Wikipedia:Articles for deletion/Criticisms of medicine


 * The following discussion is an archived debate of the proposed deletion of the article below. Please do not modify it. Subsequent comments should be made on the appropriate discussion page (such as the article's talk page or in a deletion review).  No further edits should be made to this page.

The result was delete. The length of the discussion disguises the fact that, in terms of headcount, there is a relatively clear consensus that this is not a useful article topic because of the disparate nature of the content assembled here. The article can be userfied if somebody does want to recycle some content in other articles.  Sandstein  20:12, 16 May 2018 (UTC)

Criticisms of medicine

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Fundamentally non-encyclopedia as it takes a broad vague concept that is not directly-referenced in good sources, and this necessitates the creation of a lot of synthetic editorial arguments based on a novel collection of sources. Some material may be salvageable to be used elsewhere, but this article is not viable. Alexbrn (talk) 16:41, 1 May 2018 (UTC)
 * Delete This is an essay rather than an encyclopedic article. The material should be inserted into relevant articles. Natureium (talk) 16:50, 1 May 2018 (UTC)
 * Comment. The page is well-sourced and mostly meets MEDRS, the only problem is it's too broad a topic and should be split up into other pages. It should be moved to a userpage or sandbox to preserve it until it's split into separate ideas. This current page could be a type of disambig page in the future. S EMMENDINGER  ( talk ) 17:16, 1 May 2018 (UTC)
 * Split and delete - well-soured, but an essay. Split into other articles, but delete this one. Kirbanzo (talk) 18:12, 1 May 2018 (UTC)
 * If we WP:SPLIT it, then we can't delete it, because of license requirements. I would support a split and redirect to Medicine, which will preserve the attribution information for the copyrighted material.  WhatamIdoing (talk) 18:18, 1 May 2018 (UTC)


 * Will go with that. Kirbanzo (talk) 18:30, 1 May 2018 (UTC)
 * Note: This discussion has been included in the list of Medicine-related deletion discussions. L3X1  ◊distænt write◊  21:00, 1 May 2018 (UTC)


 * Delete. Drastic violation of NPOV, and, by its very nature "critocisms of ...", not fixable. It's a conglomerate of issues wheich are treated elsewhere. DGG ( talk ) 04:39, 2 May 2018 (UTC)

