Science is a massive, ongoing human undertaking. It is a creative endeavour: the greatest scientific discoveries have involved wild guesses and hypotheses. But it also depends on rigor, self-criticism, and self-correction. The wild guesses must be tested against evidence. Science is the most dynamic of endeavours: the accepted claims of today may be overturned tomorrow. Ambitious scientists dream of changing our understanding of the world.
So how can someone make decisions that rely on science? If science is always changing, if claims are being tested and overturned, if tomorrow’s discovery could change our whole way of looking at things, why should we believe anything scientists say today? How can a creative and dynamic endeavour become a source of legitimate authority to be followed? Most of us are not going to collect and analyze atmospheric data to test whether burning fossil fuels causes climate change, but we have to decide whether to press for reduced emissions based on what scientists are saying.
This decision of the ordinary person to trust scientific authority is made even more difficult because scientific authority can be abused, and has been abused in the past. Take scientific authority in the area of mental illness. The manual of mental illness produced by the American Psychiatric Association is the famous DSM, the Diagnostic and Statistical Manual of Mental Disorders. We are currently (as of 2013) on the DSM-V. Prior to a change made in the DSM-II in 1973, “homosexuality” was defined as a mental illness. Before the DSMs, in the 19th century, an American physician defined “drapetomania”: a mental illness that caused African-American slaves to try to escape. Diagnoses of “hysteria,” “frigidity,” and many others were used to control women since the 19th century. Psychologist Bruce Levine has argued that diagnoses of ADHD and ODD are similar tools that “psychopathologize” and “medicate” people who are “natural anti-authoritarians,” “before they achieve political consciousness of society’s most oppressive authorities.”
In this fraught space of mental illness, where scientific authority has been abused and politicized and where scientific understanding is desperately needed, a debate on the causes of autism is taking place in a way that is harmful to public health. Autism Spectrum Disorder (ASD) is in the DSM, and diagnoses of autism have been going up and up. The U.S. Center for Disease Control (CDC) shows a prevalence of 6.7 per thousand in 2000 and 14.7 per thousand in 2010. The simplest explanation for this huge increase turns out to be the most likely: that it is the result of changes in the way autism is diagnosed. (Science for discussion of the U.S., Forbes for discussion of a study from Denmark).
Like so much in the field of mental illness, autism is very poorly understood. The diagnosis is based on a checklist of behaviors. Psychologist Enrico Gnaulati wrote sensitively in Salon about a case of “overdiagnosis,” in which a “brainy, introverted” boy was incorrectly diagnosed with autism – something Gnaulati believes is happening all the time.
The solution to the problems caused by trying to treat illnesses we don’t understand is to try to improve our understanding. The discovery of the “overdiagnosis” issue with regards to autism, for example, came from the scientific community. Bruce Levine’s critique of the overdiagnosis of ADHD and ODD is also one grounded in scientific principles. A major recent study has linked antidepressant drugs in pregnancy to increased risk of autism. The way to correct scientific errors, in other words, is to do better science.
But the self-correcting mechanisms of science are slow. While scientists struggle for answers, suffering people have difficulty waiting. They turn to online communities that do not use the methods of science, communities that attack the failures of scientific authority and the limitations of scientific knowledge. A large community has arisen that claims a connection between vaccinations for preventable diseases and autism. The community has grown so large and has convinced enough parents not to vaccinate their kids that public health impacts are beginning to be felt and preventable diseases may be making a comeback. It has seized on a study from the 1990s that found a correlation in a small sample group, a study whose conclusions were later overturned by massive studies of huge sample groups. Unfortunately, the anti-vaccination, or “anti-vaxxer” movement, was not placated by scientific self-correction. With celebrity endorsements and a genuine online community, the anti-vaxxers have become so numerous that they are being courted by politicians, most famously Donald Trump.
Trump’s rise has been characterized by the willingness to say ever more outrageous things. The Republican debates have seen candidates compete to see who is most willing to diverge from scientific and moral principles, and who is willing to diverge the furthest. With the anti-vaxxer claims, Trump is taking advantage of scientific illiteracy.
Scientists are not without blame in all this. Whenever scientists fail to explain science in simple language, whenever scientists rely on authority rather than trusting people to understand scientific argument and evidence, they create space for people like Trump. People need to feel empowered, like science is something that belongs to them, not something that is done to them by alien creatures in mysterious laboratories. In the case of vaccines and many others, popular science, and going further, people’s science, are actually matters of life and death. The only long-term protection against Trump and pseudo-science on the one hand, and illegitimate scientific authority (whether it’s “drapetomania” or diagnosing anti-authoritarians with ODD) on the other, is if ordinary people are able to reach an understanding not just of specific scientific claims, but of how to think scientifically. It’s a huge responsibility for proponents of science. If we’re not up to the task, the Trumps of the world will be waiting.