Manipulating science

I picked up Devra Davis's The Secret History of the War on Cancer again, her sweeping indictment of the role politics has played in the science of epidemiology vis-a-vis health risks of smoking. The book is a great read, as it not only gives you the history of the fight, but also helps one understand the skepticism related to the methods we use to tie toxic exposures to adverse health outcomes.

One fascinating aspect of the story is the metastasis of public relations into the scientific discourse. On page 193, Davis quotes from Edward Bernays' 1928 book Propaganda:

"The conscious and intelligent manipulation of the organized habits and opinions of the masses is an important element of a Democratic society. Those who manipulate this unseen mechanism of society constitute an invisible government which is the true ruling power of our country.... We are governed, our minds are molded, our taste formed, our ideas suggested, largely by men we have never heard of. This is a logical result of the way in which our Democratic society is organized.... In almost every act of our daily lives, whether in this year of politics or business, in our social conduct or our ethical thinking, we are dominated by the relatively small number of persons... who understand the mental processes of the masses. It is they who pull the wires which control the public mind."

Note the split into the rulers and the sheep, the manipulation, the invisible governance, and again the manipulation. Sound familiar? For those of you not familiar with Bernays, he is generally considered to be the father of the public relations field. He was also the nephew of none other than Sigmund Freud, and, upon reading Freud's ruminations on the human psyche, adapted many of his ideas to manipulate consumers. In fact, it was Bernays who made it not only socially acceptable, but even desirable for women to smoke.

But I digress. What is the relevance of this quote from Bernays as used by Davis? Well, this was the strategy utilized to keep the mounting data on the dangers of tobacco from becoming credible. The popular tactic this strategy yielded was to have learned men with loud reputations refute the scientific basis of the reality of harm. Sound familiar?

I am not saying that the "learned men" of today are willfully obstructing the public from seeing the dirty underbelly of what medicine has become; I do not ascribe nefarious motives to them. However, given that we even have to ask the question "Should the public be told about the trouble with medical research?", it is an issue well worth discussing.

As you know, I am a great believer in transparency in both research and lay discourse. I believe that without a robust debate about topics that are far from clear, regardless of what the "learned men" will have us believe, we do harm to the society in several ways. First, lies damage relationships. Second, obfuscation creates distrust and sets up an adversarial atmosphere, which eventually leads to subversion of intentions, no matter how noble. Just look at the vaccine "debate" and how polarizing and destructive it is to both individual and public health. Third, it is manipulative and disrespectful, presuming lack of intellectual sophistication in our population. And while I am well aware that our literacy and numeracy are at an all time low, catering to the lowest common denominator is nothing but accepting and propagating the status quo. A better solution, though more time-consuming, is to start to fill these education gaps to improve our collective ability to engage in an edifying discussion.

To assert, as has been done here, that questioning any aspect of either the vaccine usefulness or the science of evolution for that matter equates to supporting the "anti-vaxers" or creationism, betrays a deep misunderstanding of how science is advanced. Indeed, it is by questioning certain aspects of science that do not seem to make sense that scientists both gain a better understanding of these ideas and at the same time demonstrate to the public how different our ways are from the entrenched dogma of organized religions.

I for one am proud of the process of science, and for this reason am working to bring what is under the hood out in the open. If we hide the messy uncertainties of our craft, we are doing a disservice to ourselves, our patients and the public at large. Worse yet, we are engaging in the manipulation, thus relegating scientific method to the wastebasket of PR and politics.