Other beliefs have consequences which impact on one or many other people. In the world of health care, what we know dictates what we do and how we advise our patients. When someone presents with chest pain, shortness of breath, diaphoresis, tachycarida, and classic ST changes on EKG, we know they are at risk of cardiac arrest based upon hundred's of thousands of observations. Specific interventions have been tested in controlled fashions and although there are still gray areas in terms of optimum interventions, there are reasonably solid numbers in terms of risk associated with specific scenarios.
It is unfortunate that in many if not most of healthcare we see certainty where it does not exist and nowhere is this more disturbing than where health care and law intersect. There is a recent story about Dr. Marta Cohen, a pathologist in England who has taken on the study of the neuropathological findings in shaken baby syndrome. From the New Scientist:
A triad of markers
It seems that by calling into question the dogma accepted as fact by an army of expert witnesses who have testified in trials over many years, Dr. Cohen has raised the ire of those who have a vested interest in maintaining the aura of certainty. The General Medical Council has placed restrictions on her medical license which bar her from further testimony as an expert witness. It appears that she was consistently spoiling the party by showing up to testify in trials and unlike her adversaries claiming the that the triad of findings were specific, she had actual data to support the opposite contention.
I have seen this before. Twenty five years ago the presence of genital or peri-anal warts in an infant was declared proof positive of child abuse. However, after putting countless parents through the ringer, we discovered that..oh never mind, such warts can be transmitted through many other means. Furthermore, the actual numbers which are relevant are poorly defined. Are half of the cases of genital or peri-anal warts in children due to sexual abuse? 25%? 10%? 1%? Who knows and who knows how to know? How many people were jailed or placed upon the sex offender list based upon the testimony of experts whose hypotheses were essentially untestable.
I have done a modest amount of expert witness work and reviewed a number of depositions. I am surprised by the culture of certainty which prevails. It is scary how many people who are certain they know, don't know that they don't know. Furthermore, they have no concept of what they need to do in order to know how they know. The casualties are people like Dr. Cohen who has the audacity to take on a contrary opinion based upon actually testing the evidence and the tools used to make these assessments of certainty. She had her license restricted based upon the fact she failed to agree with a consensus. Sounds like Galileo. Oh yes the sun does revolve around the earth.