Research Abuse: How the Food and Drug Industries Pull the Wool over Your Eyes

© 2020 Associate Professor Ralf Sundberg. All rights reserved.

No part of this book may be reproduced, stored in a retrieval system, or transmitted by any means without the written permission of the author.

Published by AuthorHouse 10/16/2020

ISBN: 978-1-6655-8113-4 (sc)

ISBN: 978-1-6655-8114-1 (hc)

ISBN: 978-1-6655-8112-7 (e)

Library of Congress Control Number: 2020920179

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Unless the doctors of today become the dieticians of tomorrow, the dieticians of today will become the doctors of tomorrow.

Alexis Carrel, the father of vascular surgery and 1912 Nobel Prize winner, citation from Man, the Unknown (1935)

CONTENTS

Foreword

Preface

Acknowledgements

Chapter 1 On knowledge, science, and power

A scientist of course, but in whose service?

The influence of Big Oil on social development and medicine

Chapter 2 Myths and society

The fat myth

Chapter 3 Medicine and society

The food supply and nutrition

From school milk to weapons

Feeding a world in ruins

Chapter 4 The commercialization of medicine

The killer ad

Pork and beans

Research becomes brands

The branding of the AHA

Chapter 5 Market development

The NIH becomes the world’s largest financier of medical research

Blood pressure: How numbers turned into disease

Chapter 6 The commercialization of the cholesterol hypothesis

Fat, bacteria, or stress?

Eat Well and Stay Well

Ancel Keys, networker and academician

The explorer Keys and the cholesterol hypothesis

Statistics and epidemiology

In 1957, when President Eisenhower became a cardiac neurotic

A research-sociological explanation?

Chapter 7 The studies that would prove …

Framingham

Is saturated fat dangerous?

The Seven Countries Study

The Finnish Mental Hospital Study

On medical statistics

The Minnesota study

Chapter 8 The missionaries

The Nutrition Foundation and the AHA during the 1950s

The American Heart Association sways

The McGovern committee

Fat accused of murder

Dietary Goals for the United States

A wave of protest and its welcoming committee

Meanwhile, in Sweden

Yet another study using preformulated conclusions

The Consensus Conference

The propaganda agency

Thomas Moore on the cholesterol myth

Chapter 9 Experts and the art of deception

The Hippocratic oath and other trade secrets

General practitioners, specialists, and experts

Expert groups, guidelines, and healthcare programmes

Experts and opinion leaders: The dilemma

Contrary agendas and conflicts of interest

Research, newsworthiness, and dusty archives

An example of misleading claims

The trouble with medical journals

Heart epidemiology—pencil, ruler, and eraser

How to mislead using statistics on a large scale

The new study

Chapter 10 Who lurks behind current nutritional advice?

The Algarve conference

The conference on Paradise Island

American fat hysteria

Fat-free dietary fat

The studies that show that fat is not harmful

Chapter 11 The diet debate in Sweden and around the world

The origins of the diet debate

Low-fat diets are criticized, starting in Sweden

Dr Dahlqvist, the first blog debater

The effects of a lifestyle change

Dr Dahlqvist is reported to the National Board of Health and Welfare

The National Food Agency’s cover-up raises questions

Preparations for the debate

Dietary advice for diabetics—an industrial product?

The low-carbohydrate network

Annual meeting of the Swedish Society of Medicine

Critical article on diabetes and diet in Läkartidningen

The Swedish Nutrition Foundation, diet, and diabetics

The diet professors’ manifesto took precedence

More provocations

Chapter 12 The Nobel Prize, the Karolinska Institute, and industry scandal at the Karolinska Institute and Karolinska Hospital

Alfred Nobel and the Karolinska Institute

Changing conditions for collaboration between university researchers and industry

Personal experience from the Karolinska Institute and other medical faculties

Back to Lund and then on to Karolinska

My final sojourn at the Karolinska Institute

Successful use of plastics and metals in medicine

The events at Karolinska Institute leading to the scandal

The cost of the Nobel Prize

Afterword, early summer 2011

Afterword, 2016

Appendix

Endnotes

FOREWORD

Believe those who are seeking the truth. Doubt those who have found it.

