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The n e w e ng l a n d j o u r na l of m e dic i n e

Medicine a nd So cie t y

Debra Malina, Ph.D., Editor

The March of Science The True Story


Lisa Rosenbaum, M.D.

The human understanding when it has once ence mean? And given the uncertainty and error
adopted an opinion . . . draws all things else in the inevitably stuttering scientific process, how
to support and agree with it. Francis Bacon, the do we avoid further fueling distrust?
Father of Empiricism, came to this conclusion
in the 17th century, and some 350 years later, Where Trus t Bre ak s D own
three Stanford psychologists confirmed its valid-
ity.1 They recruited participants with strong be- The belief that distrust in science is widespread
liefs about the death penalty and showed them is actually somewhat unscientific itself. Cary Funk
two studies that had used similar methods, one of the Pew Research Center tells me that public
suggesting that capital punishment effectively trust in science has in fact remained stable for
deters crime and the other suggesting the oppo- decades, according to one well-known indicator
site. Asked to evaluate the evidences quality and that tracks attitudes over time. Recent survey
persuasiveness, participants rated research that data reveal that people trust scientists more than
contradicted their prior beliefs poorly in both any other group except the military to act in the
respects, and unexpectedly, exposure to it result- publics interest,2 and surveys suggest that about
ed in more, not less, polarization between the 7 in 10 Americans believe the effects of scien-
two groups. Speculating about the mechanisms tific research are more positive than negative for
of such biased assimilation, the authors noted society.3 Where trust breaks down is around
that we may interpret weakness of disconfirm- specific topics most notably, climate science
ing evidence as proof of our own beliefs and and the safety of genetically modified foods,
cling to any information that suggests less dam- about which less than half the people surveyed
aging alternative interpretations. trust information from scientists a lot.4 But the
In an era when alternative interpretations are topics on which scientific consensus is rejected
degenerating into alternative facts, I was re- are many, ranging from organic foods lack of
minded of the Stanford study during Bostons nutritional superiority to alternative medicines
March for Science. Tens of thousands of people many unproven benefits. Though people may
in some 600 cities around the world marched trust science in the abstract, when faced with
and rallied to remind the public of sciences facts they dont want to believe, they seek to
importance, demand science-informed policy, prove that the process that generated those
object to science denialism in matters such as facts is untrustworthy.
climate change and vaccines, and advocate for So are there particular pain points in the
sustained science funding. But in a polarized scientific process that people invoke to dismiss
society, what we really need to resist may be hu- scientific findings they dislike? As Harvard psy-
man nature this impulse to believe what we chologist Daniel Gilbert told me, Just the phrase
want to believe. scientific fact is a bad beginning. Recalling
Whether or not marching for science will af- the cautionary teaching from his first psychology
fect policy or public perception, some fundamen- class, Gilbert repeated the warning many of us
tal questions are raised by the rallies, the current hear on the first day of medical school: Half of
political climate, and the evolving dynamics of what were going to teach you is wrong the
science communication. What does trust in sci- problem is we dont yet know which half. Just

