SHANDS HOSPITAL AS A SCIENTIFIC RESEARCH INSTITUTION

BY BOB ALLSTON

Note: This is a draft of a Web page that Bob Allston had considered proposing to be placed in the Shands Hospital Web site, in the Arts in Medicine section, to be reviewed and edited prior to inclusion in the Shands site. However it has never been submitted to Shands Hospital for that purpose, and this Web page is not in any way associated with Shands Hospital.

INTRODUCTION

Shands, as a teaching and research hospital, is a very pluralistic institution, whose doors are open to everyone-- the public, patients, researchers, professional people, and volunteers.

As such, our people represent a broad cross section of the public in their professions, beliefs and interests. There are of course the established scientific disciplines such as medicine, biology, mathematics, physics, chemistry, engineering, psychology, sociology, anthropology, economics, etc. As well we are host to many with beliefs and interests and professions in alternative and holistic modalities of healing such as use of the arts, acupuncture, herbalism, psychic powers, therapeutic touch, as well as various religious perspectives of healing, etc.

As well, our people interact in many different ways. Many professional people as well as the public and volunteers see patients at bedside. Everyone interrelates through mail, telephone, e-mail, Web pages, etc.

At the same time, we are a scientific institution, legally obligated and dedicated to giving our patients and all who seek it, the best scientific advice and care available.

THE FOUNDATIONS OF SCIENCE

Thus it behooves us to explain the nature and bounds of science so all can understand the constraints that we must observe in order to function as a scientific institution and maintain our credibility as such an institution.

Contemporary science is based upon Aristotelian logic.

It is assumed that this logic is and always has been, since the beginning of time, uniformly applicable throughout the entire universe.

And, Aristotelian logic, as a relatively coherent body of knowledge, actually dates back much further than the Greek philosopher Aristotle from whom it derives its name. And various aspects of it go much further back into the past, indeed, long before recorded history.

As a body of knowledge and belief structure, it enjoys one of the most consistently unchallenged records throughout human experience. And specifically, since the time of Aristotle, it has remained virtually unchallenged except for some very minor points.

Since all of mathematics is derived from logic, mathematics also fits within the structure of the logic of the universe.

One of the most important characteristics of both logic and mathematics is that they have no physical existence of any nature. They are entirely creations of the mind. Another important characteristic is that all logical and mathematical constructions come the closest to achieving perfect internal harmony without contradiction, of anything that mankind has ever devised.

When we find consistent natural occurrences that can be described by mathematics or logic, we call this phenomena natural law. Thus the job of science is to discover natural phenomena that can be described by mathematics or logic. Once it is found, we call it natural law. Or to put it a little less formally, we have discovered one of the laws of nature.

Since the laws of nature thus fit the mold of mathematics and logic, they also have the properties that they all function in harmony, without contradiction. It is also impossible to "break" or "transgress" any such law in any way. That is, you may break man's law or God's law but because the laws of nature fit the mold of the logic of the universe it is totally impossible to "break" any such law. There is no way, for instance, that you can break or otherwise transgress in any way the law of gravity. Moreover all such unchanging laws are entirely dependable, having functioned in exactly the same manner, in every corner of the universe, throughout all time. Examples of natural laws that we are constantly striving to ascertain include those of physics and chemistry.

Science also assumes that what it believes to be a natural law, no matter how well proven, could be incorrect. Thus it stands ready to modify it based on more accurate experiments or information. Thus the history of science is one of continually expanding and refining our knowledge of natural law.

It is also this quality of dependability that allows science to progress. For discovering new elements of natural law invariably requires experiments employing previously discovered natural laws. Thus, if the known laws changed or were unreliable in some unpredictable fashion, new laws based on them would also be unreliable in an unpredictable fashion and medical scientists couldn't get further consistent results that they and their patients could depend upon for medical treatment.

Since it is assumed that to heal a person through divine intervention in some way would require natural laws to be capable of being changed at the will of God or some other supernatural power the world of science does not include the supernatural world. In short, science, by its fundamental nature, only functions in the domain of natural law, which is generally considered to be outside of the supernatural domain.

This is mentioned here only to help people understand that there is such a constraint upon science for those who may seek healing through God or other supernatural forces. And of course Shands fully supports your interests in seeking such support and healing. The area is of course a subject of great religious, scientific, and philosophical discussion beyond the scope of this discussion.

The above discussion is an idealized picture of logic, mathematics and natural law; that is, science. In practice, experiments are sometimes not properly set up, results of experiments are sometimes biased or misunderstood, so that on occasion results fall short of yielding credible, meaningful results.

However, all of science for the past several hundred years has been premised on this structure of logic, mathematics and natural law, and the technological advances brought by it are undeniable. And thus, science as practiced today has no serious contenders. In short, at the end of the twentieth century, there are no credible alternatives or short cuts to science, and that is why we as well as scientific institutions around the world adhere to this structure and method for advancing medical knowledge. And, if we deviated from it we would lose our credibility.

Medical science expanded significantly in the 19th century due to two (among many other) advances. One is statistics, a branch of mathematics. The other is the theory of biological evolution. In essence it was statistics that was instrumental in demonstrating that the theory of evolution had a mathematical explanation and could thus be considered a part of natural law.

And, among the most fundamental properties of evolutionary theory is the fact that competition tends to lead toward optimally functioning biological structures and optimum use of resources. Thus plants seek to place their branches so that their leaves optimally reach the sun for photosynthesis. Plants and animals optimally preserve their energy when food is in short supply.

This fundamental property of life extends into the human domain of the social sciences in many ways as well. For example, (the economic theory of) competition among alternative modalities of health care promotes advancement in health care.

HEALTH CARE AT SHANDS

So it is with health care at Shands. Our policy is to encourage all of our staff offering various modalities of healing to submit them to scientific examination of their competitive effectiveness if it hasn't been done. They are also encouraged to do so if there is reason to believe previous examinations (at Shands or elsewhere) may not have been credible or meaningful for any reason.

For, without such competitive studies, people who might be healed aren't healed, and it is impossible to give our patients the benefit of the advice and treatment they so often desperately need. And scientific advancement in the field is retarded. Thus, if you are invited to participate in such a study, we encourage you to give it serious consideration.

It bears mentioning that such studies often take the form of tedious, time consuming and expensive clinical trials such as double blind studies employing hundreds of people. However, as discussed above, there is often no alternative, for the mathematical foundations upon which such studies are based require them.

With the increasing popularity of many alternative, holistic, shaman, use of the arts, less invasive and/or lower cost modalities of healing, Shands is committed to the scientific examination of all that show promise, as resources permit. Unfortunately, the down side is that because they must often incorporate many more variables and factors than other studies, studies of these modalities of treatment are often much more complicated, more expensive, and require more time to obtain meaningful results.

By the same token, if such studies on a particular modality of healing have not been carried out or are inconclusive, it doesn't mean that particular modality is not effective. Some such modalities are certainly effective. It simply means the question remains open from the standpoint of modern science.

All things considered, we feel patients are best advised to examine modalities of treatment where credible studies have been carried out and where there has been an established track record otherwise, before considering those where the question remains open. These are questions that of course your doctor and other health care professionals can help you with.


This is a page in the Web site entitled Mainstreaming Arts in Medicine.

Copyright © 1999, Robert Allston. All rights reserved