Andre Gide

Few global endeavours have enjoyed as high a status and level of trust as science and research. There’s good reason for this, considering that progress and development have always depended on knowledge acquired through academic institutions such as universities and colleges and in industrial laboratories. New discoveries will virtually always, in one way or another, be put to both good use and bad use. History provides numerous examples of such abuse, not least of which is the development of weapons of mass destruction. Research Abuse provides examples of intentional misrepresentation and abuse of results obtained through scientific research.

Faith in science and research has been tarnished during recent decades because of incomplete and manipulated reports from the research community, in this book a practice referred to as research abuse. This retreat from scientific integrity may well result in massive consequences for both society and the individual.

There are many more or less legitimate reasons to do medical research, ranging from pure curiosity, to the desire to be able to reveal the truth, to the desire to have an academic or other career solely to earn a higher salary. Regardless of the reasons, the author or authors of scientific reports bear a great responsibility for completeness and correctness in the presentation of the results. As Research Abuse reveals, many scientists do not live up to these demands by a long shot. The reason for these deviations most often proves to be the desire for a fast-track career and/or money.

Important actors on the medical care stage are the drug companies and manufacturers of medical equipment, while the physicians are actors with completely different roles. The drug and equipment companies have a legitimate mandate to earn money for their shareholders. This requirement is best achieved by developing cost-effective drugs and methods for diagnostics and therapy. There are, however, alternative paths to achieve this goal, related to marketing and lobbying the healthcare industry decision makers.

The physician’s primary task is to be the patient’s counsel—to protect the patient’s interests and to avail oneself of all means to make the correct diagnosis and choose the best and most effective treatment. This requires both knowledge and the continuous refreshing of that knowledge.

As Research Abuse also reveals, things don’t always work that way. Many academic physicians, researchers, and other doctors, intentionally or not, abandon their professional integrity and become corporate shills.

Naturally, the industry is reliant on the doctors to use their specific products. This is the obvious reason that the pharmaceutical industry actively participates in training physicians by organizing conferences and meetings, as well as making on-site sales calls and directly marketing their products. The industry is also aware that the best advertisements they can get for a new drug are scientific publications in the most prestigious medical journals.

Since the 1970s, it has more or less become the modus operandi for the giant pharmaceutical companies to plan, perform, and analyse the results of clinical trials, then hire professional writers (ghostwriters) to prepare one or more articles. Afterwards, a renowned academic is invited to pose as the author, a so-called KOL (key opinion leader). In these mostly very well-written articles, the drug’s advantages compared to the competition are touted, whereas any risks and side effects are suppressed.

As stated in Research Abuse, many dietary and medicinal recommendations from various authorities, international as well as in Sweden, have arisen from these types of large and repeated studies which are managed and penned by the manufacturer. Many recommendations are still in effect to this very day. Several of these have resulted in medical catastrophes.

One may ask oneself how it has been possible to convince these KOLs to accept authorship of articles presenting research results to which they have not contributed anything, neither physical nor intellectual. The papers are extremely well-written—excellent for the academic career—and simultaneously provide an economic boost to one’s own research budget and to one’s personal finances. Additionally, the writers are offered many attractive travel opportunities and so forth. This phenomenon is well-documented in a book written by an American colleague, Carl Elliot, sporting the provocative title White Coat, Black Hat: Adventures on the Dark Side of Medicine. Thanks to increased awareness in recent years of problems with ghost management and ghost authoring of medical research, several measures have been taken to avoid this type of disinformation. Today, most medical journals require the authors to provide a declaration of conflict of interest or bias, but unfortunately this has apparently not been sufficient. A law is currently being enacted in the United States, the Physician Payment Sunshine Act, which requires all corporations to account for all payments to physicians or their institutions. In several states, the law has already taken effect and seems to be effective. Such a law is probably needed outside the USA as well.

Ralf Sundberg’s book illuminates both the dark and light sides of medical progress in an exceedingly illustrative manner. He accomplishes this via a most interesting and educational exposé of medical history during the most dynamic period in medical history, namely the latter half of the twentieth century. It would be desirable if all physicians were aware of the historical background of many of the substances and methods that they use today. This could possibly mean a more open mind and critical observational scrutiny of that which is presented as the absolute truth. Research Abuse should probably be included in the curriculum during the last phase of medical school. Critical thinking is a necessity in order to understand the genuine advances and to participate in research and development. As Bertrand Russell put it: Doubt is the essence of science.

