Coyne and Sheldrake again…

…this time in the pages of the New Republic, in an unfortunate ad hominem attack by the former upon the latter. Here is a sample of Coyne’s invective (note, “woo” is Coyne’s word for non-materialist ideas or perspectives): “went off the rails,” “misbehaving woomeisters,” “thinks himself an unrecognized genius, persecuted like Galileo,” “woo-spouting,” “paranoid,” “rant [what he’s referring to is far more restrained than Coyne’s own intemperance],” “paints himself as a martyr again,” “The Woomeister,” “paranoid rants.”

The occasion for all of this is Sheldrake’s post linked above, which discusses a genuinely problematic phenomenon over at Wikipedia involving that immensely seductive word “objectivity.” The trouble is that scientific materialism itself is a philosophical position that cannot be demonstrated “scientifically,” so to simply assert it as simple Truth and “objectivity” is an exercise in dogmatic intolerance.

As Sheldrake rightly points out, there really is an organization which calls itself “Guerilla Skeptics on Wikipedia (GSoW),” they really are (in Sheldrake’s words) “well trained” and “highly motivated.” They do “have an ideological agenda, and operate in teams, contrary to Wikipedia rules.” Susan Gerbic of said group really does have a training video up, and she indeed “glories in the power that she and her warriors wield.”

Topics which span cultural fault lines are naturally going to result in highly contentious Wikipedia Talk pages, as partisans fight to gain as much control as possible over the presentation of the article in question. We are not talking about an Encyclopedia Britannica article, where one person is asked to write something and a very limited number of editors join in the rest of the way. The “Guerilla Skeptics on Wikipedia” have a declared mission to steer a great many articles – and more as each week goes by – their way, along with sophisticated techniques for doing so. The problem is that they are unaware of any potential blindspots in their thinking. Specifically, I refer to that cultural paradigm of scientific materialism being simply “objective” “Truth.”

There certainly are areas of Sheldrake’s thought which I don’t follow, including “morphic resonance,” one of his central ideas. But there is no doubt that his thinking and work overall are at the very least worthy of engagement and at their best represent important critiques of certain tendencies within Science today.

What is always striking to me in Jerry Coyne’s writing is the ever-present shadow of “religion.” The word appears all the time, even when there is no reason for it to. In this current piece it announces itself twice significantly. Consider the following paragraph:

Many of you might know of Sheldrake. He enjoys a certain popularity in the US and UK among those who think that there must be “something more out there”—with “more” meaning psychic phenomena. I don’t really understand a penchant for things that aren’t supported by evidence, but that’s probably a failure of empathy on my part—as well as a product of my scientific training to doubt. I am sure, though, that some of the same psychological tendencies that promote sympathy for woo also promote sympathy for religion.

This is revealing, I think. First, “something more out there” – more, that is to say, than what is contained in a purely materialist philosophy – becomes effectively reduced to the phrase “psychic phenomena.” What’s wrong with that? Doesn’t Sheldrake believe certain “psychic phenomena” exist? Yes, he does, but nonetheless I would say Coyne’s sentence is misleading. “Psychic phenomena” is a vague phrase encompassing everything from easily mockable fringe beliefs to non-materialist ways of seeing grounded firmly in “evidence-based” practice. Then there is the link between “sympathy for woo” and “sympathy for religion.” What “religion” is he talking about? The word encompasses an extraordinarily vast and varied field of views, ideas, practices. It claims some of the most degraded as well as some of the most realized beings in our human experience.

And then later in his piece he complains about a BBC interview with Sheldrake concerning the Wikipedia war over his own (Sheldrake’s) page, on the grounds that the opposing side wasn’t represented (though he reports the BBC’s intention to do just that sometime this week). At which point there follows this parenthetical remark: “[Note: the BBC interviewer, Dan Damon, describes himself and his wife as ‘keen churchgoers’].” The implication is as clear as can be: a “keen churchgoer” is de facto suspect as an inquirer into this matter of Wikipedia integrity, in a way “The Guerilla Skeptics on Wikipedia,” well, aren’t – at all. They’re simply “objective” defenders of The Truth, of course.

