Countering medical nihilism by reconnecting facts and values

A pessimistic strain of thought is fomenting in the health studies literature regarding the status of medicine. Ioannidis’s (2005) now famous finding that “most published research findings are false” and Stegenga’s (2018) book-length argument for medical nihilism are examples of this. In this paper, we argue that these positions are incorrect insofar as they rest on an untenable account of the nature of facts. Proper attention to fallibilism and the social organization of knowledge, as well as Bayesian probabilities in medical reasoning, prompt us to ask why the cynics expect the results of quantitative studies to be incontrovertibly true in the first place. While we agree with Ioannidis and others’ identified flaws in the medical research enterprise, and encourage rectification, we conclude that medical nihilism is not the natural outcome of the current state of research.