I started reading this week’s edition of Science and was surprised to find several editorials about the relationship between science and politics. In addition to the editorials, news items like “Will Trump upend public health?” and “Trump picks lawyer for EPA.” Were no less alarming.
Marcia McNutt, President of the National Academy of
Sciences wrote the first essay (3).
She correctly discusses science as a rational neutral process that by
its very nature is apolitical. She
describes the peril of citizens ignoring scientific reality by quoting a 26%
increased mortality rate in areas of the US where political leaders dismissed
the importance of the COVID-19 vaccine.
She makes the point that science must define the body of information
that policy should be based on - but it should not actually dictate
policy. She advocates for a role of
listening to the affected people and fighting the disinformation that affects
them. Unfortunately, the process of
active listening will not do anything toward fighting misinformation – especially
when things get to the wide dissemination and meme stage.
H. Holden Thorp, Editor-in-Chief of Science journals wrote
the second essay (4) and it was more specific to the current political situation. After commenting on the win for Trump he
provides the following qualifier:
“Although his success stems partly from a willingness to
tap into xenophobia, racism, transphobia, nationalism, and disregard for the
truth, his message resonates with a large part of the American populace who
feel alienated from America’s governmental, social, and economic institutions.”
The first clause in this sentence is accurate – but there
are problems with the second. Are xenophobia,
racism, transphobia, nationalism, and dishonesty really symptoms of an underlying
problem or do they represent the real problem of an opportunistic politician
successfully scapegoating a portion of the population to gain the support of
the electorate with these biases? That
has immediate relevance for the author’s proposed solutions of decreasing scientific
misconduct to enhance public trust. He
points out that an animated defense on X/Twitter by scientists was not
successful (how could it be based on the platform’s structure, biases and
conflicts of interest?). He ends by correctly predicting that the attacks on
science and scientists will go on unabated into the future and would like to
see a response by the scientific community that makes them less successful.
The essay by Jaffrey Mervis (2) highlights concerns that
research advocates have for the Trump agenda that is described at one point as
defunding research to reduce taxes. Any
analysis of the tax plan shows that the savings are disproportionately awarded
to the top 1% of wage earners. A
research physicist points out that there is no good news for science in the
Trump agenda and that also translates to no good news to the tech industry that
depends on government funded research for innovation. Three areas from the Biden administration
that may suffer are the Chips and Science Act, climate change, and research collaboration
with China.
The essay by Jocelyn Kaiser (1) focuses on the possible
impact on the National Institutes of Health (NIH). In this essay there is clear focus on Robert
F. Kennedy, Jr. as a danger to the NIH and health related basic science
research. That danger on the one hand describes
him with the euphemism “vaccine skeptic” and on the other quotes former NIH
Director Harold Varmus as saying: ”enormous risks especially if [Trump] placed
someone as unhinged as [Kennedy] into a position of responsibility.” There is a lot of room between skeptic
and unhinged. Trying to present
an even-handed description in this case is a clear error when responding to RFK’s
rhetoric. It is not a stretch to say that his rhetoric may replace science as
the guiding principle behind the NIH.
That is a problem regarding the role of science advising policy makers and
a boundary problem on the part of rhetoricians.
Simply put – if you are an administrator with no science background and
you are making science up – stay in your lane.
Another clear example of potential problems with a
Republican Congress is still based on the COVID-19 pandemic and insistence that
the bat coronavirus research was the source of the pandemic virus. This has reached meme status in the MAGA
community fueled by rhetoric from both Trump and members of Congress who have
directly attacked NIH scientists. In some
cases those verbal attacks have resulted in threats of violence to those same
scientists. All of that happening even though the origins of SARS-CoV-2 are not
settled science - but most recent reports suggest origins in the wild like
practically all pandemic viruses. Some politicians want to reform the
NIH and that is typically a code word for changing an institution to something
more like the one they want. In the case
of the Trump administration that can include banning fetal tissue research and
I would expect other issues related to women’s reproductive health that the
religious right objects to.
The final essay by Rachel Vogel (5) is focused primarily on
the implications of Trump’s threat to leave the World Health Organization
(WHO). The author reminds us that Trump started this process in July 2020 based
on the false claim that “WHO had helped China cover up the spread of the
virus in the early days of the pandemic.”
The Biden administration came in and stopped that process. WHO member states are bracing for a second withdrawal
or a reduction in funding to key programs that many think would be catastrophic. Cuts could also be made to the US Agency for
International Development (USAID) that administers many of these programs and
other agencies funded to research and treat tuberculosis, malaria, and
AIDS. Political and religious ideology may
also be a factor. A program for AIDS relief
started by George W. Bush is a possible target for indirect support of
abortions and the use of language that right wing religious groups consider
offensive including “transgender people” and “sex workers”. It is likely that a “gag rule” on the
dissemination of abortion information will be reinstated and the penalty will
be withdrawal of funding. Like aspects
of the other essays, the author is hopeful that there will be ways to
compensate for the Trump worst case scenario. Reform of the NIH has been talked
about in the past. Europe and other
countries could compensate for the lack of US support. Competitive funding sources like the BRICS
group (Brazil, Russia, India, China, and South Africa) could also come to the
forefront. The amount of funding available
from BRICS and what those countries would require in return is speculation at
this point.