Could someone please explain? I'm relatively new to Wikipedia (although the user who suggested that I write this article is a very experienced editor and also a strong opponent of CAM), so would someone please explain to me: Thanks.NightHeron (talk) 12:08, 2 May 2018 (UTC)
 * What's wrong about writing an article "Criticism of..."? A search shows many such articles on Wikipedia, e.g., Criticism of Christianity and Criticism of Wikipedia.
 * Is it playing into the hands of CAM to admit that mainstream medicine is not perfect? If so, the NY Times is playing into CAM's hands with today's headline about prosecutors in the U.S. uncovering a massive kickback scheme by pharmaceutical companies to physicians for prescribing opioids.
 * What is wrong about an article having a broad topic? Doesn't Alternative medicine have a broad topic?
 * In what sense is my article an "essay"? Reading WP:Essays, I don't see the connection.
 * Exactly where does my article violate NPOV?
 * Where in WP:Splitting can we find the reason for suggesting splitting this article? I do see a place there where it's recommended that articles over 30 to 50 KB should be considered for splitting.  My article is 19 KB; the article Alternative medicine is 260 KB.  (I'm not suggesting splitting that article, though it does take an awfully long time to read through.)
 * The problem with a "criticism of mainstream medicine" is that it implies an "alternative", of which there is none. Much of the material you've added is decent, but it's an overly broad title, and quite a lot falls into "Criticism of the US health-care system" or "Criticism of for profit healthcare". There isn't a Criticism of physics or criticism of mathematics article. Carl Fredrik  talk 12:35, 2 May 2018 (UTC)
 * Comment: while I agree that the article would need to be rewritten to be less essay-like, to claim that there cannot be an article about "criticism of mainstream medicine" because there is no alternative is short-sighted. There are many reasonable criticisms of conventional medicine (if we take that to mean Western medicine) that don't suggest promoting things like homeopathy or astral surgery. The premise of the article is not flawed, although maybe the execution could be made more encyclopedic. ... disco spinster   talk  13:14, 2 May 2018 (UTC)
 * The main reason is that topic of "Criticism of medicine" does not exist in RS in the way the article wants to frame it. The most obvious source of "criticism of medicine" content would be fundamentalist religious sources which argue medical interventions thwart the will of god. At the nom says this is a synthetic topic which is why the article is built on original research with multiple failures of WP:V. It just ain't encyclopedic. Alexbrn (talk) 13:20, 2 May 2018 (UTC)
 * The original article was titled "Criticisms of mainstream medicine" before it was moved to the title "Criticisms of medicine". There certainly are reliable sources that cover the topic of the original title if it is framed as criticisms of modern/Western medicine. ... disco spinster   talk  13:24, 2 May 2018 (UTC)
 * I doubt there's RS (appropriate, secondary RS). The concept of "Western medicine" it in itself a fringe/ignorant concept. The original title was in fact "Shortcomings of mainstream medicine" which hints at a problematic agenda behind all this. Alexbrn (talk) 13:34, 2 May 2018 (UTC)
 * Look at the article itself, which documents criticisms of methodology in medicine by professors John Ioannidis and Marcia Angell. And the section on women and minorities being excluded from clinical trials. And criticisms based on Nazi experiments and use of the knowledge that came from them. The concept of "Western medicine" is not at all a fringe/ignorant concept, unless you think the National Cancer Institute, Wharton, and Amherst College are fringe organizations. ... disco spinster   talk  13:48, 2 May 2018 (UTC)
 * That illustrates the problem nicely. Taking just your first point, the article text "Stanford University School of Medicine Professor John Ioannidis has sharply criticized the quality of published medical research, claiming that most published findings are false" is not verified by the source (which is primary), but is pure editorial/OR. Articles must be based on secondary sources. Even then Ioannidis is not writing a criticism "of medicine", but of the quality of published research. Is is WP:OR to frame it otherwise. And even if there are secondary sources covering Ioannidis' view, while they might usefully be worked into our Medical research article; putting them here is a POVNAMED article is a big NPOV problem as DGG observed above. Alexbrn (talk) 14:00, 2 May 2018 (UTC)
 * I would suggest that the issues are of scope and context. There are too many areas that the article attempts to cover, without any unifying concept or theme beyond "These are a bunch of negative things some people have said at various times about (modern) medicine."  It's mostly a laundry list of complaints – some more useful than others – often raised by alternative medicine proponents, generally lumped together as a "modern medicine is bad, therefore my particular alternative nostrum must be better".  Some of it deals with current issues; some with more historical problems.  Some is very country-specific.  Some deals with individual incidents of misconduct and scandals; some attempts to span all of medicine.
 * For example, the first section (financial barriers to access) is very U.S.-specific in its approach. It also applies to alternative medicine&mdash;one could argue even more so, since public and private health insurers are less likely to provide coverage for unproven (and disproven) CAM therapies.
 * The second section (inadequate therapeutic relationship with patients) is a backhanded compliment, in some regards&mdash;mainstream medicine is less appealing that alt-med because practitioners are often pressed for time (see preceding section on financial pressures), and so receive less benefit from the placebo effect than alt-med practitioners; despite this handicap, mainstream medicine still works better. Again, one should note that for patients willing to pay out of pocket for the privilege, one can buy access to more physician time and attention in mainstream medicine just as one does for alt-med.
 * The third section (conflicts of interest and faulty methodology) is interesting. As Alexbrn notes above, Ioannidis' conclusions apply to all scientific publishing, and have been criticized as sometimes overstated and sometimes missing the point.  Alt-med practitioners have as much financial incentive to do sloppy research as mainstream researchers (if not more so).  CAM advocates will point to a lack of CAM research in top-tier journals as evidence of bias; they won't recognize that it's usually because their studies just aren't very well conducted.
 * The fourth and fifth sections (opioid epidemic and list of scandals) pick out a handful of incidents and issues, and lay them broadly at the feet of all 'medicine'. The opioid issue is again presented from a very U.S.-specific angle, and it is a problem that was badly exacerbated by a number of U.S.-specific legal, cultural, and economic factors.  Pulling out a couple of biomedical researchers who were found to have committed misconduct, and naming a couple of physicians who committed malpractice, is a weird sort of anecdotal evidence that doesn't really amount to a criticism of medicine; at best it is an illustration that there exist some people involved in medicine (or research) who are dishonest and unethical.  That's not a flaw in medicine; it's a flaw in people.  One would be hard-pressed to find any field that didn't have its own liars and cheats; CAM is certainly no exception.  (It's interesting that Andrew Wakefield is lumped in with the bad 'medicine' crowd, especially given how emphatically the medical community gave him the boot, and who he usually is lauded by these days for his ongoing 'work'.)
 * The sixth section on historical wrongs is interesting. Our article on professionalization certainly could use some work and perspective, and some of this material might belong there.  (Standardizing and regulating the medical profession was a good thing, as was pushing out the homeopaths; losing a century of midwives was not.)  The ethical and economic trade-offs (historical and current) involved in choosing who can participate in clinical trials is something that should be discussed in that article, as is determining the appropriate scope, length, and monitoring of such trials.  Some of the anecdotes presented might also find a home in informed consent, human subject research, and unethical human experimentation if they're not already there.  CAM has its own litany of unethical trials (and worse, the shameless marketing without trials) of its remedies.
 * In other words, what's there is already better placed (and may already be better covered) in other articles. It lacks any unifying theme other than "here are some bad things that are associated with the last century or so of modern medicine".  There's also the subtext of "Here's the CAM laundry list against modern medicine" without the self-awareness that many of the same problems exist – often to a greater extent – in CAM. TenOfAllTrades(talk) 16:28, 2 May 2018 (UTC)


 * Delete for reasons noted above (scoping, context, etc.). TenOfAllTrades(talk) 16:28, 2 May 2018 (UTC)


