Tag Archives: knowledge

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Should We Bell the Cat?

What should you do at a dinner party if the hostess, say, declares that she believes something that you know to be inaccurate -or worse, that you consider repellent? Abhorrent? Should you wait to see how others respond, or take it upon yourself to attempt to correct her belief? If it is merely a divergence of opinion, it might be considered a doctrinaire exercise -a Catholics vs Protestant type of skirmish- and likely unwinnable.

But, suppose it is something about which you are recognized to have particular credentials so your response would not be considered to be merely an opinion, but rather a statement of fact? Should that alter your decision as to whether or not to take issue with her pronouncement? Would your silence imply agreement -acquiescence to a view that you know to be not only wrong, but offensive? And would your failure to contradict her, signal something about her opinion to the others at the table? If it is an ethical issue, should you attempt to teach?

It is a difficult situation to be sure, and one that is no doubt difficult to isolate from context and the responsibilities incumbent upon a guest. Still, what should you do if, uncorrected, she persists in promulgating her belief? Should you leave the table, try to change the topic, or merely smile and wait to see if she is able to sway those around you to her views?

I can’t say that the situation has arisen all that often for me, to tell the truth -we tend to choose our friends, and they theirs, on the basis of shared values- but what risks might inhere in whatever course of action I might choose? I happened upon an insightful and intriguing article that touched on that very subject in Aeon, an online magazine:  https://aeon.co/ideas/should-you-shield-yourself-from-others-abhorrent-beliefs It was written by John Schwenkler, an associate professor in philosophy at Florida State University.

He starts, by pointing out that ‘Many of our choices have the potential to change how we think about the world. Often the choices taken are for some kind of betterment: to teach us something, to increase understanding or to improve ways of thinking. What happens, though, when a choice promises to alter our cognitive perspective in ways that we regard as a loss rather than a gain?’

And further, ‘When we consider how a certain choice would alter our knowledge, understanding or ways of thinking, we do this according to the cognitive perspective that we have right now. This means that it’s according to our current cognitive perspective that we determine whether a choice will result in an improvement or impairment of that very perspective. And this way of proceeding seems to privilege our present perspective in ways that are dogmatic or closed-minded: we might miss the chance to improve our cognitive situation simply because, by our current lights, that improvement appears as a loss. Yet it seems irresponsible to do away entirely with this sort of cognitive caution… And is it right to trust your current cognitive perspective as you work out an answer to those questions? (If not, what other perspective are you going to trust instead?)’

You can see the dilemma: is the choice or opinion you hold based on knowledge, or simply belief? And here he employs a sort of thought experiment: ‘This dilemma is escapable, but only by abandoning an appealing assumption about the sort of grasp we have on the reasons for which we act. Imagine someone who believes that her local grocery store is open for business today, so she goes to buy some milk. But the store isn’t open after all… It makes sense for this person to go to the store, but she doesn’t have as good a reason to go there as she would if she didn’t just think, but rather knew, that the store were open. If that were case she’d be able to go to the store because it is open, and not merely because she thinks it is.’

But suppose that by allowing an argument -an opinion, say- to be aired frequently or uncontested, you fear you might eventually be convinced by it? It’s how propaganda endeavours to convince, after all. What then? Do you withdraw, or smile and smile and see a villain (to paraphrase Hamlet)? ‘If this is on the right track, then the crucial difference between the dogmatic or closed-minded person and the person who exercises appropriate cognitive caution might be that the second sort of person knows, while the first merely believes, that the choice she decides against is one that would be harmful to her cognitive perspective. The person who knows that a choice will harm her perspective can decide against it simply because it will do so, while the person who merely believes this can make this choice only because that is what she thinks.’

This is philosophical equivocation, and Schwenkler even admits as much: ‘What’s still troubling is that the person who acts non-knowingly and from a mere belief might still believe that she knows the thing in question… In that case, she’ll believe that her choices are grounded in the facts themselves, and not just in her beliefs about them. She will act for a worse sort of reason than the sort of reason she takes herself to have.’

