Greenberg, Gary. The Noble Lie: When Scientists Give the Right Answers for the Wrong Reasons. Hoboken, N.J.: John Wiley & Sons, 2008. Pp.viii + 243. Hardcover, $25.95.
The “Noble Lies” discussed include turning addiction into a chronic disease, prescribing drugs as a treatment for depression, considering homosexuality as intrinsic, using insanity to protect the Unabomber from execution, defining brain death so organs can be harvested, and not treating patients in a persistent vegetative state. Each of these “lies” benefit someone, usually the person directly involved—considering depression as a treatable illness allows patients to receive otherwise proscribed medications—but are dishonest. Greenberg concludes the book by stating that the truth will emerge. The science that indicates addiction fits the usual definition of disease is sparse, but making addiction a disease opens opportunities for treatment. Declaring a person brain dead while her/his heart is still beating ensures that the organs to be harvested remain viable—benefiting another patient, as well as a surgeon. Parents are comforted by sustaining life in a comatose offspring—it is not clear if the patient is better off. One story describes how the author signed up to be a subject for research into the anti-depressant properties of omega-3 fatty acids. In the biweekly visits to the hospital the author attempts to give reasoned answers to questions about his emotional state. The researchers will have none of it. I presume they wanted data easily coded. Frequent assurances are given that “you are much improved.” The test was double blind but at the end the author had a pill tested—it was the placebo. The ways of diagnosing depression are much different from diagnosing bronchitis. One chapter deals with ensuring immortality by quick freezing bodies, or at least heads, to be woken up in a more advanced time when presently fatal ailments are curable. I suppose the noble lie is that any physical structure will be left at wake-up time. The issues considered are certainly at the boundary between science and society. The conflict is sometimes between an individual’s liberty and the life of someone else, as in abortion, drunk driving deterrence, or harvesting organs. “Disease Mongering” is creating a disease—erectile dysfunction is an example—that our medical system makes profitable for drug makers, doctors, hospitals, and others. Again, I presume some patients benefit from the existence of the new disease. In any case, nearly all the noble lies described make money for someone. Greenberg does a very good job of finding absorbing examples. I did not always agree with his thinking, but my attention never wavered. There is a great deal here to think about.