This is the second installment of a four part essay serialized in the MagMa. It contains the following parts:
Part 2: The Military-Academic-Industrial-Medico-Scientific Complex (MAIMS)
What do these enemies of the human race look like? Do they wear on their foreheads a sign so that they may be told, shunned and condemned as criminals? No. On the contrary. They are the respectable ones. They are honored. They call themselves, and are called, gentlemen. What a travesty on the name, Gentlemen! They are the pillars of the state, of the church, of society. They support private and public charity out of the excess of their wealth. They endow institutions. In their private lives they are kind and considerate. They obey the law, their law, the law of property. But there is one sign by which these gentle gunmen can be told. Threaten a reduction on the profit of their money and the beast in them awakes with a snarl. They become ruthless as savages, brutal as madmen, remorseless as executioners. Such men as these must perish if the human race is to continue. There can be no permanent peace in the world while they live. Such an organization of human society as permits them to exist must be abolished.
These men make the wounds.
Norman Bethune, Wounds[1]
Science is a product of the society that owns it. Where does that leave us? As scientists, on the one hand, we are seekers of knowledge, that’s what brought us into science in the first place, we’re people wanting to alleviate suffering. On the other hand, we’re employed – we worry about jobs, worry about funding, in that sense, we are the wage-laborers of the theory-mines, not too different from the weavers of Lancashire, and other sections which were first, originally free professions, and then gradually became proletarianized, so that now contingent labor, part-time labor, adjunct labor, is part of the process of the loss of independence. We already do not control the agenda of our research or the conditions of work. We certainly do not control what becomes of the products of our labor.
Richard Levins, »The Two Faces of Science«
Corporate Snake Oil
We must first overcome a superficial and inadequate critique that prevails in many Leftwing circles, and which tends to serve as a sort of thought-terminating cliché which hinders a deeper examination of real historical circumstances. Corporate medical and scientific firms are often accused of profiteering – e.g., overcharging for valuable commodities through patents, monopolies, regulatory capture etc. They are also accused of restriction and control of medical information, for the purpose of maintaining monopoly positions and extracting rents– thus services like Library Genesis of Z‑Library, which obviously would lead to more science being produced, particularly by scientists in the third-world, are ruthlessly persecuted. There is much truth to these criticisms, and they certainly complement the general argument that current conditions are not suitable to scientific flourishing.
However, the major flaw in these critiques which this section will seek to address, is the assumption that the commodities produced by what I will call the MAIMS (Military-Academic-Industrial-Medico-Scientific) complex always carry a genuine use-value for consumers. It is here that a full understanding of monopolization, financialization, and imperialism seems to fade away, and a quaint picture of halcyon capitalist competition takes its place, consciously or not. Such critiques tend to imagine that consumers are in a relatively decent position to assess whether medico-scientific commodities are in fact good for them (in the short, medium, or long term); that government agencies tend to make purchases in the interest of their populations, acquiring (and even imposing upon them) products and services that do benefit them; and that inferior, or at the very least, useless and dangerous products will not survive the test of both regulation and the competitive market.
As will be shown below, however, this could not be farther from reality. Indeed, the cartelization which characterizes this sphere is so profound and pervasive that it really demands a new concept– because it also entails the massive regulatory capture of agencies supposedly tasked with scrutinizing these industries, such that they are in fact totally beholden to them. Moreover, a large and ever growing portion of medical products and services are not chosen by consumers at all, but by providers, insurers, and governments (often and ever-increasingly in collusion). Products such as vaccines are directly or indirectly forced upon consumers by governments, employers, and schools. Ivan Illich traced some of the peculiar characteristics of medical care as commodity which made it, one the one hand, somewhat ill suited to subsumption under normal capitalist relations, while on the other, uniquely appropriate to the super-monopoly and super-monopsony relations that characterize capitalism today:
Medical care is uncertain and unpredictable; many consumers do not desire it, do not know they need it, and do not know in advance what it will cost them. They cannot learn from experience. They must rely on the supplier to tell them if they have been well served, and they cannot return the service to the seller or have it repaired. Medical services are not advertised as other goods, and the producer discourages comparison. Once he has purchased, a consumer cannot change his mind mid-treatment. By defining what constitutes illness the medical producer has the power to select his consumer and to market some products that will be forced on the consumer, if need be, by the intervention of the police: the producers can even sell forcible internment for the disabled and asylums for the mentally retarded. Malpractice lawsuits have mitigated the layman’s sense of impotence on several of these points, but basically, they have reinforced the patient’s determination to insist on treatment that is considered adequate by informed medical opinion.[2]
This cannot be reduced to simple capitalist relations.
