What good is “progress” in medical science?
I find the progress of medical science confusing and even disillusioning. The consensus about what’s bad for us, and what’s good for us is always changing. Whatever you’re worried about, from nutrition to cancer screening, there is bound to be a diversity of medical opinion out there, sometimes directly in conflict. And as more and more of life’s inevitable challenges are turned into medical conditions, we have more and more to worry about.
Louis Menand, writing recently in New Yorker Magazine, observes:
Progress in medical science is made by lurching around. The best that can be hoped is that we are lurching in an over-all good direction.
But there are many reasons to believe that the current direction in the US may not be “over-all good.” At the macro level we need only compare our yearly public expenditure on public health (now more than $30 billion, not counting an extra $10 billion in stimulus package funds this year) with the general state of health and health care in the US (respectively, mediocre and astronomically expensive).
Menand’s article provides a fantastic opportunity for thinking about the two-way connection between medical science and our sense of ourselves. (It also adds to a small collection of stories I have been gathering under the general topic of science policy and mental health.) It is easy, and quite defensible to focus blame for obsessive medicalization on the rapacious drug companies, but science itself also plays an important role. Menand provides a useful illustration:
Turning shyness into a mental disorder has many downstream consequences. …once a diagnosis is ensconced in the [Diagnostic and Statistical Manual of Mental Disorders], it is legitimatized as a subject of scientific research. Centers are established (there is now a Shyness Research Institute, at Indiana University Southeast) and scientists get funding to, for example, find “the gene for shyness”—even though there was never any evidence that the condition has an organic basis. A juggernaut effect is built into the system.
This juggernaut effect is based in the practice of science, and the institutions underlying that practice. The example shows that our understandings of health and our approach to medical science are directly impacted by one another, and feed off of one another in complex ways. We do not necessarily improve health outcomes by funding more medical research, but we certainly change the way health is (mis?)understood.
I recommend reading Menand’s article in full. It investigates a number of fascinating and troubling critiques of psychiatry, the most profound of which asks whether it can even be considered a valid science. And if so, what can we expect from it?