Science is very important. Most people have a fair amount of respect for science and scientists, though America is a fairly religious country. To find wisdom, one must look beneath the surface and go beyond rumor, Reddit and Twitter, and biases. How trustworthy is science in modern America? Is it truer to say that “Big Pharma” and the insurance industry and the AMA are besmirching science’s long-standing reputation as reliable and trustworthy? Or would it be fairer to characterize vaccine-avoidance, chiropractic, homeopathy, and media-based medical gurus peddling dubious treatments as chicanery to be avoided? Ought we to feel comfortable looking to researched for legitimate and safe medical/biotechnological preventatives, treatments, and research? What can our values tell us that can be helpful? Enter critical thinking!
I tend to think that the truth lies somewhere in between those two bastions. There is something to be said for the critics of modern medicine and science, but it’s not a rosy picture that can shut critics and skeptics up with the wave of an authoritative hand. It all adds up to a very tricky task for relatively uneducated consumers and patients bombarded by a dizzying array of conflicting messages, alternatives, and media manipulation. Skepticism, critical thinking, and evidence are, as ever, our allies. One can speak with one’s physician, but as they are one individual, susceptible to bias and ignorance and even co-opting, caution is urged. Scientists and physicians are people, and it is almost notorious how one can be educated in a subject (e.g., neurology or biology) and a) mistaken or wrong nevertheless or b) as ignorant and error-prone as the rest of us in any other area of life. So no, doctors aren’t better at buying automobiles, fixing plumbing, or picking football teams than others are. The author of the Sherlock Holmes novels was obviously, without a doubt, a smart individual. However, Arthur Conan Doyle was notoriously taken in by a sham common in his day — the equivalent of today’s Sasquatch. Seriously, that bad. As well, Isaac Newton was a devout Christian and an indefatigable alchemist (one step away from believing in magic). He probably made himself sick tinkering around with lead and other chemicals in his quest to make gold.
If the creator of Sherlock f-ing Holmes gets sucked into the modern equivalent of a cult, how can a 19-year-old Facebook addict from a suburb of Topeka, Kansas get it all straight in their mind? Here is a plausible response from the Yale University neurologist and expert on critical thinking, Steven Novella: “Critical thinking is a skill that can be learned and that can be reinforced by habit. The scientific approach to critical thinking is empirical; it is a way of testing our beliefs systematically against the real world. Once we develop our critical thinking skills and begin to examine our beliefs systematically, it can be very empowering. It is, in fact, a defense mechanism against all the machinations that are trying to deceive us —whether for ideological, political, or marketing reasons. Critical thinking also liberates us from being weighed down by the many false beliefs (and perhaps mutually-incompatible beliefs) we tend to hold because of our psychological makeup.” Another three-point shot from philosopher Peter Boghossian: “Critical thinking begins with the assumption that our beliefs could be in error, and if they are, that we will revise them accordingly. This is what it means to be humble. Contributing to a culture where humility is the norm begins with us. We can’t expect people to become critical thinkers until we admit our own beliefs or reasoning processes are sometimes wrong….”
However, it is worth noting that experts and highly-trained scientists and practitioners didn’t win their diplomas in a raffle; it takes years of supervised, graded, rigorous study to get through school and pass exams. Most slouches, frauds, and part-timers are weeded out — or went to the University of Barbados. It’s a gutsy thing to say “I bet that scientist is a fraud. Only frauds make such kinds of statements. Forget him.” It’s also a tall order to analyze journal articles; being a concerned parent or an armchair critic doesn’t mean one can understand research methods and proper scientific hallmarks. I have taken research methods and statistics classes, and I have learned psychotherapy under a psychodynamic practitioner; they both are difficult, but one is just a bit more reliable and trustworthy than the other. Freud, for example, or Aristotle — clearly titans in the fields they literally pioneered — look dubious, wrong, or even pathetic depending on the angle of observation. Remember also that money influences everything from the FDA down to the individual practitioner of science, and its influence is almost never positive. In fact, there is a pretty handy dictum that can help shed light into dark corners; you know it: “Follow the money.”
I have compiled some interesting sources on the side of hard science — the viewpoint that we should get vaccinated, try only treatments that have been scientifically-validated, and be conservative and prudent. Consider Science-Based Medicine.org, try The American Customer Satisfaction Index, and take seriously Cleveland Clinic’s Supplement Review. For you more adventurous and trained types, there is Google Scholar. The CDC — often the bane of vaccine skeptics — weighs in with this set of principles for deciding if a source is reliable. Cochrane is highly-thought of.