The naive view also forgets (in a highly selective fashion) the perennial human phenomenon of snake-oil: that in the sphere of medical care in particular, humans are vulnerable to deception and fraud. As the historian of medicine Roy Porter observed, »the prominence of medicine has lain only in small measure in its ability to make the sick well. This was always true, and remains so today.«[3] While deceptive practices are acknowledged, and the suppression of side-effects at least used to be a very common criticism leveraged by leftists (before such considerations were promptly banned with the roll out of Covid vaccinations), few are willing to contemplate the true extent of fraud at the very core of much medical science. This is despite the remarkably telling fact that, quite openly, most pharmaceutical industries spend more on manipulating the population into buying their products than they do on research and development. For instance, nine out of ten major pharmaceutical industries spent more – often substantially more- on sales and marketing than on research and development in 2013.[4]
It is important, moreover, to not naively analyze this as investment merely in persuading people through advertisements. As Lopez notes, »a lot of the marketing these companies do is specifically targeted toward physicians,«[5] i.e., bribing health-care providers, whose power of prescription, not to mention their personal influence as ›trusted figures‹ profoundly complicates the nexus between apparent ›buyer‹ and ›seller‹ in such an equation. The component spent on ostensibly conventional advertising, like commercials, cannot be uncritically or naively treated here either. Major news providers sell not only the ›eyes and ears‹ of viewers for specific commercials, but more importantly favorable coverage (propaganda). This is why the monopoly aspect and the extent of concentration is essential to appreciate. In 2018, for instance, the largest advertiser for every major cable news provider in the USA was hawking some ostensibly medical product.[6] This amounts to awesome influence over news coverage, and a major source of bias and self-censorship.
What is particularly glaring in this respect is that those most unwilling to contemplate the depth of fraud and deception undertaken by the MAIMS complex consistently dismiss, peremptorily and without the slightest investigation, all critiques of it as driven by fraud and grift. Honest, decent practitioners of alternative medicine or nutrition are slandered and denounced. Vaccine skepticism is persistently and absurdly attributed to the profiteering schemes of some alternative health grifters, while of course the intentions of the major vaccine producers – despite all being, as corporate persons, convicted criminals – are assumed to be as pure as the driven snow (or in more sophisticated forms, assumed to be effectively forced by the market or regulators to produce good products which they merely overcharge for). There is, without a doubt, fraud, deceit, and grift in the natural and alternative health world. However, it is nothing compared to that which exists in supposedly legitimate corporate-controlled mainstream medical science. This, among other reasons, is because of the much more genuine and competitive market, aimed at a much more critical class of consumers, towards which the former is oriented.
The author discusses his views in the above podcast from »What’s Left?«
Yet a massive and highly effective psychological operation has managed to utterly invert common sense here, and instill the absurd idea in many that anyone trying to make an honest living selling alternative health care of any sort must be a malicious fraud, whereas the craven, opportunistic scientists and doctors who work for the MAIMS complex can simply tell no lies. Healthcare providers, scientists, and researchers who work for MAIMS are pictured as idealistic lovers of humanity, and are forgiven of all sins of embroilment in the market without a second thought.
On the other hand, scientists, researchers, and health-care providers who decide to criticize, or evenly simply present an alternative to MAIMS face overwhelming social and economic risks: they face penury, the loss of medical licenses, lawsuits backed (openly or covertly) by governments and corporations, social ostracization, or even, as in the case of Brandy Vaughan, possible assassination. Yet when such individuals make even the most modest attempts to secure their own existence and livelihoods, the self-same defenders of corporate lackeys break out into the most hysterical indignation at »profiteering grifters.« It is extremely difficult to reason with these »lovers of science,« especially if one touches upon issues in which they have deeply entrained psychic investments, such as vaccines. One can hardly be surprised by this fact, however – those »advertising« budgets have certainly not gone to waste.
Medical Society
In his 1975 work Medical Nemesis, Ivan Illich launched a powerful critique of the progressive corruption of western societies by industrialized medicine, which is worth quoting from here at some length. As he observed, society was being »rearranged for the sake of the health-care system,« with the consequence that it was becoming »increasingly difficult to care for one’s own health. Goods and services litter the domains of freedom.«[7] He traced this back to the strong predisposition towards atomization and reification which have characterized the bourgeois era:
Antiquity knew no yardstick for disease. Galileo’s contemporaries were the first to try to apply measurement to the sick, but with little success. Since Galen had taught that urine was secreted directly from the vena cava and that its composition was a direct indication of the nature of blood, doctors had tasted and smelled urine and assayed it by the light of sun and moon. After the 16th century, alchemists had learned to measure specific gravity with considerable precision, and they subjected the urine of the sick to their methods. Dozens of distinct and differing meanings were ascribed to changes to read diagnostic and curative meaning into any new measurement they learned to perform. The use of physical measurements prepared for a belief in the real existence of diseases and their ontological autonomy from the perception of doctor and patient. The use of statistics underpinned this belief. It ›showed‹ that diseases were present in the environment and could invade and infect people.[8]
We note in passing here the interesting historical fact that the first clinical test using statistics, which purported to provide »hard data indicat[ing] that smallpox was threatening Massachusetts and that people who had been inoculated were protected against its attacks« were carried out in 1721 by Cotton Mather.[9] Mather’s spirited campaign for both quarantine and inoculation to combat smallpox elicited intense resistance from the population of Boston, culminating in a grenade attack on his home.[10] That vaccinationists don’t more frequently celebrate this illustrious forebear of theirs may have something to do with the fact that history had tended to remember him chiefly for his involvement in the Salem Witch Trials and zealous defense of the existence of witches. The entanglement of both Witch-Hunting and the Scientific Revolution with the general struggle to subordinate and proletarianize the restive peasantry has been brilliantly explored by Silvia Federici in her work Caliban and the Witch. There, she noted that
In Mechanical Philosophy we perceive a new bourgeois spirit that calculates, classifies, makes distinctions, and degrades the body only to rationalize its faculties, aiming not just at intensifying its subjection but at maximizing its social utility … Certainly, neither Hobbes nor Descartes spent many words on economic matters, and it would be absurd to read into their philosophies the everyday concerns of the English or Dutch merchants. Yet we cannot fail to see the important contribution which their speculations on human nature gave to the emerging capitalist science of work. To pose the body as mechanical matter, void of any intrinsic teleology … was to make intelligible the possibility of subordinating it to a work process that increasingly relied on uniform and predictable forms of behavior. Once its devices were deconstructed and it was itself reduced to a tool, the body could be opened to an invite manipulation of its power and possibility. One could investigate the vices and limits of imagination, the virtues of habit, the uses of fear, how certain passions can be avoided or neutralized, and how they can be more rationally utilized. In this sense, Mechanical Philosophy contributed to increasing the ruling-class control over the natural world, control over human nature being the first, most indispensable step. Just as nature, reduced to a ›Great Machine,‹ could be conquered … likewise the body, emptied of its occult forces, could be ›caught in a system of subjection,‹ whereby its behavior could be calculated, organized, technically thought and invested of power relations.[11]
It is important to stress that, of course, the mechanistic and atomistic model of the world did yield novel and real insights, did really enable the more efficient exploitation of nature and man. This does not foreclose it becoming, subsequently, a fetter to further scientific development, nor does it mean we can fully understand its emergence and persistence without contextualizing it the history of the bourgeoisie’s struggle for social, political, and economic dominance.