As much as I enjoy the verbiage and logical progression of his argument, I have to admit to being a little disappointed in the concluding paragraph in the article, that seems to admit that he has painted himself into a corner: ‘What’s still troubling is that the person who acts non-knowingly and from a mere belief might still believe that she knows the thing in question: that climate change is a hoax, say, or that the Earth is less than 10,000 years old. In that case, she’ll believe that her choices are grounded in the facts themselves, and not just in her beliefs about them. She will act for a worse sort of reason than the sort of reason she takes herself to have. And what could assure us, when we exercise cognitive caution in order to avoid what we take to be a potential impairment of our understanding or a loss of our grip on the facts, that we aren’t in that situation as well?’

But, I think what this teaches me is the value of critical analysis, not only of statements, but also of context. First of all, obviously, to be aware of the validity of whatever argument is being aired, but then deciding whether or not an attempted refutation would contribute anything to the situation, or merely further entrench the individual in their beliefs, if only to save face. And as well, it’s important to step back for a moment, and assess the real reason I am choosing to disagree. Is it self-aggrandizement, dominance, or an incontestable conviction -incontestable based on knowledge or unprovable belief…?

I realize this is pretty confusing stuff -and, although profound, not overly enlightening- but sometimes we need to re-examine who it is we have come to be. In the words of the poet Kahlil Gibran, The soul walks not upon a line, neither does it grow like a reed. The soul unfolds itself like a lotus of countless petals.

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Understanding as…

There is so much stuff out there that I don’t know -things that I hadn’t even thought of as knowledge. Things that I just accepted as ‘givens’.  You know, take the ability to understand something like, say, an arrangement of numbers as a series rather than a bunch of numbers, or the ability to extract meaning from some sounds -for example words spoken in English- and yet not others in a different language.

And, perhaps equally mysterious is the moment when that epiphany strikes. What suddenly changes those numbers into a series? Is it similar to what makes figure-ground alterations flip back and forth in my head: aspect perception? Is it analogous to the assignation of meaning to things -or, indeed, picking them out of the chaos of background and recognizing them as somehow special in the first place? Is it what Plato meant when he referred to the Forms –‘chairness’ or ‘tableness’ for example- abstractions that allow us to identify either, no matter how varied the shapes or sizes -the true essence of what things really are?

I suppose I’m becoming rather opaque -or is it obtuse?- but the whole idea of aspect perception, of ‘seeing as’, is an exciting, yet labyrinthine terra incognita, don’t you think? I’m afraid that what started it all was an essay in the online Aeon publication: https://aeon.co/ideas/do-you-see-a-duck-or-a-rabbit-just-what-is-aspect-perception

It was the edited version of an essay written by Stephen Law, the editor of the Royal Institute of Philosophy journal THINK. He begins by discussing some of the figure-ground changes found in, say Necker cubes whose sides keep flipping back and forth (a type of aspect perception) and then suggests that ‘A[nother] reason why changes in aspect perception might be thought philosophically significant is that they draw our attention to the fact that we see aspects all the time, though we don’t usually notice we’re doing so… For example, when I see a pair of scissors, I don’t see them as a mere physical thing – I immediately grasp that this is a tool with which I can do various things.’

Another example might be ‘…our ability to suddenly ‘get’ a tune or a rule, so we are then able to carry on ourselves.’ Or, how about religion? ‘The idea of ‘seeing as’ also crops up in religious thinking. Some religious folk suggest that belief in God doesn’t consist in signing up to a certain hypothesis, but rather in a way of seeing things.’ But then the caveat: ‘Seeing something as a so-and-so doesn’t guarantee that it is a so-and-so. I might see a pile of clothes in the shadows at the end of my bed as a monster. But of course, if I believe it’s a monster, then I’m very much mistaken.’

I have always loved wandering around bookstores. Maybe it’s an asylum -a refuge from the noisy street, or a spiritual sanctuary in a chaotic mall -but it’s more likely that the range and choice of books allows me to exercise an epiphanic region of my brain, and to practice ‘seeing as’ to my heart’s content. I’d never thought of bookstores as exercise before, of course, but I suppose the seed of ‘understanding as’ was sown by that article… or maybe it was the little girl.

