March 30, 2011
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!
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.
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!