{"id":4256,"date":"2021-12-27T13:42:05","date_gmt":"2021-12-27T12:42:05","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-ethics\/?p=4256"},"modified":"2021-12-27T13:43:03","modified_gmt":"2021-12-27T12:43:03","slug":"we-cant-just-follow-the-science","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-ethics\/2021\/12\/27\/we-cant-just-follow-the-science\/","title":{"rendered":"We can\u2019t just follow the science"},"content":{"rendered":"<p>By Franklin G. Miller.<strong>\u00a0<\/strong><\/p>\n<p>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 \u201cjust follow the science.\u201d\u00a0 For example, consider the following statement by Anthony Fauci, the chief scientific spokesperson for the Biden administration, in an interview published in <a href=\"https:\/\/www.theatlantic.com\/politics\/archive\/2021\/12\/fauci-omicron-christmas-safe\/621081\/?utm_source=email&amp;utm_medium=social&amp;utm_campaign=share\"><em>The Atlantic<\/em> <\/a>on December 21, 2021:\u00a0 \u201cWhereas now we\u2019re not doing everything perfectly, but there\u2019s a full commitment on the part of the administration to let scientific principles be the sole guide of what we do.\u00a0 Absolutely, the underlying core basis of what we do is all science.\u201d<\/p>\n<p>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.\u00a0 It comes down to two words:\u00a0 \u201csole\u201d in the first sentence, and \u201call\u201d in the second.\u00a0 While scientific principles and evidence <em>should<\/em> guide policy decisions in response to the twists and turns of the pandemic, they can never be the <em>sole<\/em> basis for these decisions.\u00a0 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.\u00a0 These European countries once again are imposing more or less stringent \u201clockdowns,\u201d as well as mandating vaccine \u201cpassports\u201d as a condition for certain activities such as eating in restaurants and attending public gatherings.\u00a0 The Biden administration has decided that such measures are not necessary, or politically desirable, now that effective COVID vaccines and boosters are readily available.\u00a0 Public health authorities and government officials in these countries are guided by the same scientific evidence, but they have reached very different policy choices.\u00a0 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.<\/p>\n<p>Philosophically, what is misguided about declaring that policies in response to the pandemic \u201cjust follow the science\u201d or should be solely guided by scientific evidence was articulated by David Hume in a famous passage in his classic work <em>A Treatise of Human Nature<\/em>, in which he pointed out that there is a logical distinction between statements about what <em>is <\/em>the case and what <em>ought<\/em> to be done.\u00a0 Applied to the pandemic context, scientific principles and evidence can never determine by themselves what policymakers ought to do.\u00a0 Policy decisions must, at least implicitly, appeal to some value judgments\u2014judgments that reasonable people may, or may not, dispute.<\/p>\n<p>Public statements about policy <em>just<\/em> following the science or having science as the <em>sole<\/em> guide mask the value judgments that underlie policy choices.\u00a0 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.\u00a0 Two key values at stake in policy choices in response to the pandemic are individual freedom and the common good.\u00a0 Individual freedom is prized by Americans, perhaps more than by citizens of any other society in the world.\u00a0 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.\u00a0 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.<\/p>\n<p>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.\u00a0 This means that mask and vaccine mandates are legitimate and desirable measures of public policy in service of the common good\u2014measures that justifiably limit individual freedom.\u00a0 Those on the right of the political spectrum disagree.\u00a0 They see mask and vaccine mandates as unjust restrictions on individual freedom and overreach by governments.\u00a0 Science plays a limited role in this debate.\u00a0 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.<\/p>\n<p>It is difficult to be optimistic about the role of rational persuasion regarding pandemic policy in the deeply polarized climate of the U.S.\u00a0\u00a0\u00a0 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.\u00a0 Ultimately policy is a matter of politics.\u00a0 It can be guided but not determined by science.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Author:<\/strong> Franklin G. Miller, Ph.D.<\/p>\n<p><strong>Affiliation:<\/strong> Professor Medical Ethics in Medicine, Weill Cornell Medical College<\/p>\n<p><strong>Competing<\/strong> interests: None declared.<!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>By Franklin G. Miller.\u00a0 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 \u201cjust follow the science.\u201d\u00a0 For example, consider the following statement by Anthony Fauci, the chief scientific spokesperson for the Biden administration, in an interview published in The [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2021\/12\/27\/we-cant-just-follow-the-science\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":354,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[8070],"tags":[],"class_list":["post-4256","post","type-post","status-publish","format-standard","hentry","category-pandemic"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>We can\u2019t just follow the science - Journal of Medical Ethics blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2021\/12\/27\/we-cant-just-follow-the-science\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"We can\u2019t just follow the science - Journal of Medical Ethics blog\" \/>\n<meta property=\"og:description\" content=\"By Franklin G. Miller.\u00a0 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 \u201cjust follow the science.\u201d\u00a0 For example, consider the following statement by Anthony Fauci, the chief scientific spokesperson for the Biden administration, in an interview published in The [...]Read More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/medical-ethics\/2021\/12\/27\/we-cant-just-follow-the-science\/\" \/>\n<meta property=\"og:site_name\" content=\"Journal of Medical Ethics blog\" \/>\n<meta property=\"article:published_time\" content=\"2021-12-27T12:42:05+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2021-12-27T12:43:03+00:00\" \/>\n<meta name=\"author\" content=\"Hazem Zohny\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Hazem Zohny\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"4 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2021\\\/12\\\/27\\\/we-cant-just-follow-the-science\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2021\\\/12\\\/27\\\/we-cant-just-follow-the-science\\\/\"},\"author\":{\"name\":\"Hazem Zohny\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#\\\/schema\\\/person\\\/e73152f6aa4e164c7d625d77cf4fed35\"},\"headline\":\"We can\u2019t just follow the science\",\"datePublished\":\"2021-12-27T12:42:05+00:00\",\"dateModified\":\"2021-12-27T12:43:03+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2021\\\/12\\\/27\\\/we-cant-just-follow-the-science\\\/\"},\"wordCount\":829,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#organization\"},\"articleSection\":[\"Pandemic\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2021\\\/12\\\/27\\\/we-cant-just-follow-the-science\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2021\\\/12\\\/27\\\/we-cant-just-follow-the-science\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2021\\\/12\\\/27\\\/we-cant-just-follow-the-science\\\/\",\"name\":\"We can\u2019t just follow the science - 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