Clinical Orthopaedics and Related Research®

Clin Orthop Relat Res (2014) 472:1063–1064 DOI 10.1007/s11999-014-3488-y

A Publication of The Association of Bone and Joint Surgeons®


Trust in Science S. S. Leopold MD

Received: 20 January 2014 / Accepted: 24 January 2014 / Published online: 6 February 2014  The Association of Bone and Joint Surgeons1 2014

Before the Enlightenment, most individuals lived and died without a single scientific, technological, or medical breakthrough advancing their basic understanding of the world or influencing their lives. In his book, The Beginning of Infinity: Explanations That Transform the World author David Deutsch explores this interesting theme, but the idea is not unique to that source. By contrast, in the last century, we have seen perhaps dozens of such advances. In technology, the automobile went from an exotic novelty to a near-essential in most of the world. Air travel morphed from an inconceivable notion to a routine, if sometimes burdensome, mode of transportation. Of course, technology has also changed how we disseminate and consume information. For example, it is much more likely that you are reading this essay electronically, rather than on paper. Ten years ago, the opposite would have been true; 20 years ago, the question would not have even made sense. In science, we have seen the crystallographic characterization of DNA, providing an explanation for the genetic diversity whose origins previously were but a source of

The author certifies that he, or any members of his immediate family, has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research1 editors and board members are on file with the publication and can be viewed on request. The opinions expressed are those of the writers, and do not reflect the opinion or policy of CORR1 or the Association of Bone and Joint Surgeons1. S. S. Leopold (&) Clinical Orthopaedics and Related Research, Philadelphia, PA 19103, USA e-mail: [email protected]

speculation. Medicine has commuted through cures what would have been death sentences only decades ago. Our own specialty now alleviates suffering with arthroscopes, microscopes, and arthroplasties, putting life back into the years of millions of people. Recognizing that not all of our ‘‘advances’’ are improvements, and also that some medical advances are thinly veiled approaches to allow physicians to deliver (and be remunerated for) more care rather than better health, there is still little doubt that the good far, far outweighs the harm. Despite these advances, trust in science remains low (about 45% of those surveyed in the United States), where it has been, more or less, since the 1970s [2]. Trust in science is even lower (approximately 35%) among selfdescribed conservatives, who constitute an important element of one of the two dominant political parties in the United States [2, 3]. In light of all that science and technology have delivered — including the very media that facilitate the dissemination of antiscientific rhetoric — it is hard to understand why so much of society wants science kept at arms’ length, and why so many bring up the topic mainly to condemn it. I might offer the usual apologia — our self-defeating (and reality-obfuscating) use of jargon, the ways that academics can use discovery as vehicles for self-promotion, and our regular leaps from one bandwagon to another: Do vitamins help [5]? Do vitamins harm [4]? Or, should we just ‘‘Stop Wasting Money on Vitamin and Mineral Supplements’’ [1]? Instead, I will save all that for another day, since none of those excuses prevented science and technology from changing our lives so dramatically. As of this writing, apart from a very few fringe candidates, there are no declared political candidates for the U.S. presidential race, and so the ideas here do not represent an endorsement of any



Clinical Orthopaedics and Related Research1


individual or party. However, the upcoming race is an opportunity for those of us who think science is important to make that belief count: • Consider adding ‘‘a thoughtful approach to science and technology’’ to whatever set of metrics you use to evaluate candidates. Science is the practice of asking important questions and answering them rigorously and reproducibly. I believe that facility (or at least familiarity) with it is a reasonable surrogate for curiosity, a hallmark of a good leader. • Consider engaging in the process when and how you can. At the very least, vote. Caucus or participate in other ways if it is possible for you to do so. The participation of thoughtful people who understand science and can explain it will diminish people’s fear and mistrust of it. • Be sure to recognize that while science is important and interesting, it is not the only source of truth. In order to serve as effective ‘‘messengers’’ as we engage in the political process, we must be sensitive to those who find truth elsewhere, and even look elsewhere for it ourselves. The late Stephen Jay Gould wrote compellingly that science and religion are ‘‘non-overlapping magisteria,’’ meaning they are not in conflict because they speak to such fundamentally different questions. Beyond that, we can learn as much about what it means to be human in good fiction, great music, and visual art


as we can in science. While many of us do not know how to read a novel for its deeper meaning, how to listen to a symphony and understand it, or how to look at a painting and really see what is there, none of us is too old to learn. Acknowledgments I thank Montri D. Wongworawat, MD, for his thoughtful improvements to this editorial.

References 1. Guallar E, Stranges S, Mulrow C, Appel LJ, Miller ER III. Enough is enough: Stop wasting money on vitamin and mineral supplements. Annals of Internal Medicine. 2013;159:850–851. 2. Hampson G. How to rebuild trust in science. Seattle Times. December 17, 2013:A-13. 3. Kobler, J. Study: Conservatives’ trust of science hits all time low. Available at: study-conservatives-trust-of-science-hits-all-time-low-. Accessed January 20, 2014. 4. Lonn E, Bosch J, Yusuf S, Sheridan P, Pogue J, Arnold JM, Ross C, Arnold A, Sleight P, Probstfield J, Dagenais GR; HOPE and HOPE-TOO Trial Investigators. Effects of long-term vitamin E supplementation on cardiovascular events and cancer: a randomized controlled trial. JAMA. 2005;293:1338–1347. 5. Witte KK, Nikitin NP, Parker AC, von Haehling S, Volk HD, Anker SD, Clark AL, Cleland JG. The effect of micronutrient supplementation on quality-of-life and left ventricular function in elderly patients with chronic heart failure. Eur Heart J. 2005; 26:2238–2244.

Trust in science.

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