Map of life expectancy at birth from Global Education Project.

Friday, March 18, 2005

Waxing Philosophical

Or maybe just waxing my moustache.

Here at Stayin’ Alive, we’ve talked about science, ethics and politics. I realize from my spirited, profound and sometimes mildly painful discussions with the crowd in the blogroll (look down and to the left), that I’m going to have to take some time to put them all together. What seest the cold, unflinching Cervantean eye when turned upon the philosophy, ethics and politics of science?

Too much for one day, or one post, to be sure, but for starters, I’ll offer a credo. There are different categories of questions, different kinds of things about which people may have beliefs. Etymologically, “science” is derived from a word simply meaning knowledge, or wisdom, but in modern parlance it has a narrower meaning. Capital “S” Science is an enterprise based on the metaphysical position that the truth is out there – that people find themselves in a universe which they can successfully explore and come to understand through the application of their senses and their reason. Scientific knowledge as such, in the strictest sense, is not controversial among scientists, but that is not to say that there are not many scientific controversies, often very bitter. So that is one of the most important distinctions that I wish to clarify.

I will talk another time about exactly how it is that we distinguish among what we know, what we think probable or possible, and what is utterly mysterious. And I will talk about what it means to know something. Right now, I will jump to another crucial point. What we know or might be able to know scientifically is not all that humans have to talk about. Knowing something about what is does not in itself answer questions about what ought to be or what people in general or someone in particular ought to do. Science can contribute to those questions by providing a factual basis on which to argue them: whatever our ethical principles, we can’t apply them unless we accurately understand the situations under consideration. One of the important tools of science, logic, can also be applied to ethical discourse, but that doesn’t make ethics a branch of natural science. Science also does not settle questions about aesthetics or artistic talent, which depend on the responses of our individual and variable minds to particular stimuli, and about which we can therefore disagree without any logical contradiction.

Since ethics and meaning come from somewhere outside of Science, Science is vulnerable to criticisms about how it should be conducted, and is open to debate about what we ought to make of the results. To take a concrete example from this site, drug companies invest billions of dollars to develop slight variations on existing drugs, at little or not real benefit to the public health, so that they can maintain their patents and protect their profits – which in turn is only possible because of aggressive and dishonest marketing of the new compounds. Those dollars might be much better spent on more innovative research, but investors don’t like the risk involved. Scientists who lend their talent and prestige to this enterprise, instead of doing work that would be of real benefit to the sick and suffering, are doing perfectly good science, but their lives are badly spent.

Even so, we now have these Cox-2 inhibitors. It turns out they increase the danger of heart attacks and strokes, and they relieve pain no better than aspirin. But, there are some people who can’t take aspirin-like drugs because they make their stomachs bleed. If they have arthritis, they might want to take Cox-2 inhibitors in spite of the risk. Scientists are the people who debate whether these drugs should still be allowed on the market, what should be on the label and package insert, whether and how they should be advertised, and how physicians should be guided in prescribing them (or not). But those really are not scientific questions. The scientific facts about the drugs must be properly understood for those discussions to happen appropriately, but the answers depend on our values, in complex ways. (I.e., it’s not just about how we evaluate risk, but how we feel about liberty, paternalism, the obligations of physicians, etc.)

And then there is Terry Schiavo. There are Scientific Facts about her condition, which some people prefer not to believe. But even if everyone did accept the same reality, they might still disagree about what ought to be done.

The Dialogue blog is where I get to talk about what all this has to do with metaphysical questions such as God. Here, I just want everyone to keep the issues straight: What is, what ought to be, what it all means. Related, but distinct.

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