As my only reader knows, I have long had a love/hate relationship with science. Science, as a genre, is a wonderful source of the kind of random information that my brain loves to tuck away and bring out to gloat over and play with again and again. My Viking hoard. Science, as a discipline, intensely annoys me because it seems to be so constrained by “rules” of rigour and correctness but so dishonest in not admitting that it has been so wrong so often while insisting that it is the only acceptable source of knowledge.
Why am I angry at Science right now? The lastest earth-shaking, ground-breaking news in women’s health is that Hormone Replacement Therapy increases the incidence of ovarian cancer. Science has proven that there is a statistically significant blah, blah, blah. Of course the “practioners” who have been supplying these cancer causing substances to their clients on the basis that there was no science to show thay were harmful, are explaining away the risks by using statistics to show that if 10,000 women took the drugs for a year then there would be relatively few extra deaths because this is not a VERY common type of cancer. One anticipates that these pseudo-scientists who are now denying the findings of science are going to next tell us that we are more at risk pushing a supermarket trolley across the carpark than getting ovarian cancer because of HRT.
Am I being unfair to criticise science because doctors, drug companies and politicians misuse it? No way. Science adores being used because that makes it useful and brings in the money for it to do more science. Science claims itself to be objective and value-neutral but come on, nothing done by man is objective or value-neutral and science has always served the best paymaster.
You may be thinking, “Isn’t this old news? Didn’t we hear about the risks of HRT some years ago?” Well, you are half right. We heard about the relationship between HRT and breast cancer. Actually, the incidence of breast cancer has fallen since that relationship was “discovered” and now statistics from the UK are showing that there is a clear, direct, statistically significant relationship between the reduction in the number of women taking HRT and the reduction in the rate of breast cancer. It is always good when reality proves the science.
So, why is this relationship with ovarian cancer even an issue? Surely only women who really need HRT for life-saving reasons would still be taking it? Actually it is still widely prescribed for “quality-of-life” saving reasons. Why put up with “it” if you don’t have to? “It” being a range of things like hot flashes, dry skin, wrinkles, grumpiness, heart disease and otsteoporosis, some serious some trivial but all supposedly best treated with HRT.
Again, why is this Science’s problem? Aren’t women responsible for making their own choices and if they think that wrinkles are worse than an increased cancer risk, isn’t it their choice? The thing is, doctors don’t take the time to explain to women that science is value-neutral and doesn’t care if they are in the percentage who DO get cancer because, after all someone has to be in that group just as others are in the group that DON’T get cancer. Guess what the women are thinking? “The doctor wouldn’t give this to me if it wasn’t good for me. Scientists wouldn’t have created it if it would harm me.” Innocent self-interest shuts out the possiblility of thinking, “Were the people who created, produced and marketed this product motivated by my well-being?”
Am I being a little unfair here? After all there are well-meaning doctors who believe that women don’t have to “suffer” menopause. Time for some feminist outrage. Menopause is not a disease. Yes, there is a small number of women who experience such severe changes that they feel that life is not worth living. HRT may be their best option for now but will they still feel that way when they are “living with” terminal cancer? What a choice. Life is full of choices but unfortunately we often personally don’t have much of a range of options to choose from because we are not offered the full range of theoretically possible options. As an information scavenger I know that my doctors have given me a fraction of the readily available information about my own medication. I also know that they have tried to persuade me into options that are now thought to be harmful and have not told me about alternatives because they are more expensive or not funded in NZ. As a health services consumer I have to make my choices based on label-reading just as I do as a grocery shopper (though in NZ, prescribed medication comes packaged with way less information than a can of beans). I would love to be able to rely on an “expert”, a doctor or scientist who would just do what was best for me, so my heart goes out to all those women throughout history who thought they could do just that and ended up dead statistics.
What is the alternative to science? Isn’t it our best and only valid source of knowledge? I am torn here because there is still the love part of my stormy relationship with science. I believe that science belongs to everyone and is something that people have always “done” and we have moved too far away from an intuitive folk knowledge of science that is based on observation and common sense. Common sense says that menopause is supposed to happen because it always has. Folk knowledge said that the less pleasant effects of menopause could be dealt with using remedies that didn’t have lethal long term consequences and that once women got to the other side they had reached a new stage in life where wrinkles no longer mattered. Imagine how much money we could save if wrinkles didn’t matter and value-neutral” science” could concentrate on cures for cancer instead of fighting the seven signs of aging?
Anyway. back to my current outrage with modern science. Folk science (otherwise known as commonsense) tells me that scientists should have known that HRT would increase the incidence of a variety of cancers. How should they have known? Well, they already knew that women who started menstruating early, or finished late were at increased risk of cancer because of a greater number of years of exposure to estrogen. They also knew that breastfeeding reduced the life-time cancer risk because it reduced the exposure to estrogen. My outrage is that scientists didn’t consider these simple facts when they decided that it would be a good idea to try giving women extra estrogen. I am further outraged that they also didn’t consider that the harmful effects of additional exposure to estrogen would not be evident for most women in the short-term. This is not a little “ooops we couldn’t have predicted that”. Value-neutral be damned. negligent scientists deserve a special place in hell alongside global warming denying politicians.