(For anyone who wishes to compare Coyne’s characterization of Sheldrake with the latter himself, I embedded in a previous post his “infamous” TEDx talk here. You may disagree with Sheldrake there to one degree or another but I really don’t think it can be said that Coyne’s constant references to him in this article as “paranoid” and a ranter, as someone who likes to proclaim himself a “persecuted” “genius” and “martyr,” as someone “off the rails,” are demonstrable. This can be said also of several interviews I have heard with Sheldrake.)

Pinker and Wieseltier’s discussion on science and the humanities

There have been several exchanges recently between Steven Pinker and Leon Wieseltier in the pages of the New Republic regarding the relationship between science and the humanities. Yesterday (September 26), there appeared this set of responses, which is well worth reading carefully and contemplating. The essay of Wieseltier’s which immediately led to this is here. It too is eminently worth reading. In fact, I consider the latter to be about as lucid, incisive, and elegant a statement as I’ve seen on the subject.

Wieseltier has become a beacon of brilliant sanity in this matter of the domain and role and limitations of Science, and the irreducible centrality of the humanities to human culture.

More about this particular exchange another time.

a response to Sean Carroll concerning scientism (1)

Sean Carroll, a physicist at Caltech, recently posted a piece entitled “Let’s Stop Using the Word ‘Scientism.'” His basic argument – which is the same as Jerry Coyne’s and others – is that the word is vague. Like Coyne, he wants us to cease using it, entirely replacing it with criticisms of specific scientific claims or practices, as they come up. Let’s take a closer look at this.

If we are not permitted to use a word like “scientism,” then we are not permitted to voice the idea that the word “science” is capable of ever masking any significant degree of self-deception. We are instead required to view it as possessing some sort of transcendental status that somehow bypasses human mediation. In other words, “Science” must be viewed as simply “The Truth,” a universal epistemological trump card, and basically incorruptible.

(I capitalize the word here, and in certain other instances, when I specifically wish to emphasize the notion of science as an entire “way of seeing,” distinct from either doctrinally religious views on the one hand, or those more broadly humanistic, on the other.)

Since that is so, this argument goes, the notions of dogmatism, extremism, ideology, and religious “fundamentalism” have no parallel in Science as a whole. The paradigms and practices of science require no overarching philosophical View – which would, of course, need to be supplied by humans, and would therefore be fallible. Nor is science capable of radically straying into any kind of cul-de-sac of error. Therefore, it’s unnecessary and even obfuscating to have a word for this danger. The danger doesn’t exist.

That is the argument. In support of it, Sean provides nine examples of how the word “scientism” is used in one instance or another, claiming that these taken together represent a vagueness or lack of specificity. They are worth reproducing:

1) Science is the source of all interesting, reliable facts about the world.
2) Philosophy and morality and aesthetics should be subsumed under the rubric of science.
3) Science can provide an objective grounding for judgments previously thought to be subjective.
4) Humanities and the arts would be improved by taking a more scientific attitude.
5) The progress of science is an unalloyed good for the world.
6) All forms of rational thinking are essentially science.
7) Eventually we will understand the important questions of human life on a scientific basis.
8) Reductionism is the best basis for complete understanding of complicated systems.
9) There is no supernatural realm, only the natural world that science can investigate.

Now, is Sean implying that all definitions must be reducible to a single thought, a single sentence? If not, I do not understand his point. Six of these nine statements (points 2-7) all go together, forming, indeed, a philosophical perspective that can most certainly be disputed.

First, let me isolate the three that do not seem fairly placed. I would question Sean’s ability to find more than a few scientists, if any, who would assert that “science is the source of all interesting … facts about the world” (point 1). Maybe such people exist somewhere, but they would be rare. His second adjective “reliable” is maybe a little more in line with the other points, but “interesting” is too vague, I think.

