學者的責任

報導指西非塞拉利昂/獅子山的伊波拉危機完全是可以避免的。伊波拉之所以蔓延到塞拉利昂,是因爲幾内亞的一個巫醫聲稱她能治愈伊波拉,引起塞拉利昂的信眾跨境去追隨她,於是疫情一發不可收拾。一個人的愚昧無知造成上千人的痛苦和死亡,我希望沈旭暉可以出來說清楚巫醫是什麽一回事。

山中雜記

看到BBC介紹伊波拉,我想起沈旭暉早幾天在一篇文章中說:伊波拉疫苗沒有出現,除了技術困難,也有成本效益考慮:當伊波拉只影響非洲,疫苗便沒有大商機,投資研究恐怕不在優先之列。西方藥廠的道德水平,在非洲早已聲名狼藉。」我不知道他有什麽證據去支持這番言論,他沒有提出來,我會懷疑他是在信口開河。

首先,伊波拉疫苗之所以沒有出現有很多可能性,最大可能就是現時醫學對這種病毒的理解和治療方法沒有重大的突破。世上有很多禍害深遠的病毒,例如愛滋病、非典型肺炎、流行性感冒等等,都沒有根治方法和預防疫苗。假如已經提出了技術問題,那就根本不用說什麽于商機、西方藥廠,這樣衹會讓人懷疑作者胡説八道,不明白科學、經濟學和現實:科技發展不單單是加大投資就能解決問題,科學家解決不了物理、生物和化學的問題,你投資多少錢都沒用。

再者,并不是沒有藥廠願意生產和研究伊波拉疫苗,兩年前就有報導有兩家藥廠已經開始人體測試,但因爲美國國防部下令和資金遭削減停止了這方面的工作。但這不帶代表所有西方國家和藥廠都停止了伊波拉疫苗的研究,加拿大的研究人員已經成功生產出能讓猴子避免病毒感染的實驗性疫苗,并將疫苗捐贈給世界衛生組織。問題是,這款疫苗從未使用在人類身上,因爲使用疫苗就代表要接種伊波拉病毒到人身上,而科學家暫時還不能保證疫苗足夠安全。這是重要的醫學操守,最終要不要進行人體上測試并不是取決于研究資金多寡,至少我希望資金多少并不會影響到這決定。

所以,就算有人證認爲資金是一個問題,我們也得比較其他證據看哪一樣更有解釋力,哪一樣更爲優先。考慮過各種證據,我們可以說:「目前沒有疫苗防止伊波拉,主要原因是實驗性疫苗還沒有通過臨床測試,研究資金的減少或者會對研究進展有阻礙」。這樣就能清晰和中肯地説明問題,也不需將矛頭指向商機、藥廠或「資本主義」。

旭暉在另一篇文章亦提到:在政府效能有限的國度,巫醫承擔醫生、律師、社工、宗教家、玄學家與地方領袖的角色,是必須的社會樞紐。何況祖傳秘方不一定沒價值,只要巫毒教有心現代化,也許和中醫一樣別有洞天。 」這是一種非常奇怪的説法,也再次讓人懷疑沈旭暉的科學知識水平。很多非洲國家的政府的確是能力有限,但這跟當地的經濟發展和科學水平有關,讓巫醫承擔醫生、律師、社工、宗教家、玄學家與地方領袖的角色」是更糟的選擇,因爲讓巫醫掌握這麽大的影響力,他們就會宣揚迷信,控制思想,讓當地人會在愚昧之中。非洲已經有很多巫醫叫人鬣狗獻上身體某部分(結果陽具被吃掉)、指控巫師偷竊陽具并吊死他們、巫醫割去小孩陽具等事件。迷信、不理解科學都會對巫醫自己和大衆的陽具造成極大傷害。

我們也可以說歐洲中世紀的教士和教會也曾「承擔醫生、律師、社工、宗教家、玄學家與地方領袖的角色」,但我們不會鼓勵任何社會再走中世紀那條路,反而應想辦法幫助它們現代化,但注意,不是「巫毒教現代化」。巫毒教本身就是一種因迷信思想而成的一個團體,它怎麽可能現代化呢?如果是說巫醫祖傳秘方現代化,這原則上不是問題,但所需要做的是拿出這些治療方法去進行現代醫學所要求的雙盲測試,如它能通過測試,現代醫學就會將這方法納入醫學的一部分。但留意,這也僅僅是治療方法通過測試,要巫醫的理念通過測試就幾乎是不可能,因爲叫得他做巫醫就説明他的理念不科學—這是「巫醫」的定義