You will want to avoid reading until you find a summation or soundbite, and then shutting the book and puffing out your chest, true believers! Science best operates as a cumulative enterprise where, just like election results, things can change rapidly as more studies, findings, and principles are examined and included. Again, physician and founder of the research-oriented, mainstream website ScienceBasedMedicine.org, Novella says in the series of lectures entitled Your Deceptive Mind: “Individual studies can be preliminary and flawed, or they can be rigorous and methodologically sound, but either way, it’s still a single study. Very few studies are so large, rigorous, and unambiguous in outcome that they can stand alone and be considered definitive. One always has to put individual studies into the context of the overall research and published literature of a field.” He goes on: “One feature of the literature that needs to be taken into consideration is called publication bias: the tendency for researchers to make more of an effort to publish their study results when they are interesting, positive, and good for their career and reputation. As well, journal editors have a bias toward publishing positive studies — the kind that will get good press releases and draw attention to their journal….”
It’s nuanced, tricky stuff to surf the web and not get stuck in a rabbit hole or a cul-de-sac. Here is a pithy point about examination of evidence: “The problem is that everyone thinks they form their beliefs on the basis of evidence. That’s one of the issues, for example, with fake news. Whether it’s Facebook, Twitter, or just surfing Google, people read and share stories either that they want to believe or that comport with what they already believe—then they point to those stories as evidence for their beliefs. Beliefs are used as evidence for beliefs, with fake news just providing fodder” ~ Peter Boghossian. Perhaps the more intelligent we are, the easier it is. Apparently not; Boghossian continues: “As Michael Shermer famously stated, ‘Smarter people are better at rationalizing bad ideas.’ That is, smarter people are better at making inferences and using data to support their belief, independent of the truth of that belief.”
And in this corner.….. The rebels, iconoclasts, and open-minded crowd will want to marshal the following resources: The Guardian’s article on science, a compelling case by BigThink, this from Business Insider, a bombshell from The Boston Globe, more bad news from The Atlantic, The Post‘s take on science, and this skeptical piece. Stop short of assuming that if someone is leveling a criticism, they must be right. We don’t accept that readily in politics, right? No Donald Trump fan takes his critics very seriously just because they criticize. If someone says they didn’t like a particular movie, do we assume they must be right (i.e., accurate and unbiased)? No, there is a tendency once one has allied with the skeptical/cynical/detractor crowd to use a kind of shorthand that goes like this: “So-and-so is a noted critic of ‘the establishment’ and ‘mainstream medicine’ and they said that this researcher (or research finding) is flawed, so they must be right. Why would they level such a charge against someone who was clean, above reproach, and legitimate??” It’s a deification of the critic. It’s a heuristic that is best avoided, though it does cut out a certain amount of work on our part, mentally. No one said critical thinking is easy. Further, we can sometimes feel that once we have a heuristic in mind — “the pharmaceutical industry is corrupt and makes bad products for profit” — it is difficult or impossible to be unbiased and fair. Usually, the truth is not so black-and-white. “Be comfortable with uncertainty. There are some things we simply cannot know or that we currently do not know. There may be times when, after reviewing all the logic and evidence, our only conclusion is that we currently don’t know,” Novella notes.
At the end of the day, critical thinking is a challenge for sure. In this age of the Internet and of celebrity experts and armchair philosophers and Monday morning quarterbacks, it’s tempting to feel like one can develop a set of assumptions, and then, much like wearing prescription eyeglasses, the world’s illusions, subterfuge, and tricks will fall away and clarity will be reliable. Thus, there is a lot of bias on each side. One look at a vaccination website will amount to a veritable parade of exaggeration, ad hominem attacks, blanket statements, inflexible heuristics, and biases. Mathematics, philosophy, and science have taken us a long way since the plucky ancient Greeks (and especially since the time of giants such as Descartes, Bacon, Newton, Galileo, and Michelangelo), but humans are fallible and money has corrupted many trusted institutions in society (e.g., the media, the government, business, and to some degree the last holdout, science). “The truth is out there,” as they said on X-Files, though. Keep looking. Keep your wits about you. Science has its problems and is in desperate need of reformation, but just because a position is alternative, fledgling, well-advertised, well-endorsed, or anti-scientific, doesn’t mean it’s legitimate. This isn’t mathematics — the opposite of a negative number may in fact be another negative number.
Here are a number quotations about critical thinking, wisdom, science, and skepticism to consider:
If you want your beliefs and conclusions to be based on solid evidence, then you have to know how to interpret evidence, but it’s not always easy or obvious how to do so. There are different kinds of evidence that each has different strengths and weaknesses. On any complex topic, there is going to be contradictory evidence, so you can’t look at any single piece of evidence and get a full picture as to what’s going on. You need to know some methods of balancing and comparing the different kinds of evidence. ~ Steven Novella
All our science, measured against reality, is primitive and childlike.
A new conceptual framework for science is significant because without an appropriate science curriculum, our students are mired in an antiquated and inaccurate account of themselves and their world.
