Behind the Crikey pay wall, Melissa Sweet writes about prostate cancer.
The argument, as far as I can tell, runs like this:
- Peter Beattie has spoken out in favour of getting screened for prostate cancer.
- A doctor disagrees with him and has written a book.
- Wayne Swan disagrees with the doctor even though the doctor has written a book.
- People should make up their own minds about whether to get screened because Beattie’s message is too simplistic.
The article reads like the point of the article was edited out in a prior version. Surely the story isn’t ‘Three people disagree, so make up your own mind about prostate screening’. Why does the doctor disagree with prostate screening? Why has he written a book? Why are ‘many GPs’ changing their practices? Given that — apparently — many GPs recommend the Atkins diet, perhaps we need a bit more of the ‘Why’ and less of the ‘He said, she said, they said’.
Perhaps she could have asked the Cancer Council for their argument. It’s freely available here and makes for some interesting reading.
Despite the above, I’m more interested in the thrust of her article: ‘Make up your own minds about prostate screening’.
A favourite essay topic in medical ethics is the question of consent. Given that patients don’t have degrees in medicine, to what extent can they make informed choices about their health? In Australia, there’s a hairy bunch of case law about what constitutes consent in the medical field but it doesn’t really get to the ethical meat of the question: how can I, as a patient, consent if I don’t have the skills needed to decide?
Even if I read all of Wikipedia and every best selling popular science book at Borders, do I have the ability to consent? How do I know how to distinguish the good science from the spin? How do I know how to spot the conspiracy theorists from the intellectually curious? How do I know how to distinguish disagreement from outright contradiction?
Let’s imagine for a moment that we’re not talking about prostate cancer but, instead, about vaccination. If Sweet’s article was ‘Beattie wants to give kids vaccines, but a doctor disagrees with him and wrote a book about how it causes autism, and Wayne Swan savaged him in the press’, is it right to leave it at that and state that people should just make up their own minds?
Let’s imagine for a moment that we’re not talking about prostate cancer but, instead, about climate change. If Sweet’s article was ‘Beattie wants to reduce carbon dioxide emissions, but a doctor disagrees with him and wrote a book about how climate change is a pile of crap, and Wayne Swan savaged him in the press’, is it right to leave it at that and state that people should just make up their own minds?
I’m not suggesting that Sweet is on the same level as the anti-vacci and climate change denial crowd. Most of her articles are pretty good. What I am saying is that these are not questions for ordinary people to ‘make up their own minds’. I’m a fairly clever chap and even I know that I couldn’t adjudicate a debate about prostate cancer screening. I don’t have the expertise.
Instead, it’s a fairly non-controversial principle to accept the best science of the day. While this will no doubt cause a few wrong turns along the way — and a lot of very morally dubious activities have gone on under the banner of ‘best science of the day’ — it’s rational to accept orthodox scientific opinion. Why? Because if the outspoken dissenters are correct and can be shown to be correct, their opinions will become orthodoxy.