by Lee McIntyre
Yet we still must face the problem of those who reject the scientific attitude outright. Those who do not seem to understand that ideologically based beliefs like intelligent design are not scientific. Those who indulge in denialism about well-warranted theories like global warming based on a fundamental misunderstanding of how science works. We will deal with those problems in chapter 8. First, however, we must face an even lower low. In the present chapter, we have seen the scientific attitude at its best. In chapter 7 we will explore it at its worst.
Notes
1. As we will see in this chapter, though, the birth of modern medicine was beset by numerous setbacks, resistance, and failure to translate understanding into practice, until the scientific attitude was firmly in place.
2. W. Bynum, The History of Medicine: A Very Short Introduction (Oxford: Oxford University Press, 2008), 108. See also W. Bynum et al., The Western Medical Tradition 1800–2000 (Cambridge: Cambridge University Press, 2006), 112.
3. It is important to note, though, that Lister did not “invent” antisepsis, although he is the person most responsible for finding an effective technique and making it routine. See Roy Porter, The Greatest Benefit to Mankind: A Medical History of Humanity (New York: Norton, 1999), 370. Even this technique, however, was resisted by some; see Porter, Greatest Benefit, 156.
4. Bynum, History of Medicine, 91.
5. Though the word scientist was not invented until 1833 (by William Whewell), there was of course the earlier Latin word scientia, which led to the sixteenth-century use of the word scientific that can be roughly translated as “producing knowledge.”
6. Bynum, History of Medicine, 91. See also Bynum et al., Western Medical Tradition, 112.
7. Porter, Greatest Benefit to Mankind, 9.
8. Porter, Greatest Benefit to Mankind, 57.
9. Porter, Greatest Benefit to Mankind, 77.
10. Porter, Greatest Benefit to Mankind, 76.
11. Even though some had hoped to grab onto the spirit of scientific advancement that arose as a result of the Enlightenment, “medicine failed to match the achievements of experimental physics or chemistry.” Porter, Greatest Benefit to Mankind, 248.
12. Porter, Greatest Benefit to Mankind, 11.
13. Porter, Greatest Benefit to Mankind, 245. It is intriguing to ask why this happened. Porter speculates that “historians have sometimes explained this apparent paradox of Enlightenment medical science—great expectations, disappointing results—as the consequence of over-ambitious theorizing” (248).
14. Porter, Greatest Benefit to Mankind, 11, 274. Some, however, will see this as unfair. While it is true that the theory behind vaccines was based not on bench science but on experience with milkmaids and their immunity against cow pox, it was Edward Jenner who embraced the scientific attitude by suggesting “but why think? Why not try the experiment?” (276). Only then, when observation was tested in experiment, did the clinical breakthrough go forward.
15. Porter, Greatest Benefit to Mankind, 284, 305.
16. Lewis Thomas, The Youngest Science: Notes of a Medicine Watcher (New York: Viking, 1983), 19–20.
17. Ira Rutkow, Seeking the Cure: A History of Medicine in America (New York: Scribner, 2010), 37.
18. Rutkow, Seeking the Cure, 37–38.
19. Rutkow, Seeking the Cure, 44.
20. Cristin O’Keefe Aptowicz, Dr. Mutter’s Marvels: A True Tale of Intrigue and Innovation at the Dawn of Modern Medicine (New York: Avery, 2014), 31.
21. Porter, Greatest Benefit to Mankind, 306.
22. “Being guided by practice and case-oriented, medicine was slow to change. The microscope had been in existence for two hundred years before it became part of everyday medical practice and transformed understanding.” Porter, Greatest Benefit to Mankind, 525.
23. For anesthesia, some of the holdouts felt that using anesthesia on a woman in labor contradicted the Bible, which said that children should be born in pain as a punishment for original sin. They felt that it was wrong to prevent people from “passing through what God intended them to endure.” Rutkow, Seeking the Cure, 59–60.
24. Porter, Greatest Benefit to Mankind, 431–432.
25. Porter, Greatest Benefit to Mankind, 432.
26. Porter, Greatest Benefit to Mankind, 433.
27. Rutkow, Seeking the Cure, 66.
28. No less a thinker than Rudolf Virchow resisted the germ theory of disease, saying at one point, “If I could live my life over again, I would devote it to proving that germs seek their natural habitat: diseased tissue, rather than being the cause of diseased tissue.”
29. Rutkow, Seeking the Cure, 79.
30. This quotation comes from John Hughes Bennett, a surgeon and professor in Edinburgh, who continued: “Show them to us, and we shall believe in them. Has anyone seen them yet?” Porter, Greatest Benefit to Mankind, 372.
