First: do no harm
... and the need for scientific humility
A great piece on from Sensible Medicine on the need to factor in unknown costs to medications: There is no Such Thing as a Free Med [1]:
Some quotes from the article:
‘When suggesting a medical treatment, doctors often proffer the justification “it can’t hurt.” I believe “it can’t hurt” is fundamentally false, and should never be accepted as the sole reason for a medical intervention. A better adage to guide medical decisions is “there’s no such thing as a free lunch.”’
‘To be clear, I say this not as a criticism of the medical community, but as a rationale for medical conservatism. In medicine, we are always playing with fire, wielding potent tools that can bring tremendous benefits, but must be handled with care, lest we get burned.’
‘In the United States, we have recommended bivalent booster vaccines to young healthy people, and have doled out Paxlovid to low-risk vaccinated patients. Both of these interventions lack evidence of benefit, and the maximum potential benefits are small. While there might be no benefit, there always might be risk of harm (both known and unimagined), and doctors should scrupulously follow our first dictum to do no harm.’
‘More generally, the history of antibiotics should remind us to exercise medical humility. The human body is complex, our understanding is incomplete, and our interventions can have unexpected consequences that only come to light years later. When the benefits are small and uncertain, we should proceed with caution.’
[1] P. Fenyves, There’s No Such Thing as a Free Med, Sensible Medicine, 11/1/2022: https://sensiblemed.substack.com/p/theres-no-such-thing-as-a-free-med