Illich notes that as late as the mid-1800s, one could still find Galen quoted with approval in declaring that »You can discover no weight, no form nor calculation to which to refer your judgment of health and sickness. In the medical arts there exists no certainty except in the physician’s senses.«[12] Robert Koch’s famous formulation of the Germ Theory towards the end of the century – which, as Lewontin notes, it had no impact that can be detected in any general metrics of health or well-being[13] – marks an evident sea-change. Illich traces a transformation
as the doctor’s interest shifted from the sick to sickness, the hospital became a museum of disease … the realization that the hospital was the logical place to study and compare ›cases‹ developed towards the end of the 18th century … The clinical approach to sickness gave birth to a new language which spoke about the diseases at the bedside, and to a hospital reorganized and classified by disease for the exhibition of ailments to students … During the entire nineteenth century, pathology remained overwhelmingly the classification of anatomical anomalies. Only towards the end of the century did the pupils of Claude Bernard also begin to label and catalog the pathology of functions. Like sickness, health acquired a clinical status, becoming the absence of clinical symptoms, and clinical standards of normality became associated with well-being.[14]
By 1975, however, Illich argued that
the age of hospital medicine, which from rise to fall lasted no more than a century and a half, is come to an end. Clinical measurement has been diffused throughout society. Society has become a clinic, and all citizens have become patients whose blood pressure in constantly being watched and regulated to fall ›within‹ normal limits. The acute problems of manpower, money, access, and control that beset hospitals everywhere can be interpreted as symptoms of a new crisis in the concept of disease. This is a true crisis because it admits of two opposing solutions, both of which make present hospitals obsolete.[15]
Like an ever constricting vice, corporate western medicine has elaborated a battery of tests, metrics, measures, and other diagnostics which have served to increasingly preclude, ostracize, or even criminalize an unmedicated existence. This occurs through not just marketing or pressure from (well-subsidized and heavily indoctrinated) healthcare professionals, but through collusion with insurance companies, policy-makers, social services providers, educational institutions, and the judiciary. Invariably, this is refracted through modern capitalism’s other technologies of social control, impacting most brutally racial, gender, and sexual minorities, as well as women and children. Ina May Gaskin and Jennifer Margulis[16], for instance, have documented in powerful terms how the process of birth in western capitalist nations has been transformed by corporate medicine into a cruel, irrational, dehumanizing, and traumatizing gauntlet for women and their children (before and after birth). Illich observes that:
An advanced industrial society is sick-making because it disables people from coping with their environment and, when they break down, substitutes a ›clinical‹ or therapeutic, prosthesis for the broken relationships. People would rebel against such an environment if medicine did not explain their biological disorientation as a defect in their health, rather than as a defect in the way of life which is imposed on them or which they impose on themselves.[17]
It is important here to stress the difference between this critique and the social-darwinist argument that a society weakens itself by treating the ill or disabled. The point is not that people should not be treated or cared for, but that the current social arrangements dictate that the treatment and care they are likely to receive is inadequate and often counter-productive, and that they can and should be cared for better. And the best way to ensure that is precisely by ensuring that they are maximally enfranchised, informed, and involved in their own treatment. By contrast, one could not hardly imagine an arrangement less likely to produce good treatment than one, like our own, in which those receiving treatment or care are maximally disempowered and subjected to a healthcare apparatus which is massively incentivized to do them harm. Indeed, it is a remarkable – and massively suppressed – fact that an incredible proportion of modern medical care exists simply to correct the ills caused, directly or indirectly, by prior medical interventions. Illich, for instance, cites a »senior official of the U.S. Department of Health, Education, and Welfare« who retired in 1973 who observed that »80 percent of all funds channeled through his office provided no demonstrable benefits to health and that much of the rest was spent to offset iatrogenic damage.«[18] Illich further contended that:
The overwhelming majority of diagnostic and therapeutic interventions that demonstrably do more good than harm have two characteristics: the material resources for them are extremely cheap, and they can be packaged and designed for self-use or application by family members. For example, the cost of what is significantly health-furthering in Canadian medicine is so low that these same resources could be made available to the entire population of India for the amount of money now squandered there on modern medicine. The skills needed for the application of the most generally used diagnostic and therapeutic aids are so elementary that the careful following of instructions by people who are personally concerned would probably guarantee more effective and responsible use than medical practice ever could. Most of what remains could probably be handled better by ›barefoot‹ nonprofessional amateurs with deep personal commitment than by professional physicians, psychiatrists, dentists, midwives, physiotherapists, or oculists.[19]
Illich, here, probably bends the stick too far – it is of course possible that more complex medical services could be desirable and beneficial, but for them to be so, we would need a social arrangement in which such complexity did not compromise transparency or democratic popular control. We will expand upon this prospect in Part 4. Illich’s presentation is also characterized by an ultra-left deviation which ascribes too much agency to self-perpetuating cultural trends, rather than properly contextualizing them in a materialist account of the class struggle. This is characteristic of Foucaldian-style genealogies, and has the upshot of excessively blaming the masses themselves for their supposed complicity in what is imposed upon them.
