O impacto da ideologização da ciência

O gráfico ao lado mostra o aumento da razão masculino/feminino de nascimento na Armênia, após a sua independência. A explicação é a seguinte: por ter forte apoio externo devido à diáspora armênia, houve entrada de muitos recursos e doações como aparelhos de ultra-som. Com o aborto permitido, houve um feminicídio em proporção maior que a chinesa. Tudo isso em um país com grau elevado de cultura, mas pertencente a um conjunto de países - a União Soviética - onde prevaleceu a ideologia sobre a ciência. Apesar do Sputinik. Esse é um pequeno exemplo de um artigo excelente publicado no International Journal of Epidemiology Cochrane on Communism: the influence of ideology on the search for evidenceMartin McKee. Acessível somente a assinantes ou aqueles com permissão da base CAPES de periódico. Abaixo, dois pequenos trecho do artigo.

In his seminal work Effectiveness and Efficiency,1 Archie Cochrane asked why, despite their enormous potential, randomized trials were much less widely used that they should be. At the time that he was writing, their geographical distribution was very uneven. He wrote ‘If some such index as the number of RCTs per 1,000 doctors per year for all the countries of the world were worked out, and a map of the world shaded according to the level of the index, one would see the UK in black, and scattered black patches in Scandinavia, the USA, and a few other countries. The rest would be nearly white. It appears in general that it is Catholicism, Communism, and underdevelopment that appear to be against RCTs. In underdeveloped countries this can be understood but what have Catholicism and Communism against RCTs?’

An example can be seen in Armenia. Shortly after gaining independence, Armenian physicians acquired large numbers of ultrasound machines, often benefiting from assistance from the extensive Armenian Diaspora. This was associated with a rapid rise in the male:female sex ratio to a level that now exceeds that in China. There are, however, many other examples. A recent study of obstetric care in a region near Moscow found that many of the obstetric interventions were ineffective, such as physical therapies based on light, electricity or magnetism, administered at some stage during pregnancy. Other treatments were unnecessarily unpleasant, such as the near universal practice of administering intra-muscular injections of vitamins. Yet, others were potentially harmful, such as the administration of diethylstilbestrol, even though it has been known since the 1960s that it causes vaginal cancer in those exposed in utero. Many of the drugs used, including a diverse range of infusions administered almost universally to pregnant women, have never been subject to rigorous evaluation.