Medicine (and science) is just fascist politics

A month or so back, someone very strange published an article explaining how evidence based medicine is "fascist." Evidence based medicine, of course "is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients." How horribly fascist. Indeed, the main individual targeted for "fascism" was himself a prisoner of the Nazis and a soldier in the fight against Spanish fascism before the Second World War.

The bloggysphere of course was very excited by this idea, and responded with its characteristic calm, dispassionate analysis. Alan Pearson ("RN MSc PhD FAAG FRCN") has written a partial defense (quoted at length over at badscience) in which he quotes the calculated considerations of blog commenters, and concludes that:

In critiquing the health sciences, serious postmodernist scholars acknowledge the possibilities for the advancement of population health inherent in current medical and healthcare research methodologies, conceding that the empirical sciences pursue practical questions and that this has led to the eradication of many previously overwhelming illnesses, diseases and symptoms.

But nonetheless advances the argument that "The ill-informed, reactionary responses to [the original paper] by the defenders of science make little contribution to the ongoing development of evidence to improve global health." He also asserts that "the reference to microfascism in the paper in question may, indeed, have some validity."

On its own, I would take this as some sort of Sokalian hoax with a co-conspirator to help the hoax persist. But it cannot be taken on its own, because the rhetoric is not so far removed from the rhetoric used by the ID movement.

Richardson begins by introducing postmodernism to his readers:

postmodernist … has played an important role in creating new ways of developing ideas in the arts, science and culture. The relativism on which it is founded, and the ‘liberation’ from sacred cows it seeks, have a place in healthcare and health science. … postmodernism is a response to … the period where science was trusted and represented progress – and essentially focuses on questioning the centrality of both science and established canons, disciplines and institutions to achieving progress.

Let's pause for a moment. "Creating new ways of developing ideas in the arts, science and culture" is exactly what the Discovery Institute's famed Wedge Document set out to do, and the DI's strategy has always been a response to the trust people have in science, and questions "the centrality of … science … to achieving progress." The DI has no research agenda, their strategy is to redefine science and to rhetorically deconstruct the process of science and to "liberate" sacred cows. Just ask DaveScot, who has posting privileges at Bill Dembski's blog and wrote there "[Science] shouldn’t be fascist either but that’s exactly what it is when it comes to challenging sacred cows like evolution."

Heck, the DI blog had a post up a month ago about the dangers of "repeating modernism's mistakes." Like Richardson, the DI complains that "[Chris] Mooney and others are living out the modernist superstition--the idea that you can have science without subjectivism; that science is a divine rather than a human activity; that facts neatly assemble themselves into theories rather than human investigators getting their hands dirty in piecing observations together. The latter is reality, and it is only good scientific practice that scientists should be debating the adequacy of a range of scientific theories--including neo-Darwinism." Set aside that the claim about Chris Mooney is false. The argument is part and parcel of the postmodern critique of fascist, evidence-based thinking.

Richardson continues:

The nature of ‘truth’ is a recurring concern to postmodernists, who generally purport that there are no truths but multiple realities and that understandings of the human condition are dynamic and diverse.

This is how IDolators approach what they think of as "science." Consider the meditation on the demarcation problem at Telic Thoughts, in which it is explained that the separation of science from non-science "is primarily a social/political question. By that I mean that the motivation for asking whether something is science or pseudoscience is primarily social/political in nature." Why would TT's macht say that? You see, "the question of demarcation almost always comes up for political political [sic]. Should the government fund this research? Should we teach that in schools? The science/pseudoscience demarcation line is supposed to provide us with acceptable candidates for government funding, educational topics, etc. God forbid we should give money to cranks or teach our children to be quacks."

The possibility that government funding goes to science for exactly the reason that science is different from non-science seems not to have even occurred to macht. That science is a way of distinguishing truth from non-truth is precisely why we try to isolate what makes science work, and why we fund and teach the process that does exactly that, and why we oppose teaching or funding things that do not follow those methods but which purport to do so.

The notion that no one view, theory or understanding should be privileged over another (or that no discourse should be silenced) is a tenet of postmodernist critique and analysis. Hlynka and Yeaman suggest that the postmodernist position is characterised by pluralism, searching for double meanings and alternative interpretations, distrust of grand theories and of established professions and their views and a commitment to the view that there are multiple truths.

It's still hard to see how this description is different from what IDolators would apply to themselves, all the while complaining about post-modern moral relativism. Of course some theories should be privileged over others. There is truth and there is truth. Theories and understandings that are untruthful are inherently less valuable and less worthy of respect than ideas that are truthful.

These things matter because the ideas represent phenomena in the real world, and the real world matters. The only way to assess what happens in the real world is by looking at evidence from that world. When scientists are dismissive of people who blithely reject the use of evidence to inform decisionmaking (whether as creationists, post-modernists or advocate of alternative medicine), we are not being microfascist, fascist, or megafascist. This is how we contribute "to the ongoing development of evidence to improve global health," and to promoting the well-being of humanity and the world we live in.