"The accepted truths of a given time can change" (Trevanian, 2005). I read this statement recently, and a flood of memories, some over 30 years old, engulfed me. Memories of philosophy, philosophy of science, and nursing knowledge development courses taken during my PhD program, during which my classmates and I attempted to apply ontological and epistemological tenets to nursing's "disciplinary" knowledge. All told, these courses amounted to 18 semester credit hours; most of them involved serious thought about the nature of truth and the relationship of truth to scientific inquiry. It was exhausting and challenging, and none of it was wasted time.
However, in the end, the main take-home message for me was that, at least in science, what is true to today may not be true tomorrow. Until that time, I had not given much thought to the "relative" nature of scientific truth. In fact, I remember some rather heated discussions with classmates about the need for something to be constant, unequivocal, and definite. We wanted the truth. Unfortunately for us and other "truth" seekers, science does not equal truth. In science, truth is not a goal or even an expectation of inquiry. Rather, the goal of science is to find the best possible answer to a question, an answer that makes sense in a way that can be demonstrated repeatedly.
As a case in point, black holes, predicted by Einstein's theory of general relativity, are thought to result from the "death" of massive stars. These dying stars leave behind cores so dense and with such gravitational pull that no matter, including light, can escape them. Black holes are important to the well-being of the universe, and yet, they are not fully understood. In fact, in May 2019 from far outer space, in a gravitational signal lasting one-tenth of one second, scientists detected the merger of two black holes. What was interesting about this merger was the mass of hole, which was heavier than expected given the mass of the merging holes. Thus, the event was a challenge to the known "truth" about black holes. Although some scientists were at first reluctant to accept the celestial occurrence as a merger of black holes and even though other explanations existed for the incredibly brief electromagnetic signal, the simplest explanation has been accepted as true (Clery, 2020). In other words, the truth about black holes is now revised, and there is a new possible truth about their characteristics.
Over the last many months of the COVID-19 pandemic, we encountered many scientific truths, some of which seemed to change daily. As examples, asymptomatic people cannot transmit the virus (shown to be untrue), and the virus does not spread through the air (likely untrue). These and other changing truths raised questions about the veracity of the science behind them. This is not the first time scientific truths have been questioned (e.g., the world is flat, the sun orbits the earth, germs do not cause illness). However, now more than ever, there is a growing mistrust about science, in part because of the rapidly changing nature of what is "true." Scientists' uncertainty, unsurprising given the novel nature of the SARS-CoV-2 virus, fuels the current mistrust in scientific truth. The lack of unified advice from scientists, healthcare providers, and government officials reinforces the mistrust. Moreover, much of the public, who are not scientifically well trained, have difficulty sorting "truth" from speculation, a condition not helped by reliance on "social" media (not scientific media) and a lack of understanding about the relationship between science and truth.
Greater understanding of science and truth would be possible perhaps if the public sought scientific information from scientific journals and scientists. However, in order for that to occur in a meaningful way, scientific journals and scientists will need to increase their efforts to explain the differences between science and truth. More essentially, journal authors and editors will need to explain differences in methods of scientific inquiry that lead to different evidence for truth (The Lancet, 2020). In fact, one aspect of the COVID-19 pandemic that may be beneficial to science is that scientists and those who publish science will learn to explain scientific findings and their relative truths in clearer, more accessible, less hyperbolic terms. At the same time, scientists need to understand that they are not infallible. Sometimes scientists get it wrong; they state something as truth when it is not and/or they fail to correct published information when new knowledge reveals a revised "truth." Scientists are human, and sometimes they have a hard time admitting they are "wrong," especially when a favorite hypothesis is not supported by evidence. However, this is the hard work of science, and it has to be done.
In nursing science, we also have relative truths. To begin, we do not all agree on what constitutes or even should constitute the science of nursing. Moreover, our collective disciplinary ideas about the nature of nursing science have changed over time. Grace and Zumstein-Shaha (2019) proposed that nursing science is defined by the knowledge needed to meet the profession's purposes while honoring its perspectives. However, there are now and always have been differences of opinion regarding those purposes and the nature of our collective perspectives. Nevertheless, and importantly, there is general agreement that nursing science is fundamentally focused on developing knowledge to improve health outcomes for all individuals and specifically for those to whom we (nurses) provide care. Nursing science itself can focus on many things, including, for example, promoting wellness in diverse communities, understanding life and living conditions that may promote wellness or conversely lead to illness, and understanding the experience and management of illness conditions, including symptom management and end-of-life. Nursing science is not setting limited; we need highly reliable nursing science in hospitals, homes, communities, schools, and other places where humans live and interact with each other and their environments in ways that affect their health. Critically, nursing science links research to practice, no matter where nursing practice occurs. Science provides the evidence for care that is designed to promote the most optimal health outcomes for all persons.
Despite this rather all-encompassing view of nursing science and its importance to human health and well-being, we should not expect universal and unchanging "truths" in our science. First of all, people change, and the world in which they live also changes. Priorities for personal and collective health change, as well. These changes in the context of human life will, by necessity, change the nature of nursing science, including what we hold to be "true" about nursing. Over time and among various groups of nursing, the purposes and perspectives of nursing will evolve; this evolution should be expected, and it will certainly change the accepted truths in nursing science.
At Nursing Research, we look forward to 2021 and to new truths in science; for us, such evolution suggests growth and further development. The truths of nursing science will be embedded in papers reporting the results of research that advance understanding of all aspects of health and that cover the spectrum of biological, behavioral, psychosocial, spiritual, and cultural factors. In particular, the Journal is particularly interested in the results of intervention and outcome studies focused on improvements in patient health and well-being. We are also interested in qualitative and mixed methods research, especially if those studies improve our understanding of human health and illness in ways that may, over time, lead to improvement in patient care and health outcomes. Moreover, in keeping with the idea that scientists need to help the public to understand scientific findings, we will expect authors to address these matters by clearly writing and by clearly explaining the context on how they obtained their findings, including the potential limitations of their "truth."
On our part, we are examining ways we might help increase understanding about the relationship of truth to science. Perhaps we will invite papers on this topic with a focus on how different research methods are used to understand the nature of the phenomena that are of interest to nursing science. Perhaps we will ask authors to provide brief "simple English" explanations of their primary findings. There are many ways we might accomplish a mission to make clear the differences between truth and science. We hope you will join us in this important effort through your own papers and work.
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