Science Works (When It’s Not Failing)
Posted in Medicine, Science, Skepticism on | 7 minutes | 9 Comments →DISCLAIMER—to say a claim is “inaccurate” is not the same as saying the claim is “false.” I fear that if I don’t include this disclaimer, those prone to twisting things around will show up in droves, accusing me of denigrating science. Should you be tempted to respond, please keep things in scope and pay attention to what I actually say, not your reaction to what I actually say!
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The inaccurate polemic that “science works” has reared it’s ugly, cherrypicked head again, this time, in a most expected place. As one might reasonably infer whenever somebody uses the pejorative “bitch” in their argument, I feel fairly safe in my assumption that the juvenile maker of this remark hasn’t seen this article from Scientific American, or any other pertinent articles for that matter.
More specifically:
Most of us are confident that the quality of our healthcare is the finest, the most technologically sophisticated and the most scientifically advanced in the world. … But there is a wrinkle in our confidence. We believe that the vast majority of what physicians do is backed by solid science. Their diagnostic and treatment decisions must reflect the latest and best research. Their clinical judgment must certainly be well beyond any reasonable doubt. To seriously question these assumptions would seem jaundiced and cynical.
But we must question them because these beliefs are based more on faith than on facts for at least three reasons, each of which we will explore in detail in this section. Only a fraction of what physicians do is based on solid evidence from Grade-A randomized, controlled trials; the rest is based instead on weak or no evidence and on subjective judgment. When scientific consensus exists on which clinical practices work effectively, physicians only sporadically follow that evidence correctly.
Medical decision-making itself is fraught with inherent subjectivity, some of it necessary and beneficial to patients, and some of it flawed and potentially dangerous. For these reasons, millions of Americans receive medications and treatments that have no proven clinical benefit, and millions fail to get care that is proven to be effective. Quality and safety suffer, and waste flourishes.
We know, for example, that when a patient goes to his primary-care physician with a very common problem like lower back pain, the physician will deliver the right treatment with real clinical benefit about half of the time. Patients with the same health problem who go to different physicians will get wildly different treatments. Those physicians can’t all be right. …even the most experienced physicians make errors in diagnosing patients because of cognitive biases inherent to human thinking processes. These subjective, “nonscientific” features of physician judgment work in parallel with the relative scarcity of strong scientific backing when physicians make decisions about how to care for their patients.
We could accurately say, “Half of what physicians do is wrong,” or “Less than 20 percent of what physicians do has solid research to support it.” Although these claims sound absurd, they are solidly supported by research that is largely agreed upon by experts.
[Sanjaya Kumar and David B. Nash, bold mine]
Personally, I feel vindicated, because I’ve been skeptical of doctors my entire adult life. Like many, I was raised on the dogma that “the doctor knows best,” and whenever I questioned this dogma, the answer was always the same, and echoes the atheist: because they’re “trained in science.” I imagine this particular dogma is as common to most Americans as any of it’s religious counterparts. I didn’t need a scientific study to tell me that doctors are not always the sound purveyors of science they’re often made out to be. I’ve literally seen people’s health plummet as a result of “following the doctor’s orders,” and the literature is chock full of documented examples. The question is, how often does this happen in non-medical science?
I pose a question to proponents of scientism: how do you know that any given scientific conclusion is in the category of “scientific conclusions which are true” vs. “scientific conclusions which are false?” You might be tempted to answer, “by doing more science,” yet, one of the previously cited links is to an article questioning the veracity of inflation theory, on which much science has been done. So, again: how can you reliably discern between junk science and real science? Again, you might be tempted to reply that real science abides by certain self-correcting protocols whereas junk science does not. Yet, following protocol is no guarantee of a reliable conclusion. So, how do you know? Is it not a sort of charitable presumption that gives science the benefit of the doubt, i.e., something like… faith? Let’s be honest here.