Shortly after reading the essay, I found myself wandering blissfully through the quiet aisles of a rather large bookstore that seemed otologically removed from the noisy mall in which it hid. Coloured titles greeted me like silent hawkers in a park, the ones that sat dislodged from their otherwise tidy rows, sometimes reaching out to me with greater promise: curiosity, as to why someone might have dislodged them, perhaps. But nonetheless, I also found myself amused at their choices: book shops are catholic in the selection they proffer and I relish the opportunity to switch my perspectives… and expand my Weltanschauung, as the Philosophy section into which I had meandered might have put it when the thought occurred.

Of course, unexpected concepts like that are one of the delights of a bookstore -turn a corner into a different aisle and the world changes. It’s where I met the little girl talking to her mother about something in a book she was holding.

No more than four or five years old, she was wearing what I suppose was a pink Princess costume, and trying to be very… mature. Her mother, on the other hand, was dressed for the mall: black baseball cap, jeans, sneakers, and a grey sweatshirt with a yellow mustard stain on the front. Maybe they’d just come from a party, or, more likely, the Food Court, but the mother was trying to explain something in the book to her little daughter. The aisle wasn’t in the children’s section, but seemed to have a lot of titles about puzzles, and illusions, so maybe they’d wandered into it for something different: for surprises.

As I pretended to examine some books nearby, I noticed a Necker’s cube prominently displayed on the page the girl was holding open.

“Why does it do that, mommy?” Even as she spoke the perspective of the cube was flipping back and forth, with one face, then another seeming to be closer.

The mother smiled at this obvious teaching moment.

“It’s a great idea, anyway,” the daughter continued, before she got an answer.

“Idea…?” the mother said, with a patient look on her face. “What’s the idea, Angie?”

Angie scrunched her forehead and gave her mother a rather condescending look. “It’s an exercise book, remember?”

That apparently caught the mother by surprise. “It’s a book of puzzles and magic, sweetheart. I didn’t see any exercises.”

Angie rolled her eyes at her mother’s obvious obtuseness. “The nexercise cube, mommy…!”

“Necker’s cube, sweetie,” she responded, trying to suppress a giggle. “It’s not an exercise cube.”

But Angie was having none of that, and stared at her like a teacher with a slow pupil. “It keeps making my mind move, mommy!” She shook her head in an obviously disappointed rebuke. “That’s exercise.”

I slipped back around the corner, unnoticed by them both I think. I felt I’d intruded on a very intimate moment and I didn’t want to trespass, but I couldn’t help wondering if Angie had come far closer to understanding Plato’s Forms than her mother or I could ever hope to.

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Is there nothing either good or bad but thinking makes it so?

Sometimes there are articles that set my head spinning. Or my mind. Ideas that I’d never thought of before. Ideas that make me rummage around deep inside, like I’m searching for a pencil, or my internal keyboard where I write the things I should remember. I often don’t, of course –remember them, I mean -how do you summarize and store enlightenment for a day, a week, a lifetime later? Sometimes you just have to explain it to yourself in your own words.

I subscribe to the online Aeon magazine -well, its newsletter, anyway- and I have to say that many of its articles are sufficiently mind-expanding as to qualify as epiphanous. Heuristic.

One such article on belief started me thinking. It was written by Daniel DeNicola, professor and chair of philosophy at Gettysburg College in Pennsylvania: https://aeon.co/ideas/you-dont-have-a-right-to-believe-whatever-you-want-to  It questions whether we have the right to believe whatever we want -the abnegation of which is in itself anathema in many quarters. But surely there’s no harm in having the unfettered right to believe whatever.

And yet, as he asserts, ‘We do recognise the right to know certain things. I have a right to know the conditions of my employment, the physician’s diagnosis of my ailments … and so on. But belief is not knowledge. Beliefs are factive: to believe is to take to be true … Beliefs aspire to truth – but they do not entail it. Beliefs can be false, unwarranted by evidence or reasoned consideration. They can also be morally repugnant… If we find these morally wrong, we condemn not only the potential acts that spring from such beliefs, but the content of the belief itself, the act of believing it, and thus the believer.’

‘Such judgments can imply that believing is a voluntary act. But beliefs are often more like states of mind or attitudes than decisive actions … For this reason, I think, it is not always the coming-to-hold-this-belief that is problematic; it is rather the sustaining of such beliefs, the refusal to disbelieve or discard them that can be voluntary and ethically wrong.’

