Semmelweis Reflex

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Ignaz Semmelweis was ridiculed

1846, Started Vienna General hospital

Postpartum infection, purpureal fever, childbed fever,

bacterial infection of the reproductive tract.

Sepsis from infections acquired in a hospital, healthcare-associated infections (nosocomial)

Home and street deliveries, low mortality

1847, death of Jakob Kolletschka

Link between cadaveric contamination and purpureal fever

"cadaverous particles"

1847, Instigated hand washing, chlorinated lime, calcium hypochlorite,

mortality rate in the First Clinic declined 90%

April 1847, mortality 18.3%.

Hand washing started mid-May 1847

June 1847, 2.2%

July 1847, 1.2%,

August 1847, 1.9%.

1848, 2 months of 0%

1849, Semmelweis obliged to leave the obstetrical clinic

1850, left Vienna, "unable to endure further frustrations in dealing with the Viennese medical establishment"

1851 -1857, unpaid doctor in Pest

Purpureal fever virtually eliminated, (8 out of 933, = 0.85%)

Semmelweis's ideas not accepted by other obstetricians in Budapest

1861, Published Aetiology, concept and prophylaxis of childbed fever

1865, Committed to asylum by colleagues, beaten up, gangrenous would to hand, died 14 days later

Semmelweis Reflex

Or the “truth is the first casualty of war”

Psychological phenomenon, rejection of new or novel ideas

Rejection of anything that contradicts established norms, beliefs, paradigms of thought,

even if ideas are well-supported by evidence.

Semmelweis’s ideas were rejected AND he was ridiculed and ostracized.

"Mob behaviour found among primates and larval hominids on undeveloped planets, in which a discovery of important scientific fact is punished". (TL, Harvard)

So, people reject new ideas, without considering the evidence in support of them

Belief perseverance

Common barrier to innovation and progress

How to avoid Semmelweis Reflex

Eliminate compromise, financial, blackmail

Eliminate vested interests

Eliminate dictatorial organisations or individuals

Control active suppression of new ideas

Accept new ideas that do not make lots of money

Don’t automatically censor new ideas

Don’t able new ideas ad disinformation

Be open-minded

Carefully evaluate new ideas on their merits.

Avoid conformation bias,

favour information that is consistent with prior beliefs.

Avoid authority bias,

“doctors are gentlemen, and gentlemen’s hands are clean, (Charles Meigs).

Avoid belief perseverance,

adhere to their initial beliefs despite contradicting evidence.

Avoid groupthink,

where consensus overrides consideration of alternatives.

Eliminate doublethink

Eliminate Newspeak

Don’t re-write history

Critically evaluate beliefs that are taken for granted

Use guided reflection

Allow new thinking by the elimination of fear of punishment

More free speech to allow circulation of new ideas,

How then shall they call on him in whom they have not believed? and how shall they believe in him of whom they have not heard? and how shall they hear without a preacher?

Truth telling, War is peace, Freedom is slavery, Ignorance is strength.

More system 2 thinking

System 1 is fast, automatic, and intuitive, operating with little to no effort,

(make quick decisions and judgments based on patterns and experiences).

System 2 is slow, deliberate, and conscious, requiring intentional effort.

Ignaz Philipp Semmelweis, 1818 - 1865

"saviour of mothers"