How often does junk science masquerade as real science? I don’t know, but as I paused to go get a coffee during the writing of this piece, I noticed the March 23-29 SF Weekly cover story titled, Weird Science: How a Bogus Child Sex Trafficking Study Fooled Some of the Most Respected Media Outlets in the Country. I literally laughed out loud. You might be tempted to respond that this was not a peer-reviewed study, but peer-reviewed studies often fall prey to the same problems: bias, ulterior motive, selective reporting… we all know the drill. What, besides the presumption of confidence in alleged scientific studies, could explain the fact that ostensibly credible media outlets perpetuated this junk science? I agree with Rick Edmond:
You see this kind of thing a lot, unfortunately… The kind of skepticism that reporters apply to a statement by a politician just doesn’t get applied to studies.
To take it a step further, the kind of skepticism atheists apply to statements made by theists often doesn’t get applied to statements made by atheists and scientists. So, again: how do you know that any given scientific conclusion is in the category of “scientific conclusions which are true” vs. “scientific conclusions which are false?”
I think my point can be safely summed up in Dr. Rosen’s response to Hume on the problem of induction:
If we accept the analysis of inductive reasoning sketched above, it may seem that Hume as done something remarkable and disturbing. He has shown that from a strictly intellectual point of view, there is no real difference between common sense and science on the one hand, and religious belief on the other. In all three cases we find a system of belief based on a fundamental conviction that cannot be justified by argument. The most dramatic way to put the point is to say that Hume has shown that common sense and science are matters of faith. Hume would resist this attempt to rehabilitate religion by “softening up” our picture of common sense and science. The faith that Hume defends is a faith that we cannot possibly avoid or resist, a faith that renders skeptical doubt utterly idle. (HT: Rufus)
I am not arguing that science should be scrapped. I am not denigrating science. I am not implying that all claims should be treated as equally warranted. Rather, I am arguing that science is but one tool in the truth-seekers shed. It is forever chained to the subjectivity of those who do it, thus forever prone to bias and error. It’s conclusions are always provisional, and always subject to change. Therefore, smug atheists and skeptics have no warrant to beat believers over the head with trumped-up polemic that science works, because often, science doesn’t work. Some intelligent people go so far as to claim that most published research findings are false.
Contrary to the protestations of the faithful, we should be skeptical of science. To fail in this regard is to commit the error of blind faith all over again, just in a different context: trusting priests who favor white robes over black. Of course, I fully expect the New Fundies to deny this, and lash out at me for “denigrating science.” Oh, the irony!
dguller
says...Cl:
As a physician myself, those are fair points. Science-based medicine is certainly not foolproof and since it trades in probability and chance, there is always the possibility that our interventions turn out to be ineffective when more evidence comes in.
That said, I think that you are overstating the case of how much medical interventions are evidence-based. You can read this post for more details: http://theness.com/neurologicablog/?p=51
In addition, you say that science is just one tool to understand the world. What other tools are there that have had the success that science has had in uncovering how the world works? As I have said before, science is flawed and imperfect, and often wrong, but it is the best method we have of discovering how the world works. Like Churchill said about democracy: “It is the worst form of government there is, except for all the others”. I would say the same about science.
Matt
says...Good post. I’m a sciencophile (though not a scientist) but I think in order to fully respect science we need to be honest about its limits and humble about its reliability. We need to remember that science, even in its purest form, is a little messier than certain polemics would like us to think. Providing a clear, objective criteria for what is and is not science has yet to be fully accomplished and, from the New Yorker article, it seems that there are still a few kinks in the system itself. In order to take full advantage of science, we need to find a way to use its own self-correcting mechanisms on the process itself.
I think a helpful way to think of science is as idee fixe of epistemology for physical properties. You reach for it, try your best to grasp it, but it will always be at least a little out of reach due to your biases or whatnot. Looking at history it really appears that science has succeeded at increasing human well-being and knowledge more often than it has failed and I see no better existing epistemology for understanding the physical world. It’s because of this that I still trust science a lot even when there are many failures of scientists.
dguller
says...cl:
>> It’s conclusions are always provisional, and always subject to change. Therefore, smug atheists and skeptics have no warrant to beat believers over the head with trumped-up polemic that science works, because often, science doesn’t work.
