This entry is going to contain a lot of stuff that's been swirling around in my mind for several weeks, and I'm not sure it all quite fits together, but I want to put some thoughts out there.
The first trigger was that I tangentially got involved in one of those discussions
about whether science is better than religion. I normally don't bother with that argument because it's boring and frequently stupid, and also because I don't think it's a meaningful comparison. Science is not only no good, but completely irrelevant, for organizing a regular rota of visitors to check up on an old lady with Alzheimer's who is estranged from her daughter. Religion is not only no good, but completely irrelevant, for understanding how prions in the old lady's brain aggregated to cause her to lose her memory and functionality. (I have no intention of asserting that atheists never visit lonely senile people, just that they don't use science to do so, because they are not idiots.)
But anyway, I joined in with this discussion because pw201
is intelligent and interesting, and there was an issue of terminology I was curious about. The discussion led to Paul asserting (relevantly):
I think it is fair to say that the established results of the physical and biological sciences are less likely to be overturned than those of the social sciences. Evolution is a fact, current theories of anthropology will be outdated in a few decades.
Woah! That really, really brought me up short. I mean, it's trivially not true, but even if it were it wouldn't be a good thing
! The whole point of why science is "better" than religion as a way of understanding how the world works is that scientific theories and models get changed when someone finds new data that contradicts the old view. This is a really good example of the way that selling science as an alternative to religion does a massive disservice to science (I care surprisingly little about vocal atheists misrepresenting religion): it leads to people, intelligent people I respect, trying to treat science as a source of eternal verities. I also absolutely disagree that physical science is inherently better than social science; it just isn't, but trying to cram science into the niche where religion or Humanism or other philosophical systems belong can really easily lead to that sort of misguided hierarchy between branches of science.
The thing is, "believing in" science in this way doesn't just offend me as a scientist; it kills people. ( science is not magic! )
And yes, that goes for medicine too; there is lots of really vital medical information that just isn't going to be found by doing randomized controlled trials and measuring the physical outcomes and applying statistics. Partly because a lot of randomized controlled trials that would be informative are also unethical. And partly because the information that can be measured physically isn't always the most important; "how fast do babies put on weight?" can be measured easily, but a more important research question is "how likely are babies to die for no discernible reason?"
Drug trials are (relatively) easy to carry out in the time-honoured "hard" science way; you give the drug to half the patients and a placebo to the other half, and you measure objective parameters about how well the two groups do. I'm in no way arguing against doing this kind of experiment – hell, I spend most of my working life doing that myself – but it doesn't mean that drugs are the best possible treatment for all possible conditions! For example most patients with joint pain would prefer physiotherapy and exercise rather than strong painkillers (and by the way, the reason I know this is because social scientists did serious research into the issue, not because some arrogant biologist assumed that his credentials totally qualified him to throw together an internet survey.) There is some evidence that the former has more benefits and fewer side-effects for a greater proportion of patients than the latter. But it's rather harder to do a double-blind trial of physiotherapy, and you can't use pure bioscience to answer questions like "how well do patients on this regime integrate into their communities and lead normal lives?" which may be as important as "what is the level of pain-related chemicals in the bloodstream of patients taking this drug versus a placebo?"
And thirdly, I suppose, don't put too much faith
in the scientific process. In the best possible circumstances it is slow and inefficient and people get harmed while science is sorting out the answer to difficult questions. When we're talking about medicine, individual variation within the population is inevitable, and however good the evidence is for a particular treatment, that best treatment will do nothing for or actively harm a proportion of patients. And to be honest, the best possible circumstances don't always apply; it's hopelessly naive to believe that all science is pure and unbiased and free of the influence of culture and political and financial considerations! Criticize superstition and woo and political bias, of course, but don't couch your criticisms in terms of assuming that the scientific mainstream is always right. That's bad rhetoric and it's atrociously bad science.