Point 9 contains words difficult to define for these purposes (“natural” and “supernatural”). It is presumably in the list because a segment of people who attack science do so from the perspective of religion, often religious fundamentalism. However, it’s not actually relevant here: notions of what is “natural” or not do obfuscate the question. There are more than enough of us deeply concerned about scientism who don’t make use of a concept of the “natural” in doing so.

And finally point 8 is rarely heard: few people will actually assent to being a reductionist. Certainly reductionism manifests as part of the larger syndrome being referred to by scientism, but the mantle of reductionism is not commonly claimed by scientists.

This leaves points 2-7, which very much do all cohere. A given individual might slightly downplay one or the other, as indeed Sean states. But in practice these can be discussed together as indicating a basic view of reality and valuation of human endeavor (and they can all be easily found in for example Jerry Coyne’s writings). Here’s one way of doing it, with only a few additions for linking purposes (the original points are in bold):

All forms of rational thinking are essentially science. Since rational thinking is our only means for getting at the truth of phenomena, the progress of science is an unalloyed good for the world. For the same reason, the humanities and the arts would be improved by taking a more scientific attitude, while philosophy and morality and aesthetics – again following on from the equation of rational thinking and science – should be subsumed under the rubric of science. Being founded and practiced upon rational bases, science can provide an objective grounding for judgments previously thought to be subjective. And when the humanities and arts (along with “philosophy and morality and aesthetics”), as above, are placed upon firm scientific ground, eventually we will understand the important questions of human life on a scientific basis.”

Even though I took more-or-less the entire core of the previous paragraph verbatim from Sean’s own points 2-7 rather than formulating it in my own words, it forms a definition of scientism that isn’t half bad, I would say. In a second post I will try to show the blindspot in this view, and some of the ways in which it is very dangerous.

scientific certainty

(from an interview in the current issue of Buddhadharma with biologist Rupert Sheldrake):

In 1894, Albert Michelson, later to win the Nobel Prize in Physics, declared, “The more important fundamental laws and facts of physical science have all been discovered, and these are now so firmly established that the possibility of their ever being supplanted in consequence of new discoveries is exceedingly remote… Our future discoveries must be looked for in the sixth place of decimals.”

Whoops. Within a generation quantum theory and general relativity would bring about such an “exceedingly remote” possibility.

Today the same kinds of claims are made for a great many theories that not only haven’t been established by centuries of rigorous work – as Michelson’s physics was. They haven’t even been properly understood, delineated, and “proven” the first time around. I’m talking about the infiltration of scientific certainties into various social “scientific” domains. Wild claims about genes for such notions as “gregariousness,” “altruism,” and “criminal personality” appear every week. But it is hard to see how these kinds of concepts are anything but trans-scientific in their profoundly imprecise and contingent natures.

(Even a one-dimensionally, completely measurable trait like height has about fifty genes connected to it, together only accounting for roughly 5 percent of a given person’s actual height, according to Sheldrake.)

That is to say, to quote from the interview again: “…human meanings, values, and purposes can only be understood in the context of human societies, traditions, philosophies, religions, and experiences.”

scientism: 3) the syndrome

In a previous post I tried to delineate the nature of a particular syndrome, one which is rarely aired outside of Science Studies, STS (Science, Technology, and Society) and other academic departments. In beginning to write about this I’m reminded of a quotation I just came across from Bill McKibben, in an interview publicizing the Burlington Book Festival:

Books remain the single most important way for societies to think seriously about themselves. There are arguments that can only be made at length, and with grace, which is to say only with books.

This certainly holds true with regard to the subject at hand. It’s exceptionally hard, in a short statement, to say anything about it that is perhaps worth saying. Nevertheless, I would like to throw out a provisional set of arguments over a series of posts. As we find ourselves moving further and further down a path whose deeper premises remain effectively unquestioned, I believe this topic can only acquire ever more importance.

I will be suggesting ten or so reasons why such questioning needs to be taken more seriously. Most of these points are not particularly controversial. Nevertheless, their direct implications rarely are addressed in the media, in policy decisions, in the broader cultural discourse more generally.