I think that you are overstating your case here a bit. It is not that those who prize science over religion have “no warrant” to criticize religious claims when compared to scientific claims. They do have warrant, because overall science has discovered more about how the world works than religious claims have, and thus when it comes to declaring ideas about how the world works, science will trump religion. However, as you pointed out, science is not omnipotent, incorrigible, and indubitable. It is limited in a variety of ways, but despite those limitations, I think that it is better than religious claims to understand the world.
cl
says...Matt,
I hear this often, and I can’t help but think that it also “really appeared” that the sun revolved around Earth. Honestly, I don’t think we have any non-subjective way to answer this question. Has science improved well-being? It’s awfully tempting to look around at things like air-conditioning, central heating, advanced farming techniques, and various technologies that have extended the human life span, eliminated pesky diseases, and increased food production–and say yes. But, as with art, it seems we can look at this and see what we want to see. Also, from who’s vantage point are we speaking here? Have you asked all the extinct species what they think about this?
Science also brought us the nuclear bomb and all other weapons of mass destruction, including all guns and all biological weapons. Science also brought us the nuclear reactors in Fukushima and Chernobyl. Science brought us crack, cocaine, and crystal meth, and look at all the untold suffering that’s resulted from those. The very same scientific advances that led to increased food production have veritably ruined our topsoils. Science brought us plumbing and irrigation, and look what’s happening to our water. Science has brought all this “technological stuff” and paper products, and look what’s happened to the environment. Sure, science has contributed towards extending the human life span, but, is that good or bad? I suppose it’s good if the people living longer aren’t tyrants and criminals, but, I suppose it’s bad if they are. What of the population problem that is undeniably fueled by the extension of life which science has brought? I could go on, but I trust that you get my drift.
How do we make a fair assessment here? I don’t deny that science has brought certain comforts, conveniences and benefits to human beings, but do those really outweigh the negative effects for both human beings and all other species? We are now at a time in history where it is legitimate to doubt the prospect of our continued existence at all, and this is 100% due to science.
dguller
says...cl:
I think that you are questioning whether knowledge in general is always better than ignorance, and this is independent of whether that knowledge is derived by the scientific method.
Perhaps you should frame the debate on those terms, because they are more accurate. Certainly, it is debatable whether knowledge is always better than ignorance. I would say that it is.
cl
says...dguller,
Of course, that’s not what I wrote. Incidentally, can you give me an example of a religious claim?
No, they don’t.
Again, not what I wrote, but, hear what you want to hear.
dguller
says...cl:
>> Of course, that’s not what I wrote. Incidentally, can you give me an example of a religious claim?
You talked about “smug atheists”, and thus brought religion into this post.
>> No, they don’t.
So, science has not discovered more truths about how the world works than other methods? And if it has, then doesn’t that count as some warrant for its claim as a superior method of knowing the world?
>> Again, not what I wrote, but, hear what you want to hear.
I know that it is not what you wrote, but I think that it is highly selective of you to focus only on scientific knowledge exclusively. Perhaps you should write a post about whether religious knowledge has a net negative effect on mankind, too, for balance? Furthermore, why do you object to making this discussion a general one about knowledge versus ignorance, rather than all about criticizing science?
cl
says...dguller,
Again: can you show me an example of a religious claim?
I most certainly did. Does that mean I said what you heard?
Did I say that? No. I said, “It’s conclusions are always provisional, and always subject to change. Therefore, smug atheists and skeptics have no warrant to beat believers over the head with trumped-up polemic that science works, because often, science doesn’t work.” That’s the point.
Then we’re in the same boat, because I think it’s highly selective of smug atheists to focus only on the apparent successes of science.
