Over on the New York Times Sunday Dialogue, our colleague, friend, and former guest blogger Dr. Robin Weiss has an conversation on Science and Politics. What happened to science, Dr. Weiss ponders?
But a disturbing trend threatens future public health initiatives. At the heart of successful public policy lies a shared, bipartisan assumption that science is trustworthy. Lately, politicians unashamedly issue proclamations tantamount to declaring, The world is flat. Climate change is a hoax. Vaccines cause autism. Intelligent design should be taught in biology class alongside evolution. The United States has the best health outcomes in the world.
Readers wrote in with a variety of thoughts: it's the almighty dollar that corrupts politicians and blinds them from the truth, scientific research is underfunded, it's those damn Republicans (you can always blame the Republicans), if not them, then the religious extremists. Science is wrong, and sometimes just evil. And Dr. Weiss then responded, I'll let you surf over there to read.
I think one of the issues that makes it hard to rely completely on science is that such truths are hard to come by. For every set of numbers, we have a set of anti-numbers, not to mention the science du jour-- whether it be hormone replacement therapy (oops) or what type of diet we should eat. Low fat diets seem to have made us fat, unless of course, the fat people aren't the ones eating the low fat diets. At any rate, we learned that the 'science' of the food pyramid wasn't science at all, but the thoughts of a group of committee members, just as our DSM diagnoses are agreed upon by consensus and debate, not clear scientific studies. One day it seems that multivitamins are associated with an earlier age of death (cause, effect, coincidence, or those who are sicker are more likely to take vitamins?) and the next day we read that male physicians who take vitamins are less likely to die of certain cancers. Calcium supplements --pushed on us for so long -- may be the cause of your kidney stones. And stay out of the sun, it's bad for you, but oh no, your vitamin D levels are too low. There are too many numbers and they are too easy to manipulate, which every side seems to do. And even when the numbers play out again and again and are indisputable -- wear your seat belt and drop that cigarette, now -- the numbers are about populations, not individuals, so there will be that person who smokes to 100 and if you're very allergic to nuts, that Mediterranean diet make make for a much shorter lifespan.
Okay, I just had to argue with Dr. Weiss a little bit. It's like making her an honorary Shrink Rapper without the screaming.
Dr. Weiss is the best! One point I heard her make in her post is that the voices from the scientific community are often treated, by news media in particular, as if they represent just another opinion that needs to be countered. So if the great majority of astrophysicists agree that the universe is expanding, that consensus is "balanced" on a news show by someone who thinks it is collapsing, or that we are all on the back of a turtle. Often what matters is the level of the sound bite. What can appear as balanced reporting actually can give a very unbalanced impression, because much of the time the person who looks the best on the news is the one with the more biased point of view.
The reason for that is due to the fact that thoughtful positions on complex subjects often involve contradictions, while the simplistic biased position removes those contradictions and does not even make an effort to represent the truth.
So Dr. Weiss is right on.
One of the problems with some research being done today is that some research is being paid for by an interested party.
As an example, consider the recent assertion that the Mediterranean diet is better than a low fat diet. Did you dig enough to discover that the "low fat" group cut back from 39% to 37% fat in their diet? Mcdougall, Ornish, Esselstyn et al think low fat is 7-9%, not 37%, so the claim that it beat a low fat diet is false. Where did the money for the study come from? The researcher are supported by the Spanish government, California walnut growers, and an international nut promotion group.
Pharmaceutical studies have the same flaw, because the manufacturers pay for the studies, and therefore the researchers know at the start how the study "needs" to turn out.
There is also the problem that scientists are under pressure to come up with conclusions. Academia is still publish or perish, which actually translates into getting research dollars sufficient to support the school and department and some of the grad students, and requires spectacular results.
For science to be trustworthy, we need complete honesty on the part of researchers, but the cost of research puts many scientists in the same position as politicians.
Until we protect scientists from this pressure, the whole society will suffer.
Really? The Mediterranean diet study was promoted by walnut growers??? That is disheartening (literally)
I thought the point of the 'low fat' group is that people couldn't stay on the low fat diet, but they could stay on the Mediterranean diet.
A recent bill in our state, partially written and researched by someone I know and trust quite well, proposes some changes to adoption law. Things that would allow for an updatable medical issues thing, things that would allow for birth mothers to change their mind later and make themselves available to be found, if the adopted is seeking, or they can change their mind the other way. Identifying information only listed if the mother chooses, and this stuff only available to the necessary parties. No mandatory open or partially open adoptions, however those who want such will have those available.
Statistics are that 96% of birth mothers putting up for adoption in this state opt for at least partialy open, but a moral lobbying group has thought it through, and they've decided it may result in girls/women who want to put up for adoption, but are afraid of losing anonymity, may abort instead.
What part of all this is OPTIONAL don't they get? What part of the mother can have it as closed or open as she wants, do they not get? What part of 96% choose some openness do they not get? What part of the medical benefit to the adopted children, potentially getting access to a medical history, do they not get?
Because one powerful person testified to the legislature that it seems to her that in her personal opinion this bill might lead to more abortions (with no facts to back that up), this gets tabled for a year. Cause the legislatures know with one phone call she can get scads of protesters and publicity . . .
