The Verdict?

The O J Simpson murder trial produced some strange evidence that proved insufficient to find him guilty -- a DNA smear attributable to one person in ten million put him at the scene of the murders; a shrunken leather glove that did not easily go on his hand was exonerating.  And the jury, not steeped in DNA testing in 1995, acquited!

So here we are with COPD, and the evidenciary trail with fine particulate matter and its implication in toxic gaseous atmospheres for COPD is strong, evidence based on measurements by multiple independent groups using a variety of methods, since 1970.  The most indicting date back to 1974, with methods that have been rehashed, reanalyzed, and even duplicated by multiple other teams, with nearly identical findings over and over.  These results have been published in respectable medical journals and through independent agencies starting twenty years ago.  They have been the basis of EPA regulations for over a decade.  The debate, once vociferous, has dwindled.

Yet the AMA stance remains totally dedicated to the statement that "COPD is a smoker's disease".

This AMA frozen position is one of the best examples of paradigm rigidity as described by Thomas Kuhn, who said in The Structure of Scientific Revolutions:
A) "There is no standard higher than the assent of the relevant community..., this issue of paradigm choice can never be unequivocally settled by logic and experiment alone."
B) "The usual prelude (to a paradigm shift) ... is the awareness of anomaly, of an occurrence or set of occurrences that does not fit existing ways of ordering phenomena.  The changes that result therefore require 'putting on a different kind of thinking cap', one that renders the anomalous law like, but that in the process also transforms the order exhibited by some other phenomena, previously unproblematic."

Kuhn pointed out Max Planck's apt observation:  "a new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it."

Perhaps, then, we can hope that the next generation will begin to assess these additional important causes of COPD, which could even (gasp) lead to research into the emissions of those elements (as though we didn't know that it is mostly fossil-fuel power plants and automotive exhausts), and that in turn could lead to more effective emission controls, or power source changes, and hopefully to more effective treatments.  Whew... lots still to do.