 * I've replaced the Ioannidis primary source by a secondary source, namely David H. Freedman's article in The Atlantic reporting on Ioannidis' work.
 * The arguments for deleting (rather than improving) the article are based on unsupported and unjustified allegations:
 * That it is "written like a personal reflection or opinion essay" (the claim made in the template). I asked for an explanation of exactly where in the article it reads like my personal opinions, but I didn't get an answer.  The article is based on facts and opinions by others, with no OR or editorializing by me.  The only relevant opinion I have (apparently a very controversial one) is that there should be a Wikipedia article on this topic.
 * That it supports CAM. Please look at the sources.  There are 41, and not a single CAM source.  There is no favorable reference to CAM anywhere in the article, and there are two negative references (end of first paragraph and end of Section 3).  Two of the authors cited (Marcia Angell and Edzard Ernst) are prominent opponents of CAM whose photographs are featured in the alt med article.  To the best of my knowledge, the objective of every single author cited in the article is to improve medicine, not to support CAM.
 * That it violates NPOV. If there are RS I've missed that say that some of the criticisms are wrong, please supply them to me or add them yourself.  When the article was in draft form, an experienced editor improved the article by helping me with Section 3 (which now refers to criticism of Ioannidis' methodology -- I hadn't been aware of those authors).  If you think that the reference to the Andrew Wakefield scandal should include a sentence praising the U.K. medical establishment for sanctioning Wakefield (and praising The Lancet for retracting his article after it was shown to be fraudulent), then please add such a sentence.  Personally, I think that such a sentence would seem silly, and that it's not necessary for NPOV, but that's just my opinion.
 * That a typical Wikipedia reader would think that the article supports religious opposition to modern medicine as being against God's will. This is a very strange allegation to make.  Are there any major religions (other than Christian Science, if you consider that a major religion) that hold that view?  Is that what most Wikipedia readers have in their minds?  I would think that the first thing that would come to mind would be any negative personal experiences that the reader (or a family member) had with hospitals or physicians.  As Steven Novella points out in a very interesting blog, personal experiences are very powerful.  Readers who have been fortunate enough not to have had such negative personal experiences might think of things that have been prominent in the media -- like the article on the front page of The New York Times yesterday about kickbacks from the pharmaceutical industry in America to physicians who prescribe opioids, or the article also on the front page of The New York Times a few weeks ago about a conspiracy of certain medical researchers and U.S. government officials to lobby the alcoholic beverages industry to finance a study that would show that regular consumption of alcohol should be part of a healthy lifestyle.  Readers in western Europe, who are likely to have had more positive experiences with healthcare than American readers, might immediately think of the Paolo Macchiarini affair, which, according to some reports, has undermined the credibility of the Nobel Prize in Physiology or Medicine.  In Britain the reader might think of The Lancet publishing the Andrew Wakefield paper that gave a boost to the anti-vaccine movement that has caused damage to public health, especially of children.  Why in the world would a reader think that "Criticisms of medicine" come from religion? NightHeron (talk) 10:27, 3 May 2018 (UTC)
 * I think that some of our editors have been triggered by the idea of altmed. Carl, in particular, I want to object to your statement that "The problem with a "criticism of mainstream medicine" is that it implies an "alternative", of which there is none."  Not only is that a highly POV statement – one that implies that it's okay for non-licensed people to do arthroscopic knee surgery, because that doesn't work and therefore doing those surgeries isn't actually "medicine" – but it's not logically sound.  Criticizing conventional medicine doesn't imply that alternative medicine exists, much less than it'd be preferable.  It only implies that your profession isn't yet perfect (a view that I believe you very strongly agree with).  The "alternative" implied by criticism is for mainstream medicine to live up to its ideals (e.g., to stop doing those ineffective knee surgeries).  WhatamIdoing (talk) 18:28, 3 May 2018 (UTC)
 * Delete Any title starting "Criticism of..." should be deleted as contrary to our core policy of WP:NPOV. Most everything has some pro/cons and they should be presented together in a balanced and factual way.  Polemics are contrary to WP:NOTADVOCATE, WP:NOTPROPAGANDA and WP:NOTSCANDAL. Andrew D. (talk) 20:40, 3 May 2018 (UTC)


 * So am I right to assume that you're also in favor of deleting all of the following articles: Criticism of Wikipedia, Criticism of Facebook, Criticism of Islam, Criticism of the Israeli government, Criticism of Apple Inc., Criticism of Google, Criticism of Christianity, Criticism of The Church of Jesus Christ of Latter-day Saints, Criticism of Mother Teresa, and Criticism of Walmart? NightHeron (talk) 22:50, 3 May 2018 (UTC)
 * Yes, they should all go too, though we might file Criticism of Wikipedia in Wikipedia space along with other self-referential pages like WP:DOOMED. Notice that, for these topics, we don't have equivalent pages with a positive spin such as Praise of Wikipedia; Praise of Mother Teresa; Praise of Google, &c.  Such one-sided encomiums would tend to get removed on the grounds that they would be promotional.  One-sided pages in the other direction are not wanted either and that's policy, "An attack page is a page, in any namespace, that exists primarily to disparage or threaten its subject...".  And there are plenty of cases where they have been deleted, e.g. Articles for deletion/Criticism of the Petroleum Industry. Andrew D. (talk) 07:39, 4 May 2018 (UTC)


 * The presence of so many "Criticism of..." pages (some quite old) on Wikipedia shows that your opinion is not a consensus view. Looking at Articles for deletion/Criticism of the Petroleum Industry, I see that there were other problems with the proposed article that caused the consensus to go toward deletion.  Typically, the basic article on a subject (such as Mother Teresa) is overwhelmingly based on positive sources, usually with brief mentions of criticisms without details.  If one tries to put in details, editors will object that that unbalances the article, violating WP:WEIGHT, and that such material belongs in a separate article.  (I'm new at editing Wikipedia, but the suggestion that I write this "Criticisms of..." article came from a very experienced editor.)  In the case of Mother Teresa, the two articles together -- the overwhelmingly positive main article and the criticism article -- provide balance.  If anything, the balance goes against the criticism article because it is much less viewed: the daily pageview average for the last 3 weeks is 6613 for the main article and 700 for the criticism article.  So Mother Teresa comes out ahead.  In a criticism article, where reliable sources are available giving criticisms of the criticisms, that should of course be included.  I've done that in Section 3, and, if anyone knows sources that say, for example, that Edzard Ernst's criticism in Section 2 is wrong, then by all means add them. NightHeron (talk) 11:40, 4 May 2018 (UTC)


 * The article under discussion is not an attack page. It does not "exist primarily to disparage or threaten" medicine.  It exists to show that, according to many sources, the practice of medicine is not perfect and needs improvement. NightHeron (talk) 14:22, 4 May 2018 (UTC)