In other words, I may inherit a belief from my family, or the circle of friends I inhabit, but that is no excuse for continuing to hold them if I come realize they are harmful or factually incorrect.

‘Believing has what philosophers call a ‘mind-to-world direction of fit’. Our beliefs are intended to reflect the real world – and it is on this point that beliefs can go haywire. There are irresponsible beliefs; more precisely, there are beliefs that are acquired and retained in an irresponsible way. One might disregard evidence; accept gossip, rumour, or testimony from dubious sources; ignore incoherence with one’s other beliefs; embrace wishful thinking ….’

Here, though, DeNicola issues a caveat. He does not wish to claim, that it is wrong, always, everywhere, and for anyone, to believe anything upon insufficient evidence. ‘This is too restrictive. In any complex society, one has to rely on the testimony of reliable sources, expert judgment and the best available evidence. Moreover, as the psychologist William James responded in 1896, some of our most important beliefs about the world and the human prospect must be formed without the possibility of sufficient evidence. In such circumstances … one’s ‘will to believe’ entitles us to choose to believe the alternative that projects a better life.’

Our beliefs do not have to be true if it is not possible to know what actually is true, or turns out to be the truth. As an example, ‘In exploring the varieties of religious experience, James would remind us that the ‘right to believe’ can establish a climate of religious tolerance.’ But even here, intolerant beliefs need not be tolerated: ‘Rights have limits and carry responsibilities. Unfortunately, many people today seem to take great licence with the right to believe, flouting their responsibility. The wilful ignorance and false knowledge that are commonly defended by the assertion ‘I have a right to my belief’ do not meet James’s requirements. Consider those who believe that the lunar landings or the Sandy Hook school shooting were unreal, government-created dramas … In such cases, the right to believe is proclaimed as a negative right; that is, its intent is to foreclose dialogue, to deflect all challenges; to enjoin others from interfering with one’s belief-commitment. The mind is closed, not open for learning. They might be ‘true believers’, but they are not believers in the truth.’

So, do we accept the right of the bearers of those beliefs to silence the rest of us, or should they merely be allowed to coexist in the noise? DeNicola wants to think, ‘[T]here is an ethic of believing, of acquiring, sustaining, and relinquishing beliefs – and that ethic both generates and limits our right to believe.’

But, I wonder if the ethic is truly assignable -the noise can be overwhelming, and those who are the most persistent in its production end up deafening the rest of us. And although any responsibility for their belief should imply accountability, to whom are they accountable -to those in power, or to those who also share the belief? Do those with firmly held beliefs read articles like the ones in Aeon? And would they be swayed by the arguments even if they did?

Is it my responsibility to convince my opponents that my beliefs are right, or rather to set about proving that theirs are wrong? A fine distinction to be sure, and one that seems inextricably embedded in the web of other beliefs I have come to accept as valid markers of reality. And yet I think the thesis of DeNicola’s argument -that a belief, even if possibly untrue, should at the very least, not be dangerous, threaten harm, or prevent others from believing something else- is the most defensible. If nothing else, it carries the imprimatur of several thousand years of wisdom: the concept of reciprocity -the Golden Rule, if you will: what you wish upon others, you wish upon yourself. Or, in the Latin of the Hippocratic Oath: Primum non nocere -First of all, do no harm.

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Nobody in Particular

Why do we believe something? How do we know that we are right? When I was a child, I was certain that the Fleetwood television set my parents had just purchased, was the best. So was the make of our car -and our vacuum cleaner too, come to think of it. But why? Was it simply because authority figures in my young life had told me, or was there an objective reality to their assertions? For that matter, how did they know, anyway? Other parents had different opinions, so who was right?

I was too young to question these things then, but gradually, I came to seek other sources of knowledge. And yet, even these sometimes differed. It’s difficult to know in what direction to face when confronted with disparate opinions. Different ‘truths’. Everybody can’t be right. Usually, in fact, the correct answer lies somewhere in the middle of it all, and it becomes a matter of knowing which truths to discard -choosing the ‘correct’ truth.

Despite the fact that most of us rely on some method like this, it sounds completely counterintuitive. How many truths can there be? Is each a truth, or merely an opinion? And what’s wrong with having a particular opinion? Again, how would we know? How could we know?

