I came across an interesting article in Wired this week written by Jonah Lehrer, Trials and Errors: Why Science Is Failing Us. In this article Lehrer explores the complexity and false steps in the pharmaceutical and biomedical industries. He begins with a story about a promising drug being tested by Pfizer in 2006. This was supposed to be a real breakthrough (and money maker) – but wound up pulled from clinical trial when it correlated with increased mortality. We spend, through industrial investment, government funding, and private foundations, an enormous amount of money each year on health related research. Most of it predicated on the idea that disease has a cause. Lehrer suggests that the fundamental flaw here is not in the specific research, but in the underlying assumption that “cause” is a real phenomenon capable of investigation. From Lehrer’s article:
This assumption—that understanding a system’s constituent parts means we also understand the causes within the system—is not limited to the pharmaceutical industry or even to biology. It defines modern science. In general, we believe that the so-called problem of causation can be cured by more information, by our ceaseless accumulation of facts. Scientists refer to this process as reductionism. By breaking down a process, we can see how everything fits together; the complex mystery is distilled into a list of ingredients. And so the question of cholesterol—what is its relationship to heart disease?—becomes a predictable loop of proteins tweaking proteins, acronyms altering one another. Modern medicine is particularly reliant on this approach. Every year, nearly $100 billion is invested in biomedical research in the US, all of it aimed at teasing apart the invisible bits of the body. We assume that these new details will finally reveal the causes of illness, pinning our maladies on small molecules and errant snippets of DNA. Once we find the cause, of course, we can begin working on a cure.
There are a number of problems with this paragraph, or so it seems to me, the first being that the search for cause is not merely reduction to the separable constituents. A “list of ingredients” is nothing without an understanding of the intricate multicomponent interactions and feedback mechanisms that occur only when they are all present together. Complexity does not point to a lack of causes, nor does it undermine the entire scientific enterprise.
Is science failing us?
or more concretely:
Does the complexity inherent in biology undermine the search for cause and effect on which science is based?
The article is long, but well worth reading. Lehrer makes many good points about the danger of oversimplifying and about the mistaken ideas and claims that have been made. He relates a story about the swing in medical practice from back pain as something that heals when left alone, to something that requires surgical intervention as indicated by new information available through MRI technology, to the current realization that many of the “abnormalities” observed by MRI were not the cause of back pain at all, but are as common among control populations as among the patients complaining of back pain. There are very important lessons here. Lehrer, however, goes a good step further – taking this and other similar examples of mistaken assessment as evidence that undermines “cause” as a real phenomenon.
The problem with this assumption, however, is that causes are a strange kind of knowledge. This was first pointed out by David Hume, the 18th-century Scottish philosopher. Hume realized that, although people talk about causes as if they are real facts—tangible things that can be discovered—they’re actually not at all factual. Instead, Hume said, every cause is just a slippery story, a catchy conjecture, a “lively conception produced by habit.” When an apple falls from a tree, the cause is obvious: gravity. Hume’s skeptical insight was that we don’t see gravity—we see only an object tugged toward the earth. We look at X and then at Y, and invent a story about what happened in between. We can measure facts, but a cause is not a fact—it’s a fiction that helps us make sense of facts.
The truth is, our stories about causation are shadowed by all sorts of mental shortcuts. Most of the time, these shortcuts work well enough. They allow us to hit fastballs, discover the law of gravity, and design wondrous technologies. However, when it comes to reasoning about complex systems—say, the human body—these shortcuts go from being slickly efficient to outright misleading.
Lehrer implies in his article that all causal reasoning is merely useful fiction. Sometimes it works well, even in complex biological and environmental systems. The increase in lifespan over the last century or so is an indication of how well this “fiction” can work. But…
And yet, we must never forget that our causal beliefs are defined by their limitations. For too long, we’ve pretended that the old problem of causality can be cured by our shiny new knowledge. If only we devote more resources to research or dissect the system at a more fundamental level or search for ever more subtle correlations, we can discover how it all works. But a cause is not a fact, and it never will be; the things we can see will always be bracketed by what we cannot. And this is why, even when we know everything about everything, we’ll still be telling stories about why it happened. It’s mystery all the way down.
It will probably come as no surprise that I think that Jonah Lehrer’s premise and reasoning is incorrect. Biological systems are incredibly complex – and the complexity plays out in ways that we are only just beginning to understand. Nonetheless causes are real and capable of investigation, from the Higgs boson, to global warming, to the origin and progress of cancer.
Perhaps you have a different idea – perhaps it is worth some conversation.
Do you think that causal beliefs are merely a useful fiction?
Are causes real or is “it” mystery all the way down?
If you wish to contact me directly you may do so at rjs4mail[at]att.net.
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