Wednesday, June 9, 2010

The Noble Lie?

In his book The Noble Lie: When Scientists Give the Right Answers for the Wrong Reasons, Gary Greenberg challenges conventional wisdom to suggest that many social vices have become labelled as diseases, without evidence, but for the betterment of society.  His book delves into the grey areas of science, politics and philosophy, conveying a line of reasoning that presents a picture of positive self-delusion on a grand scale.

This review summarises some of the challenging points in the book.

For instance, Greenberg explains how alcoholism's transition from vice to disease was a welcome one, especially following Prohibition. It was long viewed as an allergy, though the specific allergen persistently failed to appear. Even today, neither its disease-nature nor any possible cures have manifested themselves. Regardless, people are happy to accept the idea that addiction is a medical illness, perhaps, Greenberg suggests, because of our ambivalence towards the role of pleasure and our uncertainties about free will and self-determination. “With the disease model we have an answer,” he writes, “one that has the imprimatur of science; addiction isn't wrong, it's sick.”

In the absence of scientific proof that addiction is a disease, is it wrong for medical professionals to perpetuate the idea? Not necessarily, Greenberg says – there are times when what is scientifically wrong, or at least uncertain, is morally right. “There can be no doubt that the disease model has helped millions of people. If a made-up disease can be of such immense value, then we must consider the possibility that the truth is not what it's cracked up to be. Perhaps, in the republic of medicine, the fiction that addiction is a disease is a noble lie.”

Sometimes the noble lie works the other way round. In a chapter on homosexuality, Greenberg shows how humane concerns first led people to prefer a medical to a criminal definition, but conflict followed concerning the disrespect a medical definition implied toward what should perhaps be viewed as a free life choice. In 1973, following the Stonewall riots and the start of the gay rights movement, the American Psychiatric Association deleted homosexuality from the Diagnostic and Statistical Manual of Mental Disorders (DSM), a move decided not by scientific facts but by political and moral attitudes. “It may be the first time in history that a disease was eliminated by the stroke of a pen,” Greenberg writes.


  1. =====
    Greenberg: “There can be no doubt that the disease model [of alcoholism] has helped millions of people. If a made-up disease can be of such immense value, then we must consider the possibility that the truth is not what it's cracked up to be. Perhaps, in the republic of medicine, the fiction that addiction is a disease is a noble lie

    I'll confess my ignorance. How has an intentionally false disease model helped millions of people?

    If it actually has helped, then that is a story worth some detail, not just the throwaway "there can be no doubt" (just take my word for it). How exactly does this miracle work, and work better than a factual description of alcoholism? What is the intricate irony that would convince me to support the lie?

    Say an alcoholic endangers the public, a false treatment allows him to continue that endangerment, he eventually kills someone, and goes to jail. Then we have one jailed alcoholic and one dead person, because of a false treatment. Couldn't this turn out better with a true understanding instead of a "noble lie"?

    Greenberg's philosophy is the end of socially related science. If such "scientists" give themselves the right to lie to me, because they think this is better for everyone, then they are hiding behind a false veil of integrity. I'm interested in the facts and truth, or the lack thereof, and not the arrogance of a self appointed controlling class of lying "scientists".

    I want all climate scientists to raise their hands if they agree with Greenberg. I believe many of them do, and deny it all day long.

  2. Andrew, I think the book may convince you that sometimes a lie provides a set of incentives that lead to a better (more stable, more tolerant etc). My interpretation is that this mostly is the result of being able to avoid intangible moral dilemmas.

  3. Cameron,

    Did Greenberg convince you?

    If so, should I assume that you personally will occasionally lie in your public opinions, or support the lies of others when you feel it will encourage a better outcome? What about the tangible moral dilemma of using lies to persuade others, where you think the truth would be inadequate? I think that supercedes "intangible" moral dilemmas.

    Going further, do you support the government lying to the public for their and your own good?

