A Modern Dilemma: Changing Notions of Truth and Expertise in 20th-Century American Medical Science

Abstract

“Beauty is in the eye of the beholder”: so wrote Duchess, Margaret Wolfe Hungerford. So, too, might we say today, at the 21st century's beginning, and not simply of beauty, or ugliness, or of justice or injustice, or of wisdom or folly, as Ralph Waldo Emerson might have had it a generation before her, but of truth, even scientific truth. The 20th century has not been kind to many 19th-century notions, ideals, and practices. Among those it has treated the most harshly is that of objective, scientific truth. In Hungerford's day, most educated people in the Western world spoke and acted as if truth was attainable. Positive truth was available to those trained in the special knowledge and methods of the professional expert. In Western Europe and North America, the educated classes regarded such special knowledge — expertise, that is — the natural and inevitable consequence of academic and scientific institutions there. And the professionalization of American science, thanks to the faculty of American private and public graduate universities in the half-century following 1870, set the intellectual and ideological horizons of science, scholarship, and the professions. The professional ideal crystallized, with its concomitant notions of the expert with special training and knowledge and a desire to serve the general public, not greedy commercial interests. Truth was not diluted. For the professionals and their client populations, it was absolute, unchanging, timeless. The professional scientist could verify it with his expert methods.