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Medicine and Society

as Winston Churchill observed that democracy is dence quality. Just as published clinical guide-
the worst form of government except for all the lines indicate the level of evidence supporting
others, Gilbert notes that science is the worst them, perhaps similar background on the hier-
way to find truth except for every other option. archy of evidence could accompany reports of
He emphasizes that what is often perceived as new findings. Observational studies, which are
a failure of science is in a sense its greatest more abundant and often more provocative than
strength: Only by being in the business of con- randomized, controlled trials, tend to be widely
stantly changing our minds are we getting covered in the media. But whereas industry
closer and closer to truth. sponsorship of trials is frequently emphasized and
Yet it is precisely this fickleness that is often used to call findings into question, no warning
invoked in dismissing evidence-based recommen- accompanies database analyses in which causal-
dations. Nutrition science may be the area that ity can be misleadingly implied.
provides the most ammunition for distrust, given Relatedly, in Caulfields experience, the justi-
the combination of uncertainty, public interest, fication people most frequently invoke for dis-
and powerful preferences. Indeed, skepticism of missing scientific consensus that contradicts
most nutrition science is warranted, given the their beliefs is that science is corrupted by
often insurmountable challenges of controlled, political meddling, scientists ambitions, and
blinded experimentation. But the science is hard industry funding.5 Yet, illogically, research pub-
justification is unsatisfying to many people who lished by a mindfulness practitioner is often
are seeking guidance and are infuriated by con- believed, whereas a consensus from the National
flicting facts. Nutrition science has unique Academy of Sciences on genetically modified
salience because we all eat, and its upsetting to organisms isnt.5 Unfortunately, when we are told
hear that a food we love may cause Alzheimers our views are illogical, we dont generally re-
disease or stroke, especially if wed previously spond with more logical beliefs. Moreover, per-
been assured of its safety. The confluence of ceptions of corruption often arise from stories
these factors creates fertile ground for the logic that, even if rare, are true.
often invoked to condemn the scientific process If we are ever to change perceptions, it is
more generally: Why should I believe evidence critical to recognize the power of such narratives
about x when you people are always changing in fueling distrust of science. The disproportion-
your minds? The fact that we are and that thats ate representation of sciences warts typifies a
our job seems to provide little solace to a weary broader science is broken narrative that em-
public. Can we do better? phasizes the ways science isnt working at the
expense of the ways that it is. We hear about
experiments that cant be replicated, negative
Impr oving Science Communic ation
findings that remain unpublished, and the ubiq-
As tempting as it is to call for better education, uity of bias; much of this criticism arises from
Im not sure how effectively that serves us in real within our own ranks. Academia is lambasted
time. Im familiar with the scientific process, for for an incentive structure favoring quantity over
instance, and still believe evidence on the bene- quality, secrecy over transparency, and exaggera-
fits of chocolate and procrastination, while dis- tion of the significance of our results. Mean-
missing anything that calls into question my way while, remarkable gains in human longevity are
of life. But when we present specific scientific just one manifestation of sciences success
findings to the public, I think we could frame but as a reporter once told me, No one wants to
them more effectively to signal their degree of hear about the plane that lands.
uncertainty and thus enduring credibility. As Tim This preference for exposed folly, in a world
Caulfield, an expert in science communication at where social media rewards those who speak
the University of Alberta, has suggested,5 the loudest and with the most moral certitude, may
media could preface any new finding with what foster a phenomenon social psychologists call
the literature says, on balance, about the topic in pluralistic ignorance, in which most members of
question; readers might then understand that a group disagree with a norm or idea but think
any marked aberration is less likely to be true. everyone else believes in it and so dont speak
Another factor often lost in translation is evi- up. Gilbert thinks a similar dynamic may be at

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The n e w e ng l a n d j o u r na l of m e dic i n e

play in the debate among psychologists regard- impulse, I agree fundamentally with Young: we
ing the fields replication crisis. In 2015, a have lost control of the narrative about science
group of prominent psychologists published a and need to find ways to retell it.
study,6 widely covered in the media, concluding The renowned psychologist Daniel Wegner,
that over half of psychology experiments had who died of amyotrophic lateral sclerosis in
failed to replicate. Gilbert and colleagues then 2013, offered one such narrative, a theory he
published a letter pointing out three key flaws in developed at age 11 about the two types of sci-
the studys own methods,7 suggesting that it entists the bumblers, who plod along, only
therefore didnt clarify the true frequency of once in a while accomplishing something but
failed replication. Unsurprisingly, the article say- enjoying the process even if they often end up
ing psychology is in crisis received far more at- being wrong, and the pointers, who do only one
tention than the letter that said actually, we thing: point out that the bumblers are bum-
dont really know. The letter did receive signifi- bling.9 Though Wegner noted that when a bum-
cant attention from psychology researchers, bler bumbles, the pointers announce it so
however, many of whom wrote to Gilbert, saying widely and enthusiastically that the typical bum-
they agreed with him but had been afraid to bler is paralyzed in shame for quite some time,
speak up. he also emphasized the pointers necessity. Cit-
Gilbert attributes that fear to a shift in the ing William James, Wegner described two fun-
tone of public discussions of science, which I damental impulses driving scientific progress:
suspect contributes to broader conclusions that We must know the truth and We must avoid
science is corrupt and thus can legitimately be error. Wegner concluded that, We need both
ignored. Whereas people debating different bumbling and pointing, grinning credulity and
viewpoints, a process that is critical to the ad- glowering skepticism, if we are ever to establish
vance of science, might once have concluded that knowledge. If we go overboard in either direc-
Dan Gilbert is wrong, notes Gilbert, they now tion, though, we risk a field that is not knowl-
conclude that Dan Gilbert is evil. The fear of edgeable at all.
venturing into the fray means that the public Twenty-five years ago, Wegner worried that
hears far more from sciences critics than its psychological science was shifting too far to-
champions. This imbalance contributes to sci- ward error avoidance, at the expense of novel,
ence is broken narratives ranging from claims albeit potentially wrong, insights. Today, the
about the pervasiveness of medical error to the metaphor seemingly extends beyond knowl-
insistence that benefits of our treatments are edges genesis to its communication. Striking
always overhyped and their risks underplayed. the right balance between truth seeking and
The real uncertainty, if not frank falsehood, of skepticism is critical to both our process and
many of these claims is thus obscured. Mean- how we frame its findings. Our current climate
while, the consequent impressions of scientific of disbelief, I suspect, reflects less an increase in
foul play are easily generalized to the entire scientific error or uncertainty than a communi-
scientific enterprise the next time people en- cation environment in which the pointers have
counter evidence theyd rather not believe. seized the megaphones. Being loud is easily
perceived as being representative.
As we strategize about changing the narra-
Changing the Narr ative
tive, Wegners better-known work on thought
In this charged environment, how do we com- suppression may be equally germane. As he fa-
municate that science, by its nature, has breaks mously demonstrated, when people are told not
but isnt broken? Arguing against marching for to think of a white bear, they find themselves
science, Robert Young, a coastal geologist who is unable to think of anything else.10 Moreover,
concerned about worsening politicization of is- there is a rebound effect: if we are initially try-
sues such as climate science, urged scientists ing to suppress a thought and are then given
instead to go into their communities and famil- permission to indulge it, we focus on the
iarize people with the scientific process.8 We thought far more than if it had never been for-
need storytellers, he wrote, not marchers. bidden in the first place. So although communi-
While I remain sympathetic to the marchers cating sciences dynamic by focusing heavily on