Why? There are already an abundance of such posts in circulation. That’s a dead horse. Besides, according to smug atheists, there isn’t any such thing as religious knowledge.
Again, hear what you want to hear. You are responding exactly like a fundamentalist who thinks their religion has been criticized. I am NOT criticizing science, as I made explicitly clear in the closing sentences of the OP. I’m criticizing scientism and cherrypicking being used as a front to bolster the impression of intellectual superiority. I object to making this a “more general discussion about knowledge and ignorance” because that’s not what I wrote about. You want to talk about that? Okay. You wrote that knowledge is ALWAYS better than ignorance. When it comes to something like atomic weaponry, would it be better for somebody like Hitler to be ignorant, or knowledgeable? Answer honestly. No “possibly,” no “I don’t know.”
dguller
says...Cl:
>> I most certainly did. Does that mean I said what you heard?
No, it doesn’t. I thought that the context of your post was in defense of religious claims against arrogant atheists and skeptics who use science as a mighty bludgeon against religious claims. Otherwise, why bother describing the limits and negative consequences of science as a reason to restrain the behavior of atheists and skeptics? What is the point if not to provide some space for religious and supernatural claims that are denigrated by the sciences? That was my line of thinking, but if that was not what you intended, then I will just stick to what you said without inferring anything from it.
>> Did I say that? No. I said, “It’s conclusions are always provisional, and always subject to change. Therefore, smug atheists and skeptics have no warrant to beat believers over the head with trumped-up polemic that science works, because often, science doesn’t work.” That’s the point.
Do you agree that science has discovered more about how the world works than any other method? If you do, then it is a more reliable guide to understanding the world than any other, and therefore, despite its limitations, its findings should trump the findings of other methods. That is why if a controlled study shows that astrology does not work, then astrologers cannot turn around and say that they have special knowledge that cannot be captured by the scientific method. Otherwise, knowledge becomes relative, and there is more means of deciding upon the truth of how the world works. We should use the most reliable method available, which happens to be science, if truth is important.
>> Then we’re in the same boat, because I think it’s highly selective of smug atheists to focus only on the apparent successes of science.
Care to mention anyone in particular who extols the benefits of science without ever mentioning its failures or negative consequences? Do you know why scientific studies have to get ethical approval? Because there is an understanding that scientific inquiry can have negative consequences that must be weighed and discussed before a study can proceed. In addition, read any science history book. It is filled with wrong theories. No-one is trying to hide anything. All we are saying is that, despite all that you have said, science is still the best method we have to discover the world.
>> Why? There are already an abundance of such posts in circulation. That’s a dead horse. Besides, according to smug atheists, there isn’t any such thing as religious knowledge.
Okay. So you are filling a niche. That’s fine.
>> Again, hear what you want to hear. You are responding exactly like a fundamentalist who thinks their religion has been criticized. I am NOT criticizing science, as I made explicitly clear in the closing sentences of the OP. I’m criticizing scientism and cherrypicking being used as a front to bolster the impression of intellectual superiority.
So, you disagree that science is a superior method of discovering truths about the world? After all, you are talking about the “impression” of superiority, which is different from the fact of superiority. If you think that there is a better method to discover truths about the world, then would you mind sharing it with me?
>> I object to making this a “more general discussion about knowledge and ignorance” because that’s not what I wrote about. You want to talk about that? Okay. You wrote that knowledge is ALWAYS better than ignorance. When it comes to something like atomic weaponry, would it be better for somebody like Hitler to be ignorant, or knowledgeable? Answer honestly. No “possibly,” no “I don’t know.”
Nope. I was wrong. I over-generalized, and thanks for calling me on it. I guess the truth of the matter depends upon the circumstances and context, and a global assessment would be difficult. However, I would say that, in general, knowledge is better than ignorance, because in order for us to make informed decisions about what to do in the world, we require knowledge. Imagine trying to build a bridge if most engineers were ignorant of the principles of mechanics and structural design.