This is the first half of a paper written some years ago for a collection published by Praeger (Medical Science and the Advancement of World Health, ed. Robert Lanza MD). The points made appear to be as applicable now as they were then.
We live at a time when the most fundamental ideal of scientific enquiry is being called into question, and indeed explicitly rejected. This cannot fail to have a profound effect on research in all fields, not only the medical. But the effect of the dominant ideological climate may be particularly distinct in relation to medicine since this concerns the nature of human beings and the extent of their dependence on the society around them; these are matters that carry a particularly strong emotional loading from the viewpoint of the prevailing orthodoxy, and this loading sets up stringent requirements for what shall and shall not be done.
But first let us consider what may be the fundamental ideal of science. The Duke of Kent, in his 1981 presidential address to the British Society for the Advancement of Science, asserted, "I say without any equivocation that I consider it the scientist's first and imperative duty to expand the boundaries of knowledge." Similarly, Hans Eysenck stated, "Personally, I would take my stand with Thomas Jefferson: 'There is no truth existing which I fear, or would wish unknown to the whole world'" (1).
Both these assertions were made in the awareness of, and in explicit opposition to, a climate of opinion in which they are no longer widely accepted. It is old-fashioned and naive to talk of an external truth or reality toward an understanding of which the human race is advancing by successive approximations. There is no criterion of reality other than social agreement. Reverence is due only to what is socially desirable.
A central, maybe the central, determinant of contemporary attitudes in all fields of intellectual activity is the modern drive toward eliminating any sense of tension between socially agreed-upon opinion and external reality. The tension is removed by denial, more or less explicit, that there is any such thing as external reality or that it has any right to numinous status if there is. Why does it matter what is true? What is important is what is good. There is even a school of thought in the modern philosophy of science that teaches explicitly that it is impossible to arrive at objectivity in scientific observations; all observations are made in the context of the received ideology of their time and cannot be separated from it.
So we find ourselves in a situation in which one ideal of science is being, with increasing explicitness, replaced by another. The old-fashioned ideal conceived of science as striving to establish the truth, whatever it might turn out to be, whether at variance or not with what human beings would expect or prefer it to be. The new ideal conceives of science as subservient to the requirements of social desirability. This view of the matter depends on the idea that the outcomes of research can be foreseen, the social consequences of it predicted, and a definite opinion formed whether these consequences are desirable.
In fact, immensely useful, practical consequences have often arisen from the disinterested pursuit of knowledge. The Curies studied radium without foreseeing its medical applications; Sir Alexander Fleming discovered the antibiotic properties of penicillin by chance. It is impossible for the consequences of an increment in human knowledge to be accurately foreseen, even by those most directly concerned with it. Twenty years before the first use of atomic power, Einstein and Rutherford expressed their opinion that no practical harnessing of atomic power would ever be possible.
In general, it is certainly possible to argue that the ostensible modern goal of beneficial effects on society as a whole is more likely to be achieved, and to be achieved more effectively, by an adherence to the old-fashioned principles that knowledge is good in itself and that the extension and dissemination of knowledge of all facts without distinction is intrinsically desirable. Nevertheless, it is a somewhat weak position to defend a principle by demonstrating that it may be defended in terms of another principle, as if admitting that the latter is the really important one, and the former can only be justified in terms of it. As Eysenck observes, "According to the scientific ethos, scientists should fearlessly speak the truth; in theory, truth is the supreme god to whom the scientist bows. The position now is departing rather rapidly from this belief" (2). He quotes Carl Sagan as saying, "In a time of trouble, the tendency of society is to constrict the range of accepted ideas. But just the opposite — diversity, heresy — is what is needed if problems are to be solved."
The qualification "in a time of trouble" is unnecessary. Any society has a strong tendency to foster and favour only activities and intellectual productions that support the received ideology of the time, and the notion that individualistic heretics are good for anything is never likely to be applied with much energy. In a society in which the financing of research is largely, indeed almost exclusively, undertaken by the state or by collective entities which are answerable to the prevailing orthodoxy, there will be little opportunity for heresy to take effect.
The modern ideology produces two kinds of pressure, one practical and one moral. The practical one is that there is a constant transfer of freedom of action (or financial power) from individuals to the state. Individuals are heavily taxed, and their ability to pass on by inheritance even such accumulations as they are able to build up in a heavily taxed lifetime is itself subject to heavy taxation. In addition, there is taxation by inflation, and state control over the supply and value of money held in the hands of individuals. This is confiscation as surely as would be open levies on the assets every citizen, but its effects are indirect. The cost makes it less and less likely that any individual or group of individuals can carry out independent research on an adequate scale; the freedom to set up research establishments and to do independent work has thus effectively been confiscated and transferred to the state.
The moral pressure of the modern ideology is simply towards doing what reinforces it. The fact that the beliefs that actually make up the modern ideology are largely implicit, although all-pervasive, makes it more, and not less, dangerous. You will gain social reward and approval by doing research that has results other people will approve of; you will not gain it by doing research that calls into question some important, even if implicit, belief. Even if this were not supported by the financial censorship already described, it would be a powerful force.
1. Hans J. Eysenck, "The Ethics of Science and the Duties of Scientists," British Association for the Advancement of Science, New Issue, No. 1 (August 1975), reprinted in H. B. Gibson, Hans Eysenck: The Man and His Work (London: Peter Owen, 1981).
2. ibid.
Part two of this can be read here.