Battle in Print: Longer, healthier, happier? Human needs, human values and science

Raymond Tallis, 24 October 2007

Why is scientific expertise and science itself so often regarded with suspicion while nonsense about science and nonsense passing itself off as science seems to be having an increasingly easy time of it? In part this is due to myths: that applied science is running into insuperable difficulties and is failing to deliver on human needs; and that, even if it is delivering, it is doing so at a unacceptable price - that of undermining human values. Challenging these myths will be a necessary preliminary to making major progress in the public appreciation of science. (I use the word ‘appreciation’ deliberately, to encompass both understanding and celebration.)

This essay has four strands. First I will look at recent evidence of the continuing impact of science on the health and well-being of humanity as a whole. Secondly, I will celebrate science itself, not only on account of its extraordinary practical achievements, but also as a supreme expression of the most profound human values. Thirdly, I will examine the allure of junk science, which exploits negative myths about science, and observe how parasitic it is on the real thing, whose language it both appropriates and domesticates. And, finally, I will argue that such ‘spiritual’ shortcomings as science has lie not within science but in a fundamental characteristic of human consciousness of which it is a supreme and beneficent expression. These are large themes and my treatment of them will be inevitably superficial but enough, I hope, to provoke discussion.

The beneficial impact of science

It seems almost ridiculous to labour the beneficial impact of science. And yet it is necessary. In a publication from the Institute of Ideas What is Science Education For? Gerry Lawless (2006) reported a survey that found that ‘fewer than 50 per cent of the British public believed that science played a positive role in society’. A recent MORI poll conducted for the OST at first suggested a more cheerful picture with 85 per cent believing that science made a good contribution to society. However, only 71 per cent thought that the benefits of science outweighed the risks and only 44 per cent disagreed with the statement that the risks outweighed the benefits! (MORI 2005). I am going to focus briefly on an area close to my heart: medical science - at the very least to answer the ‘longer’ and ‘healthier’ questions in my title. I shall come to ‘happier’ presently.

Medicine has two fundamental aims: firstly, the postponement of death from physical illness; secondly, the reduction of suffering due to bodily ailments. Science-based medicine has delivered magnificently on both those aims.

Let us first focus on life expectancy. Between 1800 and 2000 average life expectancy worldwide more than doubled, increasing from less than 30 years in 1800 to nearly 67 in 2000 (Riley 2007). Life expectancy increased in the UK in the twentieth century dramatically: a male born in 1900 had an average life expectancy of 45 years and a female 49; by 2000, these figures had increased to 76 and 81 respectively (ONS 2001). The more recent figures for the UK might startle even those weary of hearing of the demographic revolution. Life expectancy at birth increased by nearly a decade in both men and women between the late 1940s, and the mid-1990s; in males from 66 to 74.4 and in females from 70.5 to 79.6 (Kelly 1998). These trends continue. According to a report by the House of Lords Science and Technology Committee, life expectancy in the UK is increasing at a rate of about two years for each decade that passes (House of Lords 2006).

The trends are especially striking for people who have already reached later life. A recent study of men with private pensions showed that their life expectancy at 65 had increased from 83 years and 2 months in 1997 to 86 years and 7 months in 2005 and an anticipated figure of just under 90 years by 2015 (UKSAFIA 2005). The pace quickens. The mortality rate of males between 65 and 74 fell by 20 per cent between 1901 and 1969. Subsequent 20 per cent falls took 17 years, 10 years and six years respectively (Paternoster 2007). The so-called Gomperz curve - the exponential relationship between age and mortality - seems to be flattening: death rates are slowing down in extreme old age and tending to a ceiling (Manton 2005).

Extraordinarily, this wonderful news has been greeted by some with cries of woe. The miserabilists argue that, while we may live longer, this is at the cost of an increase in the burden of suffering, often at the hands of well-meaning hi-tech medicine. They will be bitterly disappointed to learn that this is not the case. That living longer means more time to be ill is certainly true. The question, however, is whether in practice people are living with illness for a longer time. We may imagine four possible scenarios associated with increased life expectancy:

* One year of additional illness for every year of life gained;
* Less than one year of additional illness for each year of life gained;
* No additional illness for each year of life gained;
* Less overall illness despite life gained - so-called ‘compression of morbidity’.

