We want to believe that science holds all the answers. But it doesn’t. Nature and her universe grasp those answers tightly and wait for us to feebly tease them from her grasp, sometimes with fallible and clumsy attempts we humans deign to reveal or admit to ourselves. Though scientists want to believe that they cover all the bases, nature sometimes rears her head up with a loud “gotcha” as we scratch our heads at methodology gone wrong. A recent article in the New Yorker, The Truth Wears Off, asks: Is there something wrong with the Scientific Method? My head began spinning at the choice of title and by the time I got past the question posed my eyes were rolling back into my head. It made for difficult reading.
The ‘truths’ in question have to do with, in this case, repetitive clinical trials of a class of drugs, used to treat a specific psychosis, no longer showing the efficacy found in earlier trials. This leaves scientists wondering what to do with costly and rigorously formerly-proven truths that are no longer truths, and wondering what might be wrong with the Scientific Method. It would seem, at first glance and with more than a modicum of horror that Gremlins came in through the doors of science and stole the truths of the decade, those truths elicited through expensive and careful planning of studies compliant with standards we equate with the Scientific Method. Indeed, what do we do with all of this, toss the baby out with the bathwater, so to speak?
Probably not. But what is sad is that most people, and it seems that even those who employ the method, even taking it to the bank, don’t quite understand the rules, or what results or lack of results, really means.
The Scientific Method does play itself out, sometimes repeatedly, with results that toss about theories and truths like tides, sometimes cyclically, and sometimes with tragic results. You have old moldy truths? That means that you missed something, something embedded in humanity’s code that may not now, or even in the near future, be ferreted out, even if it is staring its research teams in the face. In the meanwhile, though, there are practical issues and real people affected by wavering truths, especially in the realm of psychiatric medicine. But without replication of research as per the Scientific Method, the old moldy truths would stand as truth when it shouldn’t. It works, even if we don’t like how it works, or the speed at which it works, but the Gremlins, so to speak, have to also play by the rules.
One problem lies in how we process, analyze, and eventually use the information gleaned. Though we hope that the Scientific Method eliminates the squishiness of pseudoscience, Psychiatry’s intricacies of mind somewhat arbitrarily cut into territories that include neurology and psychology, it appears that negotiating the stuff of gray matter is still gray and squishy. Unlike strep throat, which is identified by the presence of a definable organism, schizophrenia and other like diagnoses are mostly diagnosed by observation of human behaviors and a relaying of human experience between patient and human physician, who then weighs those using parameters in a manual, currently the DSM-IV. There’s a lot of room for human error, if just in discerning degrees of the seriousness of whatever diagnosed illness in any particular person. And now we’ll have a new DSM (DSM-5) that will make everyone look as though they need these meds and more…just to cope with the stresses of where to stash the Old Worn Out Truth paperwork… but will those drugs work?
Not according to a recent review of accepted data that reveals our Gremlins of Flawed Research and Reporting regarding the efficacy of antidepressants. This Psychotherapy and Psychosomatics report being submitted to the FDA concludes that because ‘negative result’ trials were not reported alongside positive trial data, we need to reconsider current treatment plans for those who suffer from depression. Our Scientific Method may work just fine, but in the end, or even in the middle as the cycle agitates, its truth may not be not born forward on any reliable basis as scientist struggle with human fallibility in an arena where profits rule, grants for research are not evenly distributed, and the general public wants something new RIGHT NOW to add to its arsenal of fix-its.
How depressing…or maddening!
The New Yorker article goes on to explain some of the quirks associated with research, most of them humanly emotional, not scientific. After all, we’re not robots testing motor oil on metal as we put chemical effects on the human mind to the test . I sincerely hope that we reconsider, as a society, just how much reliance we put on the Scientific Method in exercising our own capabilities of critical thinking and free will. Perhaps our physicians might become less the authority and more the educators, giving us appropriate choices and updates when research doesn’t bear out consistent results over the long haul. Debunking old moldy truths is part of the Scientific Method we merely hope plays out to our advantage, but our own intellectual freedoms ought not to lose out to quirks and tampering.
The question in my mind is not about truth….unless it’s about timely disclosure from research facility to front page news. My big question is…do we understand the difference between actuality and reality and a scientific truth and…do those truths, as they are, serve us well enough to take for granted? As the new truths emerge, do we underestimate the human costs of the old truths and continue to ignore those people who claim that their medications are not working and blame their demise on their own lack of compliance, or worse…their own illness? Has the Scientific Method served them well? Probably not. Has it served us well across the board and in our daily lives? Well, I do like my synthetic motor oil and Microwave popcorn maker, but I’m ever so glad not to be taking the drugs in question. I wonder what method we’d use to hold researchers subject to their own truths and scientific scrutiny.