31. Porter, Greatest Benefit to Mankind, 436.
32. Porter, Greatest Benefit to Mankind, 442.
33. Porter, Greatest Benefit to Mankind, 674.
34. Bynum, Western Medical Tradition, 112.
35. Porter, Greatest Benefit to Mankind, 525.
36. Porter, Greatest Benefit to Mankind, 525.
37. Porter, Greatest Benefit to Mankind, 527.
38. Porter, Greatest Benefit to Mankind, 527.
39. Thomas, Youngest Science, 28, 35.
40. James Gleick, Genius: The Life and Science of Richard Feynman (New York: Pantheon, 1992), 132.
41. Paul Starr, The Social Transformation of American Medicine (New York: Basic Books, 1982).
42. Starr, Social Transformation of American Medicine, 39.
43. Starr, Social Transformation of American Medicine, 56.
44. Starr, Social Transformation of American Medicine, 57.
45. Rutkow, Seeking the Cure, 105.
46. “What fundamentally destroyed licensure was the suspicion that it was an expression of favor rather than competence.” Starr, Social Transformation of American Medicine, 58. Eventually this attitude was swept away by the developments of science (59).
47. Between 1802 and 1876 (which encompassed the era of Jacksonian rebellion against medical societies) sixty-two commercial medical schools opened in the United States. Porter, Greatest Benefit to Mankind, 530.
48. Starr, Social Transformation of American Medicine, 104.
49. Rutkow, Seeking the Cure, 124.
50. Porter, Greatest Benefit to Mankind, 530.
51. Porter, Greatest Benefit to Mankind, 119.
52. Rutkow, Seeking the Cure, 147–148.
53. Porter, Greatest Benefit to Mankind, 530–531.
54. Starr, Social Transformation of American Medicine, 120–121.
55. Rutkow, Seeking the Cure, 164.
56. Bynum, Western Medical Tradition, 112.
57. Porter, Greatest Benefit to Mankind, 456.
58. Thomas, Youngest Science, 35.
59. Porter, Greatest Benefit to Mankind, 455–456.
60. There is an excellent account of this story in James Le Fanu, The Rise and Fall of Modern Medicine (New York: Carroll and Graf, 1999), 5–15, and also in Porter, Greatest Benefit to Mankind, 455–456.
61. Le Fanu, Rise and Fall of Modern Medicine, vii.
62. Le Fanu, Rise and Fall of Modern Medicine, 5.
63. Le Fanu, Rise and Fall of Modern Medicine, 160.
64. Porter, Greatest Benefit to Mankind, 455.
65. Le Fanu, Rise and Fall of Modern Medicine, 201.
66. Le Fanu, Rise and Fall of Modern Medicine, 9.
67. Le Fanu, Rise and Fall of Modern Medicine, 10.
68. Porter, Greatest Benefit to Mankind, 460.
7 Science Gone Wrong: Fraud and Other Failures
To anyone who cares about the scientific attitude, one might think that fraud is a perfunctory topic. People who commit fraud are just cheats and liars, who obviously do not embrace the values of science, right? Why bother to examine it any further than that?
We must start, though, by facing the problem at its worst. Fraud is the intentional fabrication or falsification of the scientific record.1 In the case of mere error, one’s fidelity to science is not at issue, for one can make a mistake without the intent to deceive. But in the case of fraud—where any flaws are deliberate—one’s commitment to the scientific attitude is squarely in question. In any activity as open and dependent upon the work of others as science, this is the one thing that cannot be tolerated. When one signs on to be a scientist, one is making a voluntary commitment to be open and honest in learning from experience. By committing fraud, one is putting oneself and one’s advancement ahead of this. Ideology, money, ego, and self-interest, are supposed to take a back seat to evidence. It is sometimes said that—because scientific ideas can come from anywhere—there are no heretics in science. But fraud is the one true form of scientific heresy; it is not that one’s theories are different, it is that these theories are based on invented data. Thus fraud is seen as much worse than error, for fraud is by definition intentional and what is at stake is nothing less than a betrayal of the scientific attitude itself.
Mere error turns out not to be very scary for science. As long as one has the right attitude about learning from empirical evidence, science is well equipped to deal with mistakes. And this is a good thing, because the history of science is replete with them. I am not here talking about the pessimistic-inductivist claim that in the long run most of our scientific beliefs will turn out to be false.2 I am talking about the enormous errors and dead ends that knocked science off its track for centuries at a time. Phlogiston. Caloric. Ether. Yet it is important to point out that these mistakes were not frauds, and, in fact, they were in some cases pivotal for coming up with better scientific theories. Without phlogiston we might not have discovered oxygen. Without caloric we might not understand thermodynamics. Why is this? Because science is expected to learn from error. If one embraces the scientific attitude and follows the evidence, error will eventually be rooted out. I suppose one might try to make the same case for errors that are introduced by fraud—for if science is self-correcting these too will eventually be found and fixed. But it is just such an enormous waste of time and resources to chase down the results of intentional error that this is where most scientists draw the line. It is not just the consequences of fraud that lead it to be so despised, it is the break of faith with scientific values. Nature is subtle enough; scientists don’t care to deal with any additional challenges created by deception.
