Month: Mar 2025

Medicine assumes that diseases are always caused by some identifiable biological malfunction, i.e. system failures are always caused by component failures. Despite any protestations to the contrary, this is an assertion of Cartesian Reductionism^[1], namely that any system can be divided into its component parts and the sum of those parts thus explains the whole. Further, methods that medicine prioritises and/or considers epistemologically valid to investigate diseases, also assume Cartesian Reductionism. These mean that medicine is practicing a limited form of the scientific method, which by definition requires systems to be assumed philosophically and epistemologically to be linear; medicine therefore assumes philosophically and epistemologically that patients are linear systems in all circumstances. Linear systems in this context being ones to which the superposition principle applies^[2],[3], whilst nonlinear systems are those that do not.

This implicit assumption has never been stated in any study and is not always true; patients in a substantial minority of cases must be considered philosophically and epistemologically as nonlinear systems^[4]. This philosophical and epistemological mistake was identified and corrected in engineering decades ago, largely following Three Mile Island. This was the worst nuclear accident in North America and forced engineers to identify and fix their discipline’s philosophical and epistemological problems^[5].

Of principle relevance to medicine philosophically is that nonlinear systems may have emergent failures for which there are no identifiable biological malfunctions, rather system failures may emerge from components interacting adversely and dynamically. An example of an emergent failure mode is provided in the first Johnny and Susie example below.

Of secondary relevance is that nonlinear systems can be counterintuitive, which means that what someone thinks is the right thing to do is in fact the opposite of the right thing, that is if the system is assumed to be a linear but is in fact nonlinear, then attempts to correct failures in the system can result in making the problem worse.

Of principle relevance epistemologically is that nonlinear systems may not be deterministic and/or may be oscillating abnormally as emergent failure modes and self-reinforcing pathological dynamical steady-states. These mean that when investigating such systems using linear methods, then results obtained may appear random but are in fact ordered nonlinearly, meaning that statistics cannot always be easily applied to these results or at all. The second Johnny and Susie example below illustrates how statistics can mislead when used on nonlinear systems, whilst the third Johnny and Susie example below provides an example of an emergent failure mode in the form of a self-reinforcing pathological dynamical steady-state discussed above. (Note that the transition from linear to oscillatory behaviour in the third example is usually referred to as a dynamical phase transition, analogous in hydrodynamics to the transition from laminar to turbulent flow.)

Failure to assert in studies that the patient can be assumed philosophically and epistemologically to be a linear system has rendered all quantitative medical studies as scientifically invalid, and where the assumption is not true, rendered studies both invalid and wrong. Multiple other obvious ordinary mistakes have also been identified.

As the differences between autistic people and neurotypicals are due to the former having higher neuronal densities^[6] than the latter, as higher neuronal density results in qualitative or nonlinear differences in responses to stimuli both external and internal, normal or pathological, and as medicine has failed to account for these qualitative or nonlinear differences because patients are wrongly assumed philosophically and epistemologically to be linear systems; medical knowledge for diagnostics and treatments is consequently dangerously wrong for autistic people, leading to our harms and deaths. Nonlinear differences between groups of people were of course the root cause of the thalidomide defects (the between groups being men and pregnant women in this case), and it’s disappointing that the wider lessons of this scandal were not learnt. The fourth and final Johnny and Susie example below shows how network behaviour is nonlinear pursuant to Network Theory.

The philosophical, epistemological, and other mistakes that directly affect autistic people include:

1. Failure to recognise that patients cannot always be assumed philosophically and epistemologically to be a linear system and thus consequent failure to assert in studies that this assumption is valid or to amend operationalisations when not.
2. Failure to recognise the existence of emergent failure modes, which are unique to nonlinear systems. Unlike every other similar scientific discipline like engineering, there is no concept of emergent failure modes or emergent pathologies in medicine, only linear pathologies.
3. Failure to recognise that nonlinear systems can be counterintuitive.
4. Failure to account for nonlinear confounders or even recognise their existence.
5. Failure to recognise that nonlinear systems may not be deterministic and/or may be oscillating periodically (occurring in cycles) or chaotically (occurring in episodes) as emergent failure modes, and thus that ordinary scientific and statistical methods as only used in medicine may give meaningless results.
6. Failure to recognise that increased neuronal density in autistic people is the reason for our differences in cognition and behaviours, pursuant to Information Theory and Network Theory.
7. Failure to recognise that these differences are qualitative or nonlinear compared to neurotypicals and that thus medical knowledge is dangerously wrong for autistic people. This includes diagnostics and treatments, particularly medications’ side effects which may be atypical or dangerously worse.
8. Failure to recognise that consequently there are unique pathophysiologies for autistic people.
9. Failure to recognise that drugs’ effects may be nonlinear and that these effects may increase not decrease over time. This is more likely to be true for autistic people and can be fatal.
10. Failure to recognise that side effects may be nonlinear and thus may be somewhat unpredictable with new side effects appearing and existing ones worsening over periods of time. This is more likely to be true for autistic people and can be fatal.
11. Failure to recognise that the liver enzyme CYP2D6^[7] is also present in the brain in most people where it deactivates dopamine. Autistic people are more likely to be high or ultra-high metabolisers leading to dangerously nonlinear effects from drugs that affect this enzyme.
12. Failure to recognise that because of this most antidepressants are little more than modern day cocaine as almost all inhibit CYP2D6, with associated effects on most people. These effects will be worse on autistic people.
13. Failure to recognise that most antipsychotics induce CYP2D6 thus in most people such drugs would be dysphoric, and with some painfully so. The latter would be more likely autistic.
14. Failure to recognise that the effects on CYP2D6 may cause akathisia in some people, and these people are more likely to be autistic.
15. Failure to recognise that abruptly stopping most antidepressants may cause catatonia or neuroleptic malignant syndrome (which can be fatal) on some people, and these people are more likely to be autistic.
16. Failure to recognise that antipsychotics that induce CYP2D6 may cause catatonia or neuroleptic malignant syndrome on some people, and these people are more likely to be autistic.
17. Similar failures for a host of non-psychiatric drugs that inhibit or induce CYP2D6.
18. Failure to recognise that normal and abnormal blood chemistry levels and vitals are not the same for autistic people because of nonlinear differences compared to neurotypicals pursuant to Network Theory, and because autistic people have on average larger brains with consequent greater metabolic and other related needs.
19. Failure to recognise the existence of post-partem ME/CFS, an illness autistic women are more likely to suffer from.
20. Failure to recognise that even mild kidney damage has the potential to harm and kill autistic people because our blood chemistry needs to be controlled more precisely for neurological reasons pursuant to Network Theory. No medication that may harm the kidneys states that such should be avoided by autistic people and/or only taken under medical supervision where kidneys can then be closely monitored.
21. Failure to recognise that fortifying foods with calcium may kill autistic people who have only mild kidney damage, because increases in blood calcium may cause an autistic brain to overexcite leading to seizures, heart attacks, strokes, or death.
22. Failure to recognise a similar problem for calcium containing supplements or medications with no warning that autistic people should avoid these or only take them under medical supervision.
23. Failure to recognise that triage as practiced by medicine is dangerous for autistic people because of potentially fatal rapid neurological transients including seizures that are more likely to occur on autistic people, leading to inappropriate prioritisation and consequent autistic harms and deaths.
24. Failure to recognise nutrition advice that resistant starches are healthy has doomed autistic people to pain and suffering because such starches are not very tolerable by us. Medicine is aware that some people cannot tolerate resistant starches, but those people are mostly autistic.
25. Failure to recognise that statutory requirements for medical treatment authorisation are woefully inadequate because they fail to account for nonlinear treatment effects and side effects, fail to account for interactions with nonlinear diseases like ME/CFS and epilepsy, fail to account for other nonlinear differences like autism, fail to consider whether the treatment in improving symptoms worsens the underlying pathology, and fails to attempt to explain the biological reason for most side effects, consequently failing to make (obvious) predictions of potentially harmful effects on large groups of people, including autistic people.
26. Failure to recognise that in using statistics to attempt to provide treatments that are safe and effective on most people, medicine is harming or killing or allowing to die those at genetic extremes (which includes autistic people). This is a form of eugenics and could eventually lead to humanities extinction.

The four problem areas that I have identified leading to autistic harms and deaths by medicine include the following:

1. Autistic people have different pathophysiologies to diseases that may affect the brain, either directly or indirectly, leading to different signs, symptoms, and risks.
2. Medication that is known or suspected to affect the brain, either as treatment or side effect, may have an atypical and/or exaggerated effect or side effect on autistic people.
3. Vitals and blood chemistry that are considered normal and abnormal are different for autistic people. These include (non-exhaustive) minimum and normal BP, body temperature, O₂, CO₂, blood glucose, sodium, potassium, calcium, magnesium, bicarbonates, and blood pH.
4. Signs and symptoms for diseases otherwise are different for autistic because of differences in sensory processing.

A report has thus been filed at the International Criminal Court alleging that the NHS is committing crimes against humanity against autistic people. This report can be considered medicine’s Three Mile Island moment.

---

[1] “Discourse on the Method of Rightly Conducting One’s Reason and of Seeking Truth in the Sciences” by René Descartes (1637).

[2] “Penguin Dictionary of Physics” by J Cullerne (2009).

[3] “Penguin Dictionary of Mathematics” by D Nelson (2008).

[4] Medicine uses the phrase ‘nonlinear system’ to refer to any system with nonlinear behaviour (which is not the definition in engineering) but then makes philosophical and epistemological assumptions about the system that only always apply to linear systems.

[5] “Normal Accidents” by Charles Perrow (1984).

[6] “Autism spectrum disorders pathogenesis: Toward a comprehensive model based on neuroanatomic and neurodevelopment considerations” by A Beopoulos et al in Frontiers in Neuroscience(2022).

[7] “The neuroprotective enzyme CYP2D6 increases in the brain with age and is lower in Parkinson’s disease patients” by A Mann et al in Neurobiology of Aging (2012).