ADDICTION PUBLISHING AND THE MEANING OF (SCIENTIFIC)
LIFE
Thomas F. Babor and Kerstin Stenius
A common theme in literature, philosophy and
science is the search for meaning. Addiction science incorporates
this theme as well, especially as it applies to the understanding,
prevention, and treatment of problems associated with the
use of psychoactive substances.
The global scientific enterprise of addiction
studies that has developed during the past half century would
be impossible without the publishing infrastructure that has
been described in Chapter 2 of this book. At the core of this
infrastructure is the peer-reviewed scientific article and
the expanding network of journals that publish scientific
communications in this form.
Having taken the reader through a journey of
discovery in the previous chapters of this book, it remains
to put all of this scientific, ethical and practical information
in its proper context. Throughout the book we have maintained
a focus on publishing scientific papers in peer-reviewed journals
because this is a key part of the meaning of scientific life.
Publishing is a way for the scientist to take a position and
operate in a forum representing the free exchange of ideas
and findings. In this final chapter we will explore this theme
in greater detail in relation to addiction science, which
for many highly trained researchers throughout the world is
becoming a career commitment that is not only personally rewarding,
but one that benefits society as well.
In brief, our argument is as follows. Science
is meaningless if not communicated. Addiction publishing is
a way to gain meaning in scientific life. Publishing is also
the hallmark of a productive scientific career. Scientific
integrity is a core feature of a successful career, and it
must be nurtured by individuals, groups and institutions,
including scientific journals. Finally, we will argue that
to the extent that science is a universal language and method,
there is a special need for addiction careers in low and middle
income countries.
THE MEANING OF SCIENCE
A seminal article by Ilkka Niiniluoto (2002),
professor of philosophy at Helsinki University, traces the
history of science through the various milestones in the search
for knowledge from the time of the ancient Greeks to the present
times. Aristotle, the first giant, distinguished between the
theoretical sciences that studied reality (physics, biology,
meteorology, psychology) and research on human activities
(the practical sciences like ethics and politics). His legacy,
according to Niiniluoto, lies above all in the principles
of organisation that describe how we come to know the world
and its generally accepted laws ('why' knowledge). A second
phase in the history of science came with Galileo's search
for regularities in changes ('how' knowledge).
A third, and much later change in the development
of science, began at the end of the 19th century when Charles
Pierce introduced the notion of fallibility, which claimed
that human beings are always making mistakes in their search
for knowledge and that all claims about the real world should
be questioned as the objects of critical research.
'This is true also of research, even if the
scientific method of the research community, at least in the
long run, is the most reliable way to produce and motivate
conceptions of the world.' (Niiniluoto 2002 p. 32, authors'
translation).
Niiniluoto talks about science as a self-correcting
process. This means that the scientific community has developed
its own quality assessment system (e.g., the peer review process),
that scientific claims are public, and that all parties in
the scientific community have the right to take part in discussions
about them. According to Niiniluoto, contemporary science
is characterized by objectivity (gaining as true a picture
of the object studied as possible); a critical attitude (research
should be public and open for critical discussion in the research
community); autonomy (the scientific community operates independent
of religious, political, economic, personal or social influences);
and progressivity (science creatively seeks new solutions
and builds on old ones).
Arguing further that science is a social institution,
he refers to Merton's (1973) four imperatives for the ethos
of science: 1) universalism (i.e., the truth of claims shall
be judged on impersonal grounds irrespective of the race,
nationality, class or personal characteristics of the person
who presents them); 2) communism (i.e., scientific findings
are the result of social cooperation and should be common
property); 3) disinterestedness (i.e., scientific knowledge
should be presented and analysed without considering the career
or prestige of the researcher); and 4) organized scepticism
(i.e., scientific results shall be scrutinized critically
on the bases of empirical and theoretical criteria).
Niiniluoto says that Merton's principles have
been criticized as deficient, insufficient and inconsistent
with the everyday life of research in the contemporary world.
Big Science, increasing competition for personal repute and
the inequitable concentration of resources have eroded the
ethos of science, as has the use of science in war and commercial
production, which has produced a form of applied science that
is businesslike and breaches the principles of communism and
universalism. Niiniluoto argues, though, that this activity
is not really scientia and should be viewed as something other
than academic research, even if it can often be valuable for
society. In addiction research, the increasing competition
for research positions and financial resources can foster
temptation to neglect ethical rules as well as the ethos of
science. Career considerations can press a scientist to give
priority to things other than the search for truth. The growing
share of private research funding may lead to secrecy instead
of open exchange of new ideas and research results, and to
new priorities favouring business interests rather than the
public good.
