As a scientist as well as a physician I have learned deeply how powerful measurement can be – and also how limited it often is. This has led me to qualify what I learn from medical tests and studies by saying “to the limits of our ability to detect.” If we don’t find problems on a test, it may mean that those problems don’t exist — or it may mean that we didn’t run the right test, or that the tests we have available aren’t yet sensitive enough to measure the types of problems going on.
Here are some further considerations
- People may think that “objective” can be removed from “contamination” by the subjective, but this is true only to a limited extent. Every aspect of science is influenced by underlying assumptions, often unconscious, shaped by culture, experience and temperament. What is looked at, what is not looked at, what we measure and what we don’t — these aspects of science are culturally and personally grounded, not “objective.”
- In medicine this shaping of practice by assumptions has profound influence. My training in intellectual history and analysis has sensitized me to these influences, and in my writing i work to articulate these assumptions and their impacts.
- The term “sensitive science” indicates a sensitivity to these influences. It also indicates a humility about what tests and measurements can show, and what are their limits of resolution.
- Using measurements to help people identify paths to fulfilling more potential rather than just diagnoses of what is “broken” requires both sensitive tests and sensitive interpretation