Which scenario is coming to pass? The truth is, despite some very good data from the USA and certain European countries we are not entirely sure exactly what is happening. One thing that seems to be clear is that the gloomiest scenario is not transpiring. While it is probable that total life expectancy in the UK is increasing at a slightly faster rate than healthy life expectancy, both appear to be increasing.

The best information comes from the very large databases - tens of millions of individuals - examined by Manton and others in the USA. According to the National Long Term Care survey, between 1982 and 1999 disability rates in people over 65 have decreased from 26.2 per cent to 19.7 per cent (Manton 2001). This is double the decrease in the mortality rate, and it is accelerating. In Denmark, a study conducted over the last decade has shown a compression of morbidity, with the period of chronic illness before death showing a slight reduction, despite increased longevity, indicating what is possible (Bronnum-Hansen 2005).

Why are the trends not so worrying as might have been expected? In part this is due to improvements in the prevention and treatment of illnesses that cause chronic disability. A good example here is stroke, the commonest reason for severe disability in later life. Two studies in Oxford separated by 20 years, examining the same population (Rothwell 2004), found that the age-related incidence had fallen dramatically. Consequently, instead of the anticipated increase of about 30 per cent in total strokes (due to the ageing of the population studied), there was an approximately 30 per cent fall.

If we play our cards right, things will continue to get better, for two reasons. Firstly, we could make much more progress in postponing the onset of disabling diseases by universal application of the knowledge we have now. And secondly, the biological ageing that occurs in parallel with illnesses means that death will be postponed less than the onset of disabling illness. The continued application of science-based medicine means that we may look forward to a future life in which, to use Grimley Evan’s (1997) formulation, ‘we will not only spend a longer time living, we will spend a shorter time dying’.

Such changes in life expectancy and health expectancy do not impress those who wish to diminish the role of science in human wellbeing. They will argue that they are due largely to wider social changes: wealth, income and economic development; nutrition and diet; changes in behaviour; and literacy and education. In fact these changes - most notably public health measures - are informed by science in many cases, have often been made possible by science-based technology, and, more broadly, by the rationality which science promotes and exemplifies. Besides, recent demographic trends in developed countries show improvements are due largely to increased life and health expectancy in later life, rather than decreased infant mortality. These latter are driven by advances in science-based medicine in the narrow sense. Consider the spectacular decline in cardiovascular mortality in the last 30 years from approximately 275/100,000 annually in 1970 to approximately 100/100,000 in 2003 (BHF 2007). Deaths from coronary heart disease have fallen by 44 per cent in the last 10 years alone (Unal et al. 2004).

So science is helping us to meet, with increasing success, the most fundamental human need: for a long and largely healthy life. But are we happier? I don’t think I, or anyone else, knows. If one were to believe much of what is in the press, the nation’s cerebral serotonin levels are falling even as you read this: the word is out that material progress, driven by science, has not brought happiness. Reported levels of happiness, however sophisticated the measuring and sampling techniques, do not strike me as being quite as objective and reliable as, say, reported measures of blood sugar. Soul biopsy is a primitive art and our estimates of lifetime area under the curve of human happiness are not robust. But it seems unlikely that the reduction of premature death, of prolonged disability, and the huge amelioration of the appalling discomfort from cold, hunger, infestation, injury, infection that was the lot of most people in pre-modern times, would be a potent source of unhappiness. It may of course impact less on our willingness to declare ourselves happy but this latter may be more related to expectation than to actual moment-to-moment experience. At any rate, we seem to be living longer healthier, and not definitely unhappier.

All of this is very disappointing for those who wish to see science as a source of problems rather than of solutions. Peter Medawar spoke of the tendency to emphasise the miscarriages and overlook the benefactions of science. If the benefits seem beyond question, the alternative strategy of emphasising the things that go wrong is mobilised. Anti-science hysteria - which often gets in the way of looking round for the best rather than the most ideologically attractive solutions to problems - is a pandemic in itself but I shall take one example: the disaster at Chernobyl, which has achieved an almost iconic status. John Gray spoke of it as ‘a warning against human hubris’ (Kaplinsky 2007). It was of course nothing of the sort: it was the result of criminal negligence of the kind one might expect in a state - the USSR - that was corrupt from top to bottom. The most reliable estimate of the number of deaths from the incident is the UN-backed Chernobyl Forum estimate of an eventual total of 4,000, less than the 6,000 killed in coal-mining accidents in a single year in China. Greenpeace claimed that between 1990 and 2004 alone 200,000 died, a figure that helps to support the general idea that science is bringing the nemesis that follows hubris. This idea is, amongst other things, a manifestation of the Prometheus complex, a misplaced or leftover piety; the fear that, once Prometheus stole the fire from the Gods, Apocalypse would eventually follow.