Within the movement which has coalesced around resisting the Corona measures, this misanthropic perspective has found a significant base in petty-bourgeoisie ›dissidents‹ and ›critics,‹ who are always attracted to a framework which enables them to blame the masses and exculpate the ruling class. This perspective, however, can only be maintained by a denial of the overwhelming power and influence of the MAIMS complex (and the ruling class themselves, who wield it in pursuit of their own interests).
Concentration, Cartelization, Corruption: Grounds for Medical Nihilism?
It is not merely in the directly market-facing sectors of the MAIMS complex that fraud, deceit, and corruption are the norm. Any sort of thorough economic analysis of the monopoly trends in this sphere is beyond the scope of this paper, and an existing study covering this material is unknown to the author (itself, perhaps, a telling fact). For the present purposes, however, it should be sufficient here to merely cite some of the more significant evidence for the fact that an interlinked network of cartels have achieved a degree of control, not only over the market, but over a wide array of regulatory mechanisms, such as to constitute a relationship which transcends monopoly traditionally conceived.
This has reached such a point that even bourgeois scholars, researchers, scientists, and doctors from within or adjacent to MAIMS have been pushed to fundamentally question the basic trustworthiness of modern medical research tout court. In his 2018 work Medical Nihilism, Jacob Stegenga persuasively defends the radical proposal that the extent and profundity of corruption in medical science, along with a dearth of mechanisms for rectifying it, mean that »there are fewer effective medical interventions than most people assume and that our confidence in medical interventions ought to be low, or at least much lower than is now the case.«[20] We will return in more depth to Stegenga’s core arguments subsequently, for now, his survey of skeptical statements from prominent figures is worth quoting at length:
The work written by physicians, epidemiologists, and science journalists supporting medical nihilism is vast (Recent examples include books by Marcia Angell (The Truth About Drug Companies, 2004) Moynihan and Cassels (Selling Sickness, 2005) Carl Elliott (White Coat, Black Hat, 2010), Ben Goldacer (Bad Pharma, 2012), and Peter Gøtzsche (Deadly Medicines and Organized Crime, 2013), and articles by epidemiologists such as John Ioannidis, Lisa Bero, Peter Jüni, and Jan Vandebroucke). These thinkers are not cranky outsiders, but rather are among the most prominent and respected physicians and epidemiologists in the world. For instance, the former editor of one of the top medical journals has claimed that ›only a handful of truly important drugs have been brought to market in recent years‹ while the majority are ›drugs of dubious benefit‹ (Angell 2004). Or consider the position of the epidemiologist John Ioannidis, suggested by the title of his important article: ›Why Most Published Research Findings Are False‹ (2005). The current editor of another eminent medical journal recently had this to say about contemporary medical science: ›Afflicted by studies with small sample sizes, tiny effects, invalid exploratory analyses, and flagrant conflicts of interest , together with with an obsession for pursuing fashionable trends of dubious importance, science has taken a turn towards darkness‹ (Horton, ›Offline‹ 2015).[21]
What precisely is the reason for such skepticism? First, let’s consider the corruption of regulatory agencies. A 2006 JAMA study found that in the FDA, in »73 percent of meetings at least one member of the consulting team in question had conflicts of interest« and that they, unsurprisingly, »influenced voting behavior: When panel members with conflicts of interest were excluded from voting, the judgment of the product in question was much less favorable.« Despite this fact, »panel members with relevant conflicts of interest were disqualified in only 1 percent of cases.«[22] It is not merely a matter of separate individual interests, however. Thanks to legislation like the 1992 Prescription Drug User Fee Act, the government agencies which are meant to regulate the pharmaceutical industry have become dependent on them for their own funding. So corporately, as an entity, the entire FDA is compromised: the more profitable the firms it regulates are, the more funding the supposed regulators enjoy.[23] A full 45 percent of its budget currently comes from the industry.[24] The FDA is moreover, dependent upon studies conducted by the industry itself, and is tasked with simply assessing the information they provide. It does not have the staff or capacity to run its own studies, or to try and replicate the studies submitted to it (and so, such studies are virtually never replicated).
