two minutes online, if you like.

I haven't said anything that's a "tired canard," either. I didn't say that "atheism was responsible" for anything; I said that atheist regimes are demonstrably as murderous as religious ones. What's even controversial about this?

We all acknowledge that religious people can be tyrants, bastards, and murderers. You, apparently, refuse to acknowledge that atheists can and have been, too - and even worse ones.

Do we see mass murder and mayhem committed by all the millions of Christians and Muslims and Buddhists out there, BTW? (And couldn't you even for a minute see the other side of that argument? I mean, really....)

[bls]

(And BTW: atheists have indeed killed other people because those people believed in God - in the Soviet Union, for instance. Religion is also persecuted in secular China. I'd think you could classify the extermination of the Jews in Germany as a persecution of religious people by the non-religious, too.

And I don't doubt that it will happen again. It's touching that you have such faith in the rationality of atheists, but it's misplaced.)

[V Knutsen]

Quote from above

"And after a century of "horrors unimaginable" - the worst in human history, in fact - coming out of explicitly atheist ideology, I would think it's obvious that "horrors unimaginable" will exist with or without religion - and also that religion's claims of human sinfulness are proved true, and optimistic views of human progress proved false."

I mostly agree with the above. We started out the 20th Century with the idea that "the world is in our back pocket" thinking that our moral progress will parallel our technological progress. (Read some of the egotistic statements of the 19-20th century time!!!)

But our technology just helped us kill and even mass murder on vaster, broader scales. Anyone there to claim any **overall net gain in ethics** in the 20th Century over the 19th?

And I think that we too quickly want to reject any values, ideologies, since it is not fashionable to hold onto any kind of moral absolutes. (How many college kids have YOU met who DON"T sneer at the concept of moral absolutes, revealed truth, etc.? They need not research for themselves---test truth claims for themselves, because many of them have subscribed to the "ideology on a plate" served up by whatever prof. merely appealed to them the most.)

Like medicine, let us all put it all to the test. Religion will not all fit into the empirical testing, but much more of historic Christianity is verified in large part than the average person realizes.

But unline medicine's current partly deficient research-- done on middle aged women & hormore theory, (which cost some women their lives!!!) we need to research correctly thoroughly.

Both super socialistic regeimes (the main mass murderers Naziism their hostile cousin, the still active Communism) (at times) paid lip service to established religions when it served their purpose...Both regiemes actively went after persons of faith, including Christians, who did not "tow the line" i.e. bow to their form of "god" first.

(I think of Stalin allowing churches in Moscow to stay open- unharassed while the Nazis threatened Moscow's security--a policy later reversed.)Both ideologies of death & destruction owe a big debt to Social Darwinism which they pushed to the ultimate max in slightly differing ways.)

The theory of evolution pushed into a pseudo religion....a tool which could be further honed even today by leaders who could lure persons with no real belief systems...persons whose beliefs were maybe TOO adaptable...persons whose beliefs had no real anchors...boats without rudders, or oars.

I think of the scene in the 70's movie "Cabaret" about late 1920's early 1930's Germany....After you (the audience) see scene after scene of debauched persons...you see this fresh, pure looking young teen boy singing an incredibly beautiful song. What a relief!!! So you think till the camera pans down to his Nazi uniform.

Yes, those who have rejected all anchors, but who get tired of drifting along, will be MORE EASILY seduced by those offering structure & a set of values...Deconstruction now reconstructed....by the next group that comes along with a seemingly attractive belief system...