What’s happening in Berlin (or everywhere else around the globe, like in Disneyland)? Why do people want to get the measles in 2015 and not want themselves or their kids to be vaccinated against it? What went wrong with the project of enlightenment and rationality? (Okay, that was just a rhethorical question. I know that the enlightenment project was abandoned after its kick-off meeting in the 17th/18th century due to uncertain Return on Investment and Shareholder Value.)
I’m not a fan of Western medicine because of how much it knows with absolute certainty. I’m a fan of Western medicine because it admits how little it actually knows when we apply the demanding standards of evidence based medicine. This makes it easier for us to distinguish areas where we have established medical practices that are rational and evidence-based and areas where medical practice still has much to do with belief, or with the inability of a doctor to say „I don’t know, I think doing nothing could also be an option“.
Just take a look at the Cochrane library: it’s a gigantic collaborative effort, with hundreds of scientist crawling all kinds of available studies regarding a subject and meta-analysing those studies to assess the quality of knowledge we really have.
In a large percentage of cases the answer is: we don’t know enough, the data quality is too low, especially when it comes to questions like „is new-fangled and expensive drug X more effective than placebo and / or cheaper first-generation drug Y“, or questions like „what should I eat and how should I behave to live long and successfully?“. We don’t know if reducing salt intake actually lowers your blood pressure. We don’t know if washing your newborn’s cord with Chlorhexidine vs soap actually lowers the risk of bacterial infections. Should people suffering from dementia do exercise programs? Not sure. All this new stuff about redesigning your workspace so you rather stand and walk than sit? Not sure if it keeps you healthy (but it definitely helps the furniture industry.)
On the other hand, against this background of uncertainty, there appear to be some things Western medicine knows quite well:
- if your wisdom teeth were removed, for your own sake and less ouch please use Ibuprofen instead of Paracetamol.
- if you have an acute pneumonia, please swallow antibiotics, or else you might die (just what type of antibiotics is still questionable, but still, please don’t just lie in bed and use homeopathic globuli).
- vaccines work, as exemplified by zero Polio infections in Germany since 1992 and the global eradication of Smallpox (80s).
I can understand if people, for some reason or other, like to treat aching legs with curd packs instead of Diclofenac or treat smaller open wounds with honey, because basically, there is very little high-quality evidence that using branded creams is superior to granny’s traditional honey medicine. I just don’t know how one could dispute the enormous and well-documented positive benefits of vaccination. It’s like going back to the saying the sun revolves around the earth. Again, it is part of the transparency of Western medicine to admit that in rare cases, also vaccinations can have adverse effects – but so do the sicknesses people are vaccinated against. If the level of anti-vaccination sentiments remains as high as it currently is, I think we should go the French way – and make some vaccinations mandatory.