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Copyright 2017 Massachusetts Medical Society. All rights reserved.
Medicine and Society

its failings risks heightening public disbelief, the science & engineering indicators. 2016 (https:/ /
w ww.nsf
.gov/
statistics/2016/nsb20161/#/report/chapter-7/public-attitudes
remedy is not to hide our errors. Such suppres- -about-s-t-in-general).
sion will rebound and undoubtedly fuel fur- 4. Kennedy B, Funk C. Many Americans are skeptical about
ther distrust. Instead, I think we have to learn to scientific research on climate and GM foods. Pew Research Cen-
ter. December 5, 2016 (http://www.pewresearch.org/fact-tank/
tell stories that emphasize that what makes sci- 2016/12/05/many-americans-are-skeptical-about-scientific-research
ence right is the enduring capacity to admit we -on-climate-and-gm-foods/).
are wrong. Such is the slow, imperfect march of 5. Caulfield T. In 2017, lets take back science! Policy Options.
January 11, 2017 (http://policyoptions.irpp.org/magazines/january
science. -2017/in-2017-lets-take-back-science-column-by-timothy-caulfield/).
Disclosure forms provided by the author are available at 6. Open Science Collaboration. Psychology: estimating the re-
NEJM.org. producibility of psychological science. Science 2015;349:aac4716.
7. Gilbert DT, King G, Pettigrew S, Wilson TD. Comment on
Dr. Rosenbaum is a national correspondent for the Journal. Estimating the reproducibility of psychological science. Science
2016;351:1037.
This article was published on May 17, 2017, at NEJM.org. 8. Young RS. A scientists march on Washington is a bad idea.
New York Times. January 31, 2017.
1. Lord CG, Ross L, Lepper MR. Biased assimilation and atti- 9. Wegner DM. The premature demise of the solo experiment.
tude polarization: the effects of prior theories on subsequently Pers Soc Psychol Bull 1992;18:504-8.
considered evidence. J Pers Soc Psychol 1979;37:2098-109. 10. Wegner DM, Schneider DJ, Carter SR III, White TL. Para-
2. Funk C, Kennedy B. Public confidence in scientists has re- doxical effects of thought suppression. J Pers Soc Psychol 1987;
mained stable for decades. Pew Research Center. April 6, 2017 53:5-13.
(http://www.pewresearch.org/fact-tank/2017/04/06/public
-confidence-in-scientists-has-remained-stable-for-decades/). DOI: 10.1056/NEJMms1706087
3. National Science Board. Public attitudes about S&T in general: Copyright 2017 Massachusetts Medical Society.

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