Epistemic Humility: Accruing Wisdom or Forsaking Standards?

Abstract

Abstract:A back injury forces the author, a retired psychiatrist, to confront the realities of aging. More than that, though, the experience of patienthood engenders an examination of long and deeply considered convictions regarding scientific medicine and its alternatives. One particular "complementary and alternative medicine" modality is employed as an exemplar. The reported usefulness of that therapy for some patients with chronic pain—a condition that is often poorly responsive to conventional methods—is juxtaposed to the implausible mechanism of action claimed by its practitioners, producing an enigma for which the standard explanation of "non-specific" (placebo) effects might be accurate but incomplete. The complexities involved—not least those of human heterogeneity and of the current limitations of modern medicine—point to the imperative of epistemic humility, raising the question of whether the pluralism it entails is compatible with the putative protections afforded by adherence to scientific standards in clinical care.