Tuesday, April 10, 2018

Science Isn’t Always Scientific


The name Asperger is widely known as a syndrome related to autism. The label honors Johann Friedrich Karl Asperger (1906-1980), an Austrian pediatrician who studied mental disorders in children in the 1930s and early 1940s. His diagnosis of “autistic psychopathy” related to social detachment was eventually given professional approval in the “Diagnostic and Statistical Manual of Mental Disorders” (called DSM) in 1994 as Asperger syndrome.

Asperger’s research focused on children who had difficulty making social contact, as in classic autism, but who were also highly intelligent and could lead extraordinarily productive lives. Asperger lauded the later successes of these autistic children, whose “social worth” he promoted. Because many doctors in Austria and Germany believed that genetic abnormalities reduced the worth of a human life, Asperger’s defense of his “Aspies” enabled him to cultivate a lifelong reputation as the friend of the handicapped. He had a long and successful career, eventually becoming chair of pediatrics at the University of Vienna Children’s Hospital and director of children’s clinics.

Asperger’s work was not well known until the 1980s, after he had died. Since then his 1944 discussion of those particular cases of autism has become widely known. His birthday is recognized as “International Asperger’s Day”.

But Asperger had not been so generous with children whose autism was more severe. Like many Nazi doctors, he decided whether handicapped patients were worthy of life, and sent the “unworthy” to their deaths in special institutions of mass murder. In 1942, he was senior pediatrician on a Viennese commission evaluating the status of 210 Austrian children residing in mental hospitals. 35 were judged unfit and were sent to die.

Asperger played a despicable role in a despicable system, participating in murdering children whom he deemed unworthy of life. He deserves no international honor. His name should not be used without an understanding of his deeds.

Does that mean that the condition now called Asperger’s syndrome should also not exist as a medical diagnosis and research subject? The American Psychiatric Association made a purely medical-scientific argument in 2010 that “Asperger’s disorder” no longer be listed as a separate condition in the DSM, which it produces.

Arguments among health professionals about how to diagnose and treat mental illness will probably never end, because there is so much about how our brain works that is unknown. Decisions about how autism functions should be made based on the best science that we can produce today, not on our moral condemnation of Asperger. If he was correct about the nature of his unusual cases, that disorder should have a name, just not his.

His life illustrates how scientific knowledge always has shortcomings: Einstein’s mistakes are legendary, but do not detract from his achievements. The international scientific establishment is designed to improve our understanding of ourselves and our world, by correcting mistakes and oversights in our current knowledge. That is the beauty of science.

But there are many for whom objective scientific inquiry is threatening: producers of ineffective medicines; polluters of air and water; contributors to global warming. Those who do not want to believe the best science use the existence of scientific disagreement to reject science itself. The deniers of evolution and of global warming seek out such disagreements to argue that science itself is wrong and their beliefs are right, despite the evidence.

Right now, the Trump administration is engaged in an unprecedented political attack on science. Scott Pruitt at the Environmental Protection Agency discounts scientists whose findings he doesn’t like. Most scientific research is funded by government grants. Pruitt claims that scientists who receive funding from the government are biased and should be replaced on scientific advisory committees by scientists who are funded by the industries that pollute the environment. He wants the EPA to ignore all research where participants were guaranteed that their personal health data would be kept confidential. That means ignoring virtually all large studies of public health, which show the effects of environmental pollution.

Worse than bad science is no science. There is still no director of the White House Office of Science and Technology Policy, the longest that job has ever been vacant. Without a director, leadership about science in the White House falls to the deputy assistant, Michael Kratsios, a 31-year-old with a bachelor’s in political science, who has studied voting in Greece and has never done scientific work.

Trump’s new budget request included severe cuts to science in disease control, mental health, environment, oil spills, geology, and, of course, climate.

It is hard for most Americans to judge scientific arguments, especially when people of ill will use clever techniques and obscure jargon to call into question good science. But one doesn’t need specialized knowledge to know that private industry pays for science that supports its private interests, that political ideology distorts scientific reasoning, that we need good science to stay healthy and to keep our society functioning.

Asperger let politics rule his science with tragic results. In Washington, politics again threatens to subvert science. That will have tragic consequences for us and our children.

Steve Hochstadt
Jacksonville IL
Published in the Jacksonville Journal-Courier, April 10, 2018

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