NightHeron (talk) 12:35, 6 May 2018 (UTC)
 * Section 1.1 is U.S.-specific, as its title indicates, but the access issue is not, as most countries of the world, especially in Africa/Asia/Latin America, have large proportions of the population without access.
 * That's an interesting point -- that one could argue against Edzard Ernst and David H. Freedman by saying that it's a positive feature of medicine that physicians are too pressed for time doing worthwhile things to be able to devote a lot of time to "bedside manner," the benefit of which is just a placebo effect. Do you know an RS that says this?  If so, please add it.
 * Of course, bad actors, research misconduct, and scandals occur in all branches of science, not just medicine. The reason why they are more notable in medicine (and hence merit more coverage in Wikipedia) is that what goes on in medicine has an immediate impact on the public (and so gets extensive media coverage), whereas what goes on for example in physics and mathematics does not.
 * The choice of which scandals to mention was based on notability. The Andrew Wakefield scandal was described to me by a member of WikiProject Medicine as "one of the greatest scientific frauds of the 20th century"; the media furor over the David Baltimore scandal is something I still remember a quarter century later; and the Macchianini scandal is (according to some sources) casting a cloud over the Nobel Prize in medicine because of the role of the Karolinska Institute.  Major scandals have an effect on public perceptions.
 * As pointed out elsewhere in this discussion, this article is not pro-CAM. There's no pro-CAM source or pro-CAM statement in it.  I think that the viewpoint of such sources as Ernst and Angell is that it's important to discuss the shortcomings and reduce them, in part in order to lessen the appeal of CAM to the general public.


 * Split and merge to other articles and redirect to Medicine (as already suggested by others above): Unlike above, I am not opposed in principle to "Criticism of..." articles; in my view, one of the strengths of Wikipedia is that it so frequently presents legitimate criticism of article subjects, while Wikipedia core content policies and the dialectical process of reaching consensus helps assure that such criticism is indeed (eventually, after sufficient editing!) a legitimate part of knowledge of the subject, and not negative propaganda. The primary reason I see for splitting this article is that many of the sections are not "criticisms of medicine" but are instead various "problems that have arisen in the implementation of medicine", many of them logistical problems. (In contrast, for example,  really is mostly—excepting perhaps the third paragraph—about criticism of the fundamental rationale for and process of psychotherapy, not just a description of problems that have arisen in implementing psychotherapy.) By the way, when I hear the phrase "criticisms of medicine" one of the first things that comes to mind is iatrogenic illnesses, which are not even mentioned in this article (see, e.g., ). Biogeographist (talk) 14:22, 6 May 2018 (UTC)


 * Thank you for your argument supporting articles of criticism in Wikipedia. Concerning the points you make, certainly a more precise title might be something like "criticisms of the practice of medicine and of quality control in medical research."  But I don't think that most Wikipedia readers would be surprised to find that an article titled "Criticisms of medicine" contains just what this article contains (and not criticisms of medical theory).  Similarly, the article Criticism of Christianity contains a mix of criticisms of doctrine and of implementation (with emphasis on the latter); likewise for Criticism of Islam.  The article Criticism of Wikipedia has some content related to criticisms of the basic concept (such as editing by amateurs) but mostly criticisms of the implementation (such as sexism and disproportionate coverage).  Another way my article is typical is that a new article written by a non-expert is not likely to be complete.  In particular, you point out that I left out Iatrogenesis (a word that was not even in my vocabulary).  I have added a brief section about that, and have also made the section on the U.S. opioid epidemic into a subsection of that section, in response to an editor who pointed out that it's a U.S. problem, not a worldwide problem.NightHeron (talk) 21:45, 6 May 2018 (UTC)


 * I haven't recently read the other "Criticism of..." articles, but in any case I wouldn't take their structure and content as a model for this article; an article about medicine will be evaluated differently (but within the shared framework of Wikipedia's guidelines and policies) than an article about religion or about a website (see, e.g., WP:MEDRS). I stand by my statement that the article is a mix of various problems, and I think my opinion is corroborated by similar observations by other editors above (e.g., as said: the issues are of scope and context. There are too many areas that the article attempts to cover), as well as by your own observation immediately above that a more precise title would include multiple subjects. You pointed out that a new article written by a non-expert is not likely to be complete, which is true enough, but you may have just discovered that when you create a new article on a potentially controversial subject (or with a potentially controversial premise), the need to prove that the article has a strong rationale will come with a heavy burden of proof that behooves you to make the article as "complete" and well-designed as humanly possible right from the start. Biogeographist (talk) 23:37, 6 May 2018 (UTC)
 * in the nom said that the article is synthetic (WP:SYN) and later said that this is a synthetic topic which is why the article is built on original research. But a distinction needs to be made between a synthetic article subject and synthetic article content. I see consensus among editors who have commented above (with the exception of the article creator and principal contributor, of course) that the content of the article is currently synthetic. That does not mean that the article subject is necessarily synthetic. It could perhaps be proven (using reliable secondary sources) that there is an identifiable body of secondary literature on criticism of medicine and thus that the article subject is not synthetic, even if the article content currently is; but that conclusion has not been proven either in the article itself or in this deletion discussion. Biogeographist (talk) 00:02, 7 May 2018 (UTC)


 * It's been clear from the start that a central reason for objecting to this article has been the fear that it would give aid and comfort to CAM. Some editors outlined all the ways the criticisms would apply even more to CAM than to medicine.  Some claimed that simply the title of the article implies CAM.  I've argued that nothing whatsoever in the article supports CAM, and User:Discospinster and User:WhatamIdoing also objected to the notion that the mere existence of an article on criticisms of medicine supports CAM.  The worries about CAM seem to be the main reason for wanting to delete rather than improve.  Even if it were true that this article would undermine efforts against CAM (which in my opinion is just as wrong as saying that Marcia Angell's very strong quote given in the article undermines those efforts), that would not justify censoring an article from Wikipedia.
 * It's been clear from the start that a central reason for objecting to this article has been the fear that it would give aid and comfort to CAM. Some editors outlined all the ways the criticisms would apply even more to CAM than to medicine.  Some claimed that simply the title of the article implies CAM.  I've argued that nothing whatsoever in the article supports CAM, and User:Discospinster and User:WhatamIdoing also objected to the notion that the mere existence of an article on criticisms of medicine supports CAM.  The worries about CAM seem to be the main reason for wanting to delete rather than improve.  Even if it were true that this article would undermine efforts against CAM (which in my opinion is just as wrong as saying that Marcia Angell's very strong quote given in the article undermines those efforts), that would not justify censoring an article from Wikipedia.


