But what about…

The more educated and anxious among you would have noted that I haven’t mentioned one word yet. Science. Is ‘Scientific’ knowledge exceptional? Today, especially among the educated, Scientific knowledge is considered superior to other knowledge; it is considered to be better tested and verified than other knowledge. So we should dig a bit deeper in to scientific testing.

The scientific way of testing is referred to as The Scientific Method. Generally, this consists of forming a hypothesis (put simply, a proposition) based on observations, and testing the hypothesis via experiments. The hypothesis may be a proposition which can be verified by observation of a single incident. Alternatively, it may be about a behaviour in a large population — for example the proposition that drug X can cure the condition Y. There is a specific statistical method called Hypothesis Testing, which allows testing on a sample of the population to be used as a prediction for the behaviour in the whole population.

Hypothesis testing is utilized in a controlled experiment where part of the sample is tested for the expected behaviour when the proposed condition is met. The other part of the sample is tested whether the expected behaviour is observed even if the proposed condition is not met. For example, one part of the sample can be treated with a drug to see if it cures a disease, while the other part (the control group) will be treated with a placebo to see if they get cured anyway. A double-blind trial is a controlled experiment where neither the people in the sample nor the testers are aware of who is in the control group.

Is scientifically verified knowledge objectively true? Again trying to decide directly what is true is tricky. Let’s look at different types of scientific knowledge. Physics is the most fundamental of sciences — all other scientific knowledge can be reduced to Physics. What is accepted in Physics today becomes outdated tomorrow. However, outdated Physics remains useful. Einstein’s theories are more accurate, but we still use Newton’s theories of motion as they are simpler to understand and use. We can say that the truthfulness of any theory in Physics is a moot point. Physics theories use abstract concepts which we can’t even observe directly. Regardless, they provide models which we can use for many purposes.

How about medical science? If you look at recent history, there will be many incidents of medicines which have undergone the proper procedure of testing found to be ineffective when used widely. How can that happen? It comes down to the fact that the functioning of the drug depends on the individual patient. The hypothesis of a theory can specify some assumptions or pre-conditions for the environment in which the proposition stands. The assumptions and preconditions for theories in some areas of Physics are relatively easy to control. Therefore, theories and models in areas such as Statics and Mechanics can be used reliably in many areas such as construction and transportation. However climate science and astrophysics are more speculative as the environment is very extensive and beyond the control of humans. Small variations from the assumptions will create large variations in the predicted results. Similarly the variation of human bodies and mind (the environment in which drugs function) makes it impossible to predict how a drug will work for each person.

Hypothesis testing assumes that the samples are randomized in all aspects other than the condition being tested. This is the basis on which a prediction can be made about the whole population. When a drug trial is considered successful, it means that there is a good indication that it will be effective in a large proportion of the whole population, assuming the sample is truly randomized. However the testing will not necessarily find out why it doesn’t work for some. It may well turn out that a large portion of the population have some condition which prevents the drug working.

Another aspect of drug testing is the safety. Drugs can go through several phases of trials conducted over several months or years. Possible side effects can be monitored during this time. But it is impossible to predict long term side effects. It is also impossible to predict side effects for people with specific conditions if they are not represented in the sample group. Adverse Drug Reactions, where multiple drugs taken by a patient interact to give side effects, are also impossible to predict through trials.

There are also many ways to cheat on a drug trial. For example, the likelihood of success of a trial can be increased by removing people who are unlikely to respond positively to the drug from the sample group. Biasing of the sample group can happen unintentionally too. A famous study which concluded that moderate consumption of wine can reduce the incidence of heart disease was found to be invalid as everyone in the sample group was highly educated. Seemingly unrelated biases can affect the conclusions in unforeseen ways. There are many instances of actual fraud in drug trials described here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4340084/

The reason I wanted to describe these in detail is to emphasise that truth and fallacy of knowledge is a dicey subject. Science, like any other knowledge, is useful when used for the benefit of humanity. However we should view it as useful knowledge, rather than true knowledge. One day we will find more useful knowledge than what we have today, and we should move on.