Tuesday, February 8, 2011

Science and its Application: Teaching Between the Lines

by Earon S. Davis, J.D., M.P.H.
Adjunct Professor, School of Health Sciences
Kaplan University

One of the things I enjoy most about teaching is that I get to start with all the relevant science and then proceed to the space between the facts - to the space where we are talking about human life, human health and welfare.  Our intellect may be able to grasp the reductionist products of science and the deductionist conclusions of "experts"(real and imagined) but what we really care about is what we find between the lines, in the process of making science and its interpretation meaningful and accessible to others.

I have spent years in the fields of environmental health, public health policy and environmental law, and now find myself immersed in complementary and alternative medicine and nutrition.  Like the environment, there are lots of facts about nutrition, lots of research, and even more opinions from the various interest groups as to what they mean.  In both environment and health sciences, we are told that we know what the healthy choices are, and that it is a question of will power and education as to which choices we make.  We are told that people just don't care to make the right choices.

In the environmental field, we know that this is both true and false.  We have a good deal of science, but it is so infused with politics and economic interests that we can't get our government to make the decisions necessary to protect our health and welfare, and our future.  For some unknown reason, there is preciously little research funding for answering the questions that could jeopardize industrial interests involved with the revolving door between government, industry and consulting firms.  There are so many toxic chemicals and biological and physical threats to which we are exposed that the costs of measuring the adverse impacts of any one substance are immense, certainly beyond the means provided by a Congress dependent upon private financing for their omnipresent re-election campaigns.

We all know this about environmental issues.  We know this about the struggle to allow complementary medical systems and modalities into the mainstream.  Where does the money come from to meet the double-blind, placebo-controlled standard required by the medical industry?  Of course, there is a double-standard because existing practices of mainstream medicine are very often not required to meet such a high burden of proof.  What's good for the goose is not necessarily good for the gander.

In the field of nutrition, the same observations hold true.  There is science, to be sure, but much is absent, often by design.  Who is there to be sure that the public is protected when that would mean costly changes and/or lost profit opportunities to businesses?  Who is there to create a level playing field in which consumers are protected from potentially harmful products that are engineered and marketed with great intensity and intelligence?  In the 20 years it may take to prove that a product, or type of product, is causing serious health problems, by the time a consensus emerges from the usual free-for-all of lobbying and spin-doctoring, the easily correctable problem (don't allow it to go to market) becomes terribly complex and difficult to manage without tremendous efforts and dislocations.  The end result, often, is that business products and byproducts are almost granted a presumption of innocence unless proven guilty.  The "precautionary principle" and regulatory systems are too often seen as a nuisance thwarting economic growth.

And so, the job of teaching in the health sciences involves both science and art, the art of balancing what we know, with what we don't know.  It is a realm of immense complexity where we really have more uncertainty than certainty.  Do we teach students that our limited knowledge is good enough to assert as truth?  We can teach students the latest research studies and the latest government guidelines, but how do we prepare them for the vast array of changes they will encounter during their lifetimes?  I think that we can do this by focusing on the spaces between the lines, by helping students to understand their own reactions to information and scientific studies and to allow them to experience the ways in which people are manipulated for the benefit of vested interests, even when their intentions are completely honorable.

Students come to school expecting to be taught the truths that science has revealed.  They'd like it all neatly wrapped up with no loose ends.  But life isn't that way.  Science is a process and not a product.  Technology is a tool and not a panacea.  It is susceptible to a vast array of flaws and failings, which may be ignored when it is in somebody's interest to do so.  Often, that's the bad news we have to break to them.  But from the way they are responding, perhaps it is also the good news.  When we treat science as a dynamic process, and recognize the infusion of politics into most areas of scientific debate, there is greater hope that we can correct our errors and create a new balance which respects both business opportunities and the long-term needs of our people.


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