Nowadays, with social media algorithms selecting which particular news they report on the basis of our past choices, it’s difficult to know if we are in an echo chamber unless we purposely and critically examine whatever truths we hold dear -step back to burst the bubble. Canvas different people, and sample different opinions. But, even then, without resorting to mythology, or a presumed ‘revealed’ truth that substantiates a particular religious dogma, is there an objective truth that somehow transcends all the others? Conversely is all truth relative -situationally contextualized, temporally dependent, and ultimately socially endorsed?

Should we, in fact, rely on a random sample of opinions to arrive at an answer to some questions that are only a matter of values, but not about realistically verifiable facts -such as the height of a building, say, or maybe the type of bacterium that causes a particular disease? Would that bring us closer to the truth, or simply yet another truth?

Well, it turns out that the average of a large group of diverse and even contrary opinions has some statistical merit: http://www.bbc.com/future/story/20140708-when-crowd-wisdom-goes-wrong  ‘[T]here is some truth underpinning the idea that the masses can make more accurate collective judgements than expert individuals.’ The Wisdom of Crowds ‘is generally traced back to an observation by Charles Darwin’s cousin Francis Galton in 1907. Galton pointed out that the average of all the entries in a ‘guess the weight of the ox’ competition at a country fair was amazingly accurate – beating not only most of the individual guesses but also those of alleged cattle experts. This is the essence of the wisdom of crowds: their average judgement converges on the right solution.’

But the problem is in the sampling -the diversity of the members of that crowd. ‘If everyone let themselves be influenced by each other’s guesses, there’s more chance that the guesses will drift towards a misplaced bias.’ Of course ‘This finding challenges a common view in management and politics that it is best to seek consensus in group decision making. What you can end up with instead is herding towards a relatively arbitrary position. Just how arbitrary depends on what kind of pool of opinions you start off with. […] copycat behaviour has been widely regarded as one of the major contributing factors to the financial crisis, and indeed to all financial crises of the past. [And] this detrimental herding effect is likely to be even greater for deciding problems for which no objectively correct answer exists. […] All of these findings suggest that knowing who is in the crowd, and how diverse they are, is vital before you attribute to them any real wisdom.’

This might imply that ‘you should add random individuals whose decisions are unrelated to those of existing group members. That would be good, but it’s better still to add individuals who aren’t simply independent thinkers but whose views are ‘negatively correlated’ – as different as possible – from the existing members. In other words, diversity trumps independence. If you want accuracy, then, add those who might disagree strongly with your group.’

Do you see where I’m going with all this? We should try to be open enough to consider all sides of an argument before making a considered decision. Let’s face it, you have to know what it is that you’re up against before you can arrive at a compromise. And perhaps, the thing you thought you were opposing is not so different from your own view after all.

Even our values fluctuate. Unless we are willing to be historical revisionists, it’s obvious that people in the past often assigned values differently to how we do today -sexual orientation, for example, or racial characteristic and stereotyping. And who nowadays would dare argue that women are not the equal of men, and deserve the same rights?

There are some things about which we will continue to disagree, no doubt. And yet, even a willingness to listen to an opposing opinion instead of shutting it down without a fair acknowledgment of whatever merits it might have hidden within it, or commonalities it might share with ours, is a step in the right direction.

I’m not at all sure that it’s healthy to agree about everything, anyway, nor to assume we possess the truth. It’s our truth. I think that without some dissenting input, we’d be bored, condemned to float in the increasingly stagnant backwater we chose, while just beyond our banks, a creek runs merrily past, excited to discover another view that lies beyond and behind the next hill.

After all, remember what happened to Caesar after Shakespeare had him boast: “I am constant as the northern star, of whose true-fix’d and resting quality there is no fellow in the firmament.”

Just saying…

 

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Places that we’ve come to trust

 

When I was a child, the world was an even stranger place than it is now. I knew so much less then, and the boundaries of almost every experience were unexplored and mysterious. I suppose that’s to be expected when the menu is large, and the stomach limited. So, with no internet to answer each question, and teachers who, despite their qualifications and zeal, were unable to fill in more than a decidedly modest number of the blanks, children my age migrated to the Delphic Oracle of the era: the library.

