Ethics in Science and Medicine

I would like to begin this discussion on Ethics by telling you my impression of how a scientist thinks. First, the scientist must have an open mind. If you tell me that an elephant can fly through the eye of a needle without scraping its ass I would say “show me the data”! Every idea no matter how ridiculous must be approached with an open mind. Even ideas that sound strange such as; the world is round, or that the Earth actually revolves around the Sun and not the other way around, must be given a chance. Once you have accepted the question the hypotheses can be formed and tested.

 

A difficult notion for beginning scientists to wrap their heads around is that the experiments that they will perform will never prove anything. That’s right! The results from an experiment no matter how convincing only provide support for a hypothesis or theory. Good scientists never use the word prove. Lawyers and fools may throw the word “prove” around but good scientists never do (if in fact you read or hear that science has proven the benefit of “their” product/treatment/etc… this is a sign of quackery). There have only been a handful of theories ever proven and these we call “scientific laws”. The belief that a single experiment can prove something is one of the most common errors in logic made by lay people with regards to science. For example, an individual may believe that a ridiculous treatment such as Wolfberries “cured” their Uncle Joe. It’s ridiculous because the results from one non-random-controlled case study performed without a control group provides very little data to a scientific argument. This reminds me of a great line I heard in the movie “Two Weeks Notice” where the actress tells the actor that he is” the most selfish person on the Planet” to which he replies, “that’s ridiculous, have you met every person on the Planet”? A hypothesis about people cannot truly be proven because not even the largest of sample groups can include every person on Earth.

Once you have a hypothesis about the question to be tested you must simply follow what the evidence tells you without bringing your own preconceived notions with you to the table. You must go where the data leads you. This is where Ethics comes into play. We can all cheat at our jobs and scientists can cheat on almost every type of test that we perform. Scientists by nature do not, and cannot, cheat. You see, every thing we now study is based upon the rules and lessons learned in the past. Every piece of data is like a brick in a building. If we continue to build up, and up, and up, upon bricks that are false and are forged from lies, then the whole building could come crashing down upon us. That is why Ethics in science is so incredibly important. Every great discovery in science is found by a scientist that is standing on the shoulders of the giants that came before them.

 

The reason why I find snake-oil science to be so despicable is because of the great importance of Ethics in science. Once we start following unproven scientific claims as real science the whole thing can come crashing down upon us. The result would be that we would lose the ability to tell what is real and what is not. It seems to me that the line is already becoming blurred to the general public because of snake-oil salesmen as typified by Kevin Trudeau. Pseudo-science seems to be gaining momentum by actually attacking real science by purporting a vast scientific medical conspiracy. This type of propaganda is perhaps most evident with regards to cancer treatment. As a cancer researcher I find this to be morally irreprehensible. Think about it this way: almost every Doctor and Scientist has had someone close to them die of cancer (haven’t you also?). To believe that these Doctors and Scientists actually knew of treatments that would save their loved one’s lives and refused to divulge this “top-secret information” is utterly ridiculous. If you think that I would not share my knowledge of brain tumors with my own Mother when she was diagnosed with a brain tumor known as a meningioma, then you are being ridiculous.

 

Because the truth, and Ethics, are so vitally important in science and medicine we cannot treat people by giving them false hope. The placebo effect is very real and is part of every treatment regimen whether it is from a legitimate or illegitimate source. However, it is wrong ethically, morally, and legally for a Doctor to lie to a patient and give them a placebo instead of a scientifically verified treatment without written informed consent as part of a controlled clinical trial. To treat people with “medicines” and treatments in which the only benefit is the placebo effect is inherently wrong for these exact reasons. To reiterate these reasons: because we cannot permit health care professionals to lie to their patients even if it will help the patients. That would create a slippery slope wherein the Physician could judge for themselves when and how lying to their patients would help them. Do you want your Physician lying to you? What if it would help you?

 

I recently heard of a study that suggested that the placebo effect was responsible for as much as 65% to 80% of the effectiveness of anti-depressant medication. However, it would be malpractice for a Physician to give a depressed person a placebo rather than a real anti-depressant medication. However, this is precisely what an “alternative medicine” practitioner is doing. The vast majority of pseudo-science treatments rely on the placebo effect as their only positive effect. To sell these treatments to the public is in fact selling a placebo treatment as a real one and is wrong. You may ask yourself; what does it hurt? If someone wants to believe that the electromagnetometer can heal them, and it does in fact help them due to the placebo effect, what is the harm? The harm is that first of all some people will not be able to discern for themselves what is a silly yet soothing treatment and those that think that they can forego their chemotherapy because this treatment will “cure” their cancer. If we allow snake-oil salesmen to claim anything they wish under the guise of “what’s the harm if we are lying to you if it helps you”, then where does it stop? Are we left trying to figure out whether our Doctor is lying to us every time we go to his/her office? A very slippery slope indeed!

 

There really is no such thing as “alternative medicine”. There is only experimental medicine and medicine. Once a medicine or treatment is verified as being legitimate through double-blind controlled clinical trials it simply becomes known as MEDICINE. Therefore, the term “alternative medicine” is misleading and unnecessary. If a Physician could treat a patient’s condition with an “E-Meter” or by “cupping” then why wouldn’t they? If cupping had significant support for its effectiveness as a treatment the Physician would simply whip out their cups and go to work!

 

Ethics is one of the most important values that a scientist has. Moreover, I believe that this carries over into all aspects of our lives. If someone lies to you it will be a long while before you can believe that person again (if ever). Ethics are so vital to the field of science because scientific findings build upon each other based on the veracity of previous findings. That is why once a scientist is caught lying their career is virtually over. It takes a special kind of person to be a Doctor or a Scientist and the vast majority are not liars.

~ by hbfarmstrong on December 5, 2008.