“There is no absolute knowledge. And those who claim it, whether they are scientists or dogmatists, open the door to tragedy.” ― Jacob Bronowski, The Ascent of Man
Science is often portrayed as truth and non-truth. However, science is a construct of humans and is therefore open to error and limits. As famous physicist Bronowski has pointed out, “Science mimics nature, science is not nature itself.” This makes it difficult to conclude anything with 100% certainty. Sometimes I get discouraged in the lab since experiments seem so far removed from what is actually happening in the body; how can you conclude anything? My immunology professor, Al Scott, told me that we can gleam multitudes of information from simplified models, but we must be aware of the inherent limitations. Cautious optimism, that’s what he called it.
There are certain experiments, however, that have been tested many times with the same outcome, where the uncertainty becomes minimal. Take the relationship between cancer and smoking. There have been thousands of studies showing that there is an association between smoking and cancer (read: if you smoke, you are at higher risk for cancer). Notice the wording here, scientists do not say, “If you smoke, you definitely will get cancer.” We can’t actually state this with 100% confidence.
As results trickle down to medical professionals and the public, the association becomes absolute truth: cigarettes are labeled as carcinogens. Doctors make recommendations. Patients trust their doctors. Imagine that a study involving 10 mice comes out, showing most mice in this study did not develop cancer after “smoking cigarettes.” While the scientific community dismisses this data after reading the journal article (the dosage was extremely low, the time course was short), CNN and Fox News run a story saying, “Smoking Does Not Cause Cancer.” The public becomes upset and possibly enraged; they feel betrayed by the public health community. Mistrust grows and the public turns to online sources for their medical information. People believe they know more than their doctors and refuse medical advice.
The public has found out Santa Claus is not real. How can they trust anything we say?
This vicious cycle is common. And it is certainly true of the current ‘debate’ on vaccines and autism. It was just one guy, ex-doc Andrew Wakefield, who published falsified data that spurred on a huge public uproar. It continues to whittle away the trust between public health professionals and the public.
Everyone gets frustrated. The scientists are frustrated at the public’s lack of understanding of scientific principles that seem logical to them. Doctors are frustrated because patients don’t trust in their interventions, and worse, are putting themselves and the population at greater risk for preventable diseases. The public is frustrated because they are scared and feel out of control of their health choices; no one knows who to trust so they resort to, for example, Wikipedia because that’s the only understandable resource available. It’s also frustrating because there are lots of people out there who want to make educated choices, but most likely their last biology class was years ago. Even if remembered, it wouldn’t help to understand the complexity of vaccine science.
It’s easy to blame other domains for this predicament, i.e. our education system sucks, people are stupid, doctors don’t have enough time, scientists don’t have the training… But we must all take responsibility for better science communication. I for one pledge to practice daily how to describe complex science ideas and I will start by writing another Public Health 101 article. I keep putting this off because it’s tough, but it’s so important. What small daily goal can you think of to improve your science communication and understanding?