Utopia, you are standing in it!

I caught Sir Paul Nurse’s Attack on Science on cable recently. He was exploring why people were unwilling to accept the word of science.

https://youtu.be/C3JEaigwAbg

Sir Paul believes that people should defer to experts. He named two expert consensuses: global warming and GMOs.

In his 2012 Dimbleby Lecture Sir Paul called for a re-opening of the debate about GM crops based on scientific facts and analysis:

“We need to consider what the science has to say about risks and benefits, uncoloured by commercial interests and ideological opinion.

It is not acceptable if we deny the world’s poorest access to ways that could help their food security, if that denial is based on fashion and ill-informed opinion rather than good science.”

Many activists, without blinking an eye, will reject the science of GMOs but will hound from the temple anyone who defies another consensus they agree with.

Sir Paul interviewed James Delingpole. After they agreed that science does not proceed on the basis of consensus, Sir Paul asked Delingpole why he rejected the scientific consensus on global warming but accepted the scientific consensus on cancer.

Delingpole said he did not accept the analogy, but he was otherwise flat-footed. I suggest the following answer:

1. Medicine proceeds on the basis of double blind trials and other small field experiments. Control and treatment groups are used before any treatment is applied widely. Medicine is not perfect as was the case with the misdiagnosis of the causes of stomach ulcers.

2. The lag between cause and effect are short as would be the case if you rejected emergency treatment after a car accident or cancer treatment.

3. Medicine tests the efficacy of invasive treatments, weighs side-effects and encourages adaptation and prevention.

4. The staying power of self-interest in medicine is well-known: much higher rates of surgery when there is fee for service and much lower rates of surgery if the patient is a doctor’s wife. The efforts of the medical profession to suppress new entry to inflate their own incomes are well-known.

Ken Arrow in the early 1960s famously concluded that virtually all the special features of the medical care industry could “be explained as social adaptations to the existence of uncertainty in the incidence of disease and in the efficacy of treatment”.

1. Physicians may not agree on the medical condition causing the symptoms the patient presents.
2. Even if physicians agree on their diagnoses, they often do not agree on the efficacy of alternative responses — for example, surgery or medical management for lower-back pain.
3. Third, information on diagnosis and likely consequences of treatment are asymmetrically allocated between providers and patients.
4. The reason patients seek advice and treatment in the first place is that they expect physicians to have vastly superior knowledge about the proper diagnosis and efficacy of treatment.

Like all experts, doctors can advise you of the options open to you.

You must weigh those options in light of the costs and benefits to you and those costs and benefits are known only to you.

An old mate, who was in his thirties, had to consider back surgery that had a 10% chance of leaving him in a wheelchair for life. Experts cannot tell you what to do with those odds. After months of terrible pain and incapacity, his back slowly recovered without the surgery.

Most of the debate over global warming is explained by uncertainty about both the extent and incidence of global warming and the efficacy of prevention versus adaptation.