Against Medical Nihilism Through Perseverance and Humility with Dr Ross Upshur

For thousands of years, the value of medical treatments of the day was disparaged with some frequency mostly in the form of quips from prominent people in health care, the arts, government, and social commentary. More recently, the quips evolved into formal philosophical arguments conveying a view that the likelihood of any new medical treatment becoming a major breakthrough is low. The term “medical nihilism” is now associated with this view. 

In this episode, with the physician and philosopher Dr. Ross Upshur, we cover medical nihilism conceptually and assess how well the term fits the arguments underlying it. We discuss some of the components comprising the arguments, which are generally real, and how they can contribute to medical nihilism, and validate the uncertainty existing in medicine for some. We talk further about how to accept this uncertainty and manage our health care decisions as providers, educators, and consumers without falling into the despair of medical nihilism. 

Note that throughout the episode, we mention Jacob Stegenga and his book, Medical Nihilism, and also Jonathan Fuller and his book, The New Modern Medicine. We mention Ross Upshur and Maya Goldenberg’s article, Countering Medical Nihilism by Reconnecting Facts and Values in Studies in History and Philosophy of Science. Citations for each are listed below.

Primary Sources
Upshur, Ross, and Maya J. Goldenberg. “Countering Medical Nihilism by Reconnecting Facts and Values.” Studies in History and Philosophy of Science Part A, vol. 84, Dec. 2020, pp. 75–83. (Available as pdf at Maya Goldenberg’s website.)
Stegenga, Jacob. Medical Nihilism. Oxford University Press, 2020.

Fuller, Jonathan. The New Modern Medicine: Disease, Evidence, and Epidemiological Medicine. Oxford University Press, 2025, academic.oup.com/book/61541. (Available as open access at Oxford University Press.)

Links
Biosketch for our guest Dr. Ross Upshur 
FDA list of recalls, market withdrawals, and safety alerts.

Attributions
For audio clip: From Atonement by Ian McEwan, read by Jill Tanner. Audiobook. [Recorded Books, 2002]. Accessed via Spotify.

Episode image: 
Oliver Wendell Holmes, Sr 
Credit: Oliver Wendell Holmes. Colour lithograph by Sir L. Ward [Spy], 1886. Wellcome Collection. Source: Wellcome Collection. License: Public Domain Mark.

Thanks to Dr. Ross Upshur for his interesting and insightful contributions to this episode. 

More from The Clinic & The Person

Beautifier or Destroyer: Tuberculosis in Two Paintings

Art reveals how tuberculosis intertwines with societal perceptions, from suffering and destruction to the convergence of illness and beauty ideals.

Six Kopeks or Your Life: Two Short Stories about Health Care Professionalism and Access

Timeless stories reveal persistent challenges in healthcare professionalism and access, prompting reflection on modern practices and their enduring implications.

Painting an Ideal: Luke Fildes’ The Doctor with Hannah Darvin

Luke Fildes’ 1891 painting The Doctor evolved from a criticized debut into an enduring, multifaceted symbol of the compassionate physician ideal.

Painting with Empathy: The Expressionist Art of Edvard Munch with Curator Øystein Ustvedt

Edvard Munch’s emotional portrayal of illness and suffering offers profound insights for health professionals and their education.