1990/06/01 by Robert Root‐Bernstein · 1 citation
Health Professions · Immunology and Microbiology · Medicine · #Adolescent Sexual and Reproductive Health #HIV Research and Treatment #HIV/AIDS Research and Interventions #Ignorance #Epistemology #nobody #Root (linguistics) #Philosophy #Computer science #Computer security
paper · doi:10.1353/pbm.1990.0055
openalex publication_date 1990/06/01 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/15
DO WE KNOW THE CAUSE(S) OF AIDS? ROBERT S. ROOT-BERNSTEIN* The reason for inventing a new theory is to drive us out of the hypotheses in which we hitherto have taken refuge into the state of thoroughly conscious ignorance which is the prelude to every real advance in science.— J. C. Maxwell Some of the most interesting questions in science are those that appear to have answers so obvious that no one thinks to ask them. Few people, for example, would doubt at this moment in time that we know the cause of the immunosuppression in AIDS. But do we? How do we know that we do? While many people will consider such methodological questions pointless (after all, virtual unanimity exists that HIV is the cause), it is nonetheless true that data can be interpreted only in light of theory, and that the same data may take on different meanings according to different theories. For example, consider data showing that a beach ball falls more slowly than a lead ball in earth's atmosphere at sea level. Aristotle would have considered this observation to be evidence supporting the theory that heavy objects fall faster than light ones. Galileo would have denied that Aristotle was right and declared the experiment irrelevant to an understanding of falling bodies because it was not performed in a vacuum. And a modern aeronautical engineer trained within the Galilean tradition would nonetheless find the experiment very informative —not about the law of falling bodies, but about aerodynamics. Thus, data become facts only within certain theoretical frameworks that predetermine what is to be observed and how it is to be interpreted. In the case of AIDS, we must therefore understand that when we say that HIV This research was not funded. The author expresses gratitude to Peter Duesberg, Scott Gilbert, Walter Gilbert, Mott Greene, Jonas SaIk, Fred C. Westall, Michele Root-Bernstein, and Arnold Seid for their contributions. * Department of Physiology, Michigan State University, East Lansing, Michigan 48824.© 1990 by The University of Chicago. All rights reserved. 003 1-5982/90/3304-0693 1 .00 480 I Robert S. Root-Bernstein ¦ Causes ofAIDS causes immunosuppression in AIDS, this statement presupposes a whole series of theoretical and methodological assumptions about how etiologies are established and what we mean by causation. In consequence, data showing that HIV is highly correlated with AIDS and that it infects a specific set of T-cells that are compromised in AIDS patients are insufficient to prove that HIV causes the immunosuppression in AIDS if these data can be shown to have a reasonable alternative meaning within a different theoretical framework. The question is whether such an alternative theoretical framework exists. The history of science repeatedly demonstrates that the key to finding such alternatives clearly lies in not accepting anything at face value. Assumptions need to be questioned skeptically and systematically. We must assure ourselves that our innate tendencies toward scientific positivism have not misled us in our theorizing by focusing our attention on what we observe rather than on what we expect to see and do not. Hypotheses must be invented that can cause us to rethink the meaning of our data or set new boundary conditions on the validity of our observations . We must search for phenomena that we may be missing by prematurely accepting the theory that HIV causes immunosuppression in AIDS. In short, questions of methodology will be as important to defining and solving the problem of AIDS as are clinical observation and laboratory experiment. How do we know what we know? What are the limitations of that knowledge? Many physicians and biologists may find this approach questionable. Theory, after all, is not held in high esteem in the biomedical sciences. And yet, to say that a disease agent causes a disease—that is to say, to establish an etiology—is to work as a theoretician as much as to work as an empiricist, and I believe that reference to the founders ofmodern germ theory—Louis Pasteur, Robert Koch, and their peers—surely verifies the point. It is, therefore, just as important to know how we justify the conclusion that a disease agent causes a disease as it...