SGU Episode 449
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| SGU Episode 449 |
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| February 15th 2014 |
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| (brief caption for the episode icon) |
| Skeptical Rogues |
| S: Steven Novella |
B: Bob Novella |
R: Rebecca Watson |
J: Jay Novella |
E: Evan Bernstein |
| Quote of the Week |
The inclination to sink into the slumber of dogma is so natural to every generation that the most uncompromising critical intellect must without intermission stand upon the watch against it. |
Otto Pfleiderer, 1902 |
| Links |
| Download Podcast |
| Show Notes |
| Forum Discussion |
Introduction
You're listening to the Skeptics' Guide to the Universe, your escape to reality.
This Day in Skepticism ()
- February 15: Happy Decimal Day: http://en.wikipedia.org/wiki/Decimal_Day
News Items
Organic Molecules on the Moon ()
Astrology Belief ()
New Burgess Shale Find ()
Boeing Anti-Gravity ()
Photo Lineups ()
Quickie with Bob - Fusion Beats Unity ()
Who's That Noisy ()
- Answer to last week: Alan Shephard
Questions and Emails
Question #1: Net Neutrality ()
Follow up discussion on net neutrality
Question #2: Placebo Medicine ()
This is a question perhaps specifically focused at Steve, but I would be interested in hearing everyone else's opinions as well. I am a fourth year medical student about to graduate and enter an internal medicine primary care program with the goal of becoming a future primary care doctor. As such, I will be many patients' first and/or only contact with the health system. I know that I will encounter a lot of pseudoscience in this role, and I already have seen my fair share during my clinical rotations thus far. I am unsure of how to stay true to my skeptical nature while still supporting my patients therapeutically. For example, I recently had a patient with failed back surgery syndrome – essentially, lower back pain status post surgery, now with worse pain dependent on opioids to treat. It's a bad situation – the pain is keeping him out of work, opioids are causing problems of their own (and are ineffectual and inappropriate for chronic pain), and he has exhausted the limits of our medical knowledge – he is on NSAIDs, has done physical therapy, has has had all the imaging and even the surgery without relief. So he comes in and tells me he recently started acupuncture and 'it's working wonders'. I have seen this similar story frequently – patients with fibromyalgia or arthritis, or itching, finding relief from acupuncture, or herbal medications, or homeopathy. Frankly, these particular cases have minimal 'harm' – even though alt med can have harm on a large scale when patients avoid conventional medical treatment or engage in dangerous practices, in these particular cases the patients have tried everything medicine has to offer and are still following up with their physicians. While I feel strongly that it is unethical to prescribe a placebo and would not thus go out of my way to recommend non-proven alternative medicine, if a patient takes a placebo on their own and finds relief, it would only be harmful to their health (both mental and physical) and the therapeutic doctor-patient relationship to disabuse them of the notion that the alt med is helping them. A few things could happen if I did: they stop the therapy and are in worse pain taking meds with more side effects, or they don't stop the therapy but stop seeing me because they don't trust my opinion anymore since the therapy has worked and I don't believe it. So when a patient comes to me, being helped by alternative medicine, and asks what I think, I nod and smile and say 'some patients do report relief from that'. Is that wrong? Should I be more firm to my skeptical roots? What if they ask for my opinion before starting the alternative medicine? It may legitimately be helpful through a placebo effect (which would only be minimized by my telling them the truth), they would be taking it under physician supervision, and honestly, there are a lot of medications that we DO prescribe with actual serious side effects that, on balance, are likely only minimally superior to placebo (SSRIs being a good example). These patients are taking alt med for pain or depression or other more subjective complaints, not for cancer or heart disease or something that could kill them without proper therapy. As you can see, I'm ethically conflicted, sorry for the rather rambling question. I could really use your advice!PS – all the usual: love the show, been listening for years, huge fan :)JaimePhiladelphia
Science or Fiction ()
Item #1: Scientists report the results of the first mapping of a genome of a Clovis skeleton, finding that 80% of present-day Native American populations are direct descendants. Item #2: A new study finds that crocodiles are able to climb trees, some even vertically. Item #3: Australian astronomers have discovered the oldest known star, which they date to 14.5 billion years old, 800 million years older than the age of universe.
Skeptical Quote of the Week ()
“The inclination to sink into the slumber of dogma is so natural to every generation that the most uncompromising critical intellect must without intermission stand upon the watch against it.” - Otto Pfleiderer, 1902
S: The Skeptics' Guide to the Universe is produced by SGU Productions, dedicated to promoting science and critical thinking. For more information on this and other episodes, please visit our website at theskepticsguide.org, where you will find the show notes as well as links to our blogs, videos, online forum, and other content. You can send us feedback or questions to info@theskepticsguide.org. Also, please consider supporting the SGU by visiting the store page on our website, where you will find merchandise, premium content, and subscription information. Our listeners are what make SGU possible.
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