Strange Bedfellows: Science & Medicine

INTRODUCTION

To conduct a scientific study, one must compare data from different conditions where ideally a single variable is changed. Double-blind clinical trials serve as excellent examples. In these cases different groups of patients are compared. When the researcher cannot hold constant all of the variables, the patients constituting each group must be randomized hence the double-blind selection. Double-blind means that the person assigning patients to the treatment groups never interacts with the patients. In addition, a different person who administers the treatment to the patients does not know what he or she is administering. In this way, the placebo effect is eliminated.

To conduct medical research, such careful procedures may not be employed because of urgencies and critical time considerations. Consequently, science and medicine may be at odds. An example of non-scientific medical research is the Flint Michigan water disaster. In this case, the city's water source had been change from lake to river in an attempt to reduce costs. However, there was no attempt to perform corrosion control, a procedure needed to remove lead from the water. Corrosion control is required by law. As a result, the citizens, especially the children, of Flint were suffering lead poisoning. Because of the urgency, physicians did not bother to compare Flint's water with that of a nearby town's; they simply looked for lead levels in the blood that exceeded their expectations and the Environmental Protection Agency's (EPA's) published acceptable levels. This research, though not scientific, is understandable.

In the case of the Flint water disaster, the city manager, and a number of city employees were found guilty of criminal neglect.

PROBLEM

Clearly rigorous scientific experimental investigations and medical research may not be compatible in all cases. What can be done to resolve this incompatibility? One point is that the medical researcher should understand that an investigation that does not involve a comparison as part of the experimental design is non-scientific. If there are cogent reasons for conducting the research anyway, then so be it. But the researcher should understand what they are doing and why they are doing it.

PRACTICE

Actually physicians perform mini experiments all the time. These experiments do have a hypothesis and are designed to test that hypothesis. Perhaps the best example of one of these mini experiments is when a doctor prescribes a new medication to a patient. The primary question is whether the patient will be better off on the prescribed medication. No one knows the answer until the experiment has been performed. How well will the patient tolerate the medication? How effective is the treatment? How severe are any side-effects? Will there be any interactions with any other drug(s)? These considerations bear on the primary question.

Would these experiments stand up to the rigors of peer review? Probably not, but they do have a specific purpose: to improve the medical condition of the patient.

PURPOSE

Another important consideration is that a researcher should have a clear idea of the purpose of the research. The practical purpose of most scientists is to publish in peer reviewed journals. In doing so, a scientist establishes his or her reputation and enhances the ability to secure grant funding. Of course, scientists may have and likely do have altruistic reasons for pursuing scientific research as well as a desire to know (i.e. curiosity).

Along with the purpose, the researcher should know the intended audience. Knowing ones audience is crucial in determining how best to present the research.

RESOLUTION

When one views research in terms of its purpose, I am not sure there is a conflict. There may well be trade-offs, however. The conflicts arise when researchers try to pursue multiple purposes at the same time.