Before moving on to these, however, one larger point, touched on in a previous post. There is a straw man constantly resorted to here which has to do with the crisis of polarization we’ve reached, whereby virtually any criticism directed towards Science is assumed to have “religious” motivation and a fundamentally “irrational” basis. In fact, this assumption in itself is part of the syndrome – despite the truth that indeed, religious fundamentalism’s antagonism towards rational critical thought remains one of the greatest of dangers in the world.

In any event, this is most definitely not my own point of departure, quite the contrary. What I will be focusing on most here has to do with fields relatively newly “scientized,” which in all kinds of ways touch upon important and vastly complex human questions. And because human, also especially emotive and self-interested. Prior to the past 150 years or so, “science” used to point to a fairly small and circumscribed set of disciplines. Today, as linguist Roy Harris well puts it (in The Semantics of Science):

For many years now linguistics has not been the only subject scrambling to climb aboard the bandwagon of science. Students of virtually every form of human behaviour – including psychologists, sociologists, anthropologists and educationists – have tried to do likewise, and in some cases have simply appropriated the title science as an official designation for their own discipline or subdiscipline. If people were shocked in 1914 when Clive Bell spoke of a ‘science of aesthetics,’ they have nowadays become accustomed to universities whose football coaches are “sports scientists” and whose army instructors introduce their trainees to the study of ‘military science.’ (pp. 104-105)

To which one can add, of course, the notion of “political science.”

In my most recent post on this subject I quoted the following from Jerry Coyne (my emphasis):

I prefer to think of science as an attitude rather than a method: a respect for the truth about nature and a determination to wrest that truth from obscurity by using methods that, according to most rational people, reveal what’s out there.

I find the formulation I’ve highlighted both honest and largely accurate as a description of how science operates. The trouble, to my mind, comes in with what follows the colon, with phrases such as “the truth about nature,” “most rational people,” and “what’s out there.” These beg a number of questions that need to be explored in greater depth, which I hope to be able to do in future posts.

scientism: 2) definitions

So first, some preliminary definitions. What do we talk about when we use the word “scientism”?

Very broadly, “scientism” here refers to the view and understanding of “science” effectively as a religion, though without an acknowledgment of this being so. In other words, it is a totalizing approach in which “science” is assumed capable of answering any and all ultimate/ultimately valuable questions. Most crucially for my purposes here: looked to implicitly as the default mode of inquiry regarding human psychology and potential.

More fully:

1) a: “Reason” is viewed as a unitary entity. That is to say, when something called “reason” is deemed to be operating, we are referring to the same thing, practically speaking, no matter what the context.

b: Likewise, “science” is viewed as a unitary entity. It is supposedly the case that what, say, physicists, chemists, and cell biologists do, and how they do it, is basically the same thing that, say, geologists and meteorologists do, which is basically the same thing that researchers into the effects of food and drugs on the body do, and basically the same thing that sociologists, psychologists, and evolutionary theorists do.

c: Finally, these two entities collapse into one. As Jerry Coyne, professor in the Department of Ecology and Evolution at the University of Chicago, puts it in the article I quote from in the earlier post:

…some spheres of the humanities, namely the social sciences, do give us a way to find knowledge. They do it by using the same techniques as do “real” scientists: observation, experimentation, testing of hypothesis and predictions, rational inquiry, and doubt. In fact, I have long called things like social science, history, Biblical scholarship (as opposed to theology), and archaeology “science broadly conceived.” In fact, I have said that even things like car mechanics and plumbing could be considered forms of science, for when fixing electrical problems or finding leaks, mechanics and plumbers use scientific inquiry.

…I see science as essentially continuous with things like history and archaeology. I see science not as an area of inquiry that depends on a prescribed “scientific method”: as Philip [Kitcher] and others note, there is no one “scientific method.” Science can proceed via induction or deduction, experiment or observation, or any manner of rational inquiry that produces reliable (i.e. generally verifiable and reproducible) knowledge. I prefer to think of science as an attitude rather than a method: a respect for the truth about nature and a determination to wrest that truth from obscurity by using methods that, according to most rational people, reveal what’s out there.

