The Fight against Doubt
Inmaculada de Melo-Martín and Kristen Intemann
Reviewed by Katherine Furman
The Fight against Doubt: How to Bridge the Gap between Scientists and the Public
Inmaculada de Melo-Martín and Kristen Intemann
New York: Oxford University Press, 2018, £25.99
ISBN 9780190869229
There is increasing concern about public distrust in science as the consequences of this distrust become clear: vaccine hesitancy has resulted in the return of diseases thought to be eradicated in most parts of the world, and climate denialism stalls policies that require urgent implementation. These are not idle philosophical concerns, but rather pressing, real-world problems, and much hangs on us getting the answers right. Immaculada de Melo-Martín and Kristen Intemann’s The Fight against Doubt provides a clearly written and insightful contribution to this debate, with many interesting examples to help the discussion along
The first half of the book (Chapters 2–6) looks at the problem of ‘normatively inappropriate dissent’ (which they abbreviate to ‘NID’), that is, dissent within the scientific community that hinders rather than helps scientific debate. Every notable example of public distrust in science has a group of marginal scientists who offer legitimacy—for example, Peter Deusberg for AIDS denialism and Andrew Wakefield for those who doubt the safety of the MMR (measles, mumps and rubella) vaccine (p. 3). This is a practical effect of NID. It makes it seem as though there is genuine scientific concern that a causal connection exists between the MMR vaccine and autism, and that there is doubt about whether HIV causes AIDS.
Given how much trouble NID causes, it would be convenient to be able to identify and regulate it. De Melo-Martín and Intemann consider various strategies for doing this, but all are found wanting. It turns out that any strategy we might use to identify NID also risks excluding disagreement that is scientifically beneficial. For instance, an obvious potential indicator of NID might be that dissenting scientists have financial stakes in the positions they publicly endorse. Money as a driver of disingenuous dissent is familiar to us. Consider the role the tobacco industry played in questioning the causal connection between smoking and lung cancer (Oresekes and Conway [2010]), or the more recent case of Theranos—the multibillion dollar tech start-up that faked the creation of new blood-testing technology, which it claimed challenged the orthodoxy (Carreyrou [2018]). But if we adopt the seemingly straightforward strategy of excluding scientific disagreements with financial motivation, we risk excluding mainstream scientific positions along with the fringe. One of the major supporters of vaccine safety, Paul Offit, has investments in the vaccine industry, and Rajendra Pachauri, former chair of the Intergovernmental Panel on Climate Change (IPCC), has financial investments in alternative energy technology (p. 37). De Melo-Martín and Intemann consider a number of strategies for dealing with NID—such as excluding bad faith disagreement or excluding those who lack appropriate scientific credentials—but none successfully exclude inappropriate dissent while leaving useful scientific debate intact. Perhaps this inability to generate a set of principles to regulate scientific dissent should not be surprising, given the heterogeneity of dubious challenges to mainstream science: arguing that there is a connection between the MMR vaccine and autism is very different from denying the existence of anthropogenic climate change.
However, not being able to regulate NID does not mean that all is lost. De Melo-Martín and Intemann argue convincingly that we can tolerate quite a lot of NID so long as we trust the practice of mainstream science and the scientists themselves (p. 88). Problems creep in with mistrust. We see this in the case of South African AIDS denialism in the late 1990 and early 2000s, the example with which the book opens (pp. 1–2). The then South African president, Thabo Mbeki, came to mistrust the mainstream scientific position on HIV and AIDS, because he suspected the scientists of at least implicit racism. This led him to undertake substantial independent evidence gathering and to consult non-mainstream scientists. This resulted in the avoidable deaths of 330,000 South Africans (pp. 91–2). Without mistrust, normatively inappropriate disagreement would have been irrelevant in this case. Given that there is little that we can do about NID, and that trust really matters, the rest of the book sensibly shifts to discussions of trust (Chapters 7–10).
A salient source of distrust is the role that non-epistemic values play in science (Chapters 9–10). After all, resistance to Darwin is likely to have little to do with suspicion of the science per se, and more to do with the challenge that his theories pose to people’s ways of life (Kitcher [2011], p. 16).