If we accept Niiniluoto's assertions, we can
find here the reasons why good publication practices, of the
type described in this book, are crucial for science and the
search for meaning in scientific life. Good publication practices
represent the principles that should guide the quest for truth
and at the same time demonstrate how to become a respected
member of the scientific community. If science is to be used
properly in the search for meaning as well as the basis for
the betterment of humankind, then there needs to be open access
to the enormous reservoir of scientific knowledge in the world.
That knowledge not only needs to be readily available, it
must also be recorded in a way that is understandable, useable
and certifiably free of error and bias. This is the role of
journals and the responsibility of their authors. As noted
by Lafollette (1992), a journal serves as the arbitrator of
the authenticity and legitimacy of knowledge. It provides
an historical record of a particular area of knowledge, and
confers implicit certification on authors for the originality
of their work.
CAREERS IN ADDICTION SCIENCE
Publishing with scientific integrity is the
hallmark of a productive scientific career. With the remarkable
growth of addiction science worldwide (Babor 1993, 2002),
there is now a variety of career options available to those
interested in basic, clinical or social research. Research
societies, sub-specialties within professional organizations,
and research centres have proliferated in many parts of the
world, as has the availability of addiction specialty journals
(see Chapter 2). There is growing evidence that a career in
addiction science has become a viable and rewarding way to
spend one's professional life (Edwards ed. 1991, 2002). As
noted in Chapter 2, journals and the process of scientific
publication serve the interests of career advancement and
provide a vehicle for scholarly achievement. Indeed, the easiest
way to understand a scientist's career is to review the publications
proudly listed in his or her curriculum vitae. When one looks
at the seminal thinkers and scientists in the field, it is
the published works that constitute the main record of their
professional lives as well as their achievements. Boxes 9.1-9.3
provide examples of how productive and influential addiction
researchers reflect upon qualitative and quantitative aspects
of their research and scientific communications.
BOX 9.1 GENEVIEVE KNUPFER
Genevieve Knupfer received her professional training
in sociology (Brussels; Wellesley, Mass.; Columbia, NY) and
in medicine (Rochester, NY). She worked with the Alcohol Research
Group at the University of California, Berkeley, and was an
advisor to the World Health Organization's alcoholism programme
for many years. When asked about her general approach to research,
she responded with a description of a paper she had published:
Too often the conclusions of a research publication, no matter
how tentative, are what is remembered. Too seldom are the
basic data really spelled out. To my mind, that is what we
need to look at, not at the lot of arithmetical means, multiple
regressions and correlation coefficients. I suspect, for example,
that the term 'statistically significant' means to many people
'significant' in the more general sense. My recent paper on
'Drinking for Health' (Knupfer 1987) was an attempt to expose
some of these fallacies.
Biographical and interview data from Edwards,
ed. (1991, pp. 155-162).
Quotation from Edwards, ed. (1991, p. 160).
BOX 9.2 CHARLES S. LIEBER
Charles Lieber was born in 1931 in Antwerp, Belgium.
He was a refugee in Switzerland during the Second World War.
He qualified in medicine from Antwerp in 1955. Most of his
professional life has been spent in the USA with senior research
appointments at the Harvard Medical School, Cornell Medical
College, and Mount Sinai Medical School. His prolific published
work has centered on biological aspects of alcohol abuse,
including the mechanisms underlying the development of alcoholic
cirrhosis of the liver. Here he describes some of the papers
that changed the course of biological research on alcohol:
There seemed to be an adaptive system which helps us survive
in modern society because it is relatively non-specific and
detoxifies foreign compounds even when the body has never
been exposed to them before. When we observed a similar morphological
response after alcohol, I postulated that alcohol may therefore
also be a substrate for this system. This hypothesis led to
the discovery of the microsomal ethanol oxidizing system (MEOS)
as a new pathway of ethanol metabolism.
Biographical and interview
data from Edwards, ed. (2002, pp. 11-28).
Quotation from Edwards,
ed. (2002, p. 19).
BOX 9.3 MARTHA SANCHEZ-CRAIG
Martha Sanchez-Craig, PhD, joined the Addiction
Research Foundation (ARF), Toronto, Canada, as director of
a halfway house for homeless alcoholics. In 1977 she moved
to the Clinical Institute of the ARF as a Senior Scientist
where her main line of research was in the area of brief interventions
for alcohol and drug-related problems. Despite her extensive
publication career, she cautions about the 'publish or perish'
mentality: … one of the senior people, who was conducting
experiments with small numbers of non-human subjects, said
'I don't have much regard for any scientist who doesn't publish
at least six papers a year in peer-reviewed journals'. I was
very worried about that. I met colleagues who would get depressed
or seriously worried if they couldn't publish a paper every
month. I began to think that there are a lot of people here
who like to do science that looks good and only a few who
like to do good science… But discovery fascinates me, the
kind of discovery that jumps out at you from the data. I spent
countless hours with data print-outs, looking for patterns.