Heaven forbid someone should look at actually finding out what goes on, what they're talking about, etc. before trying to kill such a bill. (Ironic, since I'm going based on what I was told and read about this, but I trust this person highly).
Erik Roskes just posted on the MPS listserv about the book Merchants of Doubt by Oreskes and Conway.
Wikipedia: "Merchants of Doubt is a 2010 book by the American science historians Naomi Oreskes and Erik M. Conway. It identifies parallels between the climate change debate and earlier controversies over tobacco smoking, acid rain and the hole in the ozone layer. Oreskes and Conway write that in each case "keeping the controversy alive" by spreading doubt and confusion after a scientific consensus had been reached, was the basic strategy of those opposing action. In particular, they say that Fred Seitz, Fred Singer, and a few other contrarian scientists joined forces with conservative think tanks and private corporations to challenge the scientific consensus on many contemporary issues."
If you read the details on the recent Mediterranean diet study, extensive help was given to the participants who followed the Mediterranean diet, in the form of coaching and explaining what to eat. The low fat group was just told to go out and eat low fat, and they were given very little or no help or instruction in doing so.
Dr. Esselstyn gets fabulous compliance with his vegan, no-added-fat diet when he coaches his patients. Those patients show documented reversal in heart disease.
The "low fat does not work" is partly misinformation by misinterpretating data and partly inability of people to understand what it means to actually eat low fat and their thinking they ate low fat. Manufactured foods labeled low fat often increase sugar content and the "low" is often misleading (example: 2% milk has half the fat of full-fat milk which is 4% milk).
The detractors of low fat diets say that Americans were told to eat low fat and obesity increased. Simultaneous to the low fat diet information, though, was the rush to high fat Atkins. Americans actually increased consumption of fat, meat, etc while in the same time period, threshold weights for overweight and obesity were racheted downwards (as were upper limits for high blood pressure).
If you study food consumption data, while categories of major food groups have undergone shifts in percentage of the diet, the overall consumption has increased through time, overall and in each category.
Why this is happening is less clear. Likely culprits are fast food, packaged snacks and sweets, and prepared meals sold through grocery stores. I have wondered for a long time if the "obesity epidemic" might partially be due to Bovine Growth Hormones fed to children via milk and meat, which are documented as showing up in the blood of human comsumers, and which function in the human body much like human growth hormones. If bovine growth hormones make cattle big and fat, and bgh are utilized by humans in almost the same way as hgh, then why would the growth hormones NOT work to make humans big and fat.
In the end, availability is meaningless if people do not have the desire to eat. Our appetites come from a time when humans were hunter gatherers, and food was much more scarce, and game was much more lean than ranched, hormone-fed livestock.
Um, vaccines (not) causing Autism is pretty clear cut. Jenny McCarthy has more or less single handedly brought measles back to the US. It's quite disheartening to hear congressional reps making statements that are completely not based in science.
Somewhere in that article and on many posts and comments here there is a theme: the general public needs to trust science, and patients and the government need to trust doctors and scientists because they are the ambassadors of science and interested in the public welfare. That is a failed patrimony. There are enough scientists for hire and enough doctors for hire or who are interested in protecting their own current way of life that the professions are not to be trusted. The tipping point is long gone. How many countless examples would you like? The professions fail to regulate themselves, let industry push them around, cry no! to governmental regulation, then blame an irrational public for not listening to them? I'm sorry, but that is childlike. Go to your rooms and pick up your mess or let the feds step in and pick it up for you. This is a bit condescending, but your industry has more than earned it. The confusion is not in the discrepancy between populations and individuals or the complexity of the issues. It is between a public who deserves ethical professionals and professionals who aren't ethical and manipulate science to please other masters...or try to hold on to a failing status quo...or are greedy for attention or money. Who is who, anymore? It's impossible to tell. Just like it's impossible to tell who is on whose dole. It's not the media who is to blame, although they want a titillating story. That is who they are and always have been and everyone knows that. Politicians only want science which backs what they want. The problem is scientists and doctors who court celebrity or attention and money at the expense of good science or intellectualism.
For medical stuff, I've just given up all the yak as utter BS. I wear my seat belt, don't smoke, exercise and eat a balanced diet. I wish I could lose weight. Oh well, on that part. I should eat less of all that healthy food! Maybe too much bovine growth hormone, although now I'm getting the milk without that and . .. still fat (to be fair to me, half that fat was caused by antipsychotics, depakote, etc). I grow, shoot or catch(fish) about half my food, maybe more than half, and all that healthy outdoor living and exercise for over 10 years hasn't helped me lose weight.
Someone mentioned astronomy. I am watching a DVD on astronomy, and in the "out there" stuff, such as the black holes section of the course, or the end of the universe stuff, the astronomer teaching the course is VERY CLEAR about which ideas are well-established, and which ideas are controversial and nobody really knows. I remember it was like that in all my college science courses that were about cutting edge stuff. It was always made clear what was well-established theory, and what was educated guess work.
I almost never see anyone as clear as that in medical writing. They pass off their pet hypotheses as fact. I'm fed up.
When I really, really get fed up with science and math illiteracy, and "educated" people even brag about how bad they are at math and science, and then launch into global warming conspiracies, I just figure maybe humans will go extinct and the planet will be better off. Then I take a break and read a zombie book. I really am disgusted with this, can you tell?
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