Science vs "Science"

It's got a lot to do with how you get your information, whether you trust science or not. And it's got a lot to do with whether you're exposed to real science or "science."

Like this "science"...



This product has been "proven by science," so we're fools not to buy it! I find that if I'm not watching a Nova or Nature or an episode of anything with Morgan Freeman or Stephen Hawking, most everything else that talks of science on the television is trying to sell me something. Most everything else is "science."

It seems like every beauty product advertisement is using "science" to convince me that I'm butt ugly and that to fix it (or prevent it from worsening) I should give them my perfectly good dollars. It's "science" after all.

I'm kind of stunned that it's legal for for-profits to cry "science" when it's their own study, when they merely asked opinions as evidence for effectiveness, or when they didn't do any studies at all. Science isn't allowed to be so biased. Science is supposed to want to improve your life first and foremost, not con you out of your money.

I'm not just thinking about this today because I've been hibernating this February, plopped in front of the tube, absorbing horrifying beauty ads through my aging, sagging wrinkled face. (I really should take care of it better by smearing money all over it.) I'm thinking about all this right now because of my friend Alice Roberts's nice piece "Childbirth: why I take the scientific approach to having a baby" posted on the Guardian Saturday.

Trends to move childbirth out of the hospital setting have put pressure on mothers and fathers to make decisions about what to do when it's time for theirs. You'd assume that because there's a movement to move things home that it's because some smart, science-minded, compassionate folks have figured out that it's healthier. If you can't stand the draconian and bloated government/insurance mogul-run healthcare system, a movement might feed your existing suspicions or opinions that there could be better ways to have a baby than by blindly following orders that these profit-motivated fascists at hospitals bark at us. 

But why assume that home childbirth folks are any less biased, less vested, less driven by self-interests? I don't know but it just seems so common for people to give rebels the benefit of the doubt more often than tradition, than institutions. (Something about "honest signaling" might have just popped into your mind if you've been trained in evolutionary theory.) What Alice found is that information on, that is, data or evidence for, what's healthiest--home or hospital or otherwise (birthing centers, for example)--is kind of difficult to come by!

For starters, she writes, 

"This is partly because the overall risks of maternal and neonatal death are now very small (about five per 100,000 women die in childbirth and four per 1,000 babies), so large numbers of mums are needed to assess relative risks. Maternity provision differs between countries, so looking at risks in other countries, even in Europe and the US, may not be terribly helpful."

Within that small risk there is a lot of jockeying for your support. So the second reason, she says, that makes it hard to find information is, 

"the politics of birth. It can be quite hard for mums-to-be to access impartial evidence and advice when it seems there are plenty of people wanting to influence your decision in one way or the other. Evangelical advocates of home birth often talk about the importance of women's choice and empowerment, as well as instilling distrust in obstetricians. For me, being empowered to make a decision requires access to good evidence and the freedom to make up my own mind. And whilst "maternal satisfaction" is often put forward as an important factor to be taken into consideration, I want to know what the relative risks are. And if there's not yet enough evidence to assess that – I want to know that too."

You'd think we all do. You'd think we all want to know the answer to "where and how will the risks be lowest for having my baby?" But we don't all hold  the belief that it's our right to know the answer to that, the way Alice knows it is, the way Alice demonstrates that it is. And it's not just an issue about the dissenters and the movements spinning information and evidence so we'll see things their way--a very real problem that Alice walks us through in the article. It's the doctors too.

Since the article's been posted in various places I've seen commenters complain how they asked their doctors for papers and numbers to help them make their birth plans and the doctors wouldn't go there. I've never had to make a birth plan but I've had similar experiences with doctors like when, for example, I asked for non-hormonal birth control options because I saw no reason to continue ingesting the stuff when the risks for long-term use aren't known and I was now married and ready to stop taking the pill. My doctor laughed at my question, laughed when I asked for a diaphragm or anything like it, and tried to convince me without any scientific evidence that the pill was fine to take your whole life.

Do I think medical decisions should lie completely in patients' hands? Of course not. We can't all be doctors. But they've got to be better ambassadors of science. They've got to be the best. They've got to be science.

It can't be up to us to figure it out for ourselves, not just because we shouldn't have to but because some of us are terrible at it when we try. This includes bright young people at my university, one for example who had a whole textbook on reproductive biology to answer this homework essay question: Write the life story of an egg. Because she cited it, I know that instead of using her high quality resource, she went straight to livestrong.com for all of her information.

Because of movements like the anti-vaccinators and all the people without celiac disease who won't eat gluten, it's easy to worry that unscientific trends with birth will dial back mortality rates to medieval ones. Heck, it's tempting to worry that when videos like this get around to some people who love all things PALEO, they will make it so.

No wonder so many of us can't trust climate scientists and evolutionary scientists. When it comes to our health, "science" has an agenda that's not always first and foremost what's best for us. When it comes to our beauty, "science" smells like money. If this is all we know of "science" then I'm less surprised of the push back against biology, ecology, climate, space exploration, etc... that to us scientists seems downright ridiculous.

If we're going to get non-scientists on board with real science, we need to take the word back.

The Remarkable Fact That We Actually Know Anything!

Scientists always say they are working at the frontier of knowledge (we usually increase the self-praise by calling it the 'cutting edge'). But that's a trivial way to express vested interest, really, because things that are known are not being explored by science, so in a sense it's the definition of science to be studying what we don't already know.

On the other hand, what we do know is rather remarkable when you think of the complexity and elusiveness of Nature. DNA and molecular interactions can't be seen the way ordinary objects and interactions can. We are dealing with very large numbers of very small particles interacting in very many ways. In fact, everything genetic, genomic, and cellular turns out to be related to everything else (to oversimplify a bit).

Yet, almost no matter what you may ask about, Googling will reveal a substantial, usually rather huge, literature on the subject. Nonetheless, the subject isn't closed, the problem not 'solved', and the complexities are manifest.

One can ask, for example, about the genetic involvement or cause of a disease, even a rare disease of variable or multiple symptoms, and find that something is known about its molecular cause.

It may be a neurotransmitter problem, or an energy metabolism one, or a developmental anomaly, etc. Variants at some gene(s) are usually known that 'cause', or at least are involved with, the trait. Yet if you dig deeper, the stories are not very tight. Prediction from gene to trait is, with some usually-rare exceptions, not that strong, and often treatment, and almost always prevention, remain elusive. Is this because we just haven't gotten around to figuring these things out, or because we don't know how to know them? Do we need a new way to think about complexity?

It's remarkable in many ways that we know anything about these problems, even if it's equally sobering how difficult it is to truly understand them. It's a combined testimony to the power of research methods, the army of investigators employing them, but also the way in which these methods reveal facts as well as uncertainties. Often the tag line in papers or the news is about what we know, and what we don't know is kept quieter. Some believe that with time and resources, our methods and technology will finish the job. Others would say that if we believe that, we are not really accepting and dealing with complexity head-on as we should. And, as we wrote yesterday, it's always sobering to realize that the assumptions we base our knowledge on may themselves be faulty--but we never know at the time which ones they are or what's wrong with them.

There's probably no one way to view this. But, still, it's amazing how much we do know about things that are so little and complex.