2) Going a small step further to make this point quite clear, a scientistic attitude believes that the same heuristic expectations – the same principles, basic approaches, forms of verification, outcomes – apply equally to the study of sentience as to non-sentient matter and phenomena. That is to say, that there is nothing ultimately distinct between the study of immaterial thoughts, intentions, emotions, let alone the movement of these within the vast mesh of interconnectedness and interdependence that comprises the human mind, and the study of a subatomic particle, an organic molecule, a rock, a mountain, the atmosphere.

3) Scientism assumes without question that only “scientific” explanations can count as “ultimate,” and ultimately satisfying. No other means or form of expressing the truth of some phenomenon or other can ever have the prestige of a “scientific” formulation.

4) Therefore, as follows on from this, Science likewise and perforce must contain the ultimate source of all values – including those informing its own assumptions and projects. Since it is viewed as providing the only ultimately trustable methods and the only ultimate explanations, it has succeeded in taking the place of religion in more-or-less all of the latter’s traditional functions, and has supplanted the humanities more generally in perceived value.

5) Finally, as a result of the specialization inherent in scientific research and language, we have had no choice but to accept what amounts to a priesthood with whom, in the last analysis, the rest of us are not allowed to disagree at the level of basic view or experimental design, interpretation of results, and so on. Just as the theological pronouncements of the medieval Western Church, delivered in Latin, were indecipherable to all but its hierarchy, today’s scientists speak a language which non-specialists do not understand and generally do not have the time and means to understand. And this has become ever more the case with ever-proliferating specializations and sub-specializations of science: even those with a solid background in each of the major sciences cannot hope to keep up with all the new vocabulary, techniques, and technology that increase year to year.

Therefore, whereas in the past a more general public conversation was possible about wisdom, knowledge, the nature of truth, and so on, today, more and more, the average person finds herself silenced with regard to ultimate questions. Instead, we quote the latest headline in the New York Times Science section – about which media reports I have written below – and shrug our shoulders.

Very rapidly we have reached a point of virtual powerlessness and to a certain extent vapidity in our public discourse, in which ordinary sound, considered, deep reason carries little prestige when placed next to the latest splashy headline conveying a presumed increase in knowledge. (Presumed because, as noted in the linked post above: in Seth Mnookin’s report newspapers paid pretty much exactly four times as much attention to original studies as to related (supporting or unsupporting) ones, with 80% of the former being subsequently refuted or unconfirmable as stated. And with one out of 57 articles on the related studies even bothering to mention that the original finding cannot be confirmed as stated!)

This is one of quite a number of effects of scientism upon our culture that will be the focus of subsequent posts.

scientism: 1) preliminary

As promised in an earlier post, some thoughts on scientism and how it functions.

There’s a somewhat understandable reason why this term is unfamiliar to most people, which is to say why our media doesn’t cover it seriously, or practically speaking at all. Though there are certainly many thinkers who don’t fall into this category (see for example the folks involved with SAND, the Science and Non-Duality Conference), our culture seems now to be rather stuck within a state of Manichean opposition between two big terms – “religion” (and more generally the humanities) and “science” (this latter usually simply and unfortunately equated with the notion of “reason,” about which more later). In truth each of these terms covers a multitude of paradigms and practices.

For believers in scientism, “religion” has simply become a code word for the root of all evil – the source of ignorance itself, regression, hatred, violence. “Science” on the other hand has become positively the guarantor of all that is good. If only we would grant it supreme ultimate power in all decision-making we would eventually find ourselves in paradise on earth – or as close to that as is possible to achieve. We would be well on our way to understanding literally everything about everything, and having no causes remaining for hatred or violence at all.