But it is important to remember that there is another source of defect in scientific work. Between fraud and honest error, there is a murky category where it is not entirely clear whether one’s motives are pure. As we saw in chapter 5, scientific error can come from fraud, but it can also come from sloppiness, cognitive bias, willful ignorance, or laziness. I hope already to have established that the scientific attitude is a robust tool to mitigate error, whatever the source. Yet here—on the verge of claiming that fraud is the worst sort of affront one can make against the scientific attitude—we should revisit the question of how to divide these sources of error along the lines of intentional versus unintentional motivations.
The key here is to be explicit in the definition of fraud. If we define fraud as the intentional fabrication or falsification of scientific data, then there are two possible ways to read this:
(1) If one has committed fraud, then one has intentionally fabricated or falsified data.
(2) If one has intentionally fabricated or falsified data, then one has committed fraud.
As we know from logic, these two statements do not imply one another and it is therefore possible for one of them to be true, while the other is not. In this case, however, I think that both of them are true. If one is committing fraud, then it has to be intentional. As we saw in the broader definition of “research misconduct” (given in note 1 to this chapter), if a mistake is due to “honest error” or “difference of opinion,” it is not considered fraud. For fraud, it is necessary to have the intention to deceive. But we must then ask whether if one commits fabrication or falsification intentionally, this is sufficient for fraud. It is. Fabrication and falsification are not just any kinds of errors; by their very definition, they cannot be done by accident. So the minute one engages in these kinds of behaviors, it seems to automatically constitute fraud. We might thus seek to define fraud by combining (1) and (2) into the following biconditional statement: “One commits fraud if and only if one intentionally fabricates or falsifies scientific data.”3 Yet this still leaves open the crucial question of how to define intentionality. Is there perhaps a better way to characterize fraud to make this clear?
Let’s turn now to the scientific attitude, and see what leverage this might give us in understanding the concept of scientific fraud. Throughout this book, I have been arguing that the scientific attitude is what defines science; that it can help us to understand what is special about science and why there is unique warrant behind scientific beliefs. Since I just got done saying that fraud is the worst sort of crime one can commit against science, it would seem to follow that fraud must constitute a complete repudiation of the scientific attitude. But now consider the following two ways of interpreting this claim:
(3) If one has committed fraud, then one does not have the scientific attitude.
(4) If one does not have the scientific attitude, then one has committed fraud.
There is an obvious problem here, for I think that thesis (3) is true, but (4) is not. How could that be? With thesis (3) it seems obvious that if someone has committed fraud, that person does not have the scientific attitude. To fabricate or falsify data is in direct conflict with the idea that one cares about empirical evidence and is committed to holding and changing one’s beliefs on this basis. So why then is thesis (4) false? The issue is a subtle one, for in some situations thesis (4) may well be true, but the issue here is that it is not necessarily true in all cases.4 To say that “if one does not have the scientific attitude, then one has committed fraud” is to make a large presumption. First, one has to be investigating in an empirical field; literature does not have the scientific attitude, but so what? Second, one is presuming that if one has the wrong attitude during empirical inquiry, one will definitely act on it. But we know from human behavior that this is not always the case. And third, what about the issue of intentionality? From thesis (2) above, it seems that if we have committed an intentional error then we have committed fraud. But the issue here is that there are many different levels of intentionality and many different reasons why someone might not have the scientific attitude.
As we saw in chapter 5, it could be that some researchers are the victims of unconscious cogn
itive bias. Or perhaps they are just lazy or sloppy. Are they also frauds? There could be a whole host of subterranean psychological reasons why not having the scientific attitude is not someone’s fault. It is not necessarily intentional when someone violates the scientific attitude. But here is the key question. What about those cases in which someone does intentionally engage in shady research practices? What about all of those less-than-above-board research practices like p-hacking or cherry picking data that I was railing against in chapter 5? Why aren’t those considered fraud the minute they are done intentionally? But the relevant question to making a determination of fraud is not just whether those actions are done intentionally, it is whether they also involve fabrication or falsification. Remember our working definition of fraud: the intentional fabrication or falsification of scientific data. (Recall too that this is a biconditional relationship.) The reason that p-hacking isn’t normally considered fraud isn’t that the person who did it didn’t mean to; it’s that, as egregious as it may seem, p-hacking is not quite up to the level of falsifying or fabricating data. One is misleading one’s scientific colleagues, perhaps, but not fabricating evidence. One may be leaving a study open to get more data so that one can publish, but this is not quite falsifying.5
Consider an analogy with lying. To tell a bald-faced lie is to say something false while knowing that it is false. But what about those instances where we have not lied, but we have not exactly told the whole truth either? This is patently dishonest, but not (quite) the same as lying. This is precisely the analogy we are looking for to mark off the difference between questionable research practices and fraud. P-hacking, selective data reporting, and the like are not considered fraud by the standard definition because they do not involve fabrication or falsification of data. Yet they are not altogether honest either.6 They are intentional deceptions that fall short of fraud. They may be a crime against the scientific attitude, but they are not quite a felony. If done intentionally we should hope that these practices can be exposed and discouraged—and even that the scientific attitude (which helps us to understand what is so wrong about fraud) may provide a tool to help us do this—but this does not mean that we should confuse them with fraud.