Don’t Dump on Science
Posted by Cottontimer on 20 Apr 2006 | Tagged as: Health, Thoughts
I believe in science. I trust the thought process, the methodology, the hard data, the cautious, yet often daring conclusions. I’m a scientist and I always will be.
I’m not saying scientific studies are always perfect or earth shattering. But I don’t dismiss anything out of hand simply because it doesn’t jive with my personal experience. There is a difference between fact and anecdote.
So imagine my dismay when I read the responses to a post mipmup wrote for BlogHer yesterday that linked to mine on birth spacing. Mir left a comment which raised important points but derided public health studies in general.
Honestly, oughtn’t there be a law that such studies directly address causation vs. correlation?
In an ideal world, we would conduct a randomized trial in which we forced women to bear children at varying intervals as dictated by scientific protocol. And we’d do every invasive medical test available to determine the biology behind any perinatal outcome we observed. Hopefully, this type of controlled experiment would identify some kind of cause and effect relationship. Humans are animals and we support animal testing for the good of humans, right?
Sadly, I don’t think any ethics board would approve of studies like this. So public health practitioners and scientists are stuck with showing associations and correlations.
“Association does not mean causation,” we are taught. It’s a good general principle to keep in mind. But sometimes, we have nothing more to go on. To be stuck in one place and not take action because we don’t have the evidence of causation we wish for would be a great disservice to all the women and future children who would benefit from some discussion and debate (yes!) stimulated by studies like the one published in JAMA, a peer reviewed, prestigious journal that has made huge scientific advances impacting your health and mine.
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Exactly. I think studies where all you have to go on are the comparitive data you might have to look at them more closely, but they aren’t invalid.
Take vaccine trials. What are you going to do, give half the kids saline the others MMR then expose them all to measles? Yikes! That’s extremely unethical. While I have my own personal issues with vaccines and vaccine trials I can’t fault the process much.
Certainly, knowledge is power and intelligent debate over the causation of factors that impact our health is important. As a mother, you know the barrage of information, advice, and just plain opinions on every single aspect of conception, every millisecond of pregnancy, birth, breastfeeding, diapering, and on and on and on. I’m not surprised that other mom’s get a tad testy at the prospect of having to absorb yet another study that seemingly adds little to (or perhaps even directly contradicts) our own experiences.
As to the point that you made (in your comment in BlogHer) about women in the developing world perhaps being more impacted by this study than those of us with access to good prenatal health…. I would argue strongly that those very women would LOVE to have more control over the spacing of their children, but have limited access to birth control, abortion is illegal and/or dangerous, they have no empowerment to refuse sex with their husbands, and are they largely uneducated. Again, I don’t see how this study helps them. Research on safe, effective, easily distributed birth control and reproductive health education would do them a lot more good.
I don’t mean to dish on you, and certainly not on science, but these are my thoughts. Take ‘em or leave ‘em.
Tris: Thanks, Tris. I think epidemiologists are often at the brunt of all this disdain because we do large population studies. We are unable to state definitively that A causes B because it is impossible to prove it in these types of studies. But epidemiological studies like the one about birth spacing are usually the first to highlight a possible causal link that is later confirmed by biological studies. I don’t think most people understand that. *fume*
river2sea72: I don’t think we disagree at all. But, I would say that just because JAMA publishes this one study doesn’t mean that there aren’t hundreds of other studies addressing the precise problems that you mention. There are plenty of community and international health initiatives that are attempting to go into developing countries and teach them about the specifics of family planning. But, it’s possible that government officials there do not understand the true impact. This JAMA study highlights that we still need to be concerned about family planning and related issues instead of dismissiong them.
And, of course, I get fed up too over this study or that study but I do my best to be objective.
Whew, she’s not mad at me
river2sea72: LOL!! Why would I be mad at you. Don’t you remember I like to stir things up?
BTW, I just left another comment over at BlogHer.
[...] But let me lay it out for you. I believe in science with my whole heart. BUT I am not so arrogant to think that we will ever be able to explain everything with science. The universe is too big and too complex. [...]