A huge problem for health care – Confirmation bias, placebo/nocebo vs reductionistic medicine?
Confirmation bias (https://en.wikipedia.org/wiki/Confirmation_bias), placebo/nocebo and critical (reductionistic?) rationalism in medicine
As I regard (definition elsewhere) placebo and nocebo as oscillating processes, I write placebo/nocebo in this way.
As I regard (definition elsewhere) confirmation bias as mainly a non-conscious spatial/limbic process and in this respect similar to placebo/nocebo processes critical rational analysis of such processes must be able to deal with this, mainly non-conscious processes not well understood. The problem can have some similarities with traditional computation requiring exact digital information and human reasoning which can deal with uncertainty to some extent.
So, how do we can increase our knowledge about placebo/nocebo approaches when we need to be able to integrate spatial/Limbic and verbal/rational thinking – or practically eastern and western medicine which are based to quite different “languages” – as also e.g. chines and western languages – verbalized as well as and written.
As I see it, in west we are not trained in spatial reasoning while in east not trained in critical rational thinking. But can it meet? George Engel tried but (almost) no one care about his thinking. As Jerry N. Downing (https://www.sunypress.edu/p-3198-between-conviction-and-uncertai.aspx – https://psycnet.apa.org/record/2007-16895-001 – ) and others , e.g. https://cdn.dal.ca/content/dam/dalhousie/pdf/faculty/medicine/departments/core-units/DME/critical-thinking/CriticaThinking-%20Listof50%20biases.pdf argue we keep to what we believe expressed more or less clearly in our field consensus – and subjective paradigm versions. That is my own conclusion with its biases trying to train myself in “both ways” relying to some extent on a psychophysiological behavioral medicine paradigm, see e.g. (an old version to bee updated) http://biopsychosocialmedicine.com/paradigm/definition/
As medicine concerns dysfunctions in real world in general and individuals in particular we need to consider both biological, psychological, social-cultural-political processes – at individual (ideographic) levels. Extremely complex and very limited understood. Why? While we need to be able to reasoning/work/discuss/analyses/… at both spatial/limbic levels as well as critical rational one!
Here we may have some use of Karl Poppers Thinking in terms of three worlds (see http://biopsychosocialmedicine.com/paradigm/summarized-of-the-paradigm-used-by-bo-von-scheele/) where our thinking is at second and “material” on third but paradigms (Thomas Kuhn) at two representing cultural evolution at individual, different group including scientific and clinical groups levels. Realizing that not one of us have access to absolute knowledge but more or less well articulated paradigms. To believe that you present examination test concerns absolute truth is to misunderstand education and epistemology, https://www.iep.utm.edu/epistemo/ – a problem many are work with, e.g. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6127608/, https://www.gp-training.net/training/communication_skills/consultation/equipoise/uncertainty.htm, https://www.bmj.com/content/357/bmj.j2180 and https://bmcfampract.biomedcentral.com/articles/10.1186/s12875-017-0650-0