It’s important to be humble, which means knowing your limits. We tend to get into trouble when we assume we have expertise or knowledge that we don’t have or when we don’t question the limits of our knowledge. ~ Steven Novella
On the authority of no one’s words
…there are good scientific reasons to think that lots of published research is actually false. In 2005, a research professor named John Ioannidis published a much-cited paper titled: “Why Most Published Research Findings Are False,” in which he showed how the pressures of academic life, the small size of many scientific studies, and the preference for unexpected findings mean that even premier journals are surprisingly likely to publish findings that just aren’t true. ~ Evan Horowitz
At the beginning of the 20th century, worldwide life expectancy was less than 40 years of age. Today the world average stands at around 70. The single biggest reason for this miraculous leap in longevity has been our ability to cure diseases. Vaccines, antibiotics, and advances in medical technology have changed the game. We are still in an arms race against many diseases, but we stand at a unique period in human history where it’s possible to imagine a day when we have conquered disease.
While nobody likes to be criticized, scientists have to develop a thick skin because criticism is part of the process of science. Pseudoscientists, however, generally cannot accept mainstream harsh criticism. As a result, they often don’t engage with the scientific community. They claim they are the victim of a conspiracy or a dedicated campaign against their ideas — perhaps because their ideas are “simply too revolutionary.” ~ Steven Novella
Scientific Science is perhaps the only human activity in which errors are systematically criticized and, in time, corrected.
Scientific knowledge is a body of statements of varying degrees of certainty — some most unsure, some nearly sure, none absolutely certain.
…much of what biomedical researchers conclude in published studies — conclusions that doctors keep in mind when they prescribe antibiotics or blood-pressure medication, or when they advise us to consume more fiber or less meat, or when they recommend surgery for heart disease or back pain—is misleading, exaggerated, and often flat-out wrong. [Dr. Ioannidis] charges that as much as 90 percent of the published medical information that doctors rely on is flawed. ~ David H. Freedman
Scientific skepticism is a mature view of the human condition and knowledge. It is not scandalized by the flaws in the human efforts of science – nor is it naïve about the existence of those flaws and the limitations of the human brain. The critical thinking approach involves doing the best that we can with the full knowledge and appreciation of those weaknesses and limitations. ~ Steven Novella
The refusal to go along with anything with which you disagree may indeed be a principled individual choice [in this case, declining to fill a prescription with which you as the pharmacist disagree], but it should not be allowed legally to displace collectively reviewed scientific findings, or to substitute for the codes of behavior we demand as a condition of handing out professional licenses.
Science is a noble endeavor, but it’s also a low-yield endeavor,” he says. “I’m not sure that more than a very small percentage of medical research is ever likely to lead to major improvements in clinical outcomes and quality of life. We should be very comfortable with that fact. ~ John Ioannidis
That is why we need a scientifically literate electorate, so that if you go to the polls you can make an informed judgment and you can draw your own conclusions rather than turning to a particular TV station to have your conclusions made for you.
The deepest sin against the human mind is to believe things without evidence. ~ Thomas Huxley
There are in fact two things, science and opinion; the former begets knowledge, the latter ignorance. ~ Hippocrates
Already feeling that they’re fighting to keep patients from turning to alternative medical treatments such as homeopathy, or misdiagnosing themselves on the Internet, or simply neglecting medical treatment altogether, many researchers and physicians aren’t eager to provide even more reason to be skeptical of what doctors do—not to mention how public disenchantment with medicine could affect research funding. [Researcher John] Ioannidis dismisses these concerns. “If we don’t tell the public about these problems, then we’re no better than nonscientists who falsely claim they can heal,” he says. “If the drugs don’t work and we’re not sure how to treat something, why should we claim differently? Some fear that there may be less funding because we stop claiming we can prove we have miraculous treatments. But if we can’t really provide those miracles, how long will we be able to fool the public anyway? The scientific enterprise is probably the most fantastic achievement in human history, but that doesn’t mean we have a right to overstate what we’re accomplishing.” ~ David H. Freedman
The dispassionate intellect, the open mind, the unprejudiced observer, exist in an exact sense only in a sort of intellectualist folk-lore; states even approaching them cannot be reached without a moral and emotional effort most of us cannot or will not make. ~ Wilfred Trotter
We live in a society exquisitely dependent on science and technology, in which hardly anyone knows anything about science and technology. ~ Carl Sagan
Science is basically an inoculation against charlatans. ~ Neil DeGrasse Tyson
Most people say that it is the intellect which makes a great scientist. They are wrong: it is character. ~ Albert Einstein
More words of wisdom on critical thinking: The Wisdom Archive at www.valuesofthewise.com
Here are a few sources you might want to engage to increase your skepticism and increase your scientific integrity:
An interesting book on ignorance, humility, and knowledge
A neat review of an assertive journal article entitled “Unskilled and Unaware of It: How Difficulties in Recognizing One’s Own Incompetence Lead to Inflated Self-Assessments”
You Are Not So Smart, a book about critical thinking for the confident personal-growth nut
The book Born to Believe, which explains the biological basis for belief — what brain processes contribute to and influence what we believe