 * You say that someone writing a new article on a controversial subject must "make the article as 'complete' and well-designed as humanly possible right from the start" or else expect it to get deleted. In practice, that would mean that non-experts should not attempt to write new articles on controversial topics.  That is not Wikipedia policy -- in fact, it goes against basic principles of Wikipedia.


 * I've looked through WP:MEDRS and don't find anything about medicine-related articles being "evaluated differently." What I do find is guidelines about medical information, especially information of a technical nature that a reader might look at for health information.  That's irrelevant to the article under discussion, which contains no such information.  Could you be more specific about what part of WP:MEDRS (or any other policy) you have in mind?


 * I've also looked through WP:SYN and found nothing relevant to the question of a topic that is broad and combines different subtopics. In addition, I've looked through WP:SYNNOT, especially the sections not mere juxtaposition, not presumed, not a catch-all, and not a policy.  All of those seem to imply that WP:SYN is not relevant here.


 * I really fail to see the basis for saying that a wide-ranging article Criticism of Christianity is okay, whereas a wide-ranging article Criticisms of medicine is not. If you have a specific place in Wikipedia policy that calls for making that distinction, please point me to it.NightHeron (talk) 01:46, 7 May 2018 (UTC)


 * Brief responses to your points/questions: (1) Not true: nom doesn't say anything about CAM, nor do most of the !votes, and speaking for myself, I don't think CAM has anything to do with it. (2) Not true: Somebody has to prove that the article has a valid rationale if they want it to survive, and that is Wikipedia policy: WP:BURDEN a.k.a. WP:PROVEIT. (3) The second paragraph of WP:MEDRS says, in boldface, Primary sources should generally not be used for medical content. That's probably the most important point relevant to the article's current content. (4) The first sentence of WP:SYN says: Do not combine material from multiple sources to reach or imply a conclusion not explicitly stated by any of the sources. The "conclusion" of Criticisms of medicine is the first sentence/paragraph, which is the thesis of the article and the statement of the article's subject: Despite the tremendous progress of medical science in raising general health levels and increasing life expectancy, there has been criticism that deficiencies retard further advances in public health and contribute to the increased commercial success and popular appeal of alternative healing modalities that are not based on science and in some cases can be very harmful. We need a secondary or tertiary source that shows how all of the issues summarized in the article's sections lead to that conclusion, otherwise the article's thesis is WP:OR. (5) I never said that this article subject is not legitimate; my position is that it has not yet been proven to be legitimate (see the previous point), and given its current state my recommendation is to split and merge to other articles where appropriate. Biogeographist (talk) 02:48, 7 May 2018 (UTC)


 * Thanks for your specific comments. (1) Some of the lengthiest commentary consisted of comparisons with CAM.  I agree completely with you that CAM has nothing to do with it.  (2) My point was that a non-expert cannot be expected to write a new article that is as complete and well-designed as humanly possible.  Wikipedia is a collective effort, and the early history of most articles shows them to be far from complete and not polished in their design.  My article was as complete and well-designed as I could make it, but far short of the humanly possible.  (3) The paragraph in WP:MEDRS with that boldface statement starts by saying that it's referring to "biomedical information," of which there is none in the article under discussion.  Do you have in mind any primary source I'm using that gives biomedical information?  The previous paragraph of the lede of WP:MEDRS states that content other than medical information is covered by general Wikipedia guidelines. (4)-(5) Thanks for clarifying.  Wouldn't that problem be solved by replacing "there has been criticism that deficiencies retard further advances in public health and contribute to the increased commercial success and popular appeal of alternative healing modalities that are not based on science and in some cases can be very harmful" simply by "there have been criticisms of deficiencies"?  After that change the lede doesn't do anything other than summarize the content.NightHeron (talk) 03:42, 7 May 2018 (UTC)
 * Biogeographist, your point (2) is incorrect. BURDEN is about providing a reliable source for an individual claim within an article.  It has nothing to do with the overall concept of an article.  For that, see WP:N.  All that WP:V has to say about the question of whether an article should exist on a subject is that there must be third-party sources for it.
 * Related to that, if you personally need sources for (4), then you could start with Alternative cancer treatments, since the perceived failures or limitations of conventional medicine are the main reason that cancer patients try "SCAM". I believe that a quick trip to your favorite web search engine will also show you that people turn to alternatives when they're dissatisfied with the institutional aspects of conventional medicine.  That is, modern medicine is pretty satisfactory if you need a broken arm fixed, but it's also pretty lousy if you want someone to do the emotional labor of listening to you until you're done talking about your fears about aging and dying.  WhatamIdoing (talk) 06:06, 7 May 2018 (UTC)
 * (1) Remember, don't mistake length of commentary for relevance or consensus. I don't think it's anywhere close to a consensus view in this discussion that a central reason for objecting to this article has been the fear that it would give aid and comfort to CAM. I don't see that at all. (2) I can see how WP:PROVEIT is not the relevant policy on this point, but generally speaking, within this AFD discussion, if the article is to be kept, somebody has to prove that keeping the article is preferable to the alternatives. I don't see anything above that is close to being good evidence that keeping the article is preferable to splitting and redirecting. (3) My larger point here, apart from WP:MEDRS, is that different judgments will be made about the content of medical articles than will be made about the content of religion articles or entertainment articles, etc. The point is not that there is something remarkable about medicine; the point is that some aspects of evaluating content are what Stephen Toulmin (in his famous book The Uses of Argument) called field-dependent, that is, relative to the particular field. An article about criticism of Facebook could be expected have a different structure than an article about criticism of medicine because the fields are different. (4)–(5) Yes, a lot could be remedied by radically changing the lead and then changing the article sections so that they support the lead in ways that are verifiable by secondary and tertiary sources. If that were done, I would definitely review the article and reconsider my !vote. Biogeographist (talk) 11:29, 7 May 2018 (UTC)


