Page 13 - Spring 19

Para-substantial truths
If medicine were an exact science to cure diseases, computers would be enough. In such a case computers would be unbeatable. Doctors are definitely needed precisely because it is not an exact science. For the same reason, the opinions of the patients, that is the comparison with their empirical truths, are necessary.
Today, there are those people who, in the Popperian sense (an hypothesis can be shown to be false by observed exceptions, but can never be proven to be true), “falsify” the truths of medicine. Today episteme (certain knowledge) and doxa (probable knowledge) are complementary. Today, the methodological rigor properly denied by the ordinary complexity of the sick being, is that which puts medicine into crisis. The absolute value of procedure in all its forms is a fundamental guarantee of scientificity.
Today, however, some, such as Prof. Burioni, instead of facing the complexity of a stochastic knowledge and a para-complete logic, aim to impose an inexact medicine as if it were exact, through procedures, algorithms, and legal obligations; making use of scientific evidence as if these were dogmatic truths and incontestable, when in reality they are not.
Most of the scientific evidence has the unpleasant drawback of being true in some cases and not being true in others. It depends on the patient with whom you are dealing. For this reason it would be good to consider them para-consistent truths that are always relative to a certain degree of complexity.
Everyone knows that the grave of evidence is the complex ill person. This does not mean it is clear that we must renounce scientific evidence and not be scientific, far from it. It only means that we must learn to use scientific
evidence in fair epistemologies: that is discrete truths, that to be truly verified are forced to deal with the real. That is to be more realistic of their experimental values.
Today society asks for greater realism, beyond the laboratories.
Social hesitation
Greater realism means dealing with gaps, contradictions, dis-confirmations, discontinuities and singular differences.
Society, empirically, has understood, in millions of different ways through millions of different individuals, the para-consistency (dealing with contradictions in a discriminating way) of the truths of medicine and for this “hesitates”.
The hesitation we discuss regarding vaccines is a problem that affects all medicine. This society “hesitates” towards a science proposed as exact when it is not exact. “Hesitates” against deception in acquiring knowledge. For these significant reasons, it “hesitates” regarding vaccines.
If it “did not hesitate” in front of a medicine proposed as an exact science when it is inexact, it would not hesitate against vaccines. Today many citizens simply “hesitate” in front of any drug, let alone in front of 10 mandatory vaccines to be given to their children.
Personally I would gladly subscribe to a pact that, in response to social hesitancy, renounced epistemic deception by proposing a definition of realistic medical science, restoring its right, as an enterprise combining knowledge and values, to fallibility.
Political medicine and society
The pact proposed by Prof. Burioni goes exactly in the opposite direction, perpetuating the epistemic deception,
denying society’s role as interlocutor, denying society’s problem of hesitation, denying all the complexities involved.
It is not by chance that its 5 points address exclusively “politics”: to ask them, in essence, to cover the epistemic deception, and to overcome the hesitation of citizens by legally obliging them to accept an unrealistic idea of medicine.
This is not just simply deceptive; it is madness. It does not lead us anywhere, and above all it is destined to increase the disillusionment of society towards science, and in particular, medicine.
On the contrary, in thinking of a “pact” we must talk to society and citizens to take care of the problem of social hesitation,(https://www.ilfattoquotidiano.it/2019/01/10/ quella-di-burioni-e-unidea-di-scienza-vecchia-e- superata-e-il-suo-patto-lo-conferma/4888431), to rethink the relationship between medicine and society, and to reconstruct a relationship of trust. This is exactly what, due to epistemic deception and much more, we have lost today.
I would ask much more from politics:
• To rethink university education, both the contents and
program of study
• To teach doctors complex reasoning
• To use knowledge of complex relationships
• To understand the problems of scientific evidence, the
value of informed consent etc.
That is to politics, it is not possible to ask for two things: • A reform of medicine,
• The resolution of the “medical question” and therefore
a new doctor.
Pseudo-sciences
The other thing that negatively affected the pact is point
11
Continued on p12