Clinical Trials In Solving Social Problems

 Clinical Trials In Solving Social Problems

M. Bakri Musa

 

Excerpt #14 from my book Qur’an, Hadith, And Hikayat:  Exercises In Critical Thinking

 

Critical thinking involves asking many and often hard, discomfiting questions. It should not be confused with “questioning” or being critical. It is not with the intention of casting doubt or being cynical. You ask questions to ascertain the truth of a claim or assertion.

 

         Consider this simple statement. I have a headache; I took aspirin and it went away. Therefore, the aspirin cured my headache. Sometimes drinking warm water would also do it; likewise with chanting verses from holy texts, or after a good sleep.

 

         With modern medicine being scientifically based, physicians solve this quandary not by listening to the utterances of famous doctors (then or now) but by doing double-blind studies. Get 200 patients with headaches and give half of them an aspirin, the other half, sugar tablet. Then analyze the results using rigorous statistical techniques. Some of those given sugar pills would have their headaches disappear anyway–on its own or just the placebo effect.

 

         Bomohs and faith healers maintain their tenacious hold on their followers based on these placebo effects, or flukes, to put it less kindly.

 

         During the Covid-19 pandemic many questioned the necessity or futility of the various measures taken, as with quarantine and the banning of mass gatherings, as well as vaccinations, social distancing, and wearing face masks.

 

         Two approaches to the problem:  One, study past epidemics; another, evaluate current measures taken by those nations that have successfully controlled the pandemic.

 

         Before embarking on such studies, one must have some basic understanding on the diseases, in particular the natural course. This could be inferred from history as when we did not have modern medical interventions, or in current isolated societies untouched by civilization in what we would refer to as “experiments of nature.”

 

         During any epidemic, for a variety of reasons most of the population would be spared. Our innate body defense mechanism is one factor. The other, out of basic survival instincts we learn to take preventive measures on our own.

 

         As for the infectious agent, if there were to be a mutation (biological change) making it more infectious or lethal, as we experienced with Covid-19 Delta variant, the figures would be scaled up. Likewise, the reverse.

 

         Consider the vast majority without symptoms. If a snake oil salesman were to sell them his miracle potion, he could brag of a 100 percent success rate, better than what those doctors could offer. He would become rich and famous. Similarly, if a religious man were to incant his special prayers to this group, he too would be famous. He could even start a new religion. One could claim many things just by rolling the dice right, or with the careful selection of clients.

 

         Hence the need for controlled double-blind scientific trials. If an intervention could reduce the incidence of disease in the group that receives it versus another that does not, then that intervention is effective. Thus the effectiveness of vaccines was established.

 

         With the Covid-19 pandemic, the anti-vaccine advocates highlighted those individual cases of side effects including the rare deaths following vaccination. The immediate conclusion was that those deaths, complications, and other adverse effects were caused by the vaccines. Those may well be.

 

         However, consider that at any given time there would be people having strokes and heart attacks or even die, often following trivial incidents like walking or watching a football game. No one in their right mind would conclude that watching a football game would cause a heart attack. Yet we do that with adverse events following vaccinations, especially the high so-called “excess deaths.” That is why we need controlled studies and careful analysis of individual cases.

 

         Next:  Thinking And Creating New Realities