科學思維和批判式思考對我們的社會非常重要。一個教育工作者應注意他在公開場合,尤其是大衆媒體上所發表言論,他有責任用證據和正當的邏輯去支持他的論述,否則,公衆就很容易因爲他的身份而照單全收,因而得出錯誤結論。公衆有能力進行批判式思考,自行去反思和搜集證據當然是更好了,但要普及這種自發性行爲,就有賴教育工作者先行樹立一個良好榜樣。沈旭暉這兩篇文章似乎離上述這個基本要求還有一段距離。

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20 則回應給 學者的責任

  1. DL 說:

    『Ebola outbreak: ‘Patient zero’ at start of deadly virus spread identified by scientists as a two-year-old toddler in Guinea』

    http://www.independent.co.uk/news/world/africa/ebola-outbreak-patient-zero-at-start-of-deadly-virus-spread-identified-by-scientists-as-a-twoyearold-toddler-in-guinea-9660864.html

    http://www.nejm.org/doi/full/10.1056/NEJMoa1404505#t=article

    『“It’s a market failure because this is typically a disease of poor people in poor countries, where there is no market. If it hadn’t been for the investment of a few governments in the development of these drugs, we would be nowhere.”』

    http://www.theglobeandmail.com/news/world/the-ethics-of-ebola-an-opportunity-to-right-a-wrong-of-history/article20023826/

    • 山中 說:

      It seems that DL cannot comprehend the meaning of “Ebola spread to Sierra Leone because of a witch doctor". And why are you posting the same news source? Didn’t I answer you already and you have absolutely no reply on that instance? Are you a troll? Tell me, since when privately owned pharmaceutical companies have any duty to develop a drug that they cannot make money on? When there is a market failure, then the state should step in. Right now we have experimental drugs because states stepped in, and state-sponsored research has been tackling this problem for decades. Why put the blame solely on pharmaceutical? Answer these questions here. If you jump around on other posts making the same comment without addressing the issues and providing coherent arguments, you will be banned for trolling.

      • DL 說:

        山中先生,

        //一個人的愚昧無知造成上千人的痛苦和死亡,….//

        那應該顯然不是「一個人的愚昧無知」而應該是「很多人」的愚昧無知。因為如果那些人不是「愚昧無知」的話,那又怎麼可能會去相信一個「巫醫」?

        由此可見,造成伊波拉蔓延到塞拉利昂(還有附近國家)絕非單一的因素。造成這次Ebola outbreak的原因相信是多於一個。

        我沒有說過也沒有否定你講的原因不是造成Ebola outbreak的原因之一,我引用網上的鏈接只是想說明沈旭暉所說的原因似乎與不少medical professionals and doctors所說的原因有類同之處,相信沈旭暉所說的也是原因之一。

        希望你不要把不完全相同的意見視之為「trolling」。

        • 山中 說:

          DL,
          我沒有說不相同的意見是trolling,而是你的行徑是trolling,搞清楚兩者分別沒有?

          • DL 說:

            對不起,我寫漏了兩個字,全句應為:
            『希望你不要把表達不完全相同的意見視之為「trolling」。』
            並表示歉意。

          • 山中 說:

            看來你還是不明白自己是做了什麽。我有說你是表達意見的問題嗎?我是說你的行爲,你看清楚沒有。

            首先,你沒有提出任何反對意見,因爲你沒有論述。你衹是單純的貼上新聞報導。我對這些新聞報導已經在之前的文章和留言中回應過了,你無法反駁,亦不作聲。但當我重登文章時,你不理之前的回應,又再貼上同樣的新聞報導,好明顯你不是來討論,而是來搗亂。而且,這樣的行爲已經不是第一次,我之前已經對你發出過兩次警告。再多一次我就立刻禁制你繼續留言。

            我再說一次是爲了讓其他人知道到底是什麽一回事。

          • DL 說:

            山中先生,

            我想對你指責我作一些澄清:

            //首先,你沒有提出任何反對意見,因爲你沒有論述。你衹是單純的貼上新聞報導。我對這些新聞報導已經在之前的文章和留言中回應過了,你無法反駁,亦不作聲。//

            正如我之前所述,既然我並不反對和否定你說的原因,那又何來會有「反駁」和「作聲」?
            我認為既然不反對任何一方故也就沒有什麼好論述的,認為只需提供一些鏈接作個參考以表明原因不止一個應已足夠。