Tore Scherstén

Professor emeritus

PREFACE

I recently happened to visit a Catholic church as one of my friends was being confirmed. During Mass, I was awed by the symbolism in some of the religious rituals. I watched the priest swing the censer around the altar. This gave a mystical shimmer that a transformation had just begun. On this altar, bread would now become flesh and wine would become blood. Together they would become the crucified body of Christ, ready to be taken by the parish. When the delightfully ringing bells signalled that the miracle was complete, I suddenly saw this ritual, familiar from my childhood but still completely foreign, in a novel light of recognition.

This sacrament is central for many Christians, but for the majority of modern people, the ritual seems incomprehensible, if not disgusting. The very notion of eating Christ’s body and drinking his blood awakens ideas of cannibalism. How ridiculous it is to believe in transformation? according to most modern people. And by the way, doesn’t the Latin phrase uttered by the priest Hoc est corpus (This is my body) remind one of the old magic formula hocus-pocus? And how numerous are not the confirmees, and even the priests for that matter, who have silently refused to believe that the sacrament bread and wine has been transformed. One can surely ask oneself how a ritual like this began and also how it could survive for more than two thousand years.

In the impulse of the moment I, piously raised in a Baptist family, now a scientist and physician, regarded this incomprehensible ritual from a completely new perspective: Even if modern, enlightened humankind does not reflect upon it, can it be so that bread and wine can be transformed to flesh and blood? That’s what science teaches us! The phenomenon is called metabolism. The symbolism is actually telling the truth, in a way.

The bread and wine is obviously not transformed while on the altar, but less than an hour after these provisions have been consumed, they have been broken down into their molecular components and quickly taken their respective places as integral parts of the cells, both in muscle (flesh) and blood inside the Christian parishioners who, according to Christian doctrine, are even called the body of Christ. Very few, and hardly any priests or pastors, profess that view nowadays.

Nor do experts in nutrition often now consider that the primary purpose of foodstuffs is to renew our bodies, because the body is constantly changing and developing. Today’s all too commercialized nutrition experts see and describe nutrients primarily as fuel, as if our bodies were vehicles that needed to have their tanks filled. Sadly, the fuel metaphor leads us to think in the wrong way.

Our foodstuff plays many more roles than simply to provide energy or calories. That’s why the composition of our food is more relevant than the actual number of calories. The main purpose for our food is actually to generate new cells to replace old cells that have died off. This production of new cells is a lifelong process. Not many people realize that all our intestinal cells are replaced in just two weeks. It takes only four weeks to replace our skin cells where the skin is thickest.

By renewing our inner and outer barriers, we protect ourselves against viruses, bacteria, parasites, and injuries. That’s how we stay alive.

During our lifetime, our bodies are renewed again and again. Within just a few years, virtually every atom in our bodies has been replaced by water, by the food that grows in the ground, and by the oxygen in the air we breathe. Everything is in constant transformation by way of what is practically an inner flame—metabolism. In this way, the four elements—earth, water, air, and fire—are united in every cell of the human body, just as it was described before natural science branched into its various disciplines. It is this perpetual transformation that is the mystical wonder of life, even for a scientist studying cellular function. This has been expressed in superstition and religion as long as humankind has existed.

The fact that nourishment from earth and mull could elicit life was a miracle to prehistoric human beings. And we should continue to describe it in this way. Long before science transformed our society, we tried to imagine where we came from, how life started, and how life is sustained. That bread could build the body and wine fortify the blood was something one could see clearly as a child growing and developing through life. But how that is possible was regarded as a miracle. It generally became the object of religious observations. Today, science has revealed how this transformation occurs. The branches of science that study this are called biochemistry and physiology. Despite that questions regarding human nutritional requirements have steadily become the object of new scientific studies since the 1950s, most people are still not sure about what’s best to eat in order to keep healthy and maintain a fit body. During recent decades, authorities have encouraged us to eat less fat and fewer calories, while at the same time we have been able to see that the number of overweight, obese, and diabetic people is on the increase. The media are also intensifying their interest on reporting about research in this area. Studies suggesting that carbohydrates—and not fat—are responsible are on the rise. These claims are, however, being intensely questioned by others. Newspapers are constantly full of alarmist reports and articles about diets: GI, LCHF, or low-fat? The raging debate is at times bitter. Even the physicians no longer know which experts are trustworthy: the Fat Doctor, the Secret Chef, or the National Food Agency?

