I came across this story this morning. In short, it tells us that EU bureaucrats have forbidden companies that sell bottled water from claiming that water can prevent dehydration. I’ve not read the ruling, just the report I link to. But it seems, on the surface, to be a decision which has taken considerable time and resources which was, in the end, motivated more by politics than anything else.
I honestly believe that maintaining hydration is one of the simplest, easiest and cheapest things individuals can do to maintain their energy and vitality. I have seen countless individuals with low fluid intakes experience considerable uplift in their general wellbeing just by upping their consumption of water and other beverages. The effect appears, to me, to be incredibly consistent. It might be a giant placebo response, of course, though trust me when I tell you that if that’s the case, few people will mind: it’s feeling better that they principally care about, not the precise mechanism(s) that brought that about.
The EU ruling took my mind to a practice known as ‘evidence-based medicine’ or ‘EBM’ for short). This is a term that is generally taken to mean medicine which has a solid research base to support it. However, should we dispense with things that have no evidence to support them even though they seem like the right thing to do and experience shows to be broadly beneficial?
If we do dispense with such things than we doctors better shut up shop – that’s because the great majority of medical practice is not supported by rigorous scientific evidence. Surgery is a prime example. When someone comes in with the signs and symptoms of an infected appendix, surgeons do not wait for ‘randomised controlled trials’ before they operate. Neither do they wait for sufficient supportive evidence before they take steps to stem significant bleeding sustained during injury (they just get on with with saving people’s lives, even in the absence of evidence).
Some years ago I read a letter in the British Medical Journal from James Michelson – Professor of orthopaedic surgery based at George Washington University in Washington in the US which should remind us all of why evidence-based medicine should not be the only evidence in town. It highlights why common sense has a role in medicine too. Here is an extract from that letter.
In the course of practice in orthopaedic surgery (although not documented in the literature), it has been my experience (those of you who adhere to the EBM doctines [sic] hopefully will excuse this phraseology) that when I hit my finger with a hammer (or mallet, for that matter), my finger hurts. It is even worse if I use a power tool (like drilling through the finger). My question: how many times do I have to do this before I can say that I have sufficient evidence to potentially causally link the hammer blow to my finger hurting? And what do I use as the control?
One of my teachers in medical school once noted that fields such as Orthopaedic Surgery were very difficult for some physicians to master because they required the exercise of “common sense”.
Professor Michelson’s got a point, I think. Those who believe the EU’s banning of the claim that water can combat dehydration is nonsense have a point too.