Whole (35 page)

It is much easier to be critical than to be correct.

—
BENJAMIN DISRAELI

A
t this point, you may be wondering: Why does the scientific establishment go along with these health-degrading schemes? Why do scientists in health-related fields produce work that supports the same strategies that have gotten us into this mess? The answer is that the goal of Truth to which academic science has always aspired has been replaced, in this distorted health system, by other goals: money, status, influence, and personal security, among others. The basis of a healthy information system is the quality of the information itself, and this industrial profit motive has distorted the very process by which the academic research that produces this information is carried out.

Recall the way information moves through the health-care system in an ideal society. The main input to that cycle is significant questions worthy of research. Scientists collectively address these questions through a healthy diversity of study designs, ranging from the extremely reductionist to the moderately wholistic and everything in between. This variety serves a couple of purposes. First, when they all more or less agree, we can be very confident in the results. Second, the reductionist studies provide new
questions, parameters, and constraints for the wholistic studies, and vice versa. And third, conflicting results gained from different types of studies show us the areas in which we may need to reframe our assumptions and pursue paradigm breakthroughs in order to get closer to the truth. As in any ecosystem, diversity contributes to the complexity, resilience, and health of the production of scientific information.

In our profit-driven system, the value added by this diversity of research is sacrificed. Instead of resulting from myriad perspectives, the weight of evidence is built from only the data deemed credible by the current paradigm—data that are the product of some form of reductionist study design. This narrow range of acceptable study methodology and research data is used to create more profit-generating “solutions” that in turn produce more problems that require research and treatment.

The question we need to ask is why. The answer, as you’ll see, is that scientists are rewarded if they contribute out-of-context information that supports industry goals while contributing to our nation’s poor health, and penalized if they don’t.

At its best and most useful, science combines the arts of wholistic observation, reductionist observation, and experimentation in pursuit of human well-being. But today we almost completely disregard the art of observation of wholes, or systems, in favor of precise quantification and manipulation of minutiae. We mistakenly judge the quality of scientific investigation in the health disciplines by its precision and focus on tiny details—in other words, on how reductionist it is. “Real” scientists investigate parts, not wholes. But this diminishes the goals of true science. What most scientists are doing today really should be called technology, not science.

This distinction matters a lot.
Technology
refers to a means, a way of accomplishing some task. It’s the last step in applied science, whereby the results of free and imaginative inquiry inform the creation of new products and services. When the “free and imaginative inquiry” phase is eliminated from the scientific roadmap, as it is in far too much medical research, we no longer have genuine science. Science is defined by the scientific method; it’s an unbiased search for truth and a willingness to be proved wrong.
Technology is defined by market potential; only those questions that can be answered with dollar signs are deemed worthy of investigation.

Modern techno-biologists are expected to look deeply into DNA and cellular metabolism, but cannot express a professional interest in a topic such as human well-being. A pursuit that broad just isn’t “scientific.” Because we limit the permissible scope of scientific inquiry to reductionist details, we have lost sight of the true meaning of human progress. We equate advancement with the development of new technologies, of new products and services, rather than human well-being and happiness.

This isn’t a new phenomenon. The subjugation of science to industrial profits has been going on for at least the past century, since capitalism devised the intellectual property protections that could fully reward those whose discoveries and inventions could be converted to products, sales, and capital. Once patent, trademark, and copyright instruments, among others, provided this protection, the engine of industrial capitalism could roar unhindered through society, using technological advancements to produce profits that were then plowed back into the system to fund more research and advancements. The system became self-replicating and self-perpetuating; initial market success provided the capital to fund subsequent market success.

The facts and information generated by science and used to create capital are the fuel that keeps the free-market engine running. The more useful the facts and information expected to be produced by a study—the better the fuel—the more likely the study is to get funded. If it won’t end up with a barcode on it, it’s probably not going to get funded.

As we’ve seen, a technological approach to nutrition—the kind that makes money for industry—includes drugs, supplements, and enriched and fortified foods. All of these are highly profitable and protected by intellectual property laws. There’s plenty of funding for this type of science, and so plenty of it gets done. By contrast, research into the nutritional effects of whole plant foods doesn’t really have market potential. You can’t patent a recommendation to eat lots of fruits, vegetables, nuts, seeds, and whole grains. So there’s no incentive for industry to invest in such research and no incentive for researchers to study and validate such claims.

Human health, happiness, and overall well-being cannot and will not be fully advanced by a corrupted free-market model manipulated by its most powerful participants. Instead of wholistic nutrition, the free-market
engine gives us marketable fragments: supplements and nutraceuticals. When we get sick from lack of proper nutrition, the market engine obliges us with reductionist solutions: patented drugs and expensive surgeries. And through it all, the research community marches to the beat set by industry, masquerading as noble seekers of truth while churning out new ways to make money at the expense of our well-being.

Do you ever wonder who pays for medical research, the kind that investigates basic biological principles and lays the groundwork for later application? University professors—at least those who are tenured—are guaranteed a salary from their institutions,
¹
but that doesn’t cover the costs of dedicated lab equipment devoted to research, or the time of the graduate assistants and postdocs who do all the grunt work.

Just as politicians must spend much of their time raising funds for reelection, so must most research scientists devote many hours to applying for and maintaining grant funding. The main sources of research funding, aside from universities, are private industry and government. Since there are more researchers seeking funding than there is money to support their research, competition for dollars is fierce. Private companies and government agencies have to make decisions about what small percentage of research grants to approve.

