Albert Einstein made some remarkable statements. His most famous expression E=mc2captured the most fundamental law of the universe. From this he predicted, among many things, that waves of gravity from creation’s initial explosion would echo through time. Yet no-one has been able to prove their existence – at least until recently, near his 135th birthday. By an amazing feat of modern technology the precise solution was found through new observations of cosmic radiation at the South Pole; another startling landmark of modern science – and a final proof of Einstein’s theories.
In the last 100 years startling technological advances have also exploded into medical practice – from molecular manipulation to neurone-activated robotics; from detailed functional imaging to targeted gene replacement. So it is not surprising that much of the world looks longingly to science to solve its quest for sustained health and longevity; pharmaceuticals, medical devices and modern medical systems must surely provide the best answers, even if costly and a long time coming. As Jeffrey Braithwaite says in a recent article in the Journal of the Royal Society of Medicine1,‘Most of us believe in the miracles of modern medicine. We like to think that there is always another scientific or technological breakthrough just around the corner promising to save even more lives;’
But are we safe in this assumption? Is this singular trust justified? Jeffrey Braithwaite also warns that, ‘We maintain this faith despite multiple contradictions.’ He cites the rapidly diminishing returns of increasingly expensive ‘high-tech’ medicine2, the growing risks of antibiotic resistance, the adverse effects inherent in all forms of treatment, and the continued lack of evidence for much of the therapy we offer routinely.
In both diagnosis and treatment both patients and health professionals commonly overestimate the benefit of technology and underestimate the influence of non-technical factors to restore and maintain of health. As Jeffrey Braithwaite points out, in spite of longstanding public awareness, ‘patients believe modern medicine can repair them after decades of alcohol, drugs, secondary lives, and dietary excesses, despite evidence to the contrary’. And not uncommonly, overestimates of medicine’s power, particularly the beneficial effects of drugs, are deliberately promulgated for financial advantage3,4.
To underestimate non-technical factors – psychological, spiritual and social – is to reduce people (well or ill) to mere machines; and to miss out on society’s most powerful influences on health. Ample evidence exists for the benefit of addressing these factors, many of which require a new way of thinking rather than high expense. PRIME, while enthusiastically supporting the use of medical science conducted with integrity and wisdom, seeks to draw attention to this whole person approach, exploring evidence for its benefit and promoting its inclusion in daily clinical practice.
Einstein, considering the challenges faced by mankind, had some similar thoughts, ‘The real problem is in the hearts and mind of man. It is not a problem of physics but of ethics.’
1 Braithwaite J. The medical miracles delusion. Journal of the Royal Society of Medicine 2014; 107: 92-3
2 Le Fanu J. The Rise and Fall of Modern Medicine, 2nd Ed. New York, NY: Basic Books, 2012
3 Journal of Epidemiology & Community Health, 2013; doi: 10.1136/jech-2013-203128
4 See also: British Medical Journal 2013; 346: 1-44