Science and human values

Let me turn now to my second theme: science and human values. The assumption is that, even if science delivers, and even delivers happiness, it does so at the cost of dehumanising us, and transgressing fundamentally human values.

This is a well-worn theme and one can trace its history, as I have done in Newton’s Sleep (Tallis 1995), at least as far back as the Romantic movement, particularly in Germany and England at the end of the eighteenth century. It has been expressed with increasing loudness in recent generations, especially by green movements, parties and campaigns. Homo faber, we are told, no longer respects the natural world which he will destroy, thereby ultimately, and inevitably, rendering the Earth uninhabitable. There is even a strain of anti-science, whose classical expression was in Adorno and Horkheimer’s (1972) Dialectic of Enlightenment, that suggests that industrialisation of death in modern wars is an expression not only of the technological possibilities opened by science but also of the spirit of science itself; that we should see the concentration camp, rather than immunisation or international airlifts of food aid, as the quintessential products of the scientific world picture. Interestingly, Primo Levi, who spent a year in Auschwitz, felt that physics and chemistry, supposedly the most inhuman of the sciences, were ‘an antidote to Fascism…because they were clear and distinct and verifiable at every step, and not a tissue of lies and emptiness, like the radio and newspapers’ (Levi 2000). And the rhetoric of fascism was organicist and anti-science, even though Fascist regimes exploited science to the full in pursuit of their unspeakable ends.

Of course, the efficacy of science has increased our power to do harm, individually and collectively, deliberately and unintentionally. To defend science on the grounds that it is intrinsically neutral and that it does not and cannot dictate what is done with the knowledge it brings, and the technology it makes possible, and that the proper role of science is not to dictate goals and aims but, once goals and aims are established, to suggest the most powerful means of achieving them, is to invite brickbats. Such a defence will merely confirm to some that science, by being intrinsically value-free - except in the choice of things it wishes to investigate - is irresponsible and amoral and thus inimical to the values of man the shepherd of being, the steward of nature, and so on.

Hostility to supposedly amoral science goes hand in hand with a sentimental view of Mother Nature. The bleak truth is that nature doesn’t care too much for us or for the people we love. Or it cares as much for the tapeworms in the gut of a child dying of the anaemia caused by the tapeworms as for the child itself. A sentimental attitude towards nature makes it easier to question the ethics of science. But even if hostility to science is merely a kind of ethical tourism - given that its loudest critics never cease to help themselves to its benefits at every moment and in every aspect of their lives - I want to take it seriously, and defend science, not only on the basis of its contribution to meeting human needs but also on the values - deeply and magnificently human values - which it expresses.

It is easy to overlook what underpins even the seemingly smallest technology and what obstacles had to be overcome in order to advance practical knowledge. Humanity had not only to find ways of transilluminating the opacity of the natural world but also to shake off what, if I may appropriate William Blake for purposes he would most certainly have disapproved of, we might call ‘mind forg’d’ manacles.

This is particularly evident in medicine, the youngest science. Its progress to useful truth took place in the face of prior (theological and other) convictions. It had also to overturn ‘common sense’ and mediated ‘cultural’ intuitions about the nature of health and disease. These man-made barriers were often supported by systems of thought, themselves backed up by institutions with authority, power and menaces; and by the less organised forces of deception and self-deception. On top of all this, it had to insert longer and longer chains of argument, knowledge, and expertise between the body and its care for itself. In short, medical science had to transform the self- consciousness of the hominid body into a vast corpus of mediated understanding (Tallis 2007).

