Objectivity is Overrated

Piret Ilver on Unsplash

The science of pain treatment and injury rehab is surprisingly controversial and rife with extraordinary claims and passionate beliefs about what works for pain — so readers often prevail upon me to be “objective.” It’s an overrated virtue. And I am often accused of bias — always by someone who disagrees with me, and it’s usually just a more formal way of saying “I think you’re wrong and you suck.” Sometimes I am praised for my neutrality, but always by someone who agrees with me, thanks to the great power of confirmation bias.

But I am not impartial on any of the controversial questions in my field, I’ve never met anyone who is, and I don’t aspire to it.

Nothing that lived and breathed was truly objective — even in a vacuum, even if all that possessed the brain was a self-immolating desire for the truth.

Area X Trilogy, Jeff VanderMeer

Objectivity and balance are often a pretentious journalistic delusion

Beware of anyone who claims to be fully objective and balanced. It is often “an attempt to secure a kind of universal legitimacy that is implicitly denied to those who stake out positions or betray a point of view” (Jay Rosen on “the view from nowhere”).

Laurie Penny: “The most dangerous thing any journalist … can do is buy into the myth of their own objectivity.” Indeed, the delusion of objectivity has taken us to the Bad Place in the twenty-first century, driving journalism right off a cliff. John Kerry (to MSNBC’s Joe Scarborough):

“The media in America has a bigger responsibility than it’s exercising today. The media has got to begin to not give equal time or equal balance to an absolutely absurd notion just because somebody asserts it or simply because somebody says something which everybody knows is not factual.”

All of this goes double for science and healthcare journalism. This field is just as polarized as politics (seriously), and false balance and premature closure in this domain have done a great deal of damage (climate change, vaccines, tobacco harms, HIV/AIDS denialism).

Trust bias you can see and respect

Instead of expecting your sources to be unrealistically neutral, look for someone with a View from Somewhere — someone unafraid to disclose and own their biases, someone who does “stake out positions or betray a point of view.” That is my goal. More from Rosen:

“In doing the serious work of journalism — digging, reporting, verification, mastering a beat — you develop a view. Expressing that view does not diminish your authority. It may even add to it.”

I assume that my biases are inevitable, constantly egregious, and utterly human. We are all bias machines. We aren’t just biase;, most of us cannot reliably detect our own biases (“it’s science”). We can only keep a bemused eye on this frailty, do some damage control, and try to avoid being overconfident about much of anything other than the rising of the sun and the absurd fallibility of confidence itself. The ideal is not to be unbiased, but to be biased with integrity.

Being biased without integrity is a familiar problem. We often see bias-acknowledgement used as a shield from criticism: “I’ve confessed my silly bias, so it’s okay!” But your bias must have some merit; just acknowledging it doesn’t place it beyond reproach.

Bias in science, especially conflicts of interest

Scientists try to be objective and unbiased, but every good one knows that it’s a losing battle and the point of science is to tame the effect of bias. Trials are randomized, blinded, and controlled to keep wishful thinking and preconceived notions from polluting the results. That's the point of experimental methodology.

There is no equivalent for science journalism (or for really anything else outside of science). But we can at least shoot for a scientific mindset.

Eliminating bias from researchers themselves simply wouldn't work. How the hell would anyone get anywhere in science without falling a little bit in love with a hypothesis now and then? That’s how they get pursued! And paid for…

The significance of conflicts of interest (COI) is often overstated. Where there is science, there must be funding, and funding sources warp science in muddy, complicated degrees ranging from hardly at all to truly, madly, deeply. Historically, the worst science has often been funded by people with a strong stake in the results. But it’s not always a deal-breaker. The same bias that threatens a study routinely comes from the same enthusiasm needed to pay for it in the first place! It’s not reasonable to expect science to only ever be done by people without any skin in the game.

The severity and relevance of any COI has to be evaluated on a case-by-case basis. Bias alone is never the problem: it’s bias without good experimental controls.

So what’s my bias here on PainScience.com?

Anti-quackery activism. Science-based medicine. I believe we fool ourselves about all kinds of things all too easily, especially about health and medicine. So I default to skepticism about treatment claims. Where most health writers want headlines about what works, I am almost constitutionally drawn to asking does it really, though? A bias for sure — but a useful one in a field flooded with hype and rotten with pseudoscience.

More biases here:

• I’m biased toward believing that unexplained pain is “real” and that patients aren’t making it up in any sense (psychosomatic, malingering).
• I advocate for patients and their autonomy, not for the professional whose authority might be threatened. When those interests conflict, I will side with patients every time.
• I am strongly biased against simplistic “structural” diagnoses as explanations for chronic pain — herniated discs, muscle imbalances, postural faults, practically anything to do with “alignment.”

Those are my filters. They occasionally make me excessively skeptical, but I’m wise to that risk — I’ve been doing this for a long time. I may not be objective, but I’ve learned a lot about how to be biased.

Related Reading

• Confirmation Bias — Confirmation bias is the human habit of twisting our perceptions and thoughts to confirm what we want to believe
• How to Simplify Chronic Pain Puzzles — Use Occam’s razor to clean up a mess of theories about your stubborn injury or pain problem
• What’s a “Claim” in Health Care? — In health care, claims often involve a more self-serving assertion
• Science versus Experience in Physical Medicine — The conflict between science and clinical experience and pragmatism in the management of aches, pains, and injuries
• Skepticism about skeptics from a skeptic, which touches on the topic of “scientism.”