 * I made the change in the lede. Thanks again for pointing out to me where there was a problem.  Overall, the content of the article is extensively sourced (44 sources for a 20 KB article) and does not editorialize.  If there are some places that are not properly sourced or where my wording does not conform to Wikipedia style, please tell me, and I'll change them.  For example, earlier someone pointed out that I should not have used a primary source for Ioannidis, and so I replaced it by a secondary source.


 * The justification for having the article is that the topic meets Wikipedia standards of notability.


 * The early discussion of deletion included several editors debating whether or not having such an article gives implicit support to CAM. Although in the nom User:Alexbrn did not mention CAM, in the course of the discussion User:Alexbrn commented that the title of the article suggests religious-fundamentalist CAM ("The most obvious source of 'criticism of medicine' content would be fundamentalist religious sources..."), accused me of having a "problematic agenda," and accused User:Discospinster of using a "fringe/ignorant concept" ("Western medicine").


 * Early in the discussion I read WP:Splitting and asked what the basis in Wikipedia policy would be for splitting this article, since I didn't find any rationale in that policy statement. No one answered.  I assumed (perhaps incorrectly) that the reason was that some editors feared that having a separate article entitled "Criticisms of medicine" would give support to CAM.  I understand that that's not your reason, and I appreciate your willingness to reconsider if the article is changed so as to remove any sourcing or other problems you see in it.NightHeron (talk) 13:27, 7 May 2018 (UTC)


 * You wrote: The justification for having the article is that the topic meets Wikipedia standards of notability. Please list below some of the sources that you used to conclude that the overall subject of the article as stated in the lead is notable—not each specific subject mentioned in each section, but the overall subject and thesis of the article as stated in the lead. If you can point out a reliable source about the overall subject of the article that mentions all or most of the specific subjects summarized in the sections, that would be great too. Thanks, Biogeographist (talk) 14:33, 7 May 2018 (UTC)


 * My conclusion about notability is based on reading WP:N, which, as User:WhatamIdoing said, is the relevant policy. There are many sources that deal with criticisms of medicine, some of which have titles such as "distrust of medicine," "failure of modern medicine," etc., but a single source normally deals with only a small part of the broad topic.  That is not a violation of notability.  For example, the topic of Criticism of Christianity passes the notability test.  However, the subtopics of the article include doctrinal criticisms, criticisms of historical acts by Christianity, criticisms about the contemporary role of Christianity, and so on.  It is likely that no single RS could be found that includes all or most of these subtopics.  There are many articles on Wikipedia besides criticism articles about which the same is true.  For example, see the list of contents of Bias, which includes a wide gamut of subsections related to different types and settings of bias.  It's doubtful that a single source could be found that discusses all or most of them.  But WP:N does not require such a single source, so neither Criticism of Christianity nor Bias violates the notability standard.


 * I don't understand what you mean by "thesis of the article as stated in the lede." The first part of the lede states an indisputable fact (that medicine has produced great benefits) and the second part states another indisputable fact (that there have been many criticisms of deficiencies) and gives a brief summary of the contents.  I don't see any "thesis."NightHeron (talk) 16:29, 7 May 2018 (UTC)


 * I asked for sources. If you don't have such sources, so be it, but everything you said above is just a repetition of arguments that have already been made (e.g., your comparison of the article to Criticism of Christianity fails again, for the reason that I have already explained twice above), and therefore does not convince me to change my position. What would convince me to change my position, corresponding to the distinction that I made above between a synthetic article subject and synthetic article content, are the sources I requested above (which would prove that the article subject is not synthetic) and revision of the article as I described above (which would prove that the article content is not synthetic, or would correct the article content so that it is not synthetic).
 * The current lead needs improvement (it had a clear thesis before you edited it).
 * Per MOS:LEAD, the lead should identify the topic, establish context, explain why the topic is notable, and summarize the most important points, including any prominent controversies. (Footnote: Do not violate WP:Neutral point of view by giving undue attention to less important controversies in the lead section.)
 * Per MOS:LEADREL: According to the policy on due weight, emphasis given to material should reflect its relative importance to the subject, according to published reliable sources.
 * Per : In some cases the definition of the article topic in the opening paragraph may be insufficient to fully constrain the scope of the article. In particular, it may be necessary to identify material that is not within scope. Biogeographist (talk) 17:22, 7 May 2018 (UTC)


 * I'm unclear on what's needed here. Of course I did read what you wrote about different fields and different types of topics being evaluated differently, but I don't see how that explains why WP:N would have a different meaning for Criticism of Christianity and for Bias than for Criticisms of medicine.


 * I could add something to the lede like: "Criticisms of medicine are important not only because progress in any area of science-based practice requires discussion of shortcomings and improvement of deficiencies, but also because the public's perceptions of medicine greatly affect the quality of health care." Then what sources would you have to see in order to accept this?  There are sources, for example, that say that a patient's perception of the medical profession affects the outcome; sources that say that negative experiences of the therapeutic relationship drive patients toward alt med; sources that say that patients are discouraged by news reports of fraudulent research; sources that say that lack of access and high cost (or perceived lack of access and high cost) are an obstacle to improved health care; and so on.  I would not be able to find a single source that says all these things, but I don't see why that should matter.


