The Pharmaceutical Journal Vol 266 No 7150 p734
June 2, 2001

Retrograde step
Painful progress
Judging science

Retrograde step

Astrology, the study of the reputed influence of the heavenly bodies on human affairs, has one thing in its favour — its great antiquity. It is generally accepted that the systematic observation of stars linked with speculation that they indicated human destinies and embodied warnings was established in Mesopotamia more than 5,000 years ago. The study of astrology then spread to Egypt, Greece, India and China. Today it is largely confined to the casting of horoscopes, which depend on the date of birth of an individual related to signs of the zodiac at the time.

Although some newspapers regularly publish horoscopes and print astrological forecasts, it is difficult to estimate how many people really put any trust in such things. It is certain that a section of the population does take them seriously, while the majority laughs them to scorn.

To give astrology a place among the serious sciences and encourage it in academic circles appears to most people brought up to study scientific disciplines as a retrograde step. According to a report in Nature for May 17, a proposal by the Indian government to have astrology taught in universities as part of the science curriculum has provoked strong protest by academics. The proposal is that funding be provided for astrology departments involving five teaching posts, a library, a computer laboratory and a horoscope bank during the academic year 2001–02. Plans are put forward to award bachelors’, masters’ and doctoral degrees in the new subject.

The scheme, oddly enough, was devised by a physicist who is the minister for education. His belief is that all the answers to problems confronting scientists are to be found in the ancient Sanskrit writings known as the Vedas and the Upanishads. Foreseeably, the proposal has been condemned by scientific researchers as an attempt to lend legitimacy to pseudoscience and superstition, something calculated to undermine the credibility of Indian science.

So far, 35 of the 200-odd universities concerned have requested permission to establish astrology courses. Meanwhile it has been urged that research in the pure sciences in India is being starved of funds, which makes it unreasonable to devote huge amounts of investment to what is generally acknowledged to be a pseudoscience. A section of academia maintains, however, that astrology qualifies as a science and calls for research facilities.

If we accept the dictionary definition of astrology as “the study of reputed occult influence of stars on human affairs”, we cannot fail to condemn India’s proposal as a sheer waste of public money. The Harvard philosopher Willard Quine commented in 1981: “Students of the heavens are separable into astronomers and astrologers as readily as are the minor domestic ruminants into sheep and goats, but the separation of philosophers into sages and cranks seems to be more sensitive to frames of reference.” Until the 17th century astrology overlapped with astronomy, but the advance of ideas concerning the nature of the universe and the causes of biological diversity effectively destroyed any scientific linking of the motions of heavenly bodies to the lives of human individuals.

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Painful progress

An editorial in The Lancet for April 21 raises the age-old problem of pain relief. Pain, it points out, is universal, afflicting people everywhere in the world, so that skilled services directed at minimising it are essential in every community. In coming years the demand for such services will grow, as populations grow older, lives are prolonged, and chronic painful conditions difficult to treat, such as arthritis, low back pain and advanced cancer, become more prevalent in developing as well as in developed nations. “If that prediction proves correct, pain management and palliative care will soon become as serious a health concern in developing nations as it has become in developed nations over the past two decades.”

One of the serious obstacles to adequate control of pain has always been the fear, not only among politicians but also among many doctors, that too lavish an availability of analgesics, particularly the potent opioids, will increase the instances of addiction. The persistent and irrational fear of creating dependence has caused many governments to impose cumbersome and intimidating restrictions on the prescribing of opioids. These result in doctors and nurses being discouraged, even prevented, from providing patients with adequate pain control. Addiction should be regarded as a rare complication of pain management, and not a major concern if medication is properly planned. Medical education still pays too little attention to the control of pain, and many doctors are therefore unprepared to assess and treat painful syndromes.

Another aspect of the affair is that many nations encourage a cultural attitude that teaches that pain is to be endured stoically and without complaint. If an individual adopts such an attitude it is difficult to know what can be done about it. It is true that the cult of the stiff upper lip is widespread. And there is a philosophical and religious side to the question. We are told, with evident reason, that pain is a warning that something in our body is calling for attention. But it is virtually impossible to understand why so much pain in our lives is permitted to exist without any apparent justification.

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Judging science

In an editorial in Science for May 11, Sir Robert May, president of the Royal Society, stresses that it is high time to expand the debate between practitioners of science on the one hand and the general public on the other, to determine exactly what people think regarding the good that science can do and the harm that in some areas it already does.

He quotes a recent poll which found that 84 per cent of Britons think that “scientists and engineers make a valuable contribution to society”, with 68 per cent thinking that “scientists want to make life better for the average person”. Yet half those asked considered that science was advancing too rapidly to enable government oversight and regulation to operate. This constitutes a danger.

May refers to the advice given by official review bodies that wide consultation, the appointment of the best people and the admission of dissenting voices be pursued. All advice must be openly published and uncertainties acknowledged. Risk assessment must be separated from risk management. When risks are involved the facts and uncertainties must be clearly stated and leave individuals to choose between options.

Risk assessment is difficult, for people may hold different subjective views, and it may be possible only to guess at risks. The idea that science represents certainty and established knowledge is inculcated in schools, but may not be reliable. There is a necessity for unlimited consultation, and the time is now past when decisions were made behind closed doors by civil servants, advised in confidence by authoritative figures. The Royal Society has promised to lead in the art of dialogue, and has launched a five-year programme of consultations throughout the United Kingdom and across society.

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