Wow folks….10 weeks later we are coming to the end. This is a shorter one than the rest of the series, but I think it’s still important. Up until now I’ve been referencing science as thought it can always provide the guidance we need if we just know where to look. Unfortunately that’s not always true. It’s at this point that I like to step back and get a little bit reflective about evidence and science in general, and how we acknowledge what we may never know. That’s why I call this section:
Acknowledging our Limitations
Okay, so what’s the problem here?
The problem is that just like research and evidence can be manipulated, so can lack of research and evidence. The reality is that there are practical, financial, moral and ethical issues facing all researchers, and there are limits on both what we know at the moment and what we can ever know. A lack of evidence doesn’t always mean someone’s hiding something. Unfortunately, none of this stops people from claiming it does. This normally comes up when someone is explaining why their opponent’s evidence doesn’t count.
What kinds of things should we be looking out for?
Mostly calls for more research. It’s tricky business because sometimes this is a perfectly reasonable claim, but sometimes it’s not. Sometimes it’s just a smokescreen for an agenda.
For example, in 2012 two doctors from the CDC were called in front of Congress to discuss vaccine safety. As part of the hearing, Congressman Bill Posey asked the doctors if they had done a study on autism in vaccinated vs unvaccinated children. You can read the whole exchange here, but the answer to the question was no. Why? Well, a double-blind placebo controlled trial of vaccines would be unethical to do. For non-fatal diseases you can sometimes do them, but you can’t actually knowingly put people in the way of harm no matter how much you need or want the data. To give a placebo (i.e. fake) measles vaccine to a child just to see if they get sick and die or not would be unethical. The NIH requires studies to actually have a “fair risk-benefit ratio”, so there either has to be low risk or high benefit. I work in oncology and have actually seen trials closed to enrollment immediately because data suggested a new treatment might have more side effects than we suspected.
A Congressman looking in to vaccine safety should know this, but to anyone listening it might have sounded like a reasonable question. Why aren’t we doing the gold standard research? What are they hiding?
Other examples of this can be asking for evidence such as “prove to me my treatment DOESN’T work“.
Why do we fall for this stuff?
Well, mostly because many of us never considered it. If you’re not working in research, it can be hard to notice when someone’s asking for something that would never get past the IRB. Even if something would be ethical, it’s hard to realize how tricky some studies would be. In something like nutrition science this is rampant. I mean, how much money would it take for you to change your diet for the next 30 years to scientists could study you?
I took a “Statistics in Clinical Trials” class a few years ago, and I was surprised that nearly half of it was really an ethics class. Every two years I (and everyone else at my institute) also have to take 8 hours of training in human subject research, just to make sure I stay clear on the guidelines. It’s not easy stuff, but you have to remember the data can’t always come first.
So what can we do about it?
Well first, recognize these limitations exist. We can and should always be refining our research, but we have to respect limits. Read about famous cases where this has gone wrong, if you’ve got the stomach for it. The Tuskegee Syphilis Experiments and the Doctor’s Trial that resulted in the Nuremberg Code are two of the most famous examples of this, but there are others. The more you know, the more you’ll be prepared for this one when you see it.
All right, that wraps up part 10! I think I’m going to cut this off here and do my wrap up next week. See you then!