    Lying to people "for their own good" strips those people of their personal dignity and rights. They usually don't take too kindly to this when they find out. I assume you would be angry to be misled by anyone, and especially by someone claiming special training and integrity.

    I don't think you would lie concerning your professional opinions and results. But, should you really support Greenberg, then please tell me and others, so that we may properly weigh your recommendations and analyses in the future.

  4. Did he convince me that some of the lies (misrepresentations of science) he discusses make our society a better place to life? Maybe (hence the question mark in the title)
    However, the point he makes is that these lies evolved through many individuals trying to make a positive contribution - with each of them probably not thinking that their little contribution is in fact a lie or a form of deception. These are unwittingly evolved lies.
    What he fails to consider are the many possible ways society could have adapted without these lies. No doubt is some cases well, and in others, not so well.
    So the challenge you are left with as a reader is whether it is better to simply buy into the lie, or to challenge the lie and risk uncertain outcomes.

    Do I think that knowingly lying for peoples own good, or for the greater good, is acceptable? No.
    The moral dilemmas raised in the book are the reason I recommend it.

  5. Cameron,

    You wrote "What Greenberg fails to consider are the many possible ways society could have adapted without these lies."

    I support that crucial insight. We immediately see the arrogance of a lie made for personal gain. The liar has given himself the right to manipulate people and presumes he will not be caught.

    Lies for the greater good are often not seen to be arrogant, just an attempt to improve things quickly and locally. But, those lies display the greater arrogance that no one else will have a better solution, and the lie interferes with getting to that solution.

    If I report the truth and others handle it badly, then it is their fault. If I lie and there is a bad outcome, then it is my fault.

  6. Well in truth, if there was no such thing as alcohol, there'd be no such thing as alcoholics. But that is not the same for gays (or those who prefer not to sleep in faith with a female but Love is something else). Gay life is created by chemical within the body and even if there were no other male around that desire might even remain because it is inbuilt. Not in all, true, some choose. But others have no choice in their natural make-up; population control takes over, as does survival of the fittest, end of the line and all that. Alcohol on the other hand is man-made and so therefore, are alcoholics; there's no disease about it. Alcoholism isn't secondary, it's simply a weakness and I don't know an alcoholic that says otherwise. Maybe I haven't met every alcoholic but I'm not sure that I need to. And there's no disease about gays either, unless we see normal make-up as a disease. Now, I haven't referenced anything here but anyone can search and find out about the chemical balance and sensibility of some not wanting to pro-create.

  7. Yes many social vices now labelled as diseases, without evidence, and for the betterment of society.

    This clear in our approach towards mental illness, in hope answers may be found to better deal with particular mental illnesses.

    Accurate ?

    Many suffering mental illness are treated successfully with minute doses of chemicals to "correct" assorted "errors" in their mental system which misbalances are believed lead to their inappropriate behavior.

    Is it that mental illness relates more to views as to when another's deviant behavior requires treatment - with them as a victim, at which point we then consider the question of what forms of treatment appropriate to be conducted upon them ?

    Killing those with deviant thoughts once was acceptable, in some places still may be.

    Alcoholism to be regarded as an addiction, implies medical problem with expected medical treatments.

    Alcoholism may be regarded as deviance... deviance from what ? Overconsumption ? Why then over-consume...

    Many consume alcohol regularly, in reasonable quantity, with little attention coming to them.

    Some consume alcohol drawing attention to them though behavior deemed not acceptable... mis-education leading to misbehavior, or an actual chemical imbalance ?

    Many suffering alcoholism are treated to reduce doses of chemicals they consume which as overdoses lead to their assorted "errors".

    Whether this due mental failure, addiction, or misbehavior, by failing to reduce their "inappropriate" behavior in being as drunks...

    Genetic studies show some over-react to the normal dosage of some chemicals...

    Is it all just chemistry ?

    Some argue the soul is just a chemical construct to explain satisfactorily where we not yet understand enough to otherwise explain...