Science, Expertise and the Production of Knowledge

No, you’re not entitled to your opinion

Interesting! The above is a thought-provoking article that I started off agreeing with and then got more and more conflicted about as I read on. The following is not so much a critique of Patrick Stokes’ article as it is my thoughts about science and authority, as inspired by his article and the comments on it.

On the one hand, I hate the phrase “well, I’m entitled to my opinion” when it is used to shut down debate, as a shield against being made to face reasonable criticism. As Stokes argues, such claims seem to be confusing taste – such as holding the opinion that strawberry is better than chocolate – with views on issues that are contentious and require a measure of evidence to support one’s arguments (and, I would add, that have a significant impact on individuals or society) such as politics, science, justice and so on.

However, Stokes and his supporters in the comments are putting a lot of faith in the authority of “technical expertise” – that is to say, people who have officially recognised training, a degree, or a job in the field of concern. Stokes uses as an example the case of anti-vaccination lobbyists vs. medical scientists, a case that is difficult to argue against because anti-vaccination lobbyists are relying on research that has been debunked and have failed to come up with any alternative critique or evidence that supports their claim vaccinations are dangerous.

But what about critiques from non-expert sources that are legitimate? I don’t believe scientific knowledge is infallible simply because a scientist has created it; not even scientists believe that. There are many examples of “scientific facts” that have gone out of favour over time as different ideas were tested and rose to prominence, and there are historically and culturally specific biases in the sciences as there are in every sphere of human society. The endeavour to remain as objective as possible in scientific research needs to be tempered with the understanding that complete objectivity is not possible while human beings are doing the research and interpreting the results; our internalised received knowledge and our own embodiment must necessarily be involved in observing, analysing and reporting data, and also reading and interpreting the reports. That doesn’t make science meaningless, but it does have an effect on the meanings we ascribe to data and the way we construct “facts”. Appeals to authority in the vein of “your argument is invalid because science!” ignore the many and varied ways that knowledge is produced, and the fact that scientific knowledge is produced too, not merely revealed.

Scientists can get it wrong, I don’t think many people would disagree with that. Furthermore, scientists can focus on the wrong things – and the problem there is that often all the scientists in a particular field are so fixated on the theory or topic that is popular at the time that few people even in that field of expertise notice it’s happening. Well-established knowledge can be internalised and taken for granted even by scientists. People outside of the field – and even outside of “science” altogether – can have an understanding of scientific method and accepted scientific knowledge and can notice flaws in research design or reporting. And often people outside of “science” are focused on additional areas (such as axes of oppression, for instance) that interact with the science in ways the scientists may not have realised or anticipated.

An example of this that is obviously relevant here is fat positive rebuttals to the accepted knowledge about “obesity”. There are legitimate critiques that have been made in and out of academia against claims that fatness is in and of itself an indicator and cause of poor health, against claims that calorie restriction and bariatric surgery are helpful and appropriate “treatments” for fatness, and against public policies and opinions based on those claims (and based on poor media reporting of those claims, too). Those critiques are legitimate even when they come from commentators who are not medical scientists.

Of course, Stokes does say that what one is entitled to is not opinion but argument – if you can back up your assertions with evidence then the critique may be valid. I can agree with that with the caveat that I think it’s important to recognise valid and relevant evidence may not be scientific in origin (although that kind of evidence can be both valuable and a useful way of dealing with opponents who do not believe information that doesn’t come out of a university or research institute). Lived experience may be readily dismissed as “anecdata” by some, but it is important. A person with an illness or disability who has made an effort to educate themselves on their own care is able to be just as much of an expert about their own health as a doctor who is not living in their body, if not more so. There’s even a great deal of research into the phenomenon of the expert patient, the “third shift” of working to maintain one’s own health with a chronic condition, and the frustrations chronically ill and disabled people have with medical experts who do not take their knowledge about their own bodies seriously.