The 5 essays highlight real problems and given Trump’s
current nominations for the Director of HHS and NIH probably minimize
them. Suggested solutions to the problem
seem to be the time-honored stay out of politics, present the data, and take
the high road. This is really an
inadequate plan. How do I know
this? The valuable lesson is that this
is what psychiatry has done for decades.
Ever since Thomas Szasz began his repetitive rhetoric that there was no
such thing as mental illness, or that psychiatric diagnoses were like
drapetomania (later modified to drapetomania was somehow a psychiatric
diagnosis) we have had to tolerate nonsensical criticism while major physician and
psychiatric groups were silent. The many
leaders in the field who did respond and had excellent responses were eventually
ignored as the neo-Szaszians continue to repeat this nonsense decades later. An experiment by Rosenhan that was exposed as
fraudulent continues to serve as an anchor point for antipsychiatrists – even though
what happened clearly did not impact the field (deinstitutionalization had
already started and the neo-Kraepelinians were already at work on reliable and
valid diagnostic criteria). The result
of this rhetoric is significant hangover on the field. It is difficult to make
a direct connection but common sense dictates that psychiatric resources
probably takes a hit from all the repetitive negative rhetoric. That is the
risk to all of medicine, public health, and scientific research with the
current MAGA rhetoric.
Science typically considers itself above rhetoric and politics
at least until the competition for grant funding heats up. The editorials all fail to comment on
this. Instead, they suggest that leading
by example, being available for consultation, and generally taking the higher
ground will somehow correct corrosive politics.
That is both a naïve and losing strategy. We currently have a party that has lied and misinformed
the public repeatedly and at record levels.
It is supported by a large mainstream media organization with the same
goals providing a constant diet of misinformation. It is funded by
billionaires. The effects of all those dynamics are easily observed in
attitudes toward real science and scientists.
Experts on autocracy and authoritarianism point out that the effect of
constant lies on any group of citizens is that eventually they don’t believe
anything – even if it happens to be the truth. A standard authoritarian tactic is to attack
expertise and pretend that it does not exist.
At no recent point in history have legitimate scientists,
physicians, and public health officials been threatened with violence by people
who have no clear idea of what they do.
In many cases these professionals have been responsible for saving
thousands of lives. That situation should be intolerable to any scientist or
modern citizen who can evaluate the effects of science. Furthermore, it should not be supported at any
level by the government, but it currently is.
The same party that that supports lies also supports threats and
violence at various levels up to an including an attempt to overthrow the US
government. With the current election there is the expectation that attempt
will be whitewashed as a protest further eroding the rule of law.
The curious aspect of this process is that it is right out
there in the open. The repetitive lies are picked up by social media. Proxies of that ideology begin to amplify
them to the point that they become memes rapidly assimilated by true believers
in the same ideology. At that point they
become part of that culture and resistant to change from rational arguments and
additional information. There is no evidence that I am aware of that change is
possible at that point and the most recent Presidential election is solid
evidence.
There is a semi rational basis to politics at best. The current election illustrates this at many
levels. Major questions of character,
intellect, and policy were ignored. The fact checking mode of the fourth estate
was minimized. Some media outlets were
mere propaganda arms and provided no information for voters to make an informed
decision.
The only rational course is to continuously counter the repetitive
propaganda being put out in social media.
There is no comprehensive strategy for doing this but it must be
done. It will take more than a few
editors from Science journals. A
starting point may be a coalition of editors of science and medical journals
with their own website dedicated to refuting misinformation and posting the
real science. The time has come to stand up for what is science and what it not
and protect people under attack for doing the right thing.
George Dawson, MD, DFAPA
References:
1: Kaiser J. Trump
won. Is NIH in for a major shake-up? Science. 2024 Nov 15;386(6723):713-714.
doi: 10.1126/science.adu5821. Epub 2024 Nov 14. PMID: 39541475.
2: Mervis J. Research
advocates see 'no good news for science'. Science. 2024 Nov
15;386(6723):712-713. doi: 10.1126/science.adu5820. Epub 2024 Nov 14. PMID:
39541473.
3: McNutt M. Science
is neither red nor blue. Science. 2024 Nov 15;386(6723):707. doi:
10.1126/science.adu4907. Epub 2024 Nov 14. PMID: 39541446.
4: Thorp HH. Time to
take stock. Science. 2024 Nov 15;386(6723):709. doi: 10.1126/science.adu4331.
Epub 2024 Nov 7. PMID: 39508752.
5: Vogel G. 'America
first' could affect health worldwide. Science. 2024 Nov 15;386(6723):715. doi:
10.1126/science.adu5822. Epub 2024 Nov 14. PMID: 39541476.
No comments:
Post a Comment