Saturday, 29 June 2013

Hilary and Steven Rose lift the lid on modern biomedical science.

Science is neither politically nor ethically neutral. Science as a social activity runs on priorities and interpretation, each of which has political and ethical significance; priorities set by governments and funding agencies. Modern science is big business. Science is a competitive enterprise. Big groups compete for funding and they compete for a platform to push their pitch. It is the story of science that is rarely told.

Science I hear you say is surely 'objective'. It sets about measuring things and testing ideas. But scientists do not work in a vacuum. Scientists are positioned, culturally at least to view the world in the way we do. What we measure and how we interpret the findings has as much significance as the measure itself. What we measure has as much to do with funding as it does with 'pure scientific endeavour'. Promotion within modern academic institutions has more to do with the size of the pot of funding a scientist can bring than on intellectual merit. We are encouraged to think within the  box rather than challenge it. It is surely best to be honest about this.

Honesty is what we find in Hilary and Steven Rose's book, Genes, Cells and Brains: The Promethean Promises of the New Biology. It is a book I would recommend all students of science to read. It is a book I would recommend we all read because it lifts the lid on the enterprise of science. It is honest because the authors do not hide their left wing political credentials. Theirs is a  distinctly Marxist view of the world. As a result I have seen this book dismissed crudely by those who find the story uncomfortable.

What these distinguished authors do is "trace the unfolding narratives of the biotechnosciences of genomics, regenerative medicine and the neurosciences" in the context of global neoliberalism and the culture of the 21st century. It is a story much of which I recognise from my own four decades working in academic institutions first as a neuroscientist and then as a biomedical ethicist. But it is a narrative they develop with precision and insight. It is a challenging story.

As an ethicist I was certainly challenged by the chapter on bioethics as part of the enterprise. Indeed an enterprise in itself. Much of what we do in bioethics is locked in to the science itself. Modern ethics, like science, claims a neutrality; it is as if it comes from nowhere. Yet much of what we do is self-justificatory. It asks not whether we should do something but rather what the justification for doing it can be. And in its utilitarian view 'science' often provides the justification in terms of numbers who may benefit. In weighing the benefits and harms, who is to say how much benefit outweighs any given amount of harm? The currency of exchange is often provided by the science itself. It is as if there can be a dessicated answer free from position, free from the narrative we share, free from emotion; a calculated balance; a formulaic ethic. And as Hilary and Steven point out any major biomedical project will today have an embedded ethicist on the payroll. Indeed so, I have been one such.

They also point out the link between the major science funding agencies such as the Wellcome Trust and the Medical Research Council and the major UK ethics bodies such as the Nuffield Foundation for Bioethics. These organisations are conjoined like twins sharing the same blood supply.

And what then of the Promethean promise? The last few decades, Hilary and Steven note, have been exciting times for bioscientists. It has been full of promise as it persuaded governments and funding agencies that big funding would lead to success, particularly in genomics and the birth of new biotech industries. For major diseases there would be a genetic cause for which a gene therapy would provide the cure; a brave new world of individually tailored medicine.

But with this new biology came a new language with a culture of metaphors that have influenced more than the science. The language of 'codes' and 'blueprint' that has influenced politics and the search for the holy grail, or as the authors say the Gene Grail. It is informatics gone mad with hope; the hope that somehow this 'code' can be unravelled; and where 'genes' don't provide the answer, they use proteomics, trying to correlate gene expression with given diseases. A decade passes without much success, so the answer must lie in getting more funding to get bigger databases, more information, more correlation power for the risk of this or that condition. New breeds of scientific entrepreneurs have "emerged from the universities and stormed into the corporate world."

Far from this information creating certainty, it creates uncertainty. The genetic complexity leads to predictive weakness with at best an associated risk.  Yet it is big business. Big Pharma's profits continue to rise, but this rise conceals a problem. The cost of bringing a new drug to market has risen to over a billion dollars. And where are these new drugs? The truth is that more and more drugs are failing in the advance stages of trials. The magic bullet is elusive.

If you want a challenging read then I can recommend this book. Indeed I would say it is compulsory reading for those who want to see a true public understanding of science, and who want to see science understood in its social and political context.

Hilary and Steven Rose's book, Genes, Cells and Brains: The Promethean Promises of the New Biology is published by Verso Books.

You may also be interested in my article: Rocking the Foundations of Biology and Politics

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