For a number of reasons which I plan to explore in future posts, this view is enabled by a few largely unquestioned assumptions, and by certain filters within the media which are mostly unconsciously placed upon the flow of information and expression. But one reason will be mentioned right away, since it is a very understandable and sensible one: namely, there is indeed an awful lot of fundamentalist insanity about, and while very far from expressing the whole truth about “religion,” let alone humanistic understanding more generally, its prominence today cannot be denied.

All the same it is important to see how something we are calling “Science” has now become short hand for “Ultimate Truth.” For true believers in Science it operates, in fact, almost precisely like a religion, though this can be hard to see. Thus, the notion of “scientism” is crucially necessary in order to point out how this can be so. Necessary as much as anything in order to keep open our capacity to detect blind spots of vision.

As I will argue, blind spots there are, and some dangerous ones too.

Sandy (2)

(continued from below)

And the results of that unfolding can only be experienced elementally. Earth yields and collapses, water expands and engulfs, heat/fire is generated and consumes, wind overpowers and destroys. Living through an actual earthquake we suddenly remember earth, real earth, not the chemical composition of soil. Maneuvering through turbulent sea or sky we remember, in our bones and blood – not “H2O” but real water, not a mere list of gases with approximate compositional percentages but real air. Our very emotions, kinds of insight, styles of personality, along with all our bodily processes, correlate remarkably beautifully and profoundly with these fundamental qualities of energy – symbolized for example by the five colors of Tibetan prayer flags.

The entirety of taoist practice and Chinese medicine, too, emerges out of elemental sacred vision and experience – again five energies, as it happens, though seen and worked with in somewhat different ways from the Indo-Tibetan. I know very little about other systems than these but enough to say that wisdom traditions in every continent seem to have arisen out of this kind of awareness.

By contrast, what does a purely scientific – that is, fundamentally conceptual and analytic – way of understanding what is “elemental” have to tell us about ourselves? About how we actually experience our lives, day to day, moment to moment? Copper, phosphorus, bromine, praseodymium: these truly are abstractions utterly disconnected from our bodily human reality. They take their places within an elegant and revelatory periodic table, yielding crisp, pristine, purposeful answers to a multitude of material concerns. And at the same time … they have nothing to say to us as we meet, personally, the phenomena of our inner lives in every instant.

I’m as much a product of my times as anyone and I’ve been experiencing Sandy, yes, as a rational phenomenon that can be “explained” via translation into meteorological language. But at the same time … there has been something, no not sentient, but in any event truly, fully alive taking place in “her.”

Today while walking, for instance, I couldn’t help but sense the closer presence of the storm. Vastly weakened from its peak, it is now passing about as close to us here as it will, and somehow this truth registered despite mostly gorgeous mild weather this last day of October. It announced itself in astonishing cloud formations and in the smell of the air, a sense of something mighty, commanding complete respect, having been discharged, of release and decline. Of the return to harmony after so monumental a display of power. Uneasy reprieve (those clouds belonging, after all, to the very same system that pulverized NJ and NYC), a feeling of some giant gliding past, all of us tip-toeing and holding our breaths as it were, hoping to avoid notice, lest maybe this Sandy character might change its mind and decide to go out, after all, with just one more bang…

a thought on Sandy

Ultra-clever apes as we can be, we “developed” Westerners have seen fit to banish all elemental/energetic understanding from our universe. All “ordinary magic,” all sacredness.

We “know” that earth, water, fire, and air are not “real” elements but rather incoherent, primitive categories of “developing,” pre-scientific cultures. We know that there is only one possible way of understanding the elemental: conceptually, via thoroughgoing analysis. In fact, really, we can’t any longer conceive that there could be an alternative mode of seeing.

We know that the universe is really made up of Hydrogen, Helium, Lithium and so on, all the way up to … Flerovium and Livermorium now, it looks like. It never occurs to us that these too are actually human creations, abstractions. Except we also know that at the sub-atomic level all that solidity breaks down in very peculiar ways difficult to conceptualize. In fact at that point it all looks rather like what the buddhists call space – their fifth element, the non-material one of accommodation/complete openness which makes all form and phenomena possible. Which makes all combinations of the other four possible.