Although sometimes an imposing stone-and-pillared structure in the middle of a large city, in more modest towns it was often only a converted cottage, or a tiny building that housed the books. But however it was dressed, it was the library with all those answers on the shelves, all that magic in the musty perfume of the books. And yes, there was the reigning priestess, the keeper of the tomes, who seemed to know just how to organize our questions and then lead us directly to the shelf where the answers lay.

It was an enchanted place, the library, and one we children got to know even years before we started school. A place where we would gather each Saturday morning in a little circle on the floor to hear someone read stories to us of faeries that danced on little flowers, of kings and queens who disguised themselves as people just like us, of bears who spoke, and fawns that cavorted through the woods all day then slept in beds of moss each night.

Later, of course, we began to read things for ourselves, and to decide what made sense and what to believe. We would read a book the librarian recommended, and then another that she hadn’t -just to check. I sometimes thought I’d wandered alone and secretly through the new ideas, but then she’d smile and congratulate me on my journey when I saw her at her desk.

I suppose we’re never really on our own when we have a book, though. It is the world, or at least its a door that opens inwards. The book is the sacred space, not the shelf on which it is forced to sleep. And I have long suspected that many things are similar to that -a school, for example, or a yoga class, a police officer, or a program on the radio -they each represent an expertise we cannot all possess. A knowledge so extensive we must partition it out in little bits to make it work. It is what a civilization does; it is what constitutes a society.

I found an incredibly insightful article entitled Truth is also a place in the online magazine Aeon on the subject that helped me to set things in context: https://aeon.co/essays/labs-courts-and-altars-are-also-traveling-truth-spots  It was written by Thomas Gieryn, a sociologist at Indiana University Bloomington, who suggests that ‘Some places make people believe.’ He describes the aura of wisdom ascribed to the ancient Oracle at Delphi. It was in a place so remote that even getting there was a struggle, and hence no doubt augmented the reliability of whatever advice was proffered. Other places, he argues, are similarly sacred: law courts, churches, laboratories, and so forth. The very stability of their location, and their often unique and recognizable architectures, lends an almost sacred air to their functions. ‘Ordinarily, truth-spots stay put over time, and those who seek believable knowledge must travel to them – not the other way around.’

But he wonders if the reliability and permanence of the location is still really necessary to perpetuate the authority. ‘[…] is longevity in a particular location always needed in order for a place to make people believe? Some truth-spots travel: they inhabit a place only temporarily. Sometimes a portable assemblage of material objects might be enough to consecrate an otherwise mundane place as a source for legitimate understandings – but only for the time that the stuff is there, before it moves on. But if a church or lab or courtroom can be folded up like a tent and pitched someplace else, can it really sustain its persuasive powers as a source for truth?’

In the abstract, that seems like an unlikely possibility. After all, part of the solace of religion, say, is in the majesty of the venue -the comfort of the pew, the quiet place that is a refuge from the busy street outside. Or, at other times it may lie in the reverberations of the organ, or the echo of a choir singing somewhere hidden in a large cathedral.

But Gieryn illustrates his thesis with examples of how the authority, if not the venue is transportable. Travelling justices can set up a court in the most unlikely of locations -a small village in China, for example, with ducks and geese waddling past. Justice can be fairly meted out to the satisfaction of villagers who might otherwise never be able to travel to a big city courtroom. Religion, too, could be promulgated outside of the boundaries of a church so long as those ceremonial symbols seen as sacred and important, accompany the duly recognized religious official.

But I suppose these things are so common nowadays, with our internet connections and social media flurries, that the very idea of immutability has become a myth. With the possible exception of religious structures, buildings permanently dedicated to a particular purpose, seem anachronistic. Atavistic. Time itself is out of joint.

Surely we are not so shallow that we think that it is the edifice that contains the authority, so naïve that we confuse the vehicle with the driver. It’s not the library that contains the book, nor even the book itself we need -it’s the ideas, the perspectives, and the wisdom travelling in an ever-expanding ripple that we should attempt to grasp…

And yet… I’d miss the smile of that wonderful lady with the dirty glasses, who sat behind the library desk and watched with motherly pride as I carried out an armful of books for another week. Call me sentimental, or just an old man trapped in reverie, but I think there is still something sacred in a place where a person like her could sit and watch -and smile encouragingly- as we struggle past.