There are other aspects of the scientific endeavour that are insufficiently acknowledged and should confirm its standing as a paradigm human activity. The first is that science is seemingly effortlessly global. Physicists in Russia, USA, and Brazil speak the same language and subscribe to the same broad theoretical framework and the same principles of inquiry within that framework and the same principles for modifying, improving or even overthrowing that framework. A scientific journal is a meeting place for people from a multitude of cultures, a cognitive United Nations. A single issue of a leading journal such as Nature will have contributors who originate from dozens of countries. This is connected with the fact that the technological applicability of science has a core of understanding which is not culturally relative: an antibiotic’s effectiveness against a particular kind of infection is not influenced by whether the patient is a woman living in Wessex or a gentleman living in the Gobi Desert.

The cultural invariance of scientific facts is also a reflexion of the uniquely powerful methods it employs to acquire reliable knowledge and to differentiate between knowledge, opinion and error. The means by which new data may be acquired and hypotheses and general theories tested, the well-founded separated from the ill-founded, have been matured in a very unforgiving environment and marinated in the sea of bitter experience. The intense hunger for ever greater understanding, for explanatorily or practically more powerful principles, and the competitiveness of scientists (often seen as a fault) has meant that science is in a permanent state of self-criticism. Looseness of thinking, sloppiness of observation, which are routine in everyday life, have an unhappier time in science that they do in other spheres of life.

The centrality of self-criticism was beautifully described in Richard Feynman’s famous commencement address to students at Cal Tech. In this, he speaks of scientific integrity as

a kind of leaning over backwards ... Details that could throw doubt on your interpretation must be given, if you know them ... If you make a theory ... you must put down all the facts that disagree with it, as well as those that agree with it. [And] you must make sure, when you are explaining what it fits, that those things it fits are not just the things that gave you the idea for the theory; but that the finished theory makes something else come out right, in addition (Feynman’s 1985).

This is both elementary and a counsel of perfection. It is not always adhered to of course, but it is difficult to imagine Feynman’s advice being part of a commencement address for lawyers, salesmen, advertising executives, alternative therapists, politicians, or even journalists, for whom - with some honourable exceptions - the supreme value is the good story.

Such integrity prevails not because scientists are uniquely honest but because dishonesty in science is uniquely ill-rewarded. Any rewards that accrue to cheats tend to be short-lived, as the tragic case of the South Korean stem cell researcher Dr Hwang Woo-suk demonstrated so dramatically. Self-criticism - ‘The Limitations of This Study’ section of the paper - is a pre-emptive strike on your critics, those peers who can judge the validity of your findings. And no one is immune from criticism. Einstein, in the 40 years after he had published one of the greatest scientific theories of all time - the general theory of relativity - had few takers for his subsequent ideas on unified field theory; and his opposition to quantum mechanics was largely ignored. Authority per se carries little authority in science.

Those who resent the power of science - except when their own well-being is at issue and they help themselves to its fruits - often claim that the collective authority of the scientific community is just as oppressive, perhaps more so, than that of revered individuals. And it has been argued that it stifles debate, that it closes minds, and prevents ‘maverick’ ideas, which may be original and true, from getting a fair hearing. This argument was rolled out when, on the basis of very poor science, Andrew Wakefield asserted a causal relationship between MMR and autism. It was backed up with the usual claims of a ‘closing of ranks’ by something called the science establishment that is interested only in the status quo, its tenure and its backhanders from Big Pharma.

In a rather extraordinary quite recent example of populist hostility to science, Richard Smith, once editor of the BMJ, has argued that clinical trials are so distorted by the bias built into their design and publication, so riddled with fraud, and so compromised by the influence of Big Pharma, that they and medical journals, whose publications are dependent on peer review, are in need of a radical overhaul (Smith 2006). The fatuous measures he suggests are not our present concern, but his premises are. In view of the transformation in the outlook for patients with vascular disease over the last two decades I described earlier, on the basis of clinical trials, Smith must believe hat the human body itself is in hock to the pharmaceutical industry, the myocardium can be bribed by the promise of free lunch and the vascular tree is susceptible to spin.

Of course, sometimes mavericks who are also geniuses find it difficult to get their views heard, taken seriously or judged fairly. But not routinely. There is always a balance to be struck between the almost continuous revisions and occasional revolutions in science on the one hand, and deliquescence into anarchy, or a collective delirium in which every paradigm-busting idea is accepted at once. Everyone will be familiar with Groucho Marx’s (I think) quip: ‘They said Newton was mad and yet he was a genius. They said Einstein was mad, and yet he was a genius. They said my Uncle Louis was mad - and he was.’ It seems quite likely that for every Einstein there are 100 Uncle Louis; for every mistreated Semmelweis asserting the connexion between poor hygienic practices and puerperal fever , there are dozens of Peter Duesbergs denying the link between HIV and AIDs.

