It is said that Jesus said “The truth will set you free” and Socrates “Knowledge will set you free”, truth and knowledge should be associated with a fact or saying. However, over the years true knowledge has been very relative with the passage of time. Philosophers and thinkers have spent ink and time trying to explain and better understand the concept of what is truth. The novelist Evelin Sullivan in her work “The Big Little Book of Lies”, recalls the Greek philosopher Diogenes, who went out with a lantern to look for an honest man and concluded that there is no honest man and all men lie.
In fact, the lies at the beginning are expressed as truths, but over time they are refuted. An idea or concept expressed by some individual, and believed by several, can be taken for a truth, without necessarily being so. There is also the opposite case, where only one person believes it and the community does not, which does not necessarily make it a lie either, and in science we have clear examples of this: Copernicus expressed his heliocentric theory in his work “On the revolutions of the celestial spheres” in 1543, the year he died, disproving the geocentric theory; that is, it was not the Sun that revolved around the Earth, but rather the Earth that revolved around the Sun, and he published it belatedly for fear of the sentences of the Inquisition. Galileo Galilei after the publication in 1632 of his work “Dialogues on the two highest systems of the world”, confirmed Copernicus’ theory, for which he was sentenced by the inquisition to be confined in his house for life. Although the phrase attributed to him of “however it moves” it is not clear if he really pronounced it or not, and if it was also at that time. This also contributes to the myth or truth of a fact.
And finally another Italian philosopher, Giordano Bruno, who agreed with Copernicus’s heliocentric theory, further argued that the universe was infinite and full of worlds where beings like us could worship their own God. He also thought that all objects are made up of atoms that move by impulse. With these concepts and without repenting of his ideas, in the court of the inquisition, he was sentenced to die at the stake.
The reasoning to reach knowledge can be inductive, as is the scientific method, that is to say that its concepts can be exposed to be verified; and deductive reasoning, which is the process of drawing deductive inferences, that is, it is the process by which conclusions are derived from initial premises or hypotheses, but the premises may be true or false or still true but the conclusion false.
For example, a true premise would be: “all men are mortal” and “Socrates is a man” so the conclusion is “Socrates is mortal”. And a true premise with a false conclusion could be: “Every Monday, Fernanda wakes up at 8 in the morning”, and “today Fernanda woke up at 8 in the morning”; the false conclusion: “therefore today is Monday”. In politics or the social sciences, establishing a truth is even more complex, especially if someone has other data.
Medicine is not immune to all these arguments. When a patient goes to a hospital or clinic for the first time, the trust that the institution or the doctor inspires in him is how he will accept treatment. Currently, patients have many ways to get information and question their doctors: the internet, with the famous “Dr. Google”, magazines, newspapers, books, social networks, verbal communications from friends, etc. All of this can help or further confuse a patient about the decision she must make regarding her condition. It is also often difficult for doctors to establish a better treatment, because despite the information on the benefit of a certain treatment, they must consider the functional, economic and social situation of the patient, in addition to the availability of resources in their institution. On the other hand, the scientific information that emerges every day is so dynamic that medical updating is very difficult. Hence the importance of medical updating in conferences and symposiums, where the update can be synthesized. In addition to all this, the pharmaceutical industry must not be forgotten, which also has its economic interests in the new drugs that come onto the market, with the usual economic benefits and where there may be biases in the results sponsored by these companies, which is why the agencies Regulatory authorities have to be increasingly cautious in accepting new therapeutic guidelines.
In all this context, the path of truth in regard to medical knowledge is somewhat tortuous, but despite this, generally the route that shines the most is the one that will best guide therapeutic decisions, passing in many cases under the trial and error, as demonstrated in the COVID-19 pandemic by the large number of treatments that were tried, the vast majority being unsuccessful.
*The author is a medical oncologist at the National Institute of Cancerology (InCan), with a master’s degree in Direction and Management of Health Institutions, full professor of the Biological Therapies course, and has been a representative for Mexico of the cooperative group SWOG (South West Oncology Group). Currently in the dissemination project: Science, politics, economics and medicine.
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