Science has published an editorial by Dr. Bill Roper, the dean of the School of Medicine and vice chancellor for medical affairs at the University of North Carolina (UNC). Dr. Roper is professor of health policy and administration in the School of Public Health, and is professor of pediatrics and of social medicine in the School of Medicine at UNC.
The sentences in bold are my emphasis.
Editorial by: WILLIAM L. ROPER
PHOTO: UNC HEALTH
Citation: SCIENCE, 30 Jun 2022, Vol 377, Issue 6601, p. 7
The past 2 years have been a strange and difficult time for the world. The COVID-19 pandemic has brought illness, hospitalization, and death near to many people. In the United States, people are divided not only on what they should do but also on what constitutes the facts. Many are seemingly in an alternative world, driven by disinformation, conspiracy theories, and anti-science beliefs. How can health and medical leaders do their jobs while trying to cope with a polarized public? They must be more effective in explaining and persuading the public on matters of science and health. This will require better clarification of two things to the public—the roles of science and politics in public policy decisions, and the means by which scientific truth is established and updated.
There is a continuing strand of argument from many in the scientific community that “we ought to get politics out of public health.” And many politicians have said that scientists are not the ones to make public policy decisions related to public health or other issues. The reality is that both science and politics are essential for public health to work well. Scientists inform public understanding of the patterns of health and illness in populations, especially when epidemics and pandemics strike. And politics—the way decisions are made in a democratic society—is vital for acting on the information and insights that the scientific community provides for the benefit of everyone.
In addition to clarifying the separate roles of science and politics, society needs to understand better how scientific truth is established and updated. It is based on verified and reproducible facts. The scientific method of gathering data, debating various formulations of the information, and arriving at consensus understandings of what is “true” about a particular matter has been the bedrock for establishing scientific truth for centuries. But in the past few years, political leaders, media personalities, and ordinary citizens have proclaimed their own “alternative facts,” disparaging the idea that anyone should question their “facts” and theories.
In his recent book, The Constitution of Knowledge: A Defense of Truth, Jonathan Rauch clearly and convincingly describes and defends the Enlightenment-born process of weighing evidence and committing to truth. He explains that the endeavor is founded on two arguments: The truth is based on what is known so far and the truth applies to everyone. Rauch argues that this has produced a process for certifying knowledge—a public system for adjudicating differences of belief and perception and for developing shared and warranted conclusions about truth. This system provides three public goods: knowledge (distinguishing reality from nonreality), freedom (encouraging rather than repressing human autonomy, creativity, and empowerment), and peace (rewarding social conciliation, maximizing the number of disagreements that are resolvable, and compartmentalizing and marginalizing disagreements that cannot be resolved).
Given that truth is based on what is known so far, it is always provisional. We likely will know more tomorrow than today, and we will then have to revise our conclusions. That is just the scientific method at work. Though science and politics have separate roles, once this system “gets the facts straight,” scientists and political leaders can work constructively together for the common good.
This knowledge-certifying system is under concerted attack today, most notably in polarized political conflicts, including about masks and vaccines, climate change, and gun violence. Restoring confidence in messages regarding science for the public good will be challenging, but it can only be done if there is an effort to explain, defend, and reinforce this public system for shepherding new knowledge. This needs to include widespread discussions across the scientific community and in the public at large, leading to a broad recommitment to the scientific method.
The challenges of communicating messages about science, health, and truth are among the often-mentioned reasons for the fatigue and discouragement that public health and medical leaders face today. And that same frustration is transferred to those who seek to engage the wider public with these messages.
Overcoming these challenges will surely be difficult, but with concerted effort it can be done, as it has before—for example, in efforts to promote widespread childhood immunizations. And this requires a never-ending commitment, as we are learning every day.