To look at fatness as a topic again, fat people frequently face poor treatment from health practitioners who refuse to treat their symptoms and want to focus solely on their fatness. This has happened to me personally on multiple occasions, such as the physiotherapist (!) who claimed I ate too many carbs despite my reported food intake giving the opposite impression, and the women’s health clinic GP who told me my chronic abdominal pain (which later turned out to be caused by endometriosis) was diverticulitis, without a pelvic exam or a colonoscopy, and then told me I didn’t need to do anything except watch what I ate. Of course, even if it had been diverticulitis, I would have required more than an admonition to “eat better” to relieve the pain (eat better than what I don’t know – she never asked me what I actually ate). Neither of these health “experts” thought they needed to pay attention to my reports of my own behaviour or experiences because my fatness told them all they needed to know. Fat people’s expertise on their own bodies and their own health-related behaviours is frequently questioned, ignored or outright dismissed.

Furthermore, as I’ve mentioned before on this blog, people don’t have an obligation to live up to current standards of good health in order to be treated with the basic human respect afforded to thin people. Fat people have no extraordinary responsibility for “healthy” behaviour over that of thin people. Regardless of the validity or otherwise of scientific claims about fat being unhealthy, it’s perfectly okay to be fat. Fat people shouldn’t have to prove how obedient we are to escape victimisation; that kind of grudging acceptance is no victory at all. And we should all resist the temptation to demonstrate what good fatties we are by trotting out blood pressure stats and daily food-and-exercise diaries and report cards from our GPs while fighting for fat liberation. Don’t play by the rules that have been made by fat-haters. Don’t bend to the demands on you to prove your worth. Your worth is self evident.

I don’t think the reason that claims about the dangers of vaccinations should be dismissed is because they come from laypeople, but because they are flawed claims that don’t appear to hold up to scrutiny. I do think that deifying SCIENCE! and SCIENTIFIC EXPERTS! as the fount of all meaningful knowledge is silly. Science is great, and I appreciate those science communicators and educators who are working to improve laypeople’s understanding of scientific method and terminology so as to improve science reporting and knowledge in the non-academic community. But it’s not the only valuable source of information in the world, and a focus on scientifically produced knowledge as more valuable than any other kind seems to work more often in favour of the privileged than the oppressed.

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One thought on “Science, Expertise and the Production of Knowledge

  1. Ollie NcLean says:

    You talk a lot about scientists – and then you mention health practitioners. Health practitioners, although broadly informed by a lot of information that has come from science, have minimal scientific training, and in particular, are notorious for poor understanding of statistics. Similarly, practitioning engineers constantly use tools that were derived through scientific methods, but my four-year engineering course included a total of 8 hours of statistics training, and a good proportion of my colleagues wouldn’t know the difference between a prior and a pancreas. By contrast, meteorologists have exceptionally well calibrated statistical interpretations of the world around them.

    It is a large part of MBBS courses to examine research papers and policy papers, and medical doctors are required as part of their registration to undergo professional development that should expose them to materials derived from science. Having seen both the MBBS training and overseas-trained doctor accreditation programmes, I have a strong appreciation for the immense amount of knowledge that medical doctors are required to learn. However, they are not scientists.

    What medical practitioners do is not science, not by a long, long way. Conflating the two is a confusion.

    By contrast, medical scientists, who write the guidelines used by medical practitioners, are not only increasing the amount of information available about certain conditions, but are generally extremely well informed about the other research that has been conducted in a given field. For a given “person with an illness…” to gain as much expertise as one of this sort of expert, they must not only dedicate a large portion of their time, they must also gain access to the journals and other publications, which are often prohibitively expensive for the typical consumer.

    Consider the other sort of “health practitioners” – providers of alternative therapies. These people may dedicate significant time to researching various conditions, but their research may based on falacious assumptions, and may be performed in such a way that does not paint a true picture of reality. They can _argue_ their points, but alternative therapy providers are typically dealing with exactly the sort of information that is best examined by science.

    Of course there are other sorts of valuable information apart from scientific information. Ethics, language, law, art – all these are essential intellectual pursuits. However, if they make assumptions that are at odds with well established science, they make baby Pierre-Simon de Laplace cry.

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