By Franklin G. Miller.
During the COVID-19 pandemic, a common refrain voiced by many public health experts and government officials in the U.S. is that public policy should “just follow the science.” For example, consider the following statement by Anthony Fauci, the chief scientific spokesperson for the Biden administration, in an interview published in The Atlantic on December 21, 2021: “Whereas now we’re not doing everything perfectly, but there’s a full commitment on the part of the administration to let scientific principles be the sole guide of what we do. Absolutely, the underlying core basis of what we do is all science.”
With all due respect to Dr. Fauci, a distinguished and dedicated public servant performing admirably in an exceedingly difficult job, there is something basically amiss in this statement. It comes down to two words: “sole” in the first sentence, and “all” in the second. While scientific principles and evidence should guide policy decisions in response to the twists and turns of the pandemic, they can never be the sole basis for these decisions. This can be demonstrated readily by comparing policy choices in the U.S. and several Western European countries in the wake of surging cases of infection and hospitalization caused by the Omicron variant of SARS-CoV-2. These European countries once again are imposing more or less stringent “lockdowns,” as well as mandating vaccine “passports” as a condition for certain activities such as eating in restaurants and attending public gatherings. The Biden administration has decided that such measures are not necessary, or politically desirable, now that effective COVID vaccines and boosters are readily available. Public health authorities and government officials in these countries are guided by the same scientific evidence, but they have reached very different policy choices. My point is not to enter the debate over how the U.S. should now be responding to the Omicron variant, but simply to emphasize that science alone cannot determine these choices, which necessarily rely on value judgments.
Philosophically, what is misguided about declaring that policies in response to the pandemic “just follow the science” or should be solely guided by scientific evidence was articulated by David Hume in a famous passage in his classic work A Treatise of Human Nature, in which he pointed out that there is a logical distinction between statements about what is the case and what ought to be done. Applied to the pandemic context, scientific principles and evidence can never determine by themselves what policymakers ought to do. Policy decisions must, at least implicitly, appeal to some value judgments—judgments that reasonable people may, or may not, dispute.
Public statements about policy just following the science or having science as the sole guide mask the value judgments that underlie policy choices. Such statements are inherently ideological: they wrap debatable policy decisions in the mantle of objective science, making them seem grounded in a way that no reasonable person can dispute. Two key values at stake in policy choices in response to the pandemic are individual freedom and the common good. Individual freedom is prized by Americans, perhaps more than by citizens of any other society in the world. But virtually everyone who takes an interest in politics and policy would agree, or at least pay lip-service to the idea, that government policies in response to the pandemic should promote the common good. However, there are basic disagreements about the legitimate scope and limits of individual freedom, and about what it is proper and reasonable for state governments and the federal government to do in promoting the common good.
As a liberal, I believe that in the current context of the pandemic in the U.S., individuals should not be free to expose others to avoidable risks of infection, serious disease, and death by refusing to wear masks in public settings or refusing to become fully vaccinated. This means that mask and vaccine mandates are legitimate and desirable measures of public policy in service of the common good—measures that justifiably limit individual freedom. Those on the right of the political spectrum disagree. They see mask and vaccine mandates as unjust restrictions on individual freedom and overreach by governments. Science plays a limited role in this debate. And appeals to scientific evidence get no traction with those who rationalize decisions to refrain from wearing masks or getting vaccinated by appeal to various conspiracy theories.
It is difficult to be optimistic about the role of rational persuasion regarding pandemic policy in the deeply polarized climate of the U.S. Nevertheless, free and open public discourse is vital to the functioning of a democracy; and this ought to include debate about the potentially competing values at stake in policy decisions. Ultimately policy is a matter of politics. It can be guided but not determined by science.
Author: Franklin G. Miller, Ph.D.
Affiliation: Professor Medical Ethics in Medicine, Weill Cornell Medical College
Competing interests: None declared.