The ethics of ignorance.

'Even the wisest of doctors are relying on scientific truths the errors of which will be recognised within a few years time,' wrote Marcel Proust a century ago. At that time most people understood the severe limitations of medicine, but today doctors are viewed as having enormous power. Medical research is seen by the public as the 'most scientific' form of scientific research (1); television programmes tend to promote a hi-tech, triumphal view of medicine; the newspapers are filled with stories of breakthroughs; funds are raised to send a small girl across the Atlantic to have her life saved by a highly complex transplant operation; and people believe that medicine has left the age of leeches and cupping to enter a scientific era where most of life's ills will be cured ifenough money can be raised to pay for the essential research. Most doctors feel uneasy with this view of modern medicine. Managing cases of multiple sclerosis, Alzheimer's disease, disseminated cancer, or ulcerative colitis, they know that doctors can often do little. Yet doctors as well believe that modern medicine is increasingly scientific and that most diseases will eventually succumb to scientific progress. I want to argue here that the scientific base of medicine is weak and that it would be better for everybody if that fact were more widely recognised.