I’ve asked myself the same kind of questions since I was a child. How was it possible that my dad could be so thin and my mom so fat, even though they ate the same food and similar amounts? Questions about nutrition continued to interest me in my teen years while I lifted weights in the belief that I would become more masculine and attractive. After having realized my failure in this area, my curiosity was reawakened during the chemistry course at medical school, as I could not fathom how my nutrition professor was so grotesquely fat. As a surgeon, I was confronted a few years later by the question of why a patient’s poor nutritional status increased the risk of complications, regardless if it was related to obesity or wasting due to an illness. Thus I became interested in applied nutrition, and began to read more and more about the subject out of pure curiosity. At the age of 40, after an international career in research within applied biochemistry, cell biology, physiology, and transplantation surgery, I started a new life as a private practitioner. I could then observe the increasing number of overweight and diabetic people. By and by, I became convinced that something must have occurred within modern medicine and that this something depends on the dietary advice given by the authorities. I have spent the last five years trying to get to the bottom of what has happened, for myself and for others.

Today we have extensive knowledge regarding those nutrients most important for producing new, healthy cells. The problem is that the science of human nutritional needs has, since the 1950s, been surrounded by myths. These myths have infiltrated our society and our thought processes so effectively that the important information provided by biochemistry, physiology, and cell biology regarding what cells actually need for growth and function does not find its target.

I try here to elucidate what the myths are, how they originated, and how they could live on. In order to do this, it was necessary to view the issues surrounding nutrition from both a life sciences and a sociological perspective. One usually chooses to see these issues from just one of the perspectives, depending on one’s educational background. But to understand what has happened to the science of nutrition, we need several pairs of spectacles. Nutrition perspectives are also intimately dependent on the opinions about how disease should be prevented. Is it primarily by means of a nutritious diet, or are drugs required? Can it even be shown that an incorrect distribution of nutrients in our diets increases the need for medication?

The difficulty has been to write simply, for the interested layperson, but at the same time with enough detail so that the text is readable for students of both social science and life sciences. Research Abuse contains numerous examples of how modern medicine has let itself be fooled by various special interest groups. The pedagogical process requires that the persons who have been involved in different ways be named. This is particularly emphasized in the last chapter of Research Abuse, where today’s debate on fat and cholesterol is used to exemplify how various interest groups influence the daily tasks of doctors and dietitians. My decision to point a spotlight at a number of living persons is not to glorify or demonize them, who for various reasons have ended up on opposite sides of the barricades in this scientific scuffle, but basically to clarify what is going on. My hope is that Research Abuse will fulfil these dual aims, partly to unmask and debunk false myths, and partly to describe my sense of wonder about the miracle of transformation that is happening in all our cells every single moment.

ACKNOWLEDGEMENTS

A book does not appear out of thin air. The contents are created, as is the substance of our lives, by interactions between people. Some of these people are close to us and others are more fleeting acquaintances, but everyone contributes his or her share to what we often mistake as our own lives and our own thoughts. People do not exist solely within themselves.

I wish to express my gratitude for all the help I received while writing Research Abuse to many more people than just those I can remember at the moment. A few, however, deserve a special mention.

First of all, I would like to thank my mentor, the adjunct and literature specialist Jan Broberg, for early on awakening my interest in the power of the quill, which became significant only after the scalpel had become the tool of my profession. Among the lecturers at medical school who inspired me are Professor Bengt Borgström, a lipid and cholesterol researcher of great personal integrity, who lowered my grade in chemistry for forgetting to note in my report (which I thought was exhaustive) the significance of butter in the absorption of beta-carotene from carrots.

Next, I want to thank my first surgery mentor, Associate Professor Bengt Pallin, who inspired me to abandon my familiar and safe rural hospital for a new, exciting research environment. Thanks also to Professor Stig Bengmark, who helped me find positions in laboratories in Sweden and the United States. My gratitude goes to Professor Bo Ahrén, who taught me medical authorship, and to Professor Thomas E. Starzl, who provided me with the ultimate environment and challenge at the University of Pittsburgh, where I had the opportunity to work side by side, hang out, and interact with some of the world’s best surgeons, biochemists, and other scientists.