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Do We Really Understand?

Okay, call me a cynic, or maybe even a curmudgeon, but I sometimes wonder just how much we understand about Information –and by extension, it’s relationship to Knowledge.

Information can be construed as the answer to a question or, seen from a different perspective, as that which has the potential to resolve uncertainty. Numbers, for example, are not information unless they pertain to something. And when we think of information in the form of data, it doesn’t necessarily require someone to receive it, but can stand alone, unwatched and unprocessed until summoned. Knowledge on the other hand can be thought of as the reception, collation, and subsequent processing of that data –requested, in other words. Whether that which stands in isolation, unprocessed and unused constitutes Knowledge is an interesting, but tricky issue –likely of the same ilk as ‘If a tree falls in the woods with no one around to hear it, does it still make a noise?’ that we all puzzled over in Philosophy 101 in University. Because data –information- has the potential to answer a question, does that automatically qualify it as knowledge even if there is no question? Even if it might not resolve any uncertainty?

I raise these issues not to transition into a discussion of information theory, but to ask how much we are furthered by information about issues that are incompletely understood –known?- even by experts in the field. I’m referring, of course, to our own DNA.

Scientists are accumulating more and more data about genes and their codes and loci on specific chromosomes. They are beginning to link particular code changes in these genes to specific conditions, and the process is just beginning. Progress seems to increase logarithmically. The promise of this information is enormous in terms of diagnosis and perhaps eventually, treatment. http://www.bbc.com/news/health-35282764

I do wonder, however, whether it is valuable or premature to offer personalized genotypes as a commercial venture to anyone who asks for them. Clearly, there are situations when the information would be helpful when questions are asked of it: risks of a genetically-carried disease, hereditary lineage, or even paternity, as examples. But do we really know more about ourselves because some company has mapped our chromosomes? Without a question being posed to which the genetic sequences are the answer, is what is received useful, or pap? At this stage of our investigation of the genetic code, is an undirected map of base-pairs on a chromosome anything other than simply that: a small scale map of largely unnamed streets of a mysterious city that happens to have the label of the requester on it? A hieroglyph?

Undoubtedly, as the data accumulate, this mapping will progress to the stage where it becomes an essential guide to a city we wish –or need- to explore. And perhaps the store of information acquired will allow retrospective analysis of things whose importance we have yet to understand. Answer questions we don’t yet have –or at least can’t yet formulate in a way that could be solved.

In the meantime, however, I worry about that very personal and private information being made available against our wishes and perhaps to our detriment. Insurance companies, for example, employers –or maybe even an untrammeled government worried about threats of terrorism or contagion may request, or perhaps legislate that the genetic information be provided –especially if it has already been obtained. Unfortunately, at least at the time of this writing, there is no protection in Canada against discrimination based on genetics. There is, however, some legislation under review (Bill S-201) that addresses this. https://openparliament.ca/bills/41-2/S-201/ One hopes that its adoption will be soon, but it is a concern that certainly needs resolution before widespread adoption of personalized DNA should be considered. Once Pandora’s box has been opened, it might be too late, so we must think long and hard about what we decide.

Well considered safeguards are essential in advance -both for governments as well as for industry that may be tempted to oversell the potential. I stand with Hamlet in this: one may smile, and smile, and be a villain.

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Scientific Gynaecology

Damn! They did it again –just when I thought I’d finally got it straight about why HDL was the ‘good’ cholesterol and how beneficial it is, they changed it on me. Well, modified it, I guess. Lipoproteins are molecules that carry fats (lipids like cholesterol and triglycerides) to and from cells in the body. HDL (High Density Lipoprotein), however, transfers these fats away from artery walls and so helps to decrease the accumulation in arteriosclerotic plaques that can cause heart attacks and strokes.

Okay, good. Eat foods rich in HDLs and Bob’s your uncle. Right? Uhmm, not so fast. At the 2015 annual meeting of the North American Menopause Society (NAMS) some scientists from the University of Pittsburgh studied 225 healthy women in their mid and late forties for almost 9 years. ‘The study revealed that elevated HDL levels during menopause were associated with increased atherosclerosis. “These findings suggest that the quality of HDL may be altered over the menopausal transition, thus rendering it ineffective in delivering the expected cardiac benefits”, said study author Samar Khoudary.

