Faith in Science

Joan Miró, The Harlequin’s Carnival, 1924-25

‘Science says so’ is an apodictic statement, leaving no room for any interlocution, which is all too often heard on today’s talk shows, in newspaper reports, put more in the way of click bait in the headlines. 

Behind this verbalisation, the assumption is that something is true because ‘science says so’. And this reasoning comes from several doctors who are also responsible for our health policies: and it is expressed as if we were called to an act of Faith, since a truth demonstrated by science becomes indissoluble, irrefutable, surrounded by an aura of eternity. I do not wish to go into the issues that have recently divided the country, where this meaning of ‘science’ has been sharpened against the most boorish denialism, but with respect to the scientific method of the 19th century, which rests precisely on the questioning of the statement ‘Sicut scientia locutus est’, ‘thus science spoke’, taking up the Latin language, speaking of science in an ecclesiastical way. If science says so, let us be careful, it is not only a truth, but a certain truth. 

Let us review a little of the philosophy of science of the last few centuries, which does not mean entering into an abstract world of words divorced from the method, but on the contrary, insinuating themselves into the method: positivism is based on the Galilean method, and leads us with great impetus towards “the magnificent destiny and progress”, once a hypothesis has been formulated and verified, the scientific thesis is valid. In the 18th century, the philosopher Hume came in to refute this very wave of positivism by introducing the concept of probability: remember Hume? He is the philosopher who brings disquiet, and as Kant would later say of him it is the one who ‘woke him up from his dogmatic sleep’: David Hume offers only good probabilities that the sun might rise tomorrow on earth, but no certainty.  And in fact, even if we don’t want to think about it too much, who knows what could happen within our microcosm of the solar system. In the film that is so controversial today ‘Don’t look up’, the sun will continue to rise, but we humans will no longer even question it. However, Hume also shows us an exit strategy: it is reasonable to doubt, but doubting unconditionally would no longer get us out of bed in the morning, with or without the sun around the earth. 

In the 1930s, the science of certainty was shaken up when Heisenberg, with his Principle of Indeterminacy, stated that there can be no objectivity, but that at the very moment we are experimenting, we become part of the participatory universe and thus fatally change the fate of the experiment. We interfere. 

This is not a trivial matter because we are also called into play with our subjectivity of choice of what we want to study and observe, and therefore, by opening other doors to these lines, what research do we want to finance: new vaccines? New genetic precision medicine to understand why there are people who do not get infected with COVID-19 despite being in constant contact with positive people? New cures for Alzheimer’s which unfortunately do not yet exist? So as not to open the chapter on new forms of energy, let us stay with vaccines. Yes, they are fundamental and effective, in the second phase of the pandemic the only way out, but are they and will they be sufficient on their own? Unfortunately, Alzheimer’s does not have a truly effective cure, because substantial funding will not go towards memory loss, but as is already happening towards Omicron, which will probably be supplanted by a new variable.  

Perhaps because the brains of the elderly are no longer of such interest? This too is pure human subjectivity, as well as collective interests, the direction that scientific research takes.

Let us return to the scientific method in the strict sense of the term: Karl Popper, ‘the great scientific preacher’ of the last century, insisted that something can be true from a scientific point of view, until it is falsified: according to the law, one would say ‘until proven otherwise’. Or in “dubio pro reo”, from Roman law: better a guilty man out than an innocent man in jail. With this analogy, Popper tells us that it is better to think we are guilty, and therefore to have cognitive distortions as scientists, so as not to spin false knowledge a priori, theories that we just love and wish to be true, however they are not or only partial. And knowledge proceeds by falsification, i.e. assuming that what we are looking for is not true, so as to interfere as little as possible with the experiment.

For Popper, in fact, there is a rigorous and precise method, aimed at containing the cognitive distortions (among which the self-affirmation bias, the desire to be right, is very powerful) that want that experiment to end as we expect it to, positive, successful. It is a method based on the null hypothesis, for example that there is no difference between two therapeutic paths, and then to understand which of the two works and which does not. With probabilities and never with certainties. Popper would never have said “science says so”, but he would have said, with probability, this drug works in a certain percentage of the population, until proven otherwise, until new discoveries are made.

Let me introduce the Austrian philosopher Paul Feyerabend, a pupil of Popper, who wrote an essay with Imre Lakatos ‘for and against the method’. Unfortunately, Lakatos passed away prematurely, but the two opened a Socratic dialogue, supporting the theses “pros” (Lakatos) and “cons” (Feyerabend) the method, to arrive at a marvellous final synergy, where methodological rigidity and anarchy – as Feyerabend calls it – of being a scientist coexist. 

