Ipse Dixit

The Latin form of the expression Ipse dixit , which means “he said it himself”, is attributed to the Roman philosopher Marcus Tullius Cicero (106-43 BC)¹ .

It is an affirmation without proof, or a dogmatic expression of opinion, or a fallacy that consists in defending a proposition by stating, without further justification, that it is “exactly as it is” because it is an intrinsic, immutable question, namely: the argumentum ad verecundiam or argumentum magister dixit.

The argumentum ad verecundiam or argumentum magister dixit is a Latin expression that means an appeal to authority or an argument based on authority that dispenses reasoning or evidence. It is a logical prose that is supported by the word or reputation of some authority or institution in order to validate the argument. And absurdly and conveniently its conclusions are based exclusively on the credibility of the author of the proposition and not on the reasons that he or she presented to support it.

Despite the origins of this expression preceding the birth of Christ, the conflicts generated by its use and abuse pervade the period after Christ as a method to disqualify the proves and to keep “everything as it is”, suppressing liberation initiatives, such as the one exemplified in the excerpt which I transcribe from Abraham Lincoln’s second debate with Stephen A. Douglas on August 27, 1858 in Freeport Illinois, on page 48²:

Lincoln said: “I pass on one or two points that I have because my time will expire very soon, but I must be able to say that Judge Douglas repeats himself again, as he did on one or two other occasions when saying Lincoln, in his ipse dixit , accusing a conspiracy of a large number of members of Congress, the Supreme Court and two presidents, to nationalize slavery... I mean that, in the first place, I did not make this type of accusation based on my ipse dixit. I just exposed the evidences tending to prove them, and I presented them to the acknowledgement of others, saying what I think proves them, but giving you the means to judge whether they prove them or not. That’s exactly what I did. I didn’t incorporate that into my ipse dixit . On this occasion, I would like to recall your attention to the evidence I have presented² .

Abraham Lincoln, the 16^th President of the USA, was assassinated 7 years after his speech denouncing a conspiracy against the freedom from human slavery in America. Despite presenting evidences so that these could be freely assessed (the principle of democracy) he was falsely accused of practicing ipse dixit by his debater, where in the absence of contrary evidence, it only remained to seek his disqualification.

In the past, the scientific method available for generating evidence was much more limited than at the present time, and therefore concepts were also limited. Even then, there already was the dichotomy between the existence of evidence and the “Because I say so!” speech similar to nowadays. The involvement of politics as well, because evidence and democracy were notably associated, and “politicization” was a positive natural phenomenon of scientific contextualization.

Unfortunately, human nature and its self-preservation and survival instincts, as in a medullary reflex, responds immaturely and selfishly towards its self-interests. And even in severe situations of high mortality, it is not capable of simply being transparent and considering the other, who in this case are patients or potential patients of COVID-19.

The available evidence of effectiveness and accuracy is not imperative or dogmatic. It is an additional element to assist in decision making, and there is always the option to not enforce it. On the other hand, we should not ignore the evidence or spend time uselessly trying to disqualify it, especially when there is no evidence to support a different recommendation.

The method of constant criticism and never striving to learn how to technically analyze the “proofs” is convenient, even if you are not able to produce them. But is inexcusable the inconsequential attitude and the lack of commitment in not considering the evidence in decision making, based on the assumption that the risk lies with the patient and not with those who exercise their ipse dixit.

The evidence establishes a parameter and it does not allow an affirmation without a proof simply in the name of autonomy and freedom of choice. The latter may seem more in line with the concept of democracy, but actually translates an obscure and non-reproducible attitude that exposes patients to uncertainties and diversions alike a Roman politics of “medicine and circuses”.

We do not need to do anything because we are unable or unwilling to do what is necessary. The transparency concerning our limitations is desirable and has been associated with evidence-based practice since the dawn of democratic and ethical humanity. We always need to exercise what is best for patients based on science that increasingly advances in strengthening fundamental human concepts during this COVID-19 epidemic, because science also learns from its mistakes:

1. We are often powerless;

2. We cannot do everything;

3. We cannot accomplish everything;

4. We strive to do what we owe;

5. If we don’t, we admit it;

6. We prepare ou for the future;

7. We do not exercise our ipse dixit .

Above all, we must acknowledge the limits in our own humanity during this constant fight against the exercise of ipse dixit . In the face of the persistent generation of scientific evidence by a few, there will only be left (or not) for those who exercise ipse dixit a sad and useless mea culpa for all the harm caused to patients.

REFERENCES

• ¹
  “Ipse dixit.” Merriam-Webster.com Dictionary, Merriam-Webster, https://www.merriam-webster.com/dictionary/ipse%20dixit Accessed 20 Jul 2020.
  » https://www.merriam-webster.com/dictionary/ipse%20dixit
• ²
  Second debate between Abraham Lincoln and Stephen A. Douglas on August 27, 1858 in Freeport Illinois, page 48. Available in: https://quod.lib.umich.edu/l/lincoln/lincoln3/1:5.1?rgn=div2;singlegenre=All;sort=occur;subview=detail;type=simple;view=fulltext;q1=ipse+dixit
  » https://quod.lib.umich.edu/l/lincoln/lincoln3/1:5.1?rgn=div2;singlegenre=All;sort=occur;subview=detail;type=simple;view=fulltext;q1=ipse+dixit

Publication Dates

• Publication in this collection
  21 Sept 2020
• Date of issue
  2020