During that time, I became reacquainted with a dear friend and colleague who played a significant role in my continued contact with the scientific world, Professor Karl E. Arfors. Karl inspired me to delve further into the scientific literature. He also introduced me to new friends such as Professor Tore Scherstén, Dr Johan Hedbrant, chief physicians Christer Enkvist and Jörgen Vesti Nielsen, Associate Professor Uffe Ravnskov, and the late Professor Lars Werkö, who have all been of great help in creating Research Abuse. I would also like to thank authors Lars-Erik Litsfeldt, Per Wikholm, and Andreas Eenfeldt, as well as Dr Elisabeth Puur and food chemist Bertil Orsmark, for their encouragement and advice;; and the numerous friends and patients whose experiences and ideas helped lay the groundwork for this task.

CHAPTER 1

ON KNOWLEDGE, SCIENCE, AND POWER

Scientists are driven by various instincts. One of these instincts is based on something as basic as the evolutionary struggle for survival. Just like other animals, we possess the ability to observe events in our surroundings and react to them. By means of the senses, the brain learns to recognize various situations and to see patterns. The ability to notice deviations from the usual is crucial to life or death, for the individual as well as for the flock. These instincts are deeply ingrained in humans, too.

Exactly as our cousins the apes, we humans are driven by curiosity. Many of us can’t resist trying to see whether new ways to solve problems are better than the old. Like the higher primates such as chimpanzees, we can also communicate solutions to problems and learn from each other.

What’s said to be uniquely human, however, is the ability to imagine the future. Other animals are thought to live completely in the moment, whereas we humans can certainly differentiate between the past, the present, and an anticipated future. The human race has a common history, and we teach our children that which previous generations have taught us. We are sort of a storytelling animal and our language is highly developed. Research on primate intelligence tells us, for example, that chimpanzees can learn sign language and pass on these skills to their offspring. What one intelligent ape or a couple of intelligent apes manage to learn is passed onto the flock.

However, unlike other animals, we have not only the distinct ability to live in the present, surviving thanks to previous experience, but also an ability to think and plan ahead. This ability to reflect might be what makes us human. However, much evidence indicates that herd behaviour often deprives us of the clarity of reflection.

Like the apes, we imitate each other’s behaviour and attitudes in order to fit into society. We also have the ability, just like the apes, to deceive each other to increase our social status.

Nils Uddenberg is a psychiatrist. During his life and career, he has reflected upon human behaviour and the many similarities we have with our ape cousins’ demeanour. He regards the ability to bluff as a distinctive characteristic of apes and humans. As skills in body language, mimicry, and eventually spoken language developed among us primates, the ability to deceive has increased among socially successful individuals—for better or for worse. In his book Gränsvarelser (Borderline beings), Uddenberg excitingly tells us just how the humanlike apes mock us and threaten our customary ideas about what is uniquely human.¹ The apes’ very capacity to imitate various behaviours and their ability to bluff are quite telling. Uddenberg is far from alone in his observations and conclusions. Desmond Morris describes in The Naked Ape how higher primates are driven partly by an exploratory curiosity and partly by social conventions.² These can naturally quite often conflict with each other.

Examples of controversies abound in science history where scientific reflection is at odds with society’s need for social control. This kind of group thinking, for example in the form of religion, has enabled various power structures in society. When individuals who enjoy social and economic privileges see their position threatened by scientific discoveries, they rarely hesitate to use all that energy to attack the ideas that these discoveries could lead to. New ideas are often dismissed by appealing in various ways to the unity of the flock. Even today, Darwin’s ideas about evolution in On the Origin of Species are opposed by right-wing Christian organizations in the United States, primarily by the Baptists, the religious denomination I myself used to belong to. Sometimes Catholics fail to recognize that in the twentieth century the Pope made a written admission that the theory of evolution may be true and not necessarily inconsistent with Christian faith. Richard Dawkins reminds us of this in his recent book on evolution, The Greatest Show on Earth.³ Not even the supreme leader of the flock—the Pope—can prevent the herd behaviour that originated in the nineteenth century!

All social scientists are probably in agreement that the controlling echelons have always used social conventions to strengthen their power base. Karl Marx was perhaps not the first person to realize that these conventions act as a soothing medicine, but his acerbic way of expressing it—that religion is the opium of the people—may have caused unnecessary bad blood among people who want to believe in the ability of religion to provide a deeper meaning for existence. What he was actually referring to, and with today’s perspective on human history—for example, the cruel human sacrifices of the Maya, Hitler’s Holocaust, and Mao’s Cultural Revolution—was all based on those currently in power exploiting the imaginations of the people for their own purposes. Controlling the masses gives power.⁴ Mass influence is more common than we think, and with the help of modern media and scientifically evaluated marketing methods, we are manipulated more than we think.

