Second Sight

All of us were shocked at saddened to hear of the motorway accident in which the Statham family, two parents and four children, were crushed to death in their car. A large truck which had ignored warning signs drove into their rear. The driver was sentenced to three years in jail for “careless driving.”

I don’t want to comment on the particular case, but I think that the connection between an offence and its actual results should stimulate some thought.

We all deplore careless driving but I daresay that any of us who have driven for a long time (my licence dates from 1953) will admit that on some occasions, distracted perhaps by adjusting volume on the radio or trying to interpret a signpost, have been guilty of it. But in the great majority of cases our momentary lapse has done no harm. Yet by ill fortune it might have done, For example we might have clipped an elderly cyclist who was manoeuvring around a pothole and who as a result has a fatal heart attack. Causing death by careless driving carries a maximum penalty of five years in prison.

Now my question is this. Should the penalty be related to the actual fault or to the inadvertent results? We know that, in the case I have cited and several others, there is an outburst of emotional fury by the relatives of the victim if they believe the sentence to be too light. Understandable of course: people are not given to thinking clearly when emotion rules. But should such strong feelings be the arbiter of justice?

Should not the culpability of the offence rather than the incidental results be the criterion for punishment? How will God judge us? (By the way, if any of you reading this should have a momentary lapse of attention at the wheel, and end up in jail, don’t forget to let me know how I can get Second Sight News to you by email.)

How much morphine do you need to control your pain? Oddly enough one factor is whether or not you know that you are receiving it. A similar effect appears with diazepam, the common tranquiliser. It seems that the objective effectiveness of such drugs is significantly enhanced by your expectation that it will do its job.

Another researcher undertook some trials in which he was given a random series of electric shocks, some of which were mild, and some quite severe. He clearly knew the difference. In the trials the mild shock was preceded by a green light and the severe by a red light. After a number of cycles, the last series ended with a series of green lights and, so, mild shocks. Except that it didn’t. The final shocks were all severe but the researcher experienced them as mild. The clear inference is that he had been trained to associate the green with mild shock, and so that what was he felt.

Mind over matter – and the interesting question of placebos. In a recent survey in the US over half the doctors who responded reported that they used placebos on a regular basis. The type of placebo varied but a familiar example would be prescribing antibiotics for ‘flu, when it is known that they are ineffective against ‘flu viruses.

You can imagine how this complicates the double blind trials which are used to measure the clinical effectiveness of a new treatment. If the subjects who are given the placebo show improvements, sometimes equalling those receiving the active treatment, the results are hard to assess. Sometimes ingenious, and expensive, strategies have to be used to eliminate this effect.

Placebos are by no means simply a matter of imagination. For example, a placebo used for controlling pain can stimulate the same elements of the brain as the clinically effective drug. And an analogous effect has been measured with Parkinson’s Disease. No doubt studies of other ailments will in many cases show similar, measurable, biological changes.

Just to make matters a little more difficult, in certain therapies the type of placebo used can alter the results. In a study of irritable bowel syndrome sham acupuncture was used to measure the placebo effect. But some recipients received this accompanied by lots of attention, while others were just given the sham treatment. Both groups did better than those who received no treatment at all, but only the group who received attention produced results which were as good as those who were given the actual drug being tested. In another study, placebo patients were warned of the (relatively mild) side effects of the active drug. About a quarter of them reported experiencing these side effects.

Acupuncture is an interesting phenomenon. On the day of embryo transfer (in assisted reproduction) the placebo group received sham acupuncture (the needles were retracted, and only the sensation of being punctured was received). Lo and behold – the number of successful implantations was 25 per cent higher than in the group who received real acupuncture. In both groups the physiological and psychological effects associated with more successful implantation were measurable.

A similar trial for the treatment of nausea resulting from cancer therapy showed no difference between the sham and the real acupuncture groups. Both were highly successful, and this was put down to the additional care and attention all participants received.This brief account of a knotty subject is no more than a few examples taken from a large amount of data and reports, many of them recent. I have tried to be representative. But not only can we see why doctors and scientists are showing increasing interest in the subject of placebos but it raises some issues for us to consider.

First, we should not be surprised at the success of alternative medicine. It works, but often we cannot know whether it is the experience of treatment which brings about the cure, or the treatment itself.