I didn't want to rely on what the statistical experts would
come up with as a result of multivariate analyses and so forth.
I wanted to see patterns with my own eyes.
Biographical and
interview data from Edwards, ed. (2002, pp. 115-125).
Quotation
from Edwards, ed. (2002, p. 124).
INDIVIDUAL RESPONSIBILITY
Research can be a lonely endeavour: late nights
spent in your study or laboratory, preparations to defend
a thesis or question someone else's dissertation, standing
on a podium to present a scientific paper. These are all individual
responsibilities experienced in the course of an individual's
professional career. In many cases it is impossible, at least
without considerable effort, for an outsider to know whether
the researcher has behaved in an ethical way. All researchers
are thus responsible for guarding the integrity of the public
trust in research. But research is also a highly social enterprise,
with much of the work now conducted in teams of investigators
and support staff that share responsibility for the completion
of a project and the publication of a scientific report. In
this context, individual responsibility sometimes becomes
diluted and ambiguous in relation to ethical matters.The research
world is also often very hierarchical. Younger researchers
are in certain ways like apprentices, being trained by their
masters, and are often economically dependent on them for
positions and promotions. These differential power relations
can further dilute ethical responsibility.
In spite of these threats to research integrity,
addiction scientists must adhere to the ideal of the polis
of the ancient Greeks, where every free man (we will have
to ignore the gender discrimination of the time) was an equal,
with similar responsibilities to decide matters of importance
and civil rights to support those responsibilities.
One implication of this book is that every
researcher must feel his or her personal responsibility for
creating a more transparent and ethical addiction research
community that includes young investigators and senior researchers
alike, as well as editors of journals and peer reviewers.
Everyone, for example, has a responsibility to use citations
in a fair and informative way, to see to it that authorship
credits are properly assigned, and to adhere to ethical rules.
If all researchers view themselves as equals in the republic
of science, this will also be the best foundation for creative
discussions that will lead to progress in research.
CREATING GOOD INSTITUTIONS
In many instances, exhortations to individual
responsibility are not enough to guarantee scientific integrity.
Good institutions are needed to support creative research
milieus with sound ethical principles. Informal structures,
such as open communication within departments (not only about
research but also about ethical problems), reading and commenting
each other's work, democratic decision-making, the tradition
of cooperation and teamwork on multidisciplinary projects,
all emanate from participatory norms and strong leadership.
Boxes 9.4-9.7 provide examples of how productive and influential
addiction researchers reflect upon the social and institutional
aspects of their research and scientific communications.
Also helpful to scientific integrity are the
more formal structures, such as policies for the ethical conduct
of research and procedures for the determination of authorship
credits. Addiction scientists have a special responsibility
to support these institutional structures rather than seeing
them as inconveniences and hindrances. In recent years addiction
journals have emerged from their relatively obscure and modest
origins to take a leadership role in the prevention of scientific
misconduct. The ethical principles for authors included in
Appendix B of this book represent the consensus of editors
who are members of the International Society of Addiction
Journal Editors. Integrity in scientific publishing can only
be enhanced by education, vigilance, clear policies and institutional
norms that put science first.
BOX 9.4 MUSTAPHA SOUEIF
Mustapha I. Soueif, PhD, was born in 1924. He
completed his graduate studies in psychology at University
of Cairo, Egypt. In addition to teaching psychology at the
University of Cairo, he also worked for the World Health Organization.
Here he describes the challenges of publishing in different
languages and the conflicts between having a national commitment
and an international vision: It is a long time now that I
have been living with this double identity; on the one hand
I feel a world-citizen, on the other I belong to Egypt. This
complex 'consciousness' or oscillating began in the late fifties
when I was carrying out my first piece of clinical research
in Egypt (at Abbassia Psychiatric Hospital) while keeping
an eye on getting it published abroad. This was the paper
on 'Testing for organicity in Egyptian psychiatric patients'.
It was accepted for publication in Acta Psychologica (in Amsterdam).
