Unenduring Truths
By Gretchen Gibbs
While my health today is excellent, five years ago I was diagnosed with breast cancer, a potentially life-threatening experience that also made me feel like a fool. I had the estrogen-positive variety of the disease, meaning it had been stoked by estrogen, prescribed by my gynecologist. This is a familiar story, how estrogen was regarded by the medical profession as a way to lessen the chances of breast cancer, but when the “best science” study was conducted, it was discovered actually to increase rates of the illness.
For the past few years I have been taking the standard post-treatment for my kind of breast cancer, a drug which counteracts the effects of whatever estrogen the body is still producing, and leads to some nasty side effects including severe arthritis, hot flashes, and depression. In the past weeks I have found new articles in the Times and Wall Street Journal showing how in some conditions estrogen does reduce the likelihood of breast cancer.
What’s a person to do? New directives from medical science are always contradicting the old ones. Don’t eat eggs. It’s OK to eat eggs. Eat margarine, not butter. Eat butter, not margarine. Drink eight glasses of water a day. Don’t bother. Most of these changes are laughable, but the breast cancer example, at least for me, is not.
I was educated to believe in scientific progress. Medicine might make mistakes, but these would be corrected with time, and eventually we would understand almost everything about how the body works, just as we would understand the workings of the atom and the universe. A recent article in the New Yorker by Jonah Lehrer about the scientific method questions this premise. Entitled “The Truth Wears Off,” the article describes the “decline effect,” the phenomenon that, over time, “truths” in science become less able to be proved. Second generation anti-psychotic drugs, for instance, once provided dramatic improvement for patients compared to their functioning under the older class of drugs. Today, studies are concluding that the old drugs are cheaper and just as good. Lehrer describes a number of similar declines in what we have regarded as scientific truths, in the social and physical sciences.
The possible reasons he describes for the “decline effect” are several. Unless the study is a clear double blind, with neither experimenter nor subject aware of which is the experimental and which the control condition, biases from both participants can affect the result. Significant experimental findings are sometimes a consequence of unusual variation in scores, which will diminish on retest, a phenomenon called regression to the mean. Journals are only likely to accept significant findings, so that negative findings languish in the experimenter’s desk drawer. Granting agencies and pharmaceutical companies do not want to submit negative findings to journals. All of these factors contribute to a spate of positive findings in our scientific journals which do not hold up well on retest.
While Lehrer is not attacking the fundamentals of the scientific method themselves, he is implying that science, as it is practiced, is not likely to arrive at enduring truths. He concludes that once the experiments are done, we still have to choose what to believe. This is a troubling notion, since neither Lehrer nor anyone else has come up with criteria to help us choose. The danger is that science will be rejected altogether, with a kind of New Age arbitrariness, leaving us victim to charlatans and quacks. While there may be other avenues to truth, rejection of science seems to me dangerous.
I would like to come up with some criteria to help us choose what to believe. I would like to find some way to reassure myself and others that science is the right path. All I can say is that I think medical science played a role in causing my breast cancer, since I had few risk factors other than taking estrogen. Yet I know that the next time I’m ill, I’ll go to the doctor, not the shaman, and see what’s prescribed. I may not take it though.
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Gretchen Gibbs is a clinical psychologist and Professor Emeritus at Fairleigh Dickinson University. She is currently writing, and working at a domestic violence agency. Reach her at guestwriter@zestoforange.com.
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