 * I don't see anything in the main body that violates WP:SYN (what you call "synthetic content"). As I mentioned before, juxtaposition does not constitute SYN.  As I said, I'd be glad to correct any place that violates WP:SYN, that is, any place that makes an inference that's not explicit in the sources.NightHeron (talk) 18:32, 7 May 2018 (UTC)


 * I'm not sure I can be of further help here. I'm not interested in rewriting the article myself or in giving detailed instruction in how it should be rewritten; perhaps you'll get some help from another editor. Notability is not the issue here, at least not for me and not for the other editors who have made points similar to mine using different words. "SYNTH is not mere juxtaposition" isn't the issue for me either, since that refers to a reader who could imagine that something might be insinuated by the juxtaposition. Biogeographist (talk) 19:12, 7 May 2018 (UTC)

Biogeographist has asked above for a list of some sources that demonstrate "that the overall subject of the article as stated in the lead is notable—not each specific subject mentioned in each section, but the overall subject". Here's a short list:


 * review
 * review
 * review
 * review
 * review

Note especially:
 * 1) There are whole books written on the specific and sole subject of problems within medicine.
 * 2) This subject has been discussed within (and without) the profession for more than a century.

There is no chance of this being declared non-notable. It's a "thing". The only question is whether we collect this content as a single article, or whether we parcel it out to related articles (including Medicine itself), with the result that those articles include more negative content than they currently do. That decision is a matter of editorial judgment. WhatamIdoing (talk) 21:11, 7 May 2018 (UTC)
 * Thanks for the references. Do you know if anything in those references (or other references) could help clarify whether we collect this content as a single article, or whether we parcel it out to related articles? Judging by the article's current state, splitting and merging sections into related articles appears best for reasons given by various editors above, but it would be good to know if there is something in those references (or other references) that would change the decisional calculus. Biogeographist (talk) 22:41, 7 May 2018 (UTC)
 * IMO we could go either way. For that matter, we could do both:  improve our coverage of unflattering facts in each of the articles, and still have a centralized place for people who want to specifically learn about problems that need to be addressed and different POVs for looking at things.
 * There is no shortage of sources. The question is primarily an editorial question:  How do you want readers to find this information?   Merging it to Medicine and related articles is a more "in your face" approach (because readers are less likely to click through to a second article), but there's more room to compare and contrast different problems if they're all in a single article.  WhatamIdoing (talk) 23:55, 7 May 2018 (UTC)
 * OK, I've started reading the first item in the list of references above, John Henry Tilden's Iconoclastic and Constructive Criticisms of the Practice of Medicine and I don't yet see the relevance of it to this article, but I'll keep reading it until I figure it out. Citing that book in this article would definitely expand the novel collection of sources cited in the nom! Biogeographist (talk) 00:15, 8 May 2018 (UTC)
 * I think you might be better off starting with The Rise and Fall of Modern Medicine. Our notion of "medicine" has changed somewhat since 1910.  WhatamIdoing (talk) 15:22, 8 May 2018 (UTC)

 Relisted to generate a more thorough discussion and clearer consensus.

Please add new comments below this notice. Thanks, Kirbanzo (talk) 17:28, 8 May 2018 (UTC)
 * Thank you for attempting to bring some sources to this discussion. I am wondering a bit about how you went about selecting and evaluating those sources before presenting them, though, and how applicable they are here. I have concerns about the 'freshness' of those sources, for instance&mdash;there seems to be only one source from the last twenty years (and then only just barely). Four of the eight are more than fifty years old, with two getting well past the century mark.  Medical practice, medical research, medical regulation, medical training&mdash;all were rather different in 1828 – or 1910, or even 1960 – than today.  If this topic were really only mentioned eight times in the last two centuries, perhaps it is not ripe for an encyclopedia article in any case....
 * The relevance of many of those sources to this discussion and this article also seems tenuous. Aside from containing the words "criticism" and "medicine" or "medical" in their titles, how do they bear on the question of whether or not we should keep this particular article, with its scattershot, laundry-list approach?  The sources provided deal variously with criticism of medical science, medical practice, and medical philosophy, and often espouse mutually contradictory views.  (For example, Barbour (1995) bemoans the failure of modern medicine to take full account of patients' psychosocial context; while Le Fanu (2000) argues that modern medical research has been crippled by...too much focus on psychosocial stuff.  And those are the only two sources less than thirty years old.)  If nothing else, surely there ought to be more recent scholarly sources that actually examine, summarize, and evaluate the assessments and predictions of these decades- and centuries-old publications, especially if they represent important viewpoints that we should refer to today.
 * Lastly, there's a lot of single-author editorializing (from single-page to book-length formats), but not a lot of context. We have individual criticisms, but no 'criticism of the criticism'&mdash;secondary examination of the criticism itself to place it in context. I stick by my original argument to delete this article&mdash;the topic is too diffuse, the sources aren't there, and the criticism of various aspects of medicine are better dealt with in various already-extant articles. TenOfAllTrades(talk) 18:56, 8 May 2018 (UTC)
 * I was aiming for sources whose titles unambiguously indicated that they were on this subject, and from a range of decades, so that nobody could claim that complaining about the state of mainstream medicine was just some media flash-in-the-pan that would be over in a week or two.
 * On the point of titles, it'd be good to include the POV from a source such as Doyal's What Makes Women Sick: Gender and the Political Economy of Health, but it'd be too tempting for someone to say that it's irrelevant because it's about sexism (as sexism happens to play out in the context of mainstream medicine), rather than "just" a pure, de-contextualized critique of pure medicine. I ran across this book via the book review "Critiques of modern medicine", which names several other left-leaning books that might be usefully consulted as part of a WP:YESPOV strategy to build a comprehensive article.
 * Specifically on the point of criticizing (the current state of) evidence-based medicine, this source has some very interesting information:
 * It seems that hierarchies of evidence are not all they're cracked up to be (largely because the quality of a study, not just its type, matters, too). WhatamIdoing (talk) 04:26, 16 May 2018 (UTC)
 * It seems that hierarchies of evidence are not all they're cracked up to be (largely because the quality of a study, not just its type, matters, too). WhatamIdoing (talk) 04:26, 16 May 2018 (UTC)