            //但當我重登文章時,你不理之前的回應,又再貼上同樣的新聞報導,好明顯你不是來討論,而是來搗亂。//

            在你重登文章時,我發現之前所貼的一個我認為是有比較重要參考作用的鏈接被刪除了。那個鏈接我認為對於表明沈旭暉所說的也是原因之一應該是不可缺少的,因而補回那個鏈接。
            如果你認為我補回一個被刪除但被認為有比較重要參考作用的鏈接就是「搗亂」的話,那實在不免令人有「強詞奪理」之感。

            我相信其他人應該是會知道到底是什麽一回事的。

          • 山中 說:

            你不提出論述何來“表明”?

            刪除?你真的是睜著眼說大話。這是你在《簡介批判式思考》的留言; 這是你在這篇上面的留言。我在《簡介》已經回過你,你又再貼出來是幹什麽?

            你這樣造謠撒謊ban你是肯定的,我給你最後一次機會説話。

          • DL 說:

            我重貼鏈接的那天確實是看不到先前的那個貼故才重貼的,可能是我當時看錯了。
            相信即使是看錯了不慎重貼也不應該被用作為ban的藉口吧?

            如果有人不慎重貼一個與你說的原因相同而與沈旭暉所說的原因不同的貼,那是否也會受到同樣對待呢?

          • 山中 說:

            我一開始用英文說不會在看一場次?也不看我原來是怎樣回你的?現在才說看錯?看錯的不是一個兩個字,而是整個回應有沒有顯示出來;如真的沒看到,也等多看幾次才說什麽被刪除留言,撒謊也找個好一點的藉口。再說,我已經三番四次警告你了。你不聽就不是我的問題。Ban,不需再多言。

          • yn 說:

            「欲加之罪,何患無辭」,一於實行中共式「和諧」?

          • 山中 說:

            分身就見一個ban一個了。

      • Wai 說:

        The posting of the same new sources by DL comes with a quote that addresses your response to Mr Shum’s argement. It cannot be more obvious. Your inability to “comprehend this 行徑 (in your words)" is no different from “ignorant indigens" (in your words again).

        In order not to distort your meaning, I quote your verbose paragraph in full:

        “首先,伊波拉疫苗之所以沒有出現有很多可能性,最大可能就是現時醫學對這種病毒的理解和治療方法沒有重大的突破。世上有很多禍害深遠的病毒,例如愛滋病、非典型肺炎、流行性感冒等等,都沒有根治方法和預防疫苗。假如已經提出了技術問題,那就根本不用說什麽于商機、西方藥廠,這樣衹會讓人懷疑作者胡説八道,不明白科學、經濟學和現實:科技發展不單單是加大投資就能解決問題,科學家解決不了物理、生物和化學的問題,你投資多少錢都沒用。"

        But on the other hand, your response to DL is contradictary to the above:

        “Tell me, since when privately owned pharmaceutical companies have any duty to develop a drug that they cannot make money on? "

        If you are not so desperate to save yourself from embarrassment when someone points to your mistakes, even politely, you should have noticed your inconsistency. How surprising is that you got so many questions for someone of whom you accused a troll. You are either as ignorant as those ignorant indigens in Africa, or you are schizophrenic.

        Besides, next time when you got a question, you should learn to ask politely.No one is obliged to tell you anything or wet-nurse you. Your frequent fits of hysteria make yourself look more like a troll.

        • 山中 說:

          1) Medicine requires testing and technical progress. 2) Pharma companies are not required to doing anything that’s going to cost them money. How are these two contradictory? Do you know that prototype vaccines exist, but they can’t be used on human because they haven’t gone through human trial? You cannot discuss facts?

          Didn’t I replied what DL said already? Didn’t I say DL was lying? Why could you see what is going on first before you open your mouth?

          Oh the above aren’t usual questions that require you to answer. Those are rhetorical questions. Try to understand what that means.

          • Wai 說:

            Your argument that “Pharma companies are not required to doing anything that’s going to cost them money" is exactly the reasons why Mr Shum said “疫苗便沒有大商機,投資研究恐怕不在優先之列。西方藥廠的道德水平,在非洲早已聲名狼藉". This is just plainly contracditory with your attack on him “我不知道他有什麽證據去支持這番言論,他沒有提出來,我會懷疑他是在信口開河。" because you just give supporting for Mr Shum’s argument. You just hold Mr Shum’s hand to slap your own face. It is more embarrassing than to admit your mistakes.

