Scientific Medicine & Engineered Futures |
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The treatment of disease and suffering has a long history, it began well before the maturation of the modern scientific world view. Where there is disease and suffering there will be a need for healers. |
To approach medicine scientifically it is necessary to both define the disease and to measure the efficacy of the treatment. Both tasks are non-trivial. A great many people in modern society may feel a malaise or any of a number of other complaints -- are they sick or 'simply' unhappy? How can you tell? If their malaise disappears, was it because they took to time to address its causes (e.g. by changing jobs, living conditions, self-destructive behaviors,etc), or because seeking out the advice of others was comforting -- or did it just heal naturally (as most diseases do). Alternatively, did they learn to ignore the symptoms? Did they ever really have a disease, or where they obsessing about common everyday events? How do we know what is sickness and what are just the toils and troubles associated with the human condition? What should be treated and what should be lived with? Crudely put, when should a person be treated and when should they be told to "suck it up"? Clearly the answer to this question is cultural and economic as well as medical -- it is likely to have different answers in different cultures. |
| What makes for a scientific medicine? |
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It seems that we can apply what we learned from other experimental studies to draw up some rules for a scientific medicine.
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| "When many cures are offered for a disease, it means the disease is not curable" - Anton Chekhov | A major hurdle in scientific medicine is subjectivity. If a patient complains of a pain, is the pain real or imagined? and does it matter? |
If symptoms disappear, did they disappear because of the treatment? The primary tool used to address these questions is the randomized double-blind, placebo-control trial. In such a trial, patients are diagnosed as having a specific disease condition. |
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They are assigned to experimental and control groups randomly. They receive treatment in a manner such at neither the patient nor the doctor prescribing the treatment knows whether they are getting the experimental drug or the placebo. This can itself pose ethical and experimental problems. For example, suppose the procedure to be test involves a surgical procedure -- in such a case the appropriate placebo also involves surgery (surgical placebo link | wiki: placebo) Clearly there are risks with the surgery, and no possible benefit to the patient. Similarly if the experimental drug makes the patient feel a specific way (for example nauseous) and the placebo does not, the patient can tell which drug they received. The doctor evaluating the effects of the trial should also not know whether or not the patient they are evaluating received the experimental drug or the control. That 'breaking the code' of the experiment is done independently, so as to minimize the effects of subjective judgment. |
Why is there 'alternative' medicines? This seems like a relatively simple question to answer. Not all patient complaints can be treated effectively by scientific medicine. This leads to two obvious follow up questions. Are these real complaints? and Are they treated effectively by alternative medicine practice? There is significant and ongoing controversy as to whether various diseases are real or psychosomatic (although a psychosomatic complaint is still a real complaint). Again these are complex issues, since the people who claim to cure 'diseases' that do not respond to scientific medicine generally have a vested interest in the reality of the disease and their method of curing it. Clearly we will be discussing these issues in class. Links: |
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What is possible? The major technological advance associated with modern molecular biology is analagous to to transformation and horizontal gene transfer. It is the ability to move, in a directed manner, specific genes from one organism to another. This process of 'intelligent design' has been made possible by a number discoveries, many associated with understanding the basic biology of bacteria. Bacteria contain plasmids, typically small circular DNA molecules that carry non-essential, although often beneficial genes. DNA fragments can be removed from or inserted into a plasmid using restriction endonucleases and DNA ligase. A new DNA formed in this manner is said to be a recombinant DNA. |
The source of the DNA can be from any organism and can include coding and regulatory sequences. The isolation of specific DNA sequences and their manipulation has been much easier by the technique of polymerase chain reaction or PCR. Very complex DNA molecules can be made through recombinant DNA technologies. |
What is desirable and what will it cost?
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Use Wikipedia |
revised
16-Apr-2006
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