ESHS/HSS Annual Meeting

“The Trouble with Medicine:” Sceptical Science in 1970s Britain

• In Event: The History of Distrust in Medical Science

English Abstract

In 1972, the Guardian columnist Ann Shearer penned a review of the physician/epidemiologist Archie Cochrane’s new book, Effectiveness and Efficiency: Random Reflections on Health Services. Though we tend to remember it now for its proselytization of the randomized controlled trial (RCT), for Shearer and others who read it in 1970s Britain, it was firmly exposé. For, in the book, Cochrane excoriated a system, she wrote, that “rarely [cures]…and by pursuing the myth that it does…deflects attention, time and money” from its other imprimatur: to care. The NHS didn’t work. Medicine didn’t work, she read Cochrane as saying.
Cochrane’s allegiance to the RCT has often made his work seem best fitted when told as part of the history of evidence-based medicine. Yet, as Shearer attests, in his own time, he was more healthcare sceptic, perhaps to the point of medical nihilist, than he was a link in an EBM chain. And he was hardly alone – in 1977 when the BBC ran an episode of its tentpole programme, Horizon, that dealt with this ‘Trouble with Medicine,’ as it was titled, it was full of sceptical medics eager to air their doubts to Horizon’s very substantial (ca 2 million per episode) viewing audience.
This talk revisits that sceptical time, delving into its substantive messages, exploring potential points of origin, and considering its dissemination across both professional and popular audiences. It ends by considering the problem of where Cochrane went and what we might – or might not – want to do about it.

Author

• Caitjan Gainty, King's College London