| > It's worth noting your entire argument is an appeal to authority or a personal attack. You mean, like when I pointed out that Asperger's was created and destroyed by votes rather then scientific evidence? Or was it when I pointed out that the NIMH is abandoning the DSM because it lacks scientific content? As to personal attack, physician, heal thyself. > To say that the DSM is devoid of scientific context is simply false ... Don't tell me. Tell NIMH director Insel, who says that same thing I do for the same reason -- the DSM lacks scientific substance. Insel recently said (http://www.nimh.nih.gov/about/director/2013/transforming-dia...): "While DSM has been described as a “Bible” for the field, it is, at best, a dictionary, creating a set of labels and defining each. The strength of each of the editions of DSM has been “reliability” – each edition has ensured that clinicians use the same terms in the same ways. The weakness is its lack of validity." "Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever. Indeed, symptom-based diagnosis, once common in other areas of medicine, has been largely replaced in the past half century as we have understood that symptoms alone rarely indicate the best choice of treatment. Patients with mental disorders deserve better." On that basis, on that evidence, you should address your beliefs about the DSM to the highest-ranking psychiatrist in the country, rather than to me. Of course, if you actually understood what constitutes science, you wouldn't be taking the position you are. > I don't think there's any better way to resolve disagreements among scientists than by voting ... Ah. Now I see the problem. Scientific questions are never resolved by voting -- not ever. They are all resolved by empirical evidence. For questions that cannot be resolved by evidence, scientists adopt the null hypothesis, the precept that an idea is false until it is supported by evidence. The bottom line is that a scientist would never say, "We don't know what this is, but let's offer clinical treatments anyway -- because the public doesn't understand either science or our poverty of knowledge." This is why Insel, and his predecessor, Steve Hyman, have taken the positions they have. This is why psychiatry and psychology are in the midst of an historical transformation, one that faces up to the fact that they are not scientific enterprises and considers a course of corrective action. |
By the way, the director of the NIMH isn't the "highest-ranking psychiatrist". That title doesn't exist.
>Ah. Now I see the problem. Scientific questions are never resolved by voting -- not ever. They are all resolved by empirical evidence. For questions that cannot be resolved by evidence, scientists adopt the null hypothesis, the precept that an idea is false until it is supported by evidence.
This is not true.
In most fields, including general medicine, there is no governing licensing body similar to the APA. This is because psychiatry is the only medical discipline that postdates the concept of regulatory bodies.
In general medicine, it's very common for two doctors to treat the same illness differently. This is why cancer patients can choose between radiology and surgery and chemotherapy.
Now, the APA could abandon the concept of regulation and allow any licensed psychiatrist to treat anything in any way, but as a society we've democratically (by vote) decided that psychiatry should be regulated, so its regulatory body decides the treatments that can and cannot be administered, and what constitutes something worth treating. (If you want to go outside this structure, you just can't call the person you're getting treatment from a psychiatrist. Priests, consolers, social workers, etc., are examples of alternatives.)
So, the world does not work the way you think it does. This is because you're espousing a philosophy of science called Positivism or Verificationism: https://en.wikipedia.org/wiki/Logical_positivism
This school of thought was abandoned in the early 1900s. Currently, the dominant philosophy of science is Falsificationism: https://en.wikipedia.org/wiki/Falsifiability#Falsificationis...
...which holds that ideas compete via aggregate evidence judged by each individual scientist, gaining ground via confirmatory evidence (though never being proven) and losing ground via falsifying evidence.
>The bottom line is that a scientist would never say, "We don't know what this is, but let's offer clinical treatments anyway -- because the public doesn't understand either science or our poverty of knowledge."
This is also not true. Doctors offer treatments that aren't definitively explained all the time. It's far better to treat something however you can than to hold off for some logical positivist verification of your claim.
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But, you've said a lot about what other people think. What is your opinion, and how did you form it?