            You surely did reply DL, but in a very rudely way. Probably only a guy like you would take the posting of a link which comes with a quote as “trolling". Your reply also mainly focuses on his “intention" of posting the link. It is not your argument, but your way of responding to different opinions that is disgusting. Many people leave comments here gently and politely even when they try to point out your mistakes. But you often take them as challenges and resort to name calling to defend your “fame and dignity" which I believe you don’t have, judging by the attention you got.

            You also have the habit of denying your mistakes by asking lots of “rhetorical questions" that make things complicated. Not that I cannot give you a treat by answering your stupid questions, but not that I let you escape by allowing you to make a digression by asking tons of irrelevant questions. “Rhetorical questions" are innocent. It is your foul mind that rapes them.

            Just as spelling out grand words and tehnical terms won’t make you a “master" that you always try to pretend, you attempt to escape from embarrassment is the exact reason that embarrasses you. Learn to be humble and apprepriate it next time when people correct you. It is the right road to the “master", though it takes longer for you. Don’t try to fight the embarrassment. No one tries to embarrass you as no one take you seriously. You are not as important and learned as you think.

          • 山中 說:

            Jesus. Pharma are not required to do something, it does not mean that in reality they are not doing something. If you read the discussion before, you will find that there are companies doing research, but for technical and regulation reasons, they can’t produce a safe vaccine just yet. Which part of this is hard to understand?

            To reiterate, here is a damn list of pharma doing ebola research: http://www.marketwatch.com/story/meet-the-drug-companies-fighting-ebola-2014-10-03

            Western private companies are investing and doing research even they are not making profit yet. This is a fact. Can you argue against a fact?

            If you don’t read what has already been said, then why bother making comments here? If you don’t read and have to comment anyway, you deserved to be berated.

            If you don’t want to read, then you can leave and stop reading.

      • Wai 說:

        Ok. I think things are deviating from the inital purpose. I try not to be a bitch winning a debate by speaking the last word. Just clarify a few points that I have made.

        From the very first beginning, I am not trying to argue whether the government “should" get involved in the production of Ebola vaccine (though personally I think so). It is a classical topic in economics and I don’t think it is possible to convine either side in one online discussion like this. The point is that Mr. Shum’s opinion on this issue is not “信口開河". At least DL post a source here which supports Mr Shum.

        If you have read the news, you must learn that just after a few Americans contracted Ebola, and there was a thread of spreading in the US, very “miraculously" an Ebola vaccine/drugs emerged. It is either a sheer miracle, or it is something that seems suspicious to many people. Maybe Pharma companies are “doing something", but does it mean they are doing enough?

        Finally, it is your right to make unilateral comments on issues. But if you want to draw learnt people to join in the discussion, you should learn to agree to disagree. If you continue to make rude accusations like “ignorant", “illiterate" or something like “you don’t read a certain article before you speak", good people will run away and your blog would only attract real trolls.

  2. chiu 說:

    Dear DL, haha, you are still arguing on this topic ? honestly being in this field, i agree with your opinion that market consideration is a major hurdle, but it is just a minor point la, compared with many “real issues" facing hk, war-torn countries and climate change. after each side has expressed one’s opinion and evidence clearly, if one is not changing one’s mind, further discussion is usually redundant, just agree to disagree la.

  3. Twice 說:

    Regarding clinical trial of drugs, it is a massive multi-layer programme which involves tens of thousands of people of different gender, race, age group, to test the drugs under a closely monitored environemt, not only monitored by the drug companies, but also the FDA. Hiring those people for trial already cost millions of USD if not billions, and please don’t forget how much hurdles you need to pass before going to the clinical trial phase.

    There are hundreds of R&D teams in large drug companies, and each is responsible for more than one type of new drug. Those who are resonsible for some most common type of disease/illness/problem, like headache, would get the most R&D funding, since they are the most common diseases/illness/problems which the company can earn the most for them, like billions of USD, even though the headache medicine may turn out to be flawed.

    For other not-so familiar disease like smallpox, there will still be R&D teams responsible for it, and they will keep doing the research in order to get experience and to prepare for the “renaissance" of the disease. However getting the most expensive part, the clinical trial, is a different story since there are no sign/hope (LOL) of epidemic of the disease, unless you get government funding for it the budget for R&D of it would be small, if not nill. Smallpox can be one example, Ebola is another.

    I hope this would let you know more fact about how this industry works.

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