continuing from part one:
The pressures discussed previously are at work within medicine. The fact that, on a certain level, much can be achieved by the application of well-established medical knowledge in relatively underdeveloped parts of the world may help to distract attention from areas of neglect in more innovative fields of research. Much that is obviously useful can be achieved by applying to very large populations simple pieces of knowledge resulting from what was once pioneering research. Because of this, it is easy to lose sight of the fact that it is new advances in knowledge, the significance of which cannot be assessed in advance, that may have the greatest effect on the potentialities open to the human race.
Actually, the consequences of the present trends appear to be somewhat different from what is usually supposed. A very small fraction of research work done in universities is "useful" in any sense, and the standards of it are quite possibly declining, for two reasons. One of these is that what serves to advance a scientist's career is the number of papers he has published, and scientists are thus under pressure to maximize this number with little regard for their content or quality; and the second is that papers that produce socially acceptable results are likely to meet with more social reward than those that do not, regardless of their technical qualities as pieces of work.
The expectation that things will be done well and effectively if they are done by large numbers of people acting together with a minimum of independence depends on somewhat uncynical assumptions about human motivation. If people are put into positions of social authority, their motivation is unquestionable; they are there to do good. If people are socially authorized scientists they are there to do science, and they are supposed to be additive: several scientists will do more science than one scientist. A statistician once remarked to me, attempting to reconcile me to the tedium of discussing a piece of work with a committee, "Discussion is always a good thing. Many heads are sure to be better than one."
In fact, the state may be disposing of colossal funds and resources for research, and deploying millions of people, but it does not follow that what is being done is necessarily advancing knowledge at a greater rate than would be achieved by even a small number of individuals who had some peculiarity of motivation that made them wish to find things out, and who also happened to dispose of financial resources that, while infinitesimal compared with the totality of those wielded by the state, were still large in relation to the capital which it is at all easy for a single individual to acquire in modern circumstances. Nor does it follow that a committee consisting of a dozen people with an average IQ of 150 will wield an effective IQ of 1,800.
What, in fact, are the motives of professional, state-supported scientists and members of directing committees likely to be, and are such people likely to interact constructively or destructively? It is an easy guess that they will be predominantly interested in their own social advancement; they will want to make decisions that will impress other people as the right kind of decisions, and they will want to do or see done the kind of research that other people will reward with higher degrees and similar marks of social favor. If young scientists are too strongly motivated in any other way — by intellectual curiosity, say, or by a desire to seek out fundamental paradoxes in the nature of things — they may well find themselves unable to stay the educational course that leads to life as a socially accredited and salaried research worker.
Some years ago a course of lectures on scientific research was given in Oxford, intended to provide information and preparation for those who might be considering proceeding to do research in the form of a higher degree. As reported to me at the time, the general tenor of these lectures was as follows: "Young people have an idea that when they start doing scientific research they will be breaking new ground and dealing with issues of burning interest. This is not so; they have to realize that research is not like this. What people do in the course of working for a D.Phil. is of practically no interest to anybody. The average number of people who read a scientific doctoral thesis, other than the author's relatives and supervisor, is estimated to be 1.8."
But even if the greater part of modern research really is uninteresting, in every possible sense, a very great deal of it is being done. As already mentioned, what advances someone's career in social terms is the production of papers. Broad and Wade have observed, "The preoccupation with publications has resulted in a veritable ocean of journals and papers. Today, there are at least 6,000 journals in medicine alone. An additional reason for the number of journals is the tremendous increase in the ranks of scientists themselves. It has been estimated that 90 percent of all scientists who ever lived are alive today." (1)
Estimates have been made of what fraction of the research being done is useful, at least in the sense that it is referred to in papers by other scientists. This is not a very high standard of usefulness, and, of course, work that is of poor quality but is ideologically attractive may well be cited frequently; it, then, will qualify as contributing to progress on this criterion. However, even estimates of this kind show that only a tiny fraction of the research papers produced have any influence on the work of other scientists and can thus be regarded as contributing to progress. According to Broad and Wade, "The available evidence indicates that the great majority of research responsible for the advances of science is produced by a small number of scientists. This small elite depends overwhelmingly on the research of other members of the elite, not on that of the wider majority. The pace of scientific advance would not obviously be slowed if this majority did not exist. It might even be enhanced if pursued by a leaner and fitter community of researchers. Perhaps there are too many scientists. Perhaps basic scientific research would be more appropriately supported by private patrons, as economist Milton Friedman has suggested, instead of by the government" (2).
One line of defence that might well be adopted by a proponent of the modern orthodoxy would be to inquire earnestly what scientific or medical research one thought was being neglected, and to require a statement of exactly what beneficial developments might be forthcoming if things were done differently. But, it is essentially the case that what is being neglected is invisible; all that can be done is to point out the presence of a very strong ideology in a position of dominance. From the requirements of the ideology one can, perhaps, indicate certain areas in which it is unlikely that research of a progressive nature will be done, but it is possible only to adumbrate vaguely some of the potentialities that might begin to emerge if it were.
The modern ideology is certainly operative within medicine — including particularly strong ideas on the nature of human beings and in what relationship they should be to society, and these ideas undoubtedly have their effect on the way medicine regards those to whom it is ministering.
It may appear that little is lost by the non-pursuit of research in some of the neglected areas; the findings, if any, could surely not be of great fundamental significance. But it is characteristic of research that one cannot be sure how interesting or significant the findings may be until one has made them, and any ideological restraint upon the extension of knowledge is a serious matter.
In conclusion, let me point out another consequence of a dominant orthodoxy which may also be overlooked. It is that it inhibits research even if the orthodox opinion is actually correct. Only research that may be expected to support it in the crudest and most obvious way is likely to be encouraged; areas that could lead to heresy must be ignored. Now it might sometimes be that research in "heretical" areas leads to an expansion of knowledge and that once it is obtained, it is observed to be compatible with the desired view of the matter after all. But, in general, there is little tendency for researchers to risk being placed under pressure to refine or develop the ideas accepted as correct, and areas of weakness, incoherence, or paradox are passed over in a discreet silence, rather than regarded as promising fields for enlightening investigation.
1. William Broad and Nicholas Wade, Betrayers of the Truth (New York: Simon and Schuster, 1982), p.53.
2. ibid, pp.222-223.