Cholesterol and cardio-vascular disease: degenerating research programmes in current medical science

This paper argues that, when examined from a Lakatosian perspective, the (mini-) research programmes that have been built to defend two important theories in modern medicine show all the marks of consistent empirical degeneration. Yet those two theories remain enormously influential—underpinning, as they continue to do, advice and treatment given to millions of people worldwide. As Lakatos and others have shown, theories in successful sciences, such as physics and chemistry, whose associated research programmes have degenerated have invariably been rejected. This is an area, then, in which Lakatosian ideas might have enormous impact—if the verdict of degeneration is correct and if it were accepted by the medical community, it could lead to change of medical treatment for millions of people. The final part of the paper looks at reasons why recommended treatment has so far not changed despite the apparent degeneration of the supporting research programmes. It therefore takes us into another area of Lakatosian scholarship—his much-discussed distinction between ‘internal’ and ‘external history of science’.