If there had not been freedom, anarchy, we would still be believing in ancient dogmas, in geocentrism, we would not have discovered the therapy of relativity, and the world would be the one described by Dante in the sky of fixed stars. It is precisely on the Copernican revolution that Feyerabend collapses the method.  

The cultural and scientific paradigm changes at a slow pace: innovators do exist, and they are those who try alternative routes never previously taken, or make associations through the observation of phenomena they see with new eyes, through the principle of serendipity, accidental discoveries, which are nothing more than an extraordinary associative creativity, such as Fleming’s famous discovery of Penicillin, or equally famous, Columbus discovering America by chance, convinced that he had circumnavigated the earth and arrived in the Indies.

In order to explore other avenues, I challenge you – we always make this mental equation – virus = vaccine as antidote, but are there other possible avenues we are excluding ourselves from? Cures, understanding how viruses behave and understanding whether there is anything beyond the vaccine discovery of the genius Edward Jenner, followed decades later by Luis Pasteur. We cannot anticipate the future, but we can cite a past example: for gastric ulcers, the treatment used to be gastro-resection surgery because there were no drugs, then came antihistamines, then proton pump inhibitors, and then it was discovered that Helicobacter pylori, a bacterium, is the cause of the ulcer itself, thanks to the studies of Barry Marshall and Robin Warren, around the end of the 20th century, and for this discovery they received the Nobel Prize in 2005.  Therapies have followed, first the antibiotic, and now the intake of probiotics to eradicate Helicobacter pylori.  A new therapeutic paradigm is here, that was unthinkable in the days when surgeons had to intervene: science said some things, today it says others. 

The reality is very complex, and I would like to stress that these discoveries have a certain verisimilitude (in English likelihood – similarity, even removing the reinforcement of the word true) and do not guarantee certain things but probable things today. Feyerabend states that our brain should not be bridled in the methodological rituals of research, because the conditioning is too rigid, but instead it is in the maximum chaos, where we have all degrees of freedom, that there is space and time where we can create. And in his essay Feyerabend goes on to verify the role that science has taken on in western society: science has become a repressive ideology, even though it began as a liberation movement, and the philosopher thought that society should protect itself from an excessive influence of science, just as it protects itself from other ideologies.

Starting from the assumption that there is no universal, ahistorical scientific method, Feyerabend deduced that science does not deserve its privileged role in Western society, since scientific views do not arise from the use of a universal method that guarantees consistently high-quality conclusions, or ethicality. In fact, he was one of the first to denounce that science had become an ideology, a faith.

The method, the yardstick serves and is a fundamental tool and we cannot give permission to the deniers to invalidate its usefulness, we know and I want to emphasize that the vaccines work (I will always be grateful to the vaccination for Covid-19, remembering the first dose received with an extraordinary emotion), but alone are not enough. Recalling that there are unfortunately also the many diseases for which there is neither a diagnosis nor a cure.

Churchill states “It has been said that democracy is the worst form of government, except for all those forms that have been tried so far.” This irony can be married with the science of Popper and his method, knowing that it is extremely improvable, leaving room for creativity, disengaging from research only in the short term and aimed at immediate profit, because it is too steeped in protocols, and becoming freer from the screaming of the inquisitor of faith who in the TV talk show repeats as a litany “science says so”.

Maria Giulia Marini

Epidemiologist and counselor in transactional analysis, thirty years of professional life in health care. I have a classic humanistic background, including the knowledge of Ancient Greek and Latin, which opened me to study languages and arts, becoming an Art Coach. I followed afterward scientific academic studies, in clinical pharmacology with an academic specialization in Epidemiology (University of Milan and Pavia). Past international experiences at the Harvard Medical School and in a pharma company at Mainz in Germany. Currently Director of Innovation in the Health Care Area of Fondazione ISTUD a center for educational and social and health care research. I'm serving as president of EUNAMES- European Narrative Medicine Society, on the board of Italian Society of Narrative Medicine, a tenured professor of Narrative Medicine at La Sapienza, Roma, and teaching narrative medicine in other universities and institutions at a national and international level. In 2016 I was a referee for the World Health Organization- Europen for “Narrative Method of Research in Public Health.” Writer of the books; “Narrative medicine: Bridging the gap between Evidence-Based care and Medical Humanities,” and "Languages of care in Narrative Medicine" edited with Springer, and since 2021 main editor for Springer of the new series "New Paradigms in Health Care."

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