In order to understand human beings, we must look at ourselves from a broader perspective than we usually do. This applies not least to the social phenomenon called medicine. Even in medicine, there are policies aimed at controlling people in a way that favours the interests of the powerful. People have always been the same, whatever we would like to think. During the Third Reich, many physicians subscribed freely to Adolf Hitler’s ideology. Biological racism was a dominating paradigm. Skulls were measured. A considerable share of the medical profession accepted the ideas of Nazism. Romani, gypsies, and epileptics were forcibly sterilized for reasons that were anything but scientific. Despite this horrific legacy, the profession I belong to is regarded with profoundly innocent eyes by most people. Why has this legacy not led to increased critical scrutiny of the medical profession? Maybe because medicine has so much in common with religion in that medicine also deals with issues surrounding life and death. Medicine’s invisible masters, like the priesthoods of past societies, have the ability to control people in ways that we seldom think about.

Most people fear the inevitability of death. Nobody knows what awaits us beyond our last breath. We imagine dying itself to be something painful. Doctors alone have the power to prolong our lives, we believe, and when death approaches, the doctor has a monopoly on providing relief from the pain. Manipulating medical practice can become an attractive way to control people and gain power over society. Many people imagine that our existence is threatened by a certain disease panorama and that by controlling our behaviour in various ways we can avoid these dangers. In the age of human superstition, diseases were believed to be punishment by the gods or spirit world, and one tried to placate these powers via the priesthood. Today, we doctors take on this role by means of more or less substantiated advice on staying healthy and ridding ourselves of disease.

Medicine has experienced enormous development and modernization during the decades after the Second World War. The country that invested most in scientific medical research was the victorious United States. Within two decades following the end of the war, US politicians increased the budgetary allocation to medical research more than 150-fold—an indication of the decline of religion in favour of new ways to influence and control people. The newly highly influential role of medicine became apparent during the 1940s, while the influence of the religions continued to decline. The triumphs of medicine can be attributed to great accidental discoveries, as when Gerhard Domagk at the German paint and chemical giant IG Farben discovered the azo dye Prontosil, predecessor to the antibacterial sulfa drugs, or as when the Scotsman Alexander Fleming discovered penicillin. Discoveries like these have fundamentally changed the conditions for human existence and the disease panorama, at least in affluent parts of the globe. When Frederick Banting and Charles Best recommended insulin treatment for diabetes, it was still a breakthrough for science-based medicine.

Researchers are driven by their curiosity. They often imagine something or formulate a hypothesis explaining the nature of something, and then are compelled to find the answer to their question. That’s why we do experiments. Experiments can strengthen the credibility of a hypothesis, but they do not prove the hypothesis. There can be factors that no one has considered behind the results of an experiment which may be revealed by future experiments. A well-performed experiment can therefore only be falsified, that is to say to disprove false assumptions. For a claim to be scientific, we usually mean that the claim can be falsified. According to this view, all claims about the existence of the gods are not scientific, because there is no method to disprove—to falsify—the existence of deities. The ideas of the Austrian philosopher Karl Popper (1902–1994) lie behind the claim that falsification is necessary for scientific discussion.⁵ As an example, he formulated the following hypothesis: All ravens are black.⁶ The hypothesis has merit as long as all the ravens we see are black, but it is enough to observe one single albino raven to negate the original hypothesis. We may not have seen an albino raven, but they actually exist.

This viewpoint places high standards on scientific hypotheses and, not least, the generalizations we often make in the name of science. Researchers may therefore not turn a blind eye to deviations in their observations that apparently conflict with the theories resulting from the observations. The history of science shows us specifically that observations of deviations from the commonplace have led to the greatest discoveries. Popper, an avid Marxist in his youth, was later forced to flee Austria because of his partially Jewish background. Later, he hotly defended the open society with his book The Open Society and Its Enemies.⁷

Another science philosopher often quoted in parallel with Popper is Thomas Samuel Kuhn (1922–1996). Kuhn, who claimed that scientific theories must also be seen from a psychological and social perspective, also