Back to the drawing board…but let’s not pretend that the madness is in the method. Bad science is just plain bad science.
Next: A culture based on bad science?
References:
- Leher, J. The Truth Wears Off: Is there something wrong with the scientific method. New Yorker [serial online]. 2010 Dec 13 [cited 2011 Jan 26]; Sect. Annals of Science. [link]
- Edmund Pigott, Allan M. Leventhal, Gregory S. Alter, John J. Boren (2010). Efficacy and Effectiveness of Antidepressants: Current Status of Research. Psychotherapy and Psychosomatics 2010;79:267-279. (DOI: 10.1159/000318293) [link]
Comments 4
Richard H. — February 7, 2011
This looks like a job for critical sociology. The very examples you cite, of antidepressants and the DSM, demonstrate that even our knowledge is not immune to social production. Has Big Pharma been the sponsor of the generally positive clinical trials? Further, while we know how certain classes of medications, like SSRIs "work" to regulate serotonin, do we really understand the mechanism by which these purportedly alleviate affective disorders? That's some boatload of side effects to swallow, the contemplation of which evoke's Becker's analysis of power with respect to drugs.
That the DSM is an artifact we know historically from the battle over the classification of homosexuality as a disorder. How it came to be otherwise is a mix of protest and happenstance. How much more is the DSM-V to be affected by the powerful influence of Big Pharma?
The relevant question in not whether our methods are flawed, but how may critique be sustained in the face of all this power.
ladyfern — February 8, 2011
We give them their power.
I have my own bones to pick with Big Pharma, but I'd still unwilling to let the general public off the hook for inviting them to party while at the same time being too busy to think of anything but the promised easier, modern, more scientific way of life over the slower-paced hard work that comes with eschewing some of the good things Big Pharma has produced. Did we make,over the last 140 years, some bad choices that became part of a nearly impermeable weave? Likely. Did we leave interstices large enough to squeeze through in a hurry? Hmmmm...I think we could suck in our guts and manage, but I'm fairly certain that the desire to do so is not there. Face it, we're not even willing to sacrifice a half hour of academics to give a wiggly kid four laps around the building six times a day instead of methamphetamine.
Richard H. — February 8, 2011
As much as my study of Gene Sharp would convince me of the consensual nature of power, that view is balanced by the bounded polity model that figures into more modern developments in social movement theorizing. Some people have greater access to authorities than others. At which point have we conceded power, and what would it take to reclaim it?
On a more personal note, I have been the parent who's resisted giving the wiggly kid methamphetamine in the overall context of "education reform" (more standardized testing and the warping of the curriculum to that end). In my state, who has spearheaded such reform, but the business community. Moreover, anyone resisting the orthodoxy of medicalization in approaching learning problems is paddling upstream against ongoing legitimization of certain "scientific" approaches rooted in power. Indeed, where Ritalin did not succeed as "mother's little pick-me-up" in the 60s and 70s, it has succeeded wildly as a treatment for "ADHD," probably precisely because children lack power. Millennials may especially lack power because they are a minority within the age structure in the population relative to their Boomer parents.
To what extent has the polity contributed to the social goods reaped by Big Pharma, by subsidizing them, and to what extent do we have the right to regulate its aggressive and excessive marketing? Arguably the scientific and business achievements of Big Pharma are separable.
That having been said, we can't neglect the mesostructure, and what is it about the profession of teaching in particular that has made it so pliable to biocentric views of children's learning problems?
ladyfern — February 9, 2011
Richard, some of that I'll wait on for now -- I'm tending alligators in my swamp, so to speak. I did want to acknowledge your personal note, though, as I believe that in honoring childhood itself, we begin to break cycles of powerlessness and reinforce that normal human behavior exists outside the curve, outside current perceptions of normal.
I'll readily admit that I experimented on my child...I unschooled until his last two years of high school. I simply never bought into the common notion that it was my duty to sacrifice my child to upstream paddling unless he was in a kayak.
Going beyond biocentric views, why on earth do we think that children have learning problems? There are myriad ways that children learn, and a wide variety of learnables; institutionally we employ very few of the former to teach a standardized narrow band of the latter. No? But I think you said that...
Reclaiming - whew!