The National Childhood Vaccine Injury Act, passed under Reagan in 1986, is even more illustrative of the profound dynamic this paper, in conjunction with my earlier piece on imperialism,[25] seeks to highlight. In the 1970s, public concerns about encephalopathy were driving down voluntary uptake of the DPT vaccine, and vaccine related lawsuits were on the rise. By 1985, vaccine manufacturers were struggling to obtain liability insurance. So, congress intervened, removing all liabilities from manufacturers and transferring them to the government– which is to say, to the population, as tax-base, itself.[26] As a consequence of the act, the U.S. Department of Health and Human Services (HSS) must defend approved vaccines against any claim that they cause injury in court, giving them a direct, strong incentive to suppress (or, at the very least, fail to fund and publish) any information which could be used against them therein. Engelbrecht et. al. note the 2009 decision of Tom Insel, a high level HHS official, to kill a 16 million study on the association of vaccination and autism, upon the explicit grounds that it could be used against the HSS in vaccine court.[27]
The transfer of liability on to the population, and simultaneous incentivization of that population’s supposed regulatory body to not expose any ills caused by vaccines, have certainly helped save a commodity which in non-monopoly conditions would’ve been hounded from the market. Indeed, since 1986, the number of recommended inoculations in the US went from 12 shots of 5 vaccines to 54 shots of 13, taking vaccines from a billion dollar sideline to a 50 billion dollar industry.[28] As Robert F. Kennedy Jr. has observed:
Since vaccines are liability-free – and effectively compulsory to a captive market of 76 million children – there is a meager market incentive for companies to keep them safe … The four companies that make virtually all of the recommended vaccines are all convicted felons. Collectively they have paid over $35 billion since 2009 for defrauding regulators, lying to and bribing government officials and physicians, falsifying science, and leaving a trail of injuries and deaths from products they knew to be dangerous and sold under pretense of safety and efficacy.[29]
It should be noted that HHS employees themselves can directly, personally collect up to 150,000$ annually in royalties. For example, key officials collect money on every sale of Merck’s HPV vaccine.[30] Robert F. Kennedy Jr. notes that:
The FDA receives 45 percent of its annual budget from the pharmaceutical industry. The World Health Organization (WHO) gets roughly half its budget from private sources, including Pharma and its allied foundations. And the CDC, frankly, is a vaccine company; it owns 56 vaccine patents, and buys and distributes $4.6 billion in vaccines annually through the Vaccines for Children program, which is over 40 percent of its total budget.[31]
Notably, a full 10 percent of the WHO’s budget comes from the Bill and Melinda Gates Foundation alone, making it the second largest donor, just behind the USA.[32]
If regulatory agencies cannot be trusted, some might argue that we can at least rely on science’s own internal mechanisms and esprit de corp. This is hardly the case. A 2005 survey of scientists in Nature found that a majority »admitted they would not avoid deceptive activities, and would simply brush to the side any data that did not suit their purposes.«[33] A 2006 report by Transparency International found that 40 percent of medical studies from 2005 were demonstrably faked or manipulated by their sponsors.[34] A point which this paper will no doubt belabor should nonetheless be recalled here: medical doctors and scientists were heavily over-represented in the Nazi party, which carried out a practice grounded in the grotesque pseudoscience of eugenics which was the dominant »scientific consensus« in the capitalist world at the time.
In his lecture on »The Two Faces of Science,« Richard Levins observed that »the basic strategic problem for the owners of science« is that »they need innovation … without the skepticism and the iconoclasm of the enlightenment.«[35] In short, they need what he terms a »bourgeois revolution in science, but not in culture.«[36] He argues that the principle way they achieve this is
by concentrating students in progressively narrower fields, rushing you through your training, saddling you with sufficient debt so that you’ll be well behaved, and pretending that that’s the expansion of knowledge… at the present time most biology departments deal with the biology of a small species of organisms, there are students who have gotten their degrees in biology who have never walked through a rainforest, or snorkeled a coral reef– who’ve never gotten down, and watched the little critters scatter in all directions, or sat in the forest for a day and watched the redwoods grow.[37]
Engelbrecht et. al. make a similar observation, noting that
most doctors themselves… have hardly more than a lay understanding of the concepts that loom on the horizons of molecular biology … if you asked most doctors to define the unmistakable characteristics of retroviruses … they’d most likely shrug their shoulders or throw out a bewildering cryptic response.[38]
Here we encounter a structural contradiction which lies at the heart of scientific progress itself: the greater the body of existing scientific knowledge, the more anyone wanting to produce new science must learn by proxy rather than independent verification– even at a secondary level or tertiary level. That is to say that not only can one not reproduce and verify the experiments or studies upon which one must rely, but one cannot even scrutinize those studies, or even sufficiently scrutinize the mediating institution which one must defer such scrutiny too (e.g., a regulatory or professional body, a journal, a university, etc.). Indeed, even those who want to advance merely as far as the already produced limits within the narrowest specialization must accept, without being able to verify or even meaningfully assess, innumerable claims produced in other fields.
