The March of Unreason: Science, Democracy, and the New Fundamentalism
BMJ 2005; 330 doi: https://doi.org/10.1136/bmj.330.7501.1214 (Published 19 May 2005) Cite this as: BMJ 2005;330:1214
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“Perceived political interests” applies in particular to irrational
and continued prescribing of contraceptive and menopausal hormones. The
evidence that over 60 conditions were found to be increased in the Royal
College of General Practitioners oral contraception study of 46,000 young
women in 1974, the premature discontinuation of the Million Women study,
the Women Health Institute HRT studies and the studies of HRT in women who
have breast cancer, including HABITS (hormonal replacement therapy after
breast cancer--is it safe?), has not stopped exogenous hormone usage.
Of course many women will flee from their medical doctors and seek
out a range of “alternative practitioners” when they begin to realise that
they have lost their health due to their doctors’ prescriptions. Many are
bewildered because associations have been vigorously denied and further
hormone exposures have been promoted enthusiastically as medication.
An excellent example is the increase in osteoporosis in hormone using
countries where the incidence of distal arm fractures in young women has
been six times greater than in men or in women in underdeveloped
countries.1,2 Clearly, increased use of hormonal contraceptives, which
predominantly act like progesterone, have helped to cause osteoporosis in
menopausal women or led to increases in allergic diseases and therefore
fracture-inducing corticosteroid medication.3 We found women taking HRT
had lower white blood cell zinc, lower red blood cell magnesium, higher
serum copper and lower serum bone specific alkaline phosphates levels than
women not taking HRT.4
Almstedt and Snow found that oral contraceptive use in young women
was associated with lower bone mineral density than that of controls. In
analysis of covariance, controlled for age and body mass index, controls
had significantly greater bone mineral density (BMD) than OC users at the
anterior-posterior and lateral spine, femoral neck, greater trochanter,
total hip, and whole body (P<_0.05. the="the" authors="authors" concluded="concluded" that="that" in="in" their="their" cross-sectional="cross-sectional" analysis="analysis" oral="oral" contraceptive="contraceptive" use="use" by="by" young="young" women="women" may="may" compromise="compromise" bone="bone" health="health" during="during" a="a" time="time" when="when" mineral="mineral" is="is" still="still" accruing.5="accruing.5" p="p"/> Attempts to stem world population increases have taken priority over
women’s health and that of their future children.
1 Cooper C. Epidemiology of osteoporosis. Balliere’s Clin Rheumatol
1993; 7; 459-77.
2 Cooper C, Melton LJ. Epidemiology of osteoporosis. Trends
Endocrinol metabolism 1992; 3: 224-9.
3 Little K. Progestogens: thrombosis and osteoporosis. J Nutr
Environ Med 1998; 8; 139-152.
4 McLaren-Howard J, Grant ECG, Davies S. Hormones replacement therapy
and osteoporosis. J Nutr Environ Med 1998; 8: 129-138.
5 Almstedt Shoepe H, Snow CM. Oral contraceptive use in young women
is associated with lower bone mineral density than that of controls.
Osteoporos Int. 2005 May 19; [Epub ahead of print]
Competing interests:
None declared
Competing interests: No competing interests
Since well before the Inquisition some men have sought to elevate
themselves and their clique above others, and one might think that Taverne
has identified just such a clique in scientists. Fortunately most
scientists practise science that is non-discriminatory, and that retains
ideal traits of open-mindedness and modesty; I fail to recognise those
traits in Watts's description of Taverne's work:-
"And not only from social theorists, who are, in practical terms, the
least of his concerns. Animal rights' campaigners, practitioners of
alternative medicine, some politicians and clerics, pressure groups such
as Greenpeace, Friends of the Earth and all forms of what he calls "eco-
fundamentalism"... these and many others are among the enemies of
scientific progress. On account of the nature of science and its reliance
on evidence, Taverne sees any attack on it as an attack on reason. And
because democracy too depends on evidence rather than authority, anything
that suppresses or damages science tends to undermine democracy itself.
Momentous stuff".
Watt's belief that "momentous stuff" consists of accusing "social
theorists, animal rights campaigners, practitioners of alternative
medicine, some politicians and clerics, pressure groups such as Green
Peace, Friends of the Earth and all forms of eco-fundamentalism" of
undermining democracy is extraordinary, not least because so many people
involved in these noble pursuits are themselves scientists in every sense
of the word - and certainly are not "enemies of scientific progress".