Interestingly, its openness to change of mind has been also used against science, as casting doubt on its truth claims. Some humanist intellectuals, who sociologise scientific truths, partly on the basis of a misreading of Thomas Kuhn’s (1970) radicalisation of Popper’s claim that the ideas that become dominant in orthodox science enjoy this status not because they are closer to the truth but because of the power of certain institutions and, more broadly, certain discursive communities to impose their interpretations on the world at large. This is nonsense, but just worth rebutting.

First of all, while there are revolutions in scientific thought, there are important achievements that are passed on from one generation to the next, either unchanged, or as part of the fabric of a wider understanding. Archimedes’ brilliant hydrostatic principle and his laws relating to the lever are still valid and useful: they are not children of their time, the product of a particular discursive community or political power structure. And Newtonian mechanics still provides an accurate description of the motion of material bodies good enough for the vast majority of circumstances. And the same is true of much clinical knowledge. The fact that medical advice changes does not gainsay that there is, by a process of hunting, or successive approximations, increasingly robust knowledge of how, for example, to prevent and treat heart attacks, as the data I have referred to earlier demonstrate so eloquently.

One of the greatest virtues of science - that it is above all a collective enterprise -may be why it is under-rated. While it has its megastars, the great bulk of science has been built up by ants like me contributing their orts of chaff to the ant heap. Unlike art, it is massively greater than the sum of the contributions of the great remembered figures. This has lessons in the conduct of human affairs more broadly; at the very least as to how to pursue great human enterprises without those enterprises falling victim to the human-all-too-human. In science we see individual arrogance and certainty, sometimes associated with brilliance, reined in by collective humility, cooperation, internationalism, submission to the highest standards of criticism, honesty; in short, by a mandated scrupulousness barely matched elsewhere in human affairs. Scientists are allowed to dream and to give their imagination free play but God help them if they mistake what they imagine, their dreams, for reality.

So there we have it: the outlines of a case for the defence. Science has brought immeasurable practical benefits, it has widened our understanding beyond this, and its methods, practices and institutions provide an example of rigour, cooperation and global convergence of understanding that humanity would do well to imitate elsewhere. So how does the word get round that science is problematic and even somehow inhuman? What is wrong with science?

Science phobia and junk science

Its worst fault is that it is difficult. Fully understanding many sciences requires being au fait with concepts that have no part in everyday life - something to which I will return - and science offers few concessions to the innumerate. The standards it sets for the acceptance of empirical claims are daunting. The way scientists operate also makes the uncertainty that surrounds their claims explicit - through, say, the use of p values and confidence intervals - is alien to a world of PR and hype. And this connects with another virtuous weakness: it is up front about its failures. While, overall, science is a story of extraordinary progress and success, from the viewpoint of the individual scientist science is largely a story of failures. Indeed, these failures are the basis of its success, just as evolution to more complex or more successful organism depends upon a multitude of mutations, the vast number of which will be deleterious. Junk science is not exposed to this evolutionary process. True science is full of disappointments, while charlatans win a prize every time.

Ironically, it is the cumulative success of science that has created the conditions under which it is more exposed to criticism. So many of the things it has produced go right - for example most technology most of the time - that we notice only those things that go wrong, and when things go wrong it is a scandal. When the flight is uneventful and the plane lands safely and on time, passengers are more sensitive to minor problems such as the orange juice not being cold enough.

The honesty of science about its limitations, its often reported failures, provides an ideal environment for anti-science, junk science, to flourish, which in part depends upon exploiting the problems and failures of science. Even so, junk science should have nothing going for it; it should be laughed to scorn by even a half-educated public. The fact that it is cognitively primitive - in, for example, its assumption that the plural of anecdote is scientific data - doesn’t seem to tarnish its image. Indeed, this is a selling point. As Bertrand Russell famously said, ‘popular induction depends upon the emotional interest of the instances, not upon their number’ and the error of confirmation bias is the very stuff of everyday belief-formation. Even so, it seems puzzling that two equally dispiriting - and if one may use the word, complementary - trends can co-exist: a free-floating attitude of suspicion towards real science and the authority of those who support it; and credulousness towards junk science and the authority of its advocates. So what is the explanation?