The valiant defender of modern medical science, by now no-doubt much aggrieved, surely calls out in frustration at this point: it is not a matter of faith, or the ethics of individual scientists! We have peer review! This institution is perhaps the most important pillar of the MAIMS mythos– yet how effective is it, actually? Is it adequate to the task of reining in these awesome tendencies towards corruption and fraud? Richard Smith, the former editor of the highly esteemed British Medical Journal (BMJ) observed that »Peer review is slow, expensive, a profligate of academic time, highly selective, prone to bias, easily abused, poor at detecting gross defects, and almost useless for detecting fraud.«[39] In 1991, he noted that there were
perhaps 30,000 biomedical journals in the world, and they have grown steadily by 7 percent a year since the seventeenth century. Yet only about 15 percent of medical interventions are supported by solid scientific evidence … this is partly because only 1 percent of the articles in medical journals are scientifically sound, and partly because many treatments have never been assessed at all.[40]
Engelbrecht et. al. note that of all the cases of fraud documented in Horace Judson’s 2004 work The Great Betrayal: Fraud in Science, not a single one was identified via the paper review system.[41] The simple fact is that peer review is subject to the same corrupting forces pervasive throughout the MAIMS complex discussed above; it does not stand above them. The reviewers are, ultimately, individual scientists with profound perverse incentives. Particularly revealing in this respect was the decision of the highly prestigious New England Journal of Medicine (NEJM) to relax its restrictions on reviewers, permitting them to continue to review even if they made up to 10,000$ a year from pharmaceutical companies – including companies whose products they directly advocated for in the journal itself! What was the rationale for such a dubious policy change ? The NEJM explained that they were no longer in a position to find enough experts without any financial connections to the pharmaceutical industry.[42]
More hardly needs to be said. Engelbrecht et al. also note that the anonymous nature of peer review is itself problematic: all it takes to suppress an article is one reviewer with a direct personal interest in not seeing a study published, to stop it from being published! One must furthermore note that the role of peer review is not merely as the unbiased adjudicator over a more or less neutral body of published research, but over a body of published research which is already profoundly biased. For it must be recalled that medical and scientific research in our current era is carried out, not by democratically accountable entities in service of the public good, but instead by opaque and secretive forces in pursuit of private profit and private control. There are innumerable means by which studies can be skewed to produce a certain desired result, and, once it is found, there is no incentive at all to replicate the study in order to confirm the results. If you have the results you desire, why look any closer? This phenomenon was exposed in John Ioannidis’s famous 2005 paper: »Why most published research findings are false.« There, he shows that »most published research does not meet good scientific standards of evidence… and many scientific studies are difficult or even impossible to reproduce … the greater the financial and other interests and prejudices in a scientific field, the less likely the research findings are to be true.«[43]
The most important fact about research in the modern epoch is that the vast majority of it is not published. When a study produces results other than those desired by its funders, those results rarely see the light of day. Primarily, this is of course because a potential harm or lack of efficacy in a product which might still manage to get onto the market in some other form is hardly something one would want to publicize. But even if a firm does not plan to market a product, they have a significant incentive to not publish data regarding its shortcomings, because, by doing so, they would help potential competitors, who may have to waste precious time and resources undertaking the same, futile, experiments. This is just one of the innumerable, glaring, structural inefficiencies of private, profit-driven (as well as covert military-intelligence driven) scientific research.
Beyond the obvious inefficiency, this phenomenon has even more significant implications when considered at full scale. As Jacob Stegenga argues in Medical Nihilism, we must recognize that every published study we encounter is a small, visible, and profoundly unrepresentative sample culled from a vast body of unpublished research which we do not and cannot see. Of course, that research which is published is massively biased in two ways: it is almost invariably research which suggests positive efficacy, and no-to-minimal harms, for whatever potentially profitable product or service being studied (or their precursors, elements, etc.). The much larger pool of research which is not published tends to be that which shows the products tested are either ineffective, dangerous, or both. The significance of this fact is even greater in the medical and particularly pharmaceutical sphere, where effect sizes in general are extremely small. As Stegenga argues, the tools for assessing medical products are also incredibly malleable and subject to conscious and unconscious bias – all across the supposed hierarchy from anecdote to observational study to meta-analysis. And when one adequately weighs these factors, the obvious and unavoidable conclusion is that one’s attitude towards current scientific research must be extreme skepticism.
One might say that medical science as currently practiced is pervaded at a profound, structural level by an inbuilt base rate fallacy. For those unfamiliar with this phenomenon, a very brief, simplified explanation may be useful here. We can indeed use an example which, by now, everyone is intimately familiar with: testing for disease. Imagine you have a test with a false positive rate of 5 percent, and a false negative rate of zero. Now imagine you apply that test to a population of 1000 people, 40 percent of whom are really ill with the disease in question. You would expect 430 positive results, and 570 negative results. All the negative results are true negatives. 400 of the positive results would be true positives, and 30 would be false positives. For many purposes, not a bad test. If a person received a positive test, they could have a 93 percent confidence that it was a true positive. Now consider you applied the same exact test to a population of 1000 people, only 20 ( i.e 2 percent) of whom were actually diseased. You would expect 69 positive tests, and 931 negative tests. Of course, as before, all 931 negatives are true negatives. But 49 of the positives are false positives, while only 20 are true positives. In such a scenario, the probability that your positive test actually means you are ill is only 29 percent.[44] If no one bore the disease, there would be 50 positive results, all of which would of course be false positives. The point of this illustration is to emphasize that without an adequate understanding of the broader body of which a piece of data or information is a sample, that sample can easily be misinterpreted.
