rationalskepticism.org

TMB wrote:
My daughter reacted badly to a vaccination, swelling and paralysis down the side of her body with the vaccination. The paediatrician (specialist allopathic doctor) suggested that we should avoid any vaccinations as her reaction was too severe. On what basis could this doctor make this recommendations? Based upon repeatable, confirmed issues around this particular vaccination? In other words did she base her diagnosis and treatment options upon a validated, double blind testing? Actually she used her professional judgement and all the experience gathered in her years practicing, all of it anecdotal. Yet I suggest it was the right choice for my daughter.

Consider another case. After taking a tested drug called Thalidomide in the 1950/60s mothers were giving getting birth defects in their children. This was just anecdotal evidence of course, as the testing required for the drug meant that only when another properly conducted trial that proved conclusively that indeed the drug was harmful and responsible for the birth defects, should it be necessary to stop administering the drug. Of course the gathering weight of anecdotal evidence became a political issue long before the issues were proven in clinical trials. This extreme example shows that many things medical begin with anecdotal evidence. It does not mean that anecdotal evidence is therefore the means to prove effective treatment, and we chuck out all conventional testing. It means that judgement of what works and does not work, regardless of belief, should guide our choices.

Going back to thalidomide, do you think that your argument of

Anecdotal evidence, no matter how extensive and sincerely believed, remains anecdotal evidence

Would have been a good position to take, especially once it was validated. Unless we apply our judgement to medicine, how can you be sure that another more subtle form of thalidomide is happening? Thalidomide simply provides us with an example, it does not mean that we fixed that problem and there are no others, and never will be, therefore we only do what the testing says we should do.

If I recall correctly you are a psychiatrist. How does the practice of this, the medical treatment of mental disorders operate with repeatable, double blind studies on what is efficacious? Is there a whole lot of off the shelf medical treatments that one can apply on a homogenous basis like broad spectrum antibiotics to patients, or is there are requirement to apply your experience, based upon anecdotal case histories in many cases, on what might work for specific patients?