Granted that junk science finds a space for itself in the gaps that true science is honest enough to admit to, exaggerating the latter’s failures and underplaying its successes, falsely accusing it of inhumanity, and appealing to the residual cognitive primitive in all of us, this would not be enough to give it credibility. There must be something more to it than its factual and methodological errors. So what does it bring to the party? Here are three things: authority attached to persons; a language borrowed from real science; and intuitive attractiveness. Let us examine them in turn.

The first - authority attaching to persons - is well illustrated by the power of celebrity endorsement (Sense About Science 2007). We can all think of examples and so, for the sake of their families, I shall not name names. The point is that when ideas are attached to celebrities they have faces. The ‘authorities’ who protest against their crackpot, ignorant ideas are faceless, like me. Celebrity or guru endorsement, of course, belongs to the pre-enlightenment dark ages from which science has escaped. The greatness of science, as we have seen, lies in part in its contempt for the argument from authority. The separation of truth from power relations - or, indeed, public relations - may be its greatest achievement. In junk science the intuitions of the famous are sufficient to define what is true. This may have catastrophic consequences when the famous in question are also powerful and are able to influence science policy and practice. Think of Thabo Mbeki, whose denial of the link between HIV and AIDs, based on junk science, has already cost hundreds of thousands lives in South Africa (McGreal 2002).

The second striking feature of junk science is its use of the terminology of real science. This brings me back to Richard Feynman’s wonderful essay ‘Cargo Cult Science’ (Feynman 1985). Cargo cults were founded on the belief that Western goods had been manufactured by ancestral spirits and were intended for Melanesian people. They reached a peak when large quantities of military materiel were dropped on Pacific islands during the Second World War. The cultists believed that more could be made to drop by imitating certain surface features of the relevant technologies. So they set up runways, made radios out of coconuts and straw and headphones out of wood, staged ‘drills’ and ‘marches’ with twigs for rifles, and so on.

And this is how it is with junk science that appropriates terms from real science, without any sense of their true meaning, and of the massive interconnected hinterland of facts and concepts and even uncertainties behind them. And so we have treatments such as ‘reflexology’ which expropriates a well-established, indeed central, concept in biological science, and uses it to label treatments that have no biological foundation whatsoever. And ‘homoeopathy’ which, being in Greek, one of the languages of science, sounds very scientific but is based on magic thinking that would shame a six-year-old child. Often Greek and Latin are combined in barbaric macaronics. The most amusing example is ‘scientology’, which is so keen to protest its credentials that it falls just short of calling itself ‘Ologyology’. This appropriation of the external apparel of science - the wooden headphones - is a backhanded compliment to the science they traduce or even despise.

Part of the allure of junk science is that it seems to bring science and everyday sense closer. So when a lifestyle guru asserts with an ignorance matched only by her reckless irresponsibility, that breast cancer can be headed off by massaging the lymphatic system, she seems to reconcile lifestyle type things - massage - and science-type things - the lymphatic system supplying the breast (Sense About Science 2007). The illusion of meaning, in which cell biology is assimilated to Hello! magazine, is achieved. But it is an illusion. For science has been developed only through resistance to our tendency to fall back into presuppositions drawn from primary common sense, much of which will have been shaped by folk belief or ill-digested science.

Indeed, to think scientifically is unnatural. As Lewis Wolpert (1992) has pointed out, ‘the way in which nature has been put together and the laws that govern its behaviour bear no apparent relation to everyday life’. We have to overcome the prejudices that dog us at every level of consciousness from immediate perception to the most abstract thoughts. Perceptual inferences, ingrained habits of thought, ruling secular and religious ideas - so many and various are the obstacles to acquiring robust knowledge. They can be resisted only by the discipline imposed by the community of scientists and their practices, with quality controls on competence and honesty. This was the ethos that Richard Feynman spoke of so eloquently. Science, once it moves out of this sphere, is in great danger of being misunderstood, and profoundly misrecognised. Even scientists themselves, when they leave their own field, are in danger of dropping some of the caution they exhibit when they are playing in front of their home crowd.

