The Tension Between Cynicism, Skepticism, and Pragmatism

La PenséeAre we cynical? We can surely find excuses to be. Examples of cynicism pop up at every glance. Certainly we see it in politics and public policy. Closer to home at ConscienHealth, people routinely find reasons for cynicism about all kinds of medical research and advice – especially nutrition and obesity. This is a real problem because progress on health requires that we find the line between skepticism and cynicism, with an outlook that favors pragmatism.

Inevitable Skepticism

Skepticism is vital for finding what is true and distinguishing it from what is false or speculative. In The Matter of Facts: Skepticism, Persuasion, and Evidence in Science, Gareth and Rhodri Leng explore various controversies in science, including the relationship between BMI, obesity, and health. They describe the role of skepticism:

“There is no shortcut. The strength of the evidence within any paper has to be judged by the reader, and it is a judgment that does not serve forever but is contingent on whatever new evidence may emerge. How well the strength of evidence is weighted will depend in part on how well the reader perceives the authors’ biases – and no less, in how well the reader knows their own biases and compensates for them. That is the challenge of scholarship.”

Destructive Cynicism

But cynicism is altogether different. It arises from distrust and a conviction that everything about the matter at hand is false. With cynicism, there is no dialogue, only nihilism. In a recent interview, author Marilynne Robinson offers perspective:

“I’m aware, day to day, of how much I have benefited from kindness and honesty and consideration. You so rarely have a really bad experience, and you hope other people have a good experience of you, but some idea has swept the country that to say that people are good is naïve. It’s as if we’re all supposed to be cynical, even though, many of us have excellent grounds not to be cynical at all. It’s a mannerism; it’s a pose.

“The distinction has to be made between skepticism and cynicism. Cynicism is a dead end. Skepticism is always justified.”

Essential Pragmatism

In the end, pragmatism is necessary for finding a way forward. What we regard as true may evolve as new evidence arises and survives skeptical examination. But pragmatism requires that we find agreement on what is clearly true and take action accordingly.

Listening, Care, and Respect

In matters of health, healthcare, and related policy, hearing and respecting diverse lived experiences can play a helpful role. In the New England Journal of Medicine, Lisa Rosenbaum explains why listening is necessary for delivering care:

“For many physicians, listening has become a luxury, squeezed out by time constraints, the demands of the electronic health record, and the countless metrics demanding our attention. If you see a patient in the clinic with a newly diagnosed cardiomyopathy and don’t prescribe a beta-blocker, the institute’s ‘quality team’ may alert you until you either prescribe the drug or justify its omission. If you spend 30 minutes listening to the same patient explain why he doesn’t see the need to take a beta-blocker, no one cares – except, of course, the patient.

“Though survey data suggest that less than a quarter of the U.S. public trusts the health care system at large, about 60% think that doctors can be trusted. I suspect, then, that the many physicians who continue to earn their patients’ trust do so despite the system, not because of it.”

It turns out that listening is fundamentally important for moving past cynicism, addressing skepticism, and finding pragmatism to solve problems.

Click here to read more from The Matter of Facts and here for a review. For Rosenbaum’s NEJM essay, click here. Finally, for perspective on cynicism, skepticism, and curiosity, click here.

La Pensée, woodcut by M.C. Escher / WikiArt

Subscribe by email to follow the accumulating evidence and observations that shape our view of health, obesity, and policy.


February 25, 2024

One Response to “The Tension Between Cynicism, Skepticism, and Pragmatism”

  1. February 25, 2024 at 8:56 am, David Brown said:

    Excerpt from ‘The Matter of Facts’. “Facts don’t have to be true to be useful; so long as a speaker and a listener are willing to accept a shared premise, they can communicate.”

    A premise is a statement or assumption on which an argument is based. A fact is always true. Assumptions may or may not be true. A belief is whatever one chooses to accept as true.

    That said, I ordered a copy of the book. Nutrition science is currently in a state of confusion because epidemiologists and biochemists profoundly disagree on matters of cause and effect.