News and Insights

Is a Little Doubt What’s Needed to Restore Faith in Science and Medicine?

April 10, 2025

While the term “alternative facts” entered the modern American lexicon in 2017, the wall between fact and fiction has always been somewhat tenuous. In ancient Greece, Socrates was condemned to death based on “fake news.” Alternative facts about science and medicine have also existed since the founding of our country, as Lewis Grossman discusses in his book, Choose Your Medicine: Freedom of Therapeutic Choice in America. In the present day, the spread of medical disinformation is promoted virally by social media to a population that may not be optimally equipped to discern fact from fiction.

The Role of Misinformation and Education

Results from the 2022 Program for International Student Assessment (PISA), which is coordinated by the Organization for Economic Cooperation and Development (OECD) rank the United States 10th in science and 26th in math out of the 81 countries that participated. Misinformation and disinformation are more readily accepted in a society that lacks knowledge of basic science principles or math skills that make it possible to understand probability and statistics.

So, can we lay the blame for the growing lack of faith in science and medicine on historic trends, our failing educational system, and malign actors promoting their own political, financial, or philosophical agendas over widely available and unedited channels? In part. But doing so fails to acknowledge the critical role that science communicators have played in undermining our own credibility. Because here’s a fun fact about facts: accepted dogma isn’t always right, and “fringe” theories occasionally turn out to be correct (and sometimes transformative). Insisting otherwise doesn’t help our cause.

The Credibility Challenge for Science Communicators

In 1633 the Roman Catholic Church convicted Galileo on suspicion of heresy for promoting the idea that the earth revolves around the sun. In 1983, Barbara McClintock was awarded the Nobel Prize in Physiology or Medicine for her discovery of genetic transposition (aka  “jumping genes” or the concept that some genetic elements can move around the genome) — research that had been ridiculed when first published in the 1940s and 1950s. As a more recent example, Katalin Kariko, who co-shared the Nobel Prize in Physiology or Medicine in 2023 for research that enabled the development of mRNA-based COVID-19 vaccines, struggled for years to secure funding for her “unorthodox” ideas about messenger RNA and had her research findings rejected from high-profile scientific journals.

Today, we rightly celebrate these visionary scientists for their ability to pursue research that flew in the face of “accepted fact” but in doing so we acknowledge that sometimes the dogma is wrong. And maybe regaining credibility requires a greater willingness to acknowledge what we don’t know, what is evolving, and what is usually but not always true. Perhaps leaving a little room for doubt will help people feel like they are being told the whole story and not just the good parts.

In a recent opinion piece in MedPage Today, Dua Hassan, MD, MPH, discusses the distinction between no harm and no known harm in the context of water fluoridation, and cautions that overpromising safety while understating uncertainty will erode public trust. Dr. Hassan cites a systematic review and meta-analysis of the studies evaluating if fluoride exposure is associated with children’s IQ scores, which was published in January in JAMA Pediatrics.  This analysis concluded that there are insufficient data to determine if the current recommended level of water fluoridation in the United States has a negative impact on children’s IQ. That isn’t to say it’s not safe. But it also doesn’t say that it is. There is uncertainty. Insisting otherwise or answering every question about safety with a list of known benefits of fluoridation only makes it look like there is something to hide and breeds mistrust.

Lack of Trust Can Have Deadly Consequences

Matt Hongoltz-Hetling writes in the New York Times about a young mother who eschewed standard care after being diagnosed with early and highly treatable breast cancer – opting instead for an unproven regimen intended to make her body less acidic. Her decision was driven as much by her desire to avoid the very well-known and often debilitating side effects of chemotherapy and the impersonal and sterile care that we too often encounter in our for-profit health care system as it was by the belief that the medical system has been co-opted by special interests. As she pursued a liquid diet of smoothies and de-acidifying supplements, the cancer spread through her body. An episode of intense back pain led to a diagnosis of metastatic disease that had spread to her bones and was terminal. Had she pursued chemotherapy after her initial surgery she had a greater than 90% chance of living the rest of her life cancer-free.

Lack of faith in science and medicine is also becoming increasingly deadly to our industry. As Adam Feurestein writes in STAT, the current dismantling of the FDA and NIH is the direct result of the industry being one “that everyone [bleeping] hates.” Health and Human Services Secretary Robert F Kennedy Jr. “believes that pharma makes people sick” – a view shared by millions of Americans. Feurstein notes that the industry creates lifesaving medicines but also argues that “it can be maddeningly deceptive, overly promotional and financially profligate.”

Transparency and Trust in Scientific Communications

Those of us in the scientific communications realm need to consider how we contribute to this sentiment. We recognize that no medication, device, or surgery is 100% safe and effective, but you’d hardly know that based on the marketing copy we develop. The high-speed voiceovers and microprint describing adverse events pretty much screams “we don’t really want you to know this but are legally bound to say we told you.” Beyond what we broadcast to millions of viewers and listeners throughout the country, patients often don’t receive accurate risk information from their own doctors. A recent survey of patients with hypoparathyroidism found that 87% of respondents had developed the condition following head or neck surgery (the most common cause of the disease), yet only 11% fully understood that this was a potential risk before they consented to surgery. In my own experience, members of my family have faced debilitating insomnia and medication-induced autoimmune disease from taking prescription medications. These potential side effects were never broached by the treating physician prior to beginning therapy.

Embracing Doubt to Rebuild Faith

As science communicators we daily face the challenge of being part of the problem or identifying solutions that balance transparency with real-world corporate constraints. One way to meet that challenge is to avoid the hyperbole that has become all too common. Early-stage data are promoted as transformative! Revolutionary! Breakthrough technology! Small studies are painted as definitively robust. It’s past time to tone down the rhetoric. Building successful brands depends on earning trust with customers, and trust only comes through consistently honest and transparent communications. This is more challenging in our industry given the diverse audiences that constitute our “consumers” – patients, physicians, regulators, payers. While each of these audiences may have different questions, concerns, and priorities, it is incumbent upon us that we deliver timely, accurate, and complete information in language that is accessible and meaningful to them.

To be clear, providing nuance about the limitations of knowledge and contextualizing small, but non-zero risks in ways that allow people to make informed decisions and opinions isn’t easy. This is especially true when we are limited by character counts and the desire for quotable sound bites. But we must rise to the challenge. Patients and healthcare professionals will benefit from communications that are more balanced and help patients reconsider science and medicine as forces for good — even if they are imperfect. Acknowledging our doubts may be the best weapon we have in the fight to rebuild faith in the power of science and medicine. Science communicators have a unique opportunity to be the voice of reason that bridges the gap between doubt and faith.