What we call research ranges all the way from very basic, almost esoteric investigations, to very applied experiments that might more properly be called technology development (although the division between what is basic and what is applied is often vague and vigorously contested even within a single institution). While both types of research are useful, when it comes to funding, our system is biased toward the latter—even when the funding doesn’t come from industry.

The majority of total health research, basic and applied, is funded by the pharmaceutical industry or by agencies beholden to it (such as the U.S. National Institutes of Health). Because the pharmaceutical industry expects a profitable return on that investment, its decisions on funding understandably tend toward applied science; the chief criterion they use for evaluating research proposals is usually how much money can be
made. However, even government funding, via agencies such as the NIH or the National Science Foundation (which is the primary source for basic research), imposes reductionist criteria, either directly or indirectly, on just about all research into health and nutrition.

Unfortunately, over the last few decades I have observed a gradual encroachment by the corporate sector and its priorities into the domain of basic research at universities and related research agencies. The effects of this encroachment can be seen at nearly every level, from individual study design (what gets studied and how) and the way scientists interpret their findings, to the directions their careers take.

If an applicant for basic research hopes to get funding, he or she is virtually required to ensure that the proposed hypothesis be “focused”—a code word for reductionist. To successfully compete for funding for this kind of research, applicants should want to study the detailed biological effects of a single nutrient rather than the food from which it came, or to search for the key biochemical mechanism that explains an effect rather than survey an array of possible mechanisms. In the pejorative jargon of the research community, wholistic research is described as “going on a fishing expedition” or “using the shotgun approach.”

In basic research, each new reductionist finding usually leads to an obvious question: “What next?” The almost universal (and oftentimes legitimate) response from researchers is to recommend more research. (This certainly keeps our labs funded and running!) As a consequence, these researchers limit their ability to gain broader insight into the more fundamental phenomena that should be their mandate as basic research scientists. “What’s next” is almost always another reductionist question that gets the results of the previous study closer to the marketplace. It doesn’t matter whether or not we scientists give voice to our commercial interests in these research discussions; ultimately, research findings gain value and relevance when money can be made, and that affects how we think about our next steps. Whichever way these studies are designed and executed,
they nonetheless represent steps on the pathway to commercial exploitation. Potential marketplace value has proven a powerful magnet toward which the research enterprise inexorably is pulled. In fact, as the years have passed, I have become more and more convinced that marketplace potential is the only goal of even the most basic, non-applied biomedical research.

I am not saying that individual researchers are even necessarily aware of these assumptions; they may be totally oblivious to this concern. Many researchers will be offended by these remarks and may deny that they are personally doing research for marketplace utility and possible financial return for themselves or their employer. But they are still working within a system whose primary motivation is a return on financial investment. Monetary return is the principal fuel that propels our biomedical system, and almost all professional biomedical researchers are part of and beholden to this system. The more a research investment is perceived as being able to yield a return, the more enthused and supportive the society at large becomes, from consumers and entrepreneurs to politicians and research-funding agencies.

There’s some evidence that funding pressure induces researchers to commit fraud to keep their funders happy. I’m not talking about egregious research sins like falsification or fabrication of data, but much subtler stuff. According to the colorfully titled “Scientists Behaving Badly” from the June 2005 issue of
Nature,
which reported on a survey of over 3,000 U.S.-based researchers who received NIH funding, 15 percent admitted to “changing the design, methodology or results of a study in response to pressure from a funding source.”
²
When we break out the data by career stage, things get even more interesting. While only 9.5 percent of researchers in the early part of their careers reported engaging in this behavior, that number skyrocketed to 20.6 percent for those in mid-career. It seems that industry is quite good at training scientists to comply with their market motives. As well, this increase suggests that the longer established researchers are immersed in the system, the less they want to disturb that system. They’ve
invested too much time, energy, personal identity, and professional status into their labs to put their funding at risk.

Two other admissions from the same survey help us see how these questionable practices conspire to damage the entire field of health research. First, 15.3 percent of health researchers admitted to “dropping observations or data points from analyses based on a gut feeling that they were inaccurate.” Talk about seeing what you want to see and disregarding the rest! Even if an outlier bit of data managed to survive the reductionist study design, one-seventh of the researchers felt free to ignore it based on “gut feel,” or, in other words, prejudice. Second, 12.5 percent of the researchers said they would overlook “others’ use of flawed data or questionable interpretation of data” in informing their own research agenda and supporting their own conclusions. In other words, they would pretend that bad research that bolsters their own beliefs was actually good research, and quote it within their own papers to substantiate those beliefs. The sum total of all these admissions is a medical research engine that plays fast and loose with fundamental truths, picks and chooses data to support premeditated and prepaid conclusions, and is not very likely to contradict the sales and marketing agenda of the industries that sponsor its research.

I would argue for several reasons that the percentages in the previous paragraph are actually low. First, this behavior is so automatic that much of it is done unconsciously. Many researchers are literally unaware of the corrupting influence that their funders’ expectations and pressures have on the integrity of their research. Second, “bad” behaviors are routinely underreported by survey respondents, even when assured anonymity as they were in this instance. And third, the survey response rate was just under 42 percent. It’s probable that the 58 percent who declined to return the survey were even more susceptible to funding pressure than the respondents, as most voluntary surveys are completed and returned by those with the least to hide and who are least ashamed of their behavior.