Is it not fundamental to science that there is no truth, but a
constant search towards the truth? Is it not fundamental to scientists to
recognise there is no truth - even when faced with perceived 'hard
evidence' - as our perceptions are notoriously fickle, and the truth
requires one to maintain the search generation after generation? That
seems to be the consensus after centuries, in Europe, of scientific
endeavour; each century finds science still short of the truth.
Then what of those who claim they know the truth, are they not the
fundamentalists whose lack of reason fails to meet our democratic
expectations, who are the real enemies of scientific progress?
Regards
John H.
Competing interests:
Practising scientist
Competing interests: No competing interests
I do not know what Dr. Grant means by perceived political interests
and I do not follow her gist of mentioning the explosion of alternative
practitioners.
I do know that the explosion of alternative practitioners was long
overdue, given the fact that we orthodox practitioners have let the people
down. Big time.
The phony bovine droppings of how effective modern medicine is and
how essential, has not been accepted by mainstream Joseph Sufferee,
increasingly, the trend is to run from your doctor and perhaps with good
reason.
Talk about scientific medicine and the like bores me as much as it
does those who ultimately pay the bill, man is not a potpourrie of
chemical compounds who can be beamed up or sideways to put him together
again.
Modern Medicine is perhaps scientific in its own eyes, but it is
really no more effective than it was when it wasn't modern.
Competing interests:
None declared
Competing interests: No competing interests
I agree with Ellen: modern science is wonderful. In the right hands
it can even prove that it is safe to inject babies with mercury.
Competing interests:
Parent of an autistic child
Competing interests: No competing interests
The review and the two rapid responses I have read here are both
interesting. I err on the sides of both science as well as economics.
We all know about the rational economic person. This rational person
bases most decisions not on perfect information, but on some information
that he/ she deems to be adequate for his/ her own risk assessment.
Surely some information is better than not; whether it is in knowing
whether HRT is safe long-term or not or whether it is a good idea to carry
a piece of uranium in your pocket as a lucky charm (like its famous
discoverer did, according to folklore).
The trouble however is that many non-science people today lack basic
science literacy to comprehend complex situations, leave alone have the
ability to ask at least a few right questions to get information.
Value-free science I think is a pipe-dream; every bit of 'good'
science is linked to some economic goal, even if it is only to continue to
get research council funding for the laboratory doing this science.
Competing interests:
None declared
Competing interests: No competing interests
What is truth? What is proof of scientific truth? The answer should
be scientific truth is reproducible in repeated identical experiments. As
John Stone points out much medical “truth” has become what is paid for by
vested interests. Perceived political interests have also fuelled
irrational censorship. Full detailed publication of confounded,
conflicting, and often misleading or mistaken epidemiological studies have
been guaranteed extensive, main stream, “peer reviewed” publication for
many decades.
In contrast, highly significant scientific studies, which irrevocably
refute established medical practices based on these confused or mistaken
epidemiological studies, are often rejected or ignored if published. The
chequered history of the adverse effects of contraceptive and menopausal
hormone use is a brilliant example of lack of emphasis on scientific
truth. These non-scientific attitudes have led to an explosion in the
number of alternative medical practitioners and much bewilderment among
the general public.
Competing interests:
None declared
Competing interests: No competing interests
The issue here is surely not about good science, but about confusing
good science with the commercial objectives of industries (notably the
pharmaceutical and biotech). It is also the case that while no single
person can master all the science that ordinary people are perfectly
capable of taking an intelligent ethical view on the usefulness and wisdom
of new technological developments, and evidently Lord Taverne would even
like to exclude people who are expert who do not agree with him. These are
very odd views for a Liberal-Democrat front-bench spokesman.
Frankly, we need more barriers between government and industry, not
less, and greater protection for the public and the planet.
I posted only yesterday about the context of this polemic in response
to Michael Fitzpatrick's review of David Kirby's 'Evidence of Harm' [1]
[1] 'The background to this article II' 19 May 2005:
http://bmj.bmjjournals.com/cgi/eletters/330/7500/1154#107271
Competing interests:
None declared
Competing interests: No competing interests
relevance of science
Unless we judge strictly by the criteria of science itself, which
are
limited to quantitative measurements, it is not obvious that the
degree of human happiness or meaning has increased much
over that of the hunter-gatherer tribes. On the other hand the
threats to our survival as a species brought by the technology and
commerce derived from science have multiplied in scale and
complexity to the point where it is unlikely that any effort of
science ( or politics ) will be sufficient to stem our march to
catastrophe. It might be time to ask if the particular type and realm
of reason used by science is really of paramount importance to
the rest of us.
Competing interests:
None declared
Competing interests: No competing interests