And yet, how interesting it is that for example we also give our hurricanes names. Human, mortal names, as befits a would-be democratic age, but names all the same. How is this so very different from the practice of cultures all over the world in naming deities of Ocean, Thunder, Fire, particular territories of the earth, the animating spirits of individual animals or plants? We no longer say Briareos but rather Sandy or Irene, but the impulse is the same, isn’t it?

The objection of course will be: ah but we don’t actually believe there’s a sentient being in there somewhere, animating that storm with purpose. This is true, but also not quite the point.

An energetic or sacred understanding of reality is not at all antagonistic to a scientific one as such. The two modes of perception simply operate in different registers, different realms in a sense. Side by side with all the explanations of why this storm was so unprecedented and powerful, with the hourly projections concerning trajectories, timing, wind speeds, rainfall, surge heights, another form of experience could yet be sensed within the discourse, dimly but unmistakeably. Underpinning the assumption of pure rationality lay, in fact, an attitude of awe, and fundamental incomprehension. Something like the “beginner’s mind” of Zen.

With all of our knowledges, we will never capture a storm in the pure abstraction of concept. We know, too, that we cannot master a storm. We may split atoms in a kind of ultimate display of techno-analysis, but even the terrifyingly murderous weapons that can be produced from such cleverness are still no match for an “entity,” that is to say a process, like Sandy. So we may only sit, and watch, and wait, as something far bigger than what our comprehension can encompass … unfolds. In its own sweet time.

(to be continued)

what health care + unlimited profit cannot help but create

There has been a flurry of good books recently on the state of psychiatry, more specifically on the proliferation of “syndromes” over the past several decades, and the vast increases in people being prescribed drugs for these – including ever larger numbers of children. Marcia Angell had two excellent pieces in The New York Review of Books a year or so ago: “The Epidemic of Mental Illness: Why?” and “The Illusions of Psychiatry”. These reviewed the following: Unhinged: The Trouble with Psychiatry – A Doctor’s Revelations about a Profession in Crisis, by Daniel Carlat; Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, by Robert Whitaker; and The Emperor’s New Drugs: Exploding the Antidepressant Myth, by Irving Kirsch.

Now comes one of the single best summations of what is terribly wrong with our current system of health: an article in The Guardian by psychiatrist Ben Goldacre called “The Drugs Don’t Work: A Modern Medical Scandal.” It’s long but very worth reading in full.

What Goldacre’s piece is so good at is making clear just how corrupt the process is by which new drugs become approved for sale. For example, most people are not aware that negative test results simply don’t need to be published, and rarely are. Goldacre begins with an experience he’d had prescribing the antidepressant Reboxetine. He’d read the published studies (the results of the trials were “overwhelmingly positive”), talked it over with his patient, and they went ahead. However, two years ago a much bigger picture emerged when researchers were able to locate and collect all the data on this particular drug. It turns out that out of seven trials comparing it to a placebo, only one of these showed a positive result. And this, of course, was published. The other six trials, making use of nearly 10 times the number of patients, showed the drug worked no better than a sugar pill.

These were never published.

The story is the same with studies comparing Reboxetine to other antidepressants. And it’s the same with studies on side effects.

Here is Goldacre’s summary of the current state of affairs:

Drugs are tested by the people who manufacture them, in poorly designed trials, on hopelessly small numbers of weird, unrepresentative patients, and analysed using techniques that are flawed by design, in such a way that they exaggerate the benefits of treatments. Unsurprisingly, these trials tend to produce results that favour the manufacturer. When trials throw up results that companies don’t like, they are perfectly entitled to hide them from doctors and patients, so we only ever see a distorted picture of any drug’s true effects. Regulators see most of the trial data, but only from early on in a drug’s life, and even then they don’t give this data to doctors or patients, or even to other parts of government. This distorted evidence is then communicated and applied in a distorted fashion.

