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Francis Collins: Is He Fit To Lead The NIH?

Francis Collins, M.D., Ph.D., is probably best known for his leadership of the Human Genome Project, though his discoveries of the Cystic Fibrosis, Huntington’s, and Neurofibromatosis genes are also extraordinary accomplishments. Dr. Collins is a world-renowned scientist and geneticist, and also a committed Christian. In his recent best-selling book, The Language Of God, Dr. Collins attempts to harmonize his commitment to both science and religion.

Some critics (such as Richard Dawkins) have expressed reservations about Dr. Collins’ faith, wondering if it might cloud his scientific judgment. Since Collins was rumored to be the most likely candidate for directorship of the NIH (and he was nominated for the position yesterday, but must be confirmed), and because I wanted to know if Dawkins et al. had any reason for concern, I decided to read The Language Of God.

First of all, Christians are a rather heterogeneous group – with a range of viewpoints on evolution, science, and the interpretation of Biblical texts. On one extreme there are Christians (often referred to as “young earth creationists” or simply “creationists”) who believe in an absolutely literal interpretation of the Genesis story, and see evolution as antithetical to true faith. Dr. Collins suggests that as many as 45% of Christians may actually be in this camp.

On the other end of the spectrum are Christians who embrace evolution, accept and promote scientific thinking, and understand the Bible to be a blend of poetry, allegory, and historical literature. While they see the Genesis account of creation as poetic, the Gospel accounts of Jesus’ life and teachings are considered to be more literal.

Collins’ views are very representative of the scientific end of the Christian spectrum. In fact, he spends several chapters attempting to help creationists embrace evolution. He takes great pains to explain how irrational it is to deny the evidence we have (both from a genetic, and an archeological/basic science perspective) for evolution. He argues that evolution is not an enemy of faith, but rather an enlightening look at how God’s creative process works.

Collins also takes on “Intelligent Design (ID),” exposing it as a PR play, not a true scientific theory. He suggests that ID is an “argument from personal incredulity” expressed in the language of mathematics, biochemistry, and genetics. Furthermore, Collins explains that ID proponents have confused the unknown with the unknowable – there is no current “irreducible complexity” that cannot be explained by evolutionary theory. We don’t need a “God of the gaps” to explain what we’ve yet to learn.

One of the more interesting parts of the book is Dr. Collins’ mathematical review of the incredibly low odds of the right blend of atoms/elements and the correct rate of expansion of the universe to occur by chance. He argues that certain atomic particles needed to be present in unequal and varying amounts at the earliest moment of the Big Bang to produce – eventually – the right conditions for life as we know it. He uses this analogy: it’s possible that a poker player could randomly obtain a straight flush in 50 consecutive hands. However, a more plausible explanation is that he’s cheating. In the same way, the universe could have come into being by coincidence, but it’s more likely that it was a coordinated event.

Collins’ argument for the existence of God is compelling to me. His explanation of why he chose to become a Christian is a little less so. Collins often resorts to lengthy quotes of C.S. Lewis in lieu of his own theological rationale – but I suppose we can forgive him for this. He is first and foremost a scientist, not a theologian, and his book simply reflects that fact. [Those interested in a more compelling theological rationale for Christianity might try Timothy Keller’s, The Reason For God: Belief In An Age Of Skepticism.]

In summary, Collins claims to believe in “theistic evolution.” He says that few people have heard of it because it harmonizes science and religion – and “harmony is boring” and doesn’t have a PR agenda. Nonetheless, he finds it internally consistent and intellectually satisfying. The material world is best understood through scientific inquiry, the spiritual world cannot be tested or understood by science. Matters of conscience, morality, and a yearning for answers to questions that may not be resolved empirically (What happens to us after death? What existed before the Big Bang? Is there a soul?) are matters best left for religion.

After reading The Language Of God, I feel confident that Collins is a reasonable person. He embraces science more successfully than many people of faith, and I didn’t notice anything about his beliefs that would make me question his ability to lead the NIH in true, scientific inquiry. In fact, The Language Of God may embolden other Christians to join the Science-Based Medicine movement by offering them a rational way to allow faith and science to co-exist. I hope that  scientists who hold atheist or agnostic religious views will embrace this small group of evolutionary theists as religious moderates who fully support scientific orthodoxy.

Why Non-Scientists Should Not Direct Scientific Efforts: Senator Harkin’s Misguided Beliefs Exposed

I’ve been blogging a lot recently about the problems caused by health policy makers who don’t appear to understand medicine or science. I’ve also been lamenting the relative lack of physician input at the highest level of health reform. But today I’d like to present a prime example of the perfect storm in health policy: when willfulness, ignorance, and magical thinking combine to push an agenda despite billions of tax payer research dollars proving the futility of such efforts.

In this video, Senator Tom Harkin describes the impetus behind the creation of the National Center for Complementary and Alternative Medicine (NCCAM). Harkin suggests that he single-handedly introduced legislation in 1992 that created the Office of Alternative Medicine at the National Institutes of Health (NIH). This office paved the way for an entire new branch of research at NIH devoted to exploring the potential validity of non-science based medical practices such as homeopathy, acupuncture, traditional Chinese medicine, energy healing, meditation and more. He introduced the legislation because a friend of his experienced a substantial health improvement after trying one of these non-science based therapies. Essentially, an entire branch of the NIH was founded on an anecdote.

What’s worse is that after a decade of careful analysis of these alternative therapies, science has shown that not a single one of them appears to be efficacious beyond placebo. One would think that Senator Harkin would be embarrassed by the colossal waste of tax payer resources spent on this pet project of his. But no, instead he chastises the scientists who did the research, saying that they had failed to do their job of “validating” the therapeutic modalities. Wow. I guess he was never interested in finding out the truth about what works and what doesn’t – because when objective analysis reveals that these modalities don’t work, then the science must be flawed.

Now don’t get me wrong – healthy eating, regular exercise, emotional and psychological support are critical factors in good healthcare, and I fully believe that America needs to become a “wellness culture” in order to prevent chronic diseases and improve quality of life. I also believe that Americans are often over-treated and over-medicated when lifestyle interventions might be their best treatment option. However, in encouraging behavior modifications, we don’t need to foist placebo therapies on them under the banner of science. The problem with “integrative medicine” is that it takes some good medical principles and infuses them with scientifically debunked and outdated systems of thought (debunked repeatedly by NCCAM, the very scientific body that Harkin hoped would validate them.)

What we really need to do is stop splitting the practice of medicine into “integrative” vs “non-integrative” and simply follow scientifically vetted best practices. Patients need a comprehensive approach to their health, a medical home with a good primary care physician coordinating their care, reliable health information to support their decision-making, a strategy to eat well and exercise regularly, and mental health services as needed.

Senator Harkins’ plan to continue flogging the alternative medicine “dead horse” is not helpful – it’s not good science, and it’s not a good way to spend our tax dollars. I can only hope that one of the positive effects of Comparative Clinical Effectiveness Research will be to put an end to the promotion of the ineffective therapies that Harkin fervently hoped would be validated. I also hope that the new Federal Coordinating Council will not support funding to pet projects that are founded upon anecdotes, pseudoscience, and wishful thinking. Now more than ever we need good science underpinning our healthcare spending, and we need informed scientists advising our government on priorities for America’s health.

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Addendum:

More outrage from the medical blogosphere over Harkin’s views:

1. Dr. David Gorski:  Senator Tom Harkin: “Disappointed” that NCCAM hasn’t “validated” more CAM

2. Dr. Peter Lipson: Harkin’s War On Science

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