Did this really need to be relisted? The only person arguing to keep is the creator. Natureium (talk) 19:13, 8 May 2018 (UTC)
 * Delete a bad relist. Concensus is to delete already. This should be closed now. Legacypac (talk) 19:42, 8 May 2018 (UTC)
 * The last two comments misrepresent the discussion. It would be very helpful if a disinterested administrator could examine the discussion (and article) and determine whether a consensus to delete (not the same as majority vote) has been reached, or whether there should be "no consensus" closure.  User:Alexbrn in the deletion template claimed that the article is "written like a personal reflection or opinion essay" (but when I asked for evidence of this, no one responded), and in the nom disparaged the sources and claimed that the topic is too broad; later User:Alexbrn also alleged bad faith on my part, claiming that there is a "problematic agenda behind all this."  Some of the discussion concerned questions that, as far as I'm aware, have no basis in Wikipedia policy, such as (i) whether or not the existence of a Criticisms of medicine article implies support for alternative medicine and quackery or for the religious-fundamentalist notion that medical care is against the will of God, and (ii) whether or not a single source can be found that touches upon all or most of the sections and subsections.  Some of the discussion included specific criticisms that led me to make three improvements (replacing a primary source by a secondary source, deleting a part of a sentence in the lede that wasn't supported by sources in the article, and adding a short section on Iatrogenesis).  Other parts of the discussion about the article were positive, saying, for example, that the "premise of the article is not flawed," that sourcing is good, that notability should not be an issue, and that CAM should not be an issue either.NightHeron (talk) 21:05, 8 May 2018 (UTC)
 * Keep. I have already commented above. The article is an encyclopedic collection of criticisms of Western medicine. The criticisms don't have to be consistent with each other or form some kind of coherent whole. They don't have to all relate to the same aspect of medicine. They don't have to be "fresh"; even though medicine has advanced over the years, we don't need to ignore what has been said about it in the past (historical research is a thing). It is not biased to have such an article if it doesn't take a position one way or another, and it doesn't have to (nor would it) give equal weight to crackpot theories. There are many reliable sources that discuss what are perceived to be shortcomings of Western medicine. You don't have to agree with them or think they are "rational" but they are notable. ... disco spinster   talk  13:18, 9 May 2018 (UTC)
 * I'd also like to point out that the article Criticism of science survived an AfD with unanimous keeps. ... disco spinster   talk  20:30, 9 May 2018 (UTC)
 * Delete per OP. -Roxy, the dog. barcus 11:30, 11 May 2018 (UTC)
 * ?? Can anyone explain to me what WP:OP (open proxies) has to do with this discussion?NightHeron (talk) 11:51, 11 May 2018 (UTC)
 * When you cease being a newbie, you will realise that in context, OP means original poster. -Roxy, the dog. barcus 12:18, 11 May 2018 (UTC)
 * Bashing people for not happening to know all of the internet slang (this isn't even wiki-specific jargon) is unkind and WP:BITEy. I think you should amend your comment.  WhatamIdoing (talk) 04:19, 16 May 2018 (UTC)
 * Keep. and divide to "Criticism of the US medical system" and " Criticism of mainstream medicine" (or possibly Criticism of Western mainstream medicine",), both articles that we do not have and  which would be appropriate. Contrary to what was said, an article should form a coherent whole.  I point out that the US medical system viewed in its economic  meaning does unfortunately include homeopathy and chiropractic , which are clearly not scientific medicine.  These are therefore separate topics.  DGG ( talk ) 22:44, 14 May 2018 (UTC)
 * I could support this approach. WhatamIdoing (talk) 04:17, 16 May 2018 (UTC)
 * I'm not clear on what DGG is suggesting when he says that "the US medical system viewed in its economic meaning" includes alt med. Does this just mean that American consumers financially support a large alt-med industry?  If so, the same is true in many countries (China, India, Brazil, U.K., Russia, etc.).  How does that relate to the topic of the article under discussion, which is criticisms of mainstream medicine?  The original title was "Criticisms of mainstream medicine," but I think that even with the title "Criticisms of medicine" it will be clear to readers that we're talking about criticisms of standard medical practice, not alternative modalities.  Criticisms of homeopathic and chiropractic treatments belong elsewhere.NightHeron (talk) 05:47, 16 May 2018 (UTC)
 * The US Medical system, seen as asocial and economic institute, consists of those institutions and activities which people and governments support for the purpose of preventing and curing disease. This includes both parts that actually do this, and parts that do not do what they are supposed to. One can discuss and criticise this system on grounds of economics, social distribution of care, and results.  DGG ( talk ) 08:52, 16 May 2018 (UTC)


 * Does "those institutions and activities which people" support include private ones, such as companies big and small, organizations, and wellness centers that promote alt med?NightHeron (talk) 15:16, 16 May 2018 (UTC)


 * The above discussion is preserved as an archive of the debate. Please do not modify it. Subsequent comments should be made on the appropriate discussion page (such as the article's talk page or in a deletion review). No further edits should be made to this page.