That was the first step towards establishing my reference
group, defined in this case as a group of international scientists
who would judge the worth of my research on its objective
merits. My international identity, however, was definitely
promoted through my contact with the WHO in Geneva. In 1966
I was approached by the WHO people to prepare a paper for
publication in the UN Bulletin on Narcotics reporting on our
work on 'Hashish Consumption in Egypt' which has been under
way since 1957. This I did, and the paper was published in
1967. In 1970 I was invited to participate in a 'scientific
group' meeting to be held at WHO headquarters. The recognition
my work received there was deeply gratifying.
Biographical
and interview data from Edwards, ed. (1991, pp. 427-444).
Quotation from Edwards, ed. (1991, p. 436).
BOX 9.5 JOY MOSER
Joy Moser (1921-2001) studied languages before
receiving a Masters degree in Public Health. She worked for
the World Health Organization in Geneva (1950-1981), first
as an editor, then as scientific assistant and finally as
Senior Scientist in the Mental Health Programme. Her extensive
work at WHO reflects the important role of mission-oriented
commissioned papers and expert committee reports in the development
of hypotheses, theories, and applied research that eventually
are published in peer-reviewed journals. In the following
quotation, she talks about how WHO facilitated the seminal
work of Griffith Edwards and colleagues (1977) in the development
of the alcohol dependence syndrome concept and the introduction
of a broader alcohol problems perspective to the international
policy making process: Between 1973 and 1975 a steering group
prepared and discussed extensive reviews of the state of knowledge
on these matters. All this material was synthesized by Dr.
Edwards and the complete documentation was submitted to a
wider group of investigators from various parts of the world.
This group's final report was published together with several
of the working papers…... One result of this project was that
the term 'alcohol dependence syndrome' described in the report
was accepted for the ninth revision of the ICD. Moreover this
project seems to have promoted considerably increased recognition
that it is not enough to focus on treatment of the person
with this syndrome (the 'alcoholic'). Many other disabilities
related to alcohol consumption are likely to be of greater
public health significance because they are so prevalent and
have such an impact on society. Actually the term 'alcohol-related
problems' soon came into very general use. At the same time,
interest was growing in the need to develop more effective
ways of preventing or limiting the impact of alcohol-related
problems.
Biographical and interview data from Edwards, ed.
(1991, pp. 3-23).
Quotation from Edwards, ed. (1991, pp. 12-13).
BOX 9.6 KETTIL BRUUN
Kettil Edmund Bruun (1924-1985) received his
doctoral training in sociology from the University of Helsinki.
His alcohol research was most identified with his work at
the Finnish Foundation for Alcohol Studies, where he was served
as a Scientist Director (1955-80). He received the Jellinek
Prize in 1971. He is perhaps best known for his influential
book, Alcohol Control Policies in Public Health Perspective,
published in 1975 under the auspices of the World Health Organization.
As Robin Room states: 'This book, known in some circles as
the ‘purple book’ from the color of its cover in the English
language edition (it has appeared also in Finnish, German
and Swedish), has attained an unusual prominence in the literature,
becoming the basic citation for its fundamental argument,
as that argument has gained increasing acceptance. ‘Changes
in the overall consumption of alcoholic beverages have a bearing
on the health of the people in any society. Alcohol control
measures can be used to limit consumption: thus, control of
alcohol availability becomes a public health issue’.
In the
following quotation Bruun describes with characteristic modesty
the process that gave rise to the book: The background was
that I had to rethink my ideas of alcohol control in the light
of the Finnish experience in 1968/69 when controls had been
suddenly relaxed with dramatic increase in consumption and
harmful effects. My own liberal views on alcohol policies
had received a blow. Then I was confronted in the European
Office with international issues. I thought that I had to
reconsider my position and that probably the best way to do
it was to try to have a group which could develop a perspective
beyond the specific situation in Finland. The situation was
fortunate because many of the relevant questions had by then
been focused for research. The group which emerged from my
invitation did a marvellous job.
Biographical and interview
data from Edwards, ed. (1991, pp. 365-375).
Quotations from
Room (1986) Kettil Bruun, 1924-1985: an appreciation. The
Drinking and Drug Practices Surveyor, 21, pp. 1, 42-49; and
Edwards, ed. (1991, pp. 371-372).
BOX 9.7 ALBERT TUYNS
Albert Tuyns was born in 1922 in Belgium. He
received his MD from the University of Brussels in 1948, and
was awarded an MPH from Johns Hopkins School of Public Health
in 1962. He worked for 15 years as an epidemiologist with
the International Agency for Research on Cancer (1967-1982).