Scientific practice is shot through with value judgements, from what is studied to how things are classified, and to what appears to be a plausible hypothesis in light of the available evidence. Elliot ([2017]) eloquently describes this as a ‘tapestry of values’, an image that makes clear that you cannot unpick the values without unravelling the whole enterprise. What is worse, scientists may not even be aware that they have invoked certain value judgements or implicit biases (p. 119). For example, in the history of biology, scientists influenced by sexist stereotypes developed accounts of human reproduction with the egg as a passive recipient of burrowing sperm, neglecting the chemical activity of the egg (p. 118). It is unlikely that biologists were consciously sexist in developing this account, rather it just seemed a plausible description of what they saw in the evidence, given their prior beliefs.
De Melo-Martín and Intemann suggest a number of strategies for dealing with this problem: making values transparent where possible, developing avenues for public criticism, diversifying methods, and diversifying the scientific community itself (pp. 125–8). This is certainly not the end of the extremely contentious debate within philosophy of science, but the authors are clear that they are not trying to have the final word here (p. 127). This strikes me as fair, given that there is already a lot going on in this book and the values in science debate is substantial.
I suspect that de Melo-Martín and Intemann underestimate the hardness of the problem, however. It isn’t just that values are fully integrated into the production of science or that the scientists might not be aware of their values, both of which are hard problems; it’s also that even being able to identify value judgements where they occur requires considerable technical expertise, effectively excluding laypeople. This is clear in Julian Reiss’s ([2017]) work on fact–value entanglements in economics. To illustrate his discussion, he uses the example of consumer price measures, which is the measure of how much a fixed baskets of goods costs over time. One of the value judgements made in the creation of this metric is how to weigh various households (Reiss [2017], p. 140). In order to see what these value judgements are, their implications for the measure and the ultimately the implications for its various users, we already need a pretty sophisticated grasp of economics. Also worrying is that there are many of these value-laden decision points, all of which require technical expertise to see where the value call is made: ‘Others include the selection of the aggregation formula, the treatment of new goods, of quality changes and of new outlets’ (Reiss [2017], pp. 140–1). Thus the values embedded in much of the scientific enterprise are effectively invisible to ordinary members of the public, and not readily explainable to them. This knocks out a number of de Melo-Martín and Intemann’s suggestions, such as increasing both transparency and avenues for public criticism.
Another way in which values in science become relevant is in the context of policy-making and the use of the products of science (Chapter 10). Importantly, science does not dictate policy. A significant example of this is the US debate over the availability of emergency contraception without a prescription. The FDA declared that that emergency contraceptive pill Plan B is safe and effective for females of all ages. But the resulting policy decision was to continue to restrict over-the-counter access for those under the age of seventeen. This policy decision was ultimately overturned by the courts, but it is an illustrative reminder that the path from science to policy is not value-free (p. 125).
Recognizing the role that values play in science-based policy-making is useful. As de Melo-Martín and Intemann helpfully explain, this recognition allows for better engagement with those who seemingly resist the science in a number of cases. In particular, if someone resists a policy on the grounds of values rather than science, offering more evidence won’t resolve the dispute (pp. 141–2). And values in policy are not inaccessible in the ways that values in the sciences sometimes are: technical expertise is not required to see where the value judgements lie. We can and do engage in debates and discussions about which values we want upheld in our societies—just think of the 2018 abortion referendum in Ireland, which was very little about science and very much about values. That is not to suggest that resolving value disagreements is easy—we are likely to require assistance from our colleagues in political philosophy and political science to do this well—but at least we can see what the values are and where the disagreements lie.
De Melo-Martín and Intemann conclude (in Chapter 11) that we need more research, especially from the social sciences, to better understand the sources of distrust and to develop better interventions (p. 152). Whatever the future of the ‘fight against doubt’ looks like, it is likely to be less narrowly focused on disagreements within the scientific community and more focused on the social context in which science takes place, including social values. In this regard, The Fight against Doubt does not offer a resolution to the problem so much as it opens up space for new ways of thinking about what to do next. This is a valuable contribution.
Katherine Furman
University College Cork
katherine.furman@ucc.ie
References
Carreyrou, J. [2018]: Bad Blood: Secrets and Lies in a Silicon Tech Startup, London: PanMacMillan.
Elliot, K. [2017]: A Tapestry of Values: An Introduction to Values in Science, New York: Oxford University Press.
Kitcher, P. [2011]: Science in a Democratic Society, Amherst, NY: Prometheus