From this it also follows that, even in conventional medicine, care, attention, taking symptoms seriously, and general “bedside manner” will not only complement direct therapy but may often be a substitute. Social skills are increasingly a part of medical education particularly for GPs, but this will take time to work its way through the system: doctors are no more talented by nature in communication than any other group. A remaining constraint is that bedside manner simply takes more time than issuing a prescription.

There are moral issues, too. Some doctors are concerned about the deception, implicit or direct, which placebo therapy normally (but not invariably) requires. The question may press particularly hard in clinical trials where some patients may be excluded from promising treatments in order to test the therapy.

Of particular interest to us is the extent to which our state of mind can affect not only our perceived outcomes, but our actual biology. We may often have limited control over our state of mind, but we certainly have a degree of control. And the behaviour of therapists (genuine or phoney) can influence our state of mind. So can the informal carers among our family and friends. What we think with our immaterial minds can affect, for good or ill, what happens to our material bodies.

I wonder, and it is just speculation, whether recognising in Jesus his authority and his messianic mission from his Father may have played a part in the healing miracles. If divine faith can move mountains then it can certainly move a few neuron connections or cells in the right direction.

Tell us about your reactions to all this on www.secondsightblog.com. Perhaps you have some experiences to share.

I knew Tom very well when we were boys but I had not met him for some time until recently. Under the misapprehension that I was an expert on moral advice, he sought my opinion. He is a scrupulous man and the issue was clearly one of importance to him.

He had been divorced several years ago, and he had remarried. Children by both marriages. I don’t know the reason for his divorce. Having returned to Catholicism he wanted to know the best way to rectify matters. He told me that his first wife would not have him back (she herself is remarried) and his second wife was not prepared to live as “brother and sister”. Their children are young.

Yes, I did respond to his question but I shan’t, for the moment at least, tell you what I said. But I would be very interested know what you think I should have said

2009 will be the year of Charles Darwin. 12 February is the 200th anniversary of his birth, and his great book On the Origin of Species was published 150 years ago on 24th November. Festivals and symposia are already planned, and we may look forward to endless comment in the press.

We can see Darwin as the great liberator – freeing us from the superstitious burden of being created by God, and transporting us into the sunny uplands of scientific nirvana. In recent times, his theory of natural selection has become a proxy for a general view that the flora and fauna of the world have come about through biological causes, relegating the existence of God to a gratuitous hypothesis. 

On the other side of the divide is the theory of intelligent design in which God is the necessary agent intervening to a greater or less degree in the creation of the species. My purpose is to explain why this difference is born of a false dichotomy, and that neither approach conflicts, so long as our thinking is clear and we understand the limitations of each.

Evolution is an immensely complicated subject (and appears more complicated every day) but the principle is simple. In the process of reproduction many mutations occur. The great majority are harmful and so disappear. But a tiny number prove useful and give the species a small additional chance of survival in the existing environment. Those with this advantage are likely to breed more than those without, and so the advantage tends to accumulate. Over many thousands of generations, genetic mutations can result in substantial changes.

The story of the peppered moth is illustrative. Before the Industrial Revolution the light-coloured moths were camouflaged against the light-coloured trees, while the dark-coloured were an easy prey for birds. But as the tree trunks blackened through industrial pollution, the advantage switched to the dark-coloured version. And, with successive generations, the proportion of black moths increased greatly, at the expense of their lighter cousins. The survival of the fittest for the prevailing environment could be observed in action.

But this relatively minor alteration within a species is a long way from the development of the variety of complex species from the original basic life forms. And so we are right to call evolution a theory since there is no practical way in which all the missing links can be discovered. Nevertheless it is a very strong theory, supported by various different forms of complementary evidence – and recently much strengthened by deepening knowledge of DNA. Indeed this new knowledge is prompting science to explore supplementary ways through evolution may occur. There cannot be a proof, but the degree of plausibility is so high that those who discount the theory appear to be generally motivated by principle rather than by rigorous examination of the science.

Intelligent design always needs definition. The meaning can range from the literal 6-day account of Genesis to various levels of divine intervention in the evolutionary process in order to correct its course towards God’s ultimate ends. At the very least it cannot be disproved, and since satisfactory empirical evidence is not obtainable it is not a scientific issue.

