Elites and Medicine

A reader makes a good point:

"One interesting case study for elitism is medicine. Your familiarity is through experience with HIV; mine, cancer. The point though is the same. There was at first an unresponsive God-like community that made unassailable pronouncements about the science and medicine. Correctly this was rebelled against. But now we have charlatans and healers who have no basis, except anecdotes if that, for their claims. And substantial members of the public believe them over the science. Part of this is because for cases like AIDS and cancer, sometimes science hasn't an answer yet. Nonetheless, the "everyone's opinion is equal" attitude is now as destructive as the God-like elitism. Somehow we need a happy medium - acknowledging expertise while demanding that it explain itself. The anti-knowledge forces are not just religious fundamentalists; read some of the anti-medicine nonsense out there."

I have to agree. One of the most persistent sub-currents out there among people with HIV and AIDS is superstition, or the notion that all drugs are somehow poisonous, or that homoepathic quackery can replace actual science, or that HIV doesn't cause AIDS, and so on. This is particularly widespread among some gays and African-Americans, some of the populations most at risk. You have magazines like Harper's giving credence to "theories" that HIV is unrelated to AIDS - in 2006! In the early days, you had people like Larry Kramer telling everyone that AZT was poison, despite the fact that it was then and remains today a critical component of many effective anti-HIV cocktails (it was disastrous only as over-dosed mono-therapy). Every day, I get emails telling me to try aspirin or St John's Wort for HIV. The right response, I think, is not to take what the science establishment says on faith - let alone the public health establishment. The answer is to try and understand the science as best you can, to ask the right questions, to keep asking, to get second opinions. There is an alternative between fundamentalism and relativism, between authority and nihilism. That alternative is curious and empirical skepticism, which must, of course, respect those whose knowledge of any particular subject is inevitably far deeper than our own. That kind of skepticism is important not only for a patient with a life-threatening disease, but also for liberal democracy and liberal learning. We need to recover it.