In their 40 years of practice after leaving medical school, doctors hear about what works ad hoc, from sales reps, colleagues and journals. But those colleagues can be in the pay of drug companies – often undisclosed – and the journals are, too. And so are the patient groups. And finally, academic papers, which everyone thinks of as objective, are often covertly planned and written by people who work directly for the companies, without disclosure. Sometimes whole academic journals are owned outright by one drug company. Aside from all this, for several of the most important and enduring problems in medicine, we have no idea what the best treatment is, because it’s not in anyone’s financial interest to conduct any trials at all.

Goldacre includes a disturbing example of a dangerous drug (Rosiglitazone) remaining on the market for years because the system is so flawed. The trouble is: nothing changes in this regard. There has been a record number of fines imposed upon the pharmaceuticals in recent years but even though the amounts seem high to us, they represent a non-constraining fraction of annual profits. So there is simply no incentive to be safer; every incentive to cut corners, spin results, and find new “markets”…

Seth Mnookin on the current troubling state of science reporting

Seth Mnookin over at PLOS has an excellent piece on the present state of science writing, worth reading in full. Here are some highlights:

Lest anyone think that the ENCODE case was sui generis, just this past Wednesday, a team of researchers based in France published a paper in PLOS ONE titled “Why Most Biomedical Findings Echoed by Newspapers Turn Out to be False: The Case of Attention Deficit Hyperactivity Disorder.” (The paper’s authors were intentionally evoking the title of John P. A. Ioannidis’s groundbreaking 2005 piece, “Why most published research findings are false,” which built off of his earlier JAMA paper, “Contradicted and Initially Stronger Effects in Highly Cited Clinical Research.”) After examining every newspaper report about the ten most covered research papers on ADHD from the 1990s, the authors were able to provide empirical evidence for a troubling phenomenon that seems to be all but baked in to the way our scientific culture operates: We pay lots of attention to things that are almost assuredly not true.

The first cited article above (by Gonon, Konsman, Cohen, and Boraud) examined 47 scientific publications on ADHD from the 1990s, “echoed by 347 newspaper articles.” The authors selected the 10 most echoed publications, tracked all subsequent research relating to them up to 2011, and also followed newspaper coverage of this research. Here were their results:

Seven of these ten publications were initial studies; three were not. Of the seven, “the conclusions in six of them were either refuted or strongly attenuated subsequently. The seventh was not confirmed or refuted, but its main conclusion appears unlikely.” Of the three, one of the findings has been attenuated. (In other words, eight out of ten of these studies, 80%, cannot be confirmed as originally stated, and 60% have already been either refuted or “strongly attenuated.”)

Now, how did newspapers report on all this? “The newspaper coverage of the “top 10” publications (223 articles) was much larger than that of the 67 related studies (57 articles). Moreover, only one of the latter newspaper articles reported that the corresponding “top 10” finding had been attenuated.”

Put another way, newspapers paid pretty much exactly FOUR times as much attention to the original studies–80% of which have either been subsequently refuted or unconfirmable as stated–than to the related studies. And a grand total of one out of 57 articles on the related studies even bothers to mention that the original finding cannot be confirmed as stated!

Why is this the case? Mnookin suggests:

Because it’s sexier to discover something than to show there’s nothing to be discovered, high-impact journals show a marked preference for “initial studies” as opposed to disconfirmations. Unfortunately, as anyone who has ever worked in a research lab knows, initial observations are almost inevitably refuted or heavily attenuated by future studies–and that data tends to get printed in less prestigious journals. Newspapers, meanwhile, give lots of attention to those first, eye-catching results while spilling very little (if any) ink on the ongoing research that shows why people shouldn’t have gotten all hot and bothered in the first place… The result? “[A]n almost complete amnesia in the newspaper coverage of biomedical findings.”

He goes on to summarize: “…publications that should be exemplars of nuanced, high-quality reporting are allowing confused speculation to clutter their pages; researchers and PIOs are nudging reporters towards overblown interpretations; and everything we write about will probably end up being wrong anyway — not that we’ll bother to let you know when the time comes.”