Evolution in itself is a mindless process; it has no internal purpose. It works though filtered chance in which the random mutations of reproduction have to pass the test of enhancing, or at least not diminishing, the survival value of their host. One might compare it with a fisherman who uses a large meshed net. The fish that swim in are of random size but only those who pass the test of the mesh are caught. 

This makes evolution, as you would expect, untidy. So the bower bird builds a nest to attract a mate, but the nest is never used. The peacock has an unnecessarily large tail to prove his suitability as a father. We are prone to bad backs because we were not originally bipedal. The spermatic cord travels in a vulnerable circuitous loop because an ancestor had its gonads near its liver. All rather unintelligent, but because these systems work well enough they survive.

Naturally our interest is focussed on the human line. Although homo sapiens is genetically closer to the chimpanzee than the chimpanzee is to the gorilla, it did not spring into existence overnight. In fact our lines of descent diverged about 5 million years ago, and we have no evidence of any significant changes in the hominid line for the next 3 million years. Our own species is very new in evolutionary terms, appearing in Africa about 200,000 years ago. The small population (perhaps 10,000 to 50,000 individuals) began its emigration about 60,000 years ago. Neanderthals, our evolutionary cousins, spread somewhat earlier. Current evidence suggests that they sometimes lived alongside homo sapiens, and may have interbred to some degree. They declined for a variety of reasons. Fossil records suggest that they were skilled, innovative and may have had limited powers of speech.

Despite our genetic similarity to the chimpanzee (which is by no means the whole story for genes can express themselves differently and in different combinations) we are struck by the obvious differences. Our capacity for self consciousness, abstract thinking, freedom of the will, and our sense of moral obligation stand out. These faculties are not explicable through biology, although they necessarily work through the brain. For example, freewill cannot by definition be caused by the biological, and without freewill moral responsibility has no meaning.

 If I describe such faculties, as I do, as being infused by God I have no account to give about how this happened beyond the fact that the human brain must have evolved biologically into an instrument through which the faculties could work. I do not know whether Neanderthals, or other species earlier in the human line, had souls, but the evidence of intelligent activities suggests that we cannot rule this out.

If homo sapiens were purely the result of biological evolution the anthropologists would hold that descent from a single couple was extremely unlikely. But this would be irrelevant in the case of a soul infused by an act of God, who could have chosen monogenism or polygenism according to his purposes. What we do know is that we inherit a nature which is a blend of the biological and the spiritual, and that it is our inability to integrate our selfish, biological, elements with our aspirational, spiritual elements in which disorder lies.

So I do believe in intelligent design in the sense that God used evolution as his biological methodology. Whatever his reasons may have been, in human terms I recognise that the fisherman who uses a combination of the random tempered by the filter of the mesh has chosen a more economical method than picking out his fish by hand. But I need to remember that nothing, in the end, is random to God, who knows from all eternity the movement, and mutation of creation, right down to the most basic sub-nuclear particle. The outcome of evolution was known and intended in every detail from the beginning.

I also know that my spiritual faculties were created and given to me directly by God. I could not meaningfully claim truth for any proposition I have made if I were obliged to make it only through the biology of my brain. Biology could not give me a mind to judge the workings of my brain or my emotions. And I could not see how far I fall short of the life of love if biology were my only means of knowing that I should follow the good and avoid the evil. Moreover such faculties are not susceptible to evolution. For instance one either has free will or one has not: there is no halfway house.

So, as believers in a creator God, natural selection through evolution is not an obstacle but a fruitful way of exploring the wonderful way through which he most probably worked. Our celebration of Darwin’s anniversary year should be all the richer since we are able to see the methodology in its proper context.

I am aware that my account is simplistic. There is much more to say about the complexities of evolution, including some real difficulties raised by its critics. Or the part that a Catholic priest played in discovering the mechanism of inheritance. The integral intellectual connection of Darwinism to eugenics needs to be examined. The claim that the source of altruism is evolutionary advantage requires assessment. I would like to have written more about the myopic vision of the secular scientist. I would like to have looked more closely at our first ancestors and discussed the part that Original Sin played in our inheritance from them. I shall try to deal with some of this in my fortnightly Science and Faith column during the year. But I would be greatly helped by your comments and suggestions.