Science and human consciousness

This takes me to my final, and perhaps most important, theme. Why is science, which has delivered so much, and has been utterly in tune with human values, regarded as somehow alien? It is, I believe, because science is the most developed, even the most extreme, expression of an aspect of human consciousness that causes us an almost metaphysical discomfort (Tallis 2005). It belongs to that part of human awareness which is least at ease with itself.

Humans are uniquely knowing animals: they transcend their individual bodily sensations to know that objects exist, that events take place, that such-and-such is the case. This explicit sense of the existence of states of affairs independent of sensory experiences lies at the root of our awareness of being situated in a natural world that has intrinsic properties, causal relations, and its own laws; and this lies at the origin of the massively organised nosiness that is science. We live not only in our own bodies and a world of immediate experience but also in a lattice work of facts, propositions and surmises constructed by millions of strangers. This is true of everyday life: we inhabit a world of words as well as a world of people and things. But science is the most developed product of this community of minds, of a mode of consciousness that is remote from the immediacy of sense experience.

While the factual knowledge we live in, by, and among lifts us up from nature and enables us to engage the natural world on more favourable terms, it also creates a great division within us. We are divorced from an immediate sense of being what we are, as presented through ordinary experiences. And we find it very difficult to be the facts of our case and even more difficult to be the scientific facts of our case. We would not, of course, wish to revert to the condition of sentient beasts, or to the cognitively less developed states of pre-scientific man. While junk science is hardly the way to repair the division of human consciousness most profoundly expressed in the austere discourses of science, by pandering to intuitions - which are usually woven out of half-digested science - it seems to narrow the gap just a little.

These intuitions may be particularly attractive when one is ill. The distance between the experience of illness and the scientific explanation of disease is sometimes insupportable, particularly if the sickness is incurable. How much better it is to think that your woe is due to the marriage of immunology, or ‘immune-thingies’, lifestyle, and an astrological concern for your welfare than that it is due to a urea of 45, which could be anyone’s urea of 45. Alternative medicine promises - groundlessly of course - an interpretation of illness that is both effective and integrated into the rest of your life. Because it has a kind of intuitive appeal, and personalises disease processes, it narrows the gap a little between the alien facts of your case and your immediate suffering. There are, of course, many other attractions of alternative medicine based on junk science (Tallis 2004), but this is the deepest it seems to me.

Combating hostility to science

What then is to be done about the depressing statistics regarding public attitudes to science which I cited at the beginning of this paper? One approach will be to point to the ubiquity of science in things that work, that go right, that make our lives possible and not uncomfortable. To remind those who seem unaware of it that our every moment is clad in, sustained by, the products of high science; that we conduct our public and private lives in a massive ‘artefactscape’ in which the individual items are the meeting place of huge bodies of knowledge arrived at with great difficulty, requiring imagination, patience, skill, conscientiousness and sometimes genius. The sceptics should be invited to ‘untake the for granted’.

A parallel approach is to make people aware of the high standards necessary to arrive at knowledge robust enough to enable us to create the technology that controls those things that we fear - weather, predators, illness; how reliable knowledge comes at a very great price. This is educational. The increasing focus on a shrinking corpus of facts deemed ‘relevant’ in a curriculum that pays little attention to what underlies them and how they were arrived at, offers Ripley’s Believe It or Not rather than science education. And, beyond that, there is the need to underline the connexion between science and humans at their best, and to unmask the charms of junk science, exposing its parasitic nature. We need, in short, to be tough not only on unreason but also on the causes of unreason. This will require a better understanding of the apparent rationale of anti-science and the surface charms of junk science.

So long as first-rate science is treated with suspicion - symptomatised in ever more oppressive regulatory constraints, in opposition to ethical research on humans and animals and on responsible stem cell research, and in the credence given to anti-science, junk science and to the authority of individuals who have no scientific training or understanding to pronounce on science - progress will be that much more difficult.

Science has not only vastly extended our life and comfort span and the range of experiences open to us, and so addressed human needs, but is perhaps one of the most profound expression of the greatest human values: our care for our fellow men and our wish to make sense of the world in which we find ourselves. It seems odd to have to say this, but alas it does need spelling out, as does the fact that those who denigrate the past achievements and the future potential of true science, and promote junk science, are enemies of mankind’s best hope for a better future. In short, enemies of mankind.

