John Ruffin, former head of the National Institute of Minority Health and Health Disparities wrote:
"The
19th-century scientist and pathologist Rudolph Virchow gave voice to many of
our present-day concerns about disparities and went a long way toward defining
the task before us. A socially minded man, he believed that science should
speak the language of the common people and that medicine should serve the
public's health. He wrote, 'If medicine is to fulfill her greatest task, then
she must enter the political and social life…'"
Do you agree and why? Is it permissible for scientists to become advocates in the areas of their research? What steps can one take to balance advocacy with the objectivity that is considered the ideal in scientific inquiry?
There is plenty to unpack with regard to Virchow’s statement. Ruffin suggests that Virchow’s statement considers medicine’s “greatest task” to be the service of public health. I agree with this. It’s interesting to consider the environment in which Virchow made his statement. He is known as the “father of modern pathology,” and as such, he must have seen enormous potential to benefit society through the almost completely uncharted territory of tissue pathology. He lived through the industrial era, and probably envisioned a future society where beneficial policies were guided by the discoveries of medicine.
In regard to scientists advocating for areas of research, I
think this is often necessary. It’s hard to estimate the value of a lot of
scientific endeavors, and without substantial passion and advocacy from scientists
conducting the research, many potentially useful experiments would never
happen. Like most ideas in discussed in this course, however, there isn’t just
a single way to advocate, nor is it always the best option. Virchow was a
leading figure in his time for scientific advocacy, and he often promoted his
own work at the expense of others. For example, he did not believe that the germ
theory of pathology was correct, and he actively spoke out against it, stating
that if he could repeat his life, he would spend it proving that germs seek to take
advantage of diseased tissue rather than to cause disease. As a leading figure,
he may have knowingly or unknowingly caused a delay in the uptake of better
practices in medicine, such as sterile technique, all while his own research interests
were furthered.
Resnik and Elliot spend a lot of time talking about values in science and
medicine. I feel like their ideas reflect the spirit of Virchow’s statement
about medicine entering the political and social life, but the argument has
more than 100 year’s worth of additional consideration on the matter. They
suggest that there are already obvious values inherent in science and medicine,
like the values of objectivity and accuracy. What is also clear, is that advancements
often have a potential to benefit society by improving the design of laws, technology, medical practice, etc. Because scientists and
physicians have benefitted from the support that society has provided them, it
seems fair that the values included in their work should be neutral or beneficial
to the extent that the they affect areas beyond the work itself. This can be
accomplished by identifying what potentially could be affected by ongoing efforts
and address any concerns, conflicts of interest, or otherwise through open discussion.
Please describe a controversy for health disparities research that you learned about in this course, or alternatively an area of research that should be prioritized in health disparities. Include why you find this area interesting or controversial.
One concept resulting in many controversies that I became aware of during the course was that a lot of research in medicine is conducted amongst populations that are less diverse than the groups to which the results apply. Part of the problem with this was summarized well; Imagine that one is studying a disease in a population that is homogeneous with respect to an important component risk factor for the disease. That factor would never be identified because there is no comparator group. This idea has resonated with me because I’m aware that in dementia research, there is a disparity in representation among many groups of people. I think that as science continues to gain traction in understanding neurodegenerative disease, it will be critical to expand the inclusion criteria for research studies.