Researchers hypothesize that the hormonal changes may be associated with the modified effect of HDL, especially estradiol reduction’.

Great! Now what am I going to tell my patients? A lot of them are already confused by the plethora of conflicting data in the scientific literature to which Dr. Google so readily directs them. Don’t we know anything for certain anymore? For that matter, did we ever deal in certainties? It’s a question written in their eyes –a silent reproof for my previous dicta, a withering acknowledgement that doctors may not speak ex cathedra.

Well, the very nature of Science, is that it uses Inductive Logic to derive general principles from observations. So, as the usual example goes, if we only ever see crows that are black, then it seems reasonable to conclude that all crows are black –until, that is, someone sees a white crow. Or -my favourite: ‘absence of evidence is not necessarily evidence of absence’. As Karl Popper insisted, Scientific knowledge should always be able to be falsified with contrary evidence. Hence, it is usually couched in statistics to reflect the probability of its truth.

It’s also why the world is so exciting: there are always surprises.

But Juna was unimpressed. For her, the purpose of Life was to hunt for certainty and then cling to it like a parental hand. She seemed resistant to any prescriptive opinion that I offered although she would always listen politely and smile at the appropriate times. Then she would offer her personal assessment of where she felt her problem lay as if it were a debate that required equal time for rebuttal. Equal consideration for the opposing side.

“That’s very interesting, doctor,” was how she would start her counter-argument. Then would come the pause. “But, isn’t it possible that there could be another way of looking at the same issue?”

And then she would have me; there’s always another way of looking at something.

She’d notice my expression, smile mischievously and continue the attack. “I mean, how can we say for certain that diet doesn’t play a major role in yeast acquisition?” And she would sit back in her chair, cross her arms like a prosecuting attorney and challenge me to counter that.

Whenever I apprise my colleagues of what goes on in my office, they always tell me that I shouldn’t run it like a courtroom, but I have to admit that I’m often curious to hear the opinions of the other side.

Juna was always delightfully provocative; she seemed to sense where the boundary was and although she’d sometimes reach across it, she never stayed for long. “You guys always seem to get it wrong, doctor,” she volunteered one time with a twinkle in her eyes. She had recently crossed the threshold into menopause and was intrigued both by the changes and the variety of opinions as to what to do about it.

I raised one eyebrow -our signal that I was willing to engage- and smiled. “I mean, look at the fiasco over hormone replacement…” she said, pretending confusion.

“We still use them occasionally.” I felt I had to defend them for some reason, although I hadn’t prescribed them for a long time. But the look of disbelief on her face –a mother listening to her son’s feeble defence- demanded an explanation.

“Knowledge is constantly expanding, Juna. What we believe today may be superseded by additional knowledge tomorrow.”

It was her turn to raise an eyebrow –she loved the gesture. “Then is it knowledge that is expanding, or simply conjecture?”

I rolled my eyes –the necessary next step in the process. “Science is conjecture in a way. It gathers together observations and tries to make sense of them with a general principle –a conjecture, if you will.”

She shook her head slowly –a teacher confronting a slow pupil. “If things are always subject to change, then how am I to decide? What am I to believe?”

I sighed politely. Philosophers have been wrestling with the same problem for millennia and Juna wanted a definitive resolution in the thirty minutes I had allotted in my busy day for her appointment. Things were getting out of control. “Using current knowledge…” I started slowly, choosing my words carefully as I tip-toed through the minefield she had set in front of me. “… is sort of like a buying a car. Despite how advanced the current model is, there are usually improvements in a new one… So, even if you need it, do you never buy one because it will soon be out of date?”

Her face stayed neutral as she thought about it. Sometimes even a desperately conceived metaphor can accomplish what erudition finds difficult.

“You mean like Ovid’s All things change; nothing perishes?”

I have to admit I’d never heard that one before, but it sounded sort of like a concession.

“What’s past is prologue,” I tried to reply in kind, quoting Antonio from Shakespeare’s Tempest, but it was a feeble attempt -I’m just a gynaecologist after all. But she smiled nonetheless: a truce.