How is this fallacy characteristic of modern medical science more generally? Let’s say you encounter a study published in a peer-reviewed journal. The study is excellently designed, and if it shows significant results; we may be inclined to assume those positive results reflect a true phenomenon. So if the study shows a drug works, for instance, we assume the drug does in fact work. This is no different, however, than looking at a single positive case from our very good test described above, and assuming it to be true positive based purely on the intrinsic false positive rate of the test itself. As we saw, even though the test itself is very accurate, if no one is actually sick, you can still produce a positive result if you test enough people. Now consider that the drug, in fact, doesn’t work – this is comparable to our scenario with no disease above. If you ran the study once, or even 10 times, you would expect that every time you ran the study, it would produce a ’negative‹ result: it would accurately indicate that the drug didn’t in fact work. But what if you ran the same study 50 times? Or a hundred? You could get a very good study to produce the ›false positive‹ you need.
The problem with assessing research published in peer review journals is that we have no idea of the true baseline. When we encounter a study which indicates that a drug is effective, or doesn’t cause harm, we have no idea how many times the same or comparable studies have been undertaken which have indicated otherwise. And as stressed above, the studies we do see are of course not simply a random sample of a pool which we cannot see, but an extremely unrepresentative sample, which massively skews towards the ›false positives‹ of apparent efficacy, or the ›false negatives‹ or apparent safety. And this is occurring in a context in which the studies themselves are often already not very good in the first place![45] As Stegenga concludes, under the currently prevailing conditions, on basic, epistemic-structural grounds, we must thus have minimal confidence in the claims of medical science regarding either the safety or efficacy of medical products. Stegenga, who comes from a thoroughly bourgeois, reformist perspective, even acknowledges that tinkering around the edges of this problem – better tools for meta analysis, stricter standards for undertaking research – cannot possibly overcome this profund, structural problem.
His conclusion, in the face of this fact, however, is defeatist: he makes a plea for a ›gentle medicine‹ to mitigate the evident and ever accumulating net harms produced for the population by the poison medicine of our current epoch. The problem, however, is not science or medicine per se, but their capitalist fetters. At a certain point, science under capitalism reaches an inevitable inflection point after which it increasingly degenerates into its opposite. Internally, this is because as scientific knowledge increases, the entire scientific enterprise becomes mediated, more and more reliant on one’s ability to trust institutions and professional bodies to ensure knowledge accumulated by others has itself been done so scientifically. Yet as capitalism evolves into imperialist monopoly capitalism, the capacity of such institutions and bodies to withstand direct subordination to the interests (›conspiracies‹) of the ruling class becomes ever more impossible. Furthermore, as the great mass of the population is repressed, stultified, and banned from engaging in science themselves, it becomes impossible for the small, hyper-indoctrinated, and heavily disciplined and policed segment of population who are actively involved in science to metabolize the actual knowledge and information produced. As we have shown, this is not just theoretical speculation, but can be empirically demonstrated: the peer review system has been demonstrably undermined by the super-monopolistic concentration tendencies within the MAIMS. Real science, beneficial to the masses, at anything like the scale at which it is supposedly undertaken today, would and will only be possible under conditions in which it is directly and transparently controlled and subordinated to the direct democratic interests of the whole population, and when that population is freed from drudgery, armed with education and independence, and themselves capable, collectively, of manning and operating the sorts of bodies and mechanisms which could actually satisfactorily mediate such a scale of informational exchange. The alienated labor of a minority of ›experts‹, shackled and constrained by their subordination to the ruling class, must become the intellectually and spiritually fulfilling, collective enterprise of us all. The continued flourishing of science is, in short, only possible under communism.
For obvious reasons, the petty-bourgeoisie elements within the movement resisting the Corona program, and critiquing virology generally, are uninterested in acknowledging this reality. Instead, they generally advocate absurd, impractical individualistic solutions, where people are expected to somehow engage independently in this research themselves – every self-contained bourgeois atom, starting presumably with cartesian meditations and working their way out to a comprehensive self-elaborated worldview. This is in fact typical of the general program of ›resistance‹ offered by petty-bourgeois ’skeptics‹ and ›critics‹: do your own research, growyour own food, research what you should or shouldn’t eat, get off the grid, etc. – it is all really very easy, you just need boundless leisure time, infinite resources, and no obligations or commitments!
The current, miserable and degraded state of affairs in which the great mass of the global population now lives is not, pace the anti-Corona Right, because of their own sinfulness, laziness, idiocy, or cowardice. It is because a tremendously coordinated, calculated, and ruthless class struggle has been waged against them. Of course, the masses have resisted in turn – openly and covertly, actively and passively, across innumerable sites of struggle, large and small. Indeed, the main thing that has hindered and limited the success of this resistance is precisely the idiocy, cowardice, and naivety of the petty-bourgeois elements who have installed themselves as leaders only to constantly derail it with their fantasies of reconciliation with the ruling class and individual escapist solutions.
Once one grasps the true scale and nature of what we face, however, only one conclusion can be drawn: the only way to actually maintain and improve our own health, and the health of others, is class struggle. The ruling class who control the MAIMS complex – this vast, cruel machinery of domination, exploitation, and debilitation – must be overthrown once and for all. Without revolutionary theory, ofcourse, there can be no revolutionary movement – and that entails exposing the ideologies the ruling class employ to undermine, confuse, and derail the popular struggle against them. In Part 3, we will show why mainstream virology must be counted amongst the most pernicious of these.