(This is an edited version of the Sense About Science 2007 Lecture, delivered at Cruciform Lecture Theatre, University College London, 1st March 2007)

Raymond Tallis was Professor of Geriatric Medicine at the University of Manchester and a consultant physician in Health Care of the Elderly in Salford (1987-2006).  His numerous medical publications include two major textbooks, and he has also published fiction, poetry, articles on the philosophy of the mind, philosophical anthropology, literary theory, the nature of art and cultural criticism.


Adorno, T. and M. Horkheimer (1972). Dialectic of Enlightenment. J. Cumming (trans). London, Verso

BHF (2007). British Heart Foundation Website (Accessed February 2007).

Bronnum-Hansen, H. (2005). ‘Health expectancy in Denmark, 1987-2000’. European Journal of Public Health 15: 20-5.

Feynman, R.P. (1985). ‘Cargo cult science’ in E. Hutchings (ed.) Surely You’re Joking, Mr Feynman! Adventures of a Curious Character. London, Unwin Paperbacks.

Grimley Evans, J.G. (1997). ‘Implications for health services’. Philosophical Transactions of the Royal Society B: Biological Sciences 352: 1887-1893.

House of Lords (2006). Ageing: Scientific Aspects. House of Lords Science and Technology Committee Follow-up 6th Report of Session 2005-2006. London, HMSO.

Kaplinsky, J. (2007). ‘“A disaster waiting to happen” - why are we so anti-nuclear?’ in J. Panton and O. Marc Hartwich (eds.) Science vs Superstition. Buckingham, University of Buckingham Press and Policy Exchange.

Kelly, S., K. Dunnell and J. Fox (1998). ‘Health trends over the last 50 years’. Health Trends 30:10-5.

Kuhn, T. (1970). The Structure of Scientific Revolutions. 2nd edition. Chicago, University of Chicago Press.

Lawless, G. (2006). ‘A vicious circle’ in T. Gilland (ed.) What is Science Education For?’. London, Academy of Ideas.

Levi, P. (2000). The Periodic Table. R. Rosenthal (trans). London, Penguin.

Manton, K.G. and X. Gu (2001). ‘Changes in prevalence of chronic disability in the United States: black and nonblack population above age 65 from 1982-1999’. Proc Natl Acad Sci USA 98: 6354-9.

Manton, K.G., I. Akusevich and A. Kalminski (2005). ‘Human mortality at extreme ages’. Abstract of paper presented at Annual Meeting of the Population Association of America, Philadelphia.

McGreal, C. (2002). ‘Thabo Mbeki’s catastrophe’. Prospect Magazine 72.

MORI Poll (2005). IST ‘Science in Society’.

ONS (2001). HMSO Health Statistics Quarterly 9. Office for National Statistics (ONS).

Riley, J.C. (2001). Rising Life Expectancy: A Global History. Cambridge, Cambridge University Press.

Rothwell, P.M. et al. (2004). ‘Changes in stroke incidence, mortality, case-fatality, severity, and risk factors in Oxfordshire, UK from 1981 to 2004’ (Oxford Vascular Study). Lancet 363: 1925-33.

Sense About Science. (2007). ‘Sense about science for celebrities’. Sense About Science. January.

Smith, R. (2006). The Trouble with Medical Journals. London, Royal Society of Medicine.

Tallis, R. (1995). Newton’s Sleep. Two Cultures and Two Kingdoms. London, Macmillan.

Tallis, R. (2004). Hippocratic Oaths: Medicine and its Discontents. London, Atlantic Books.

Tallis, R. (2005). The Knowing Animal. A Philosophical Inquiry into Knowledge and Truth. Edinburgh, Edinburgh University Press.

UKSAFIA (30.9.2005). ‘Continuous mortality review’. UK Society of Actuaries, Faculty and Institute of Actuaries (UKSAFIA) Press Release.

Unal B., J.A. Critchley and S. Capewell (2004). ‘Explaining the decline in coronary heart disease mortality in England and Wales between 1981 and 2000’. Circulation 109: 1101-1107.

Wolpert, L. (1992). The Unnatural Nature of Science. London, Faber.

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