He was a recipient of the Jellinek Award in 1982. His published
work with Georges Pequinot provided the first systematic link
between alcohol and cancer, and the interactions with tobacco
smoking. These findings had enormous implications for public
health and health policy. Here he describes some of his professional
writings on the subject: It is one of my favourite theses
that the aetiology of cancer is probably multi-factorial;
the association of alcohol and tobacco is - I believe - the
clearest demonstration of this. I tried to express this in
an editorial (Tuyns 1991) in the British Journal of Cancer.
(p. 318) Alcohol and cancer? … a large group of workers produced
that monograph (International Agency for Research on Cancer
1988), people coming from various parts of the world. From
the epidemiological standpoint we had no major difficulties,
and I remember that we described the correlation between cancer
of the breast and drinking. (p. 319) You look at your past
life and you say I have been working for 20, 25, 30 years,
what did I do really? What has come out of it, beneficial
or not? I did my job to the best of my capacities, that's
all. I am grateful to society, to my parents, professors,
friends, who gave me a chance to produce good work; in return
I contributed some valid pieces of knowledge and other work
which was not so valuable. I feel that I have been useful,
that I have respected my contract, as we say in French. (p.
320)
Biographical and interview data from Edwards, ed. (2002,
pp. 313-321).
Quotations from Edwards, ed. (2002).
AWARENESS OF GLOBAL INEQUALITY
Addiction is a global concern, and the concepts
of universalism and autonomy suggest that knowledge gained
from research should be shared throughout the world. Unfortunately,
resources for both research and scientific communications
are limited in many parts of the world, and research is often
conducted in the more resourced countries with parochial interests
in mind. Moreover, the dominance of English as the de facto
language of science comes at a price for the majority of the
world where other languages predominate. Addiction researchers
in the English speaking and the more developed countries have
a special obligation to conduct and present their research,
whenever possible, in a way that benefits the rest of humankind.
The peer review process should be open to scientists from
all languages and nationalities, as should the editorial boards
of the journals serving as the gatekeepers for scientific
truth. Publication in addiction science should not be limited
by language or culture. This is not only a question of fairness,
it also speaks to the cross-cultural generalizability of scientific
findings and the need to discover universal truths.
CONCLUSION: THE MEANING OF SCIENTIFIC LIFE
In Chapter 1 of this book we referred to the
medieval philosopher Maimonides and his Guide for the Perplexed.
This was perhaps not a very modest analogy. We do not want
to suggest that this book - or any book for that matter -
can remove all confusion and provide a researcher with the
guidance needed to have a successful career in addiction science.
Even if all of the information contained in these chapters
is used faithfully, the route of the informed researcher will
not lead to a Paradise where all problems that arise are easily
solvable. Rather, we hope the information in this book will
lead its readers to the agora of science, a community square
or common ground where open and democratic discussions can
take place between equals about the difficult problems all
researchers, novices and career professionals alike, encounter
in their everyday work. Having explored the meaning of scientific
life to this point, the editors will not be so presumptuous
as to venture into the meaning of nonscientific life, except
to say that like science, meaning in life is probably found
as much in the quest for truth as in its actual discovery.
REFERENCES
- Babor, T.F. (2002) In their own words: conversations
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- Babor, T.F. (1993) Megatrends and dead ends:
alcohol research in global perspective. Alcohol Health and
Research World, 17, 177-186.
- Bruun, K., Edwards, G. and Lumio, M. et al.
(1975) Alcohol Control Policies in Public Health Perspective.
Helsinki: Finnish Foundation for Alcohol Studies, Vol. 25.
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of a Specialist Field. Oxford, UK: Blackwell Science.
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and London UK: Transaction Publishers.
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J. and Room, R. (1977) Alcohol-Related Disabilities. Geneva:
WHO Offset Publication, No. 32.
- International Agency for Research on Cancer
(IARC) (1988) Alcohol drinking. Monographs on the Evaluation
of the Carcinogenic Risks to Humans, Lyons, France: IARC,
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- Knupfer, G. (1987) Drinking for health: the
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- Lafollette, M.C. (1992) Stealing into Print.
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- Merton, R. (1973) The Sociology of Science.
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- Niiniluoto, I. (2002) Tieteen Tunnuspiirteet
[The characteristics of science] in: Karjalainen, S., Launis,
V., Pelkonen, R. and Pietarinen, J. eds. Tutkijan Eettiset
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Tampere: Gaudeamus.
- Room, R. (1986) Kettil Bruun, 1924-1985:
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- Tuyns, A. (1991) Alcohol and cancer. an instructive
association. British Journal of Cancer, 64, 415-416.
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