Footnotes
[1] Norman Bethune, The Wounds (Ontario: Little Books of Hope), https://marxistleninist.wordpress.com/2009/02/14/norman-bethune-wounds/
[2] Ivan Illich, Medical Nemesis: The Expropriation of Health (New York: Pantheon, 1976), Ch. 4.
[3] Jacob Stegenga, Medical Nihilism (Oxford: Oxford University Press, 2018) p. 7. (Henceforth: Stegenga, Medical Nihilism).
[4] German Lopez, »9 Of 10 Top Drugmakers Spend More on Marketing than Research,« Vox (February 11, 2015), https://www.vox.com/2015/2/11/8018691/big-pharma-research-advertising.
[5] Ibid.
[6] Chris Ariens, »Here Are the Biggest Advertisers on Fox News, CNN and MSNBC,« TVNewser (TVNewser, March 9, 2018), https://www.adweek.com/tvnewser/here-are-the-biggest-advertisers-on-fox-news-cnn-and-msnbc/359057/
[7] Ivan Illich, Medical Nemesis: The Expropriation of Health (New York: Pantheon, 1976), Ch. 7.
[8] Ibid., Ch. 4.
[9] Ibid.
[10] Wikipedia contributors, »Cotton Mather,« Wikipedia, The Free Encyclopedia, https://en.wikipedia.org/w/index.php?title=Cotton_Mather&oldid=1130217017 (accessed January 15, 2023).
[11] Silvia Federici, Caliban and the Witch, (Brooklyn: Autonomedia, 2004), pp. 139 – 140. (Quotes from Foucault).
[12] Ivan Illich, Medical Nemesis: The Expropriation of Health (New York: Pantheon, 1976), Ch. 4.
[13] Richard Lewontin, »Biology as Ideology,« Lecture 3.
[14] Ivan Illich, Medical Nemesis: The Expropriation of Health (New York: Pantheon, 1976), Ch. 4.
[15] Ibid.
[16] See Jennifer Margulis, The Business of Baby (New York: Scribner, 2013) and Ina MayGaskin, Ina May’s Guide to Childbirth (New York: Bantam, 2003).
[17] Ivan Illich, Medical Nemesis: The Expropriation of Health (New York: Pantheon, 1976), Ch. 4.
[18] Ibid., Ch. 7.
[19] Ibid. ch. 4
[20] Stegenga, Medical Nihilism, p. 184.
[21] Stegenga, Medical Nihilism, p. 5.
[22] Engelbrecht et al., Virus Mania, Introduction
[23] Ibid.
[24] Ibid., ch. 8.
[25] T. Mohr, »Imperialism Today is Conspiracy Praxis,« Magma- Magazin Der Masse, September 24 2022, https://magma-magazin.su/2022/09/t‑mohr/imperialism-today-is-conspiracy-praxis/.
[26] Wikipedia contributors, »National Childhood Vaccine Injury Act,« Wikipedia, The Free Encyclopedia, https://en.wikipedia.org/w/index.php?title=National_Childhood_Vaccine_Injury_Act&oldid=1129783439 (accessed January 14, 2023). https://web.archive.org/web/20221125055505/https://en.wikipedia.org/wiki/National_Childhood_Vaccine_Injury_Act
[27] Robert F. Kennedy Jr., »Deadly Immunity,« in Engelbrecht et. al., Virus Mania. Ch. 8.
[28] Ibid.
[29] Ibid.
[30] Ibid.
[31] Ibid.
[32] Julia Crawford, »Does Bill Gates Have Too Much Influence in the Who?,« SWI (swissinfo.ch, May 7, 2021), https://www.swissinfo.ch/eng/politics/does-bill-gates-have-too-much-influence-in-the-who-/46570526.
[33] Brian Martinson, »Scientists behaving badly,« Nature, 9 June 2005, pp. 737 – 738 as cited in Engelbrecht et al., Virus Mania, Ch.2.
[34] Robert F. Kennedy Jr., »Deadly Immunity,« in Ch. 8, Engelbrecht et. al., Virus Mania.
[35] Richard Levins, »The Two Faces of Science«
[36] Ibid.
[37] Ibid.
[38] Engelbrecht et. al., Virus Mania., Ch. 1.
[39] Ibid., Ch. 2
[40] Richard Smith, »Where is the Wisdom? The Poverty of Medical Evidence ‚« British Medical Journal 303, (Oct 5, 1991): p. 798.
[41] Ibid.
[42] Ibid.
[43] As quoted in Ibid.
[44] Example adapted from Wikipedia contributors, »Base rate fallacy,« Wikipedia, The Free Encyclopedia, https://en.wikipedia.org/w/index.php?title=Base_rate_fallacy&oldid=1125810770
[45] All readers are encouraged to read Richard Levins’ brilliant parody of modern medical research, which effectively makes the point of this entire section in a succinct page: »Scientific Method for Today’s Market,« The Mathematical Intelligencer, 37 (1), 47 – 47, 2015 (March 1). https://link.springer.com/content/pdf/10.1007/s00283-014‑9488‑7.pdf?pdf=button
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Acknowledgments
This essay is profoundly indebted to the feedback, commentary, and editing of Molly Klein, Karel Svoboda, and Hieropunk. It is also extensively informed by the criticism and analysis of Jacob Levich, as well as Phil Greaves and the network of commentators and researchers around them.
Cover Image: Wound-man, 16th Century, wikimedia commons
