Horses for courses: The need for pragmatism and realism as well as balance and caution. A commentary on Angel

Abstract

0277-9536/$ e see front matter 2011 Elsevier Ltd. doi:10.1016/j.socscimed.2011.06.049 One of the major impediments to translating scientific advances into benefits for human populations is the different, sometimes conflicting, explanatory models and terminologies used in different fields of endeavour and the fundamental differences in the goals and the values placed upon different goals. For example, the article I will be commenting on, “Agency versus Structure: Genetics, Group Membership, and a New Twist on an Old Debate” (Angel, 2011) is framed in sociology-speak in terms of “agency” versus “structure”. Most non-sociological readers will not be familiar with these terms (and the definitions are, perhaps, not entirely simple and straightforward (Scott & Marshall 2009)) and the author acknowledges that there is dispute about the usefulness of this distinction (Angel, 2011). The current commentary article is written from my own perspective as a clinical psychiatrist. I have been involved in molecular genetic investigation of major psychiatric disorders for the last 20 years. I regard genetics as a scientific tool capable of improving understanding of the causes and triggers of illness. Medical practitioners have to be pragmatists (Craddock, Kerr, & Thapar, 2010). Medical training and practice requires willingness to adopt different models in different situations with the single over-riding aim of trying to get the best possible outcome for the patient seeking help (Craddock et al., 2008; Craddock et al., 2010). Angel’s (2011) article is an interesting and stimulating article that makes several important points. Many of the key views