In a thesis he calls medical nihilism, Dr. Jacob Stegenga argues that society’s confidence in the effectiveness of medical interventions ought to be low. Stegenga points to bias and malleability in medical research, the ubiquity of tiny effect sizes from the best studies, and the thin theoretical basis of many interventions. After describing the arguments for this position, he will discuss what medical nihilism entails for clinical practice, medical research, and regulation. As an alternative, Stegenga suggests that “gentle medicine” is a better course -- that is, a less aggressive clinical practice. He says the aims and priorities of medical research should be reconfigured and that regulatory standards should be strengthened. This lecture was recorded on Wednesday, October 30, 2019.

00:00 - [Introduction]

07:35 - [Medical nihilism]

12:55 - [Evidence and confidence]

17:10 - [Biased research]

24:30 - [Small effect sizes]

29:20 - [Few magic bullets]

35:45 - [Most important medical discoveries since 1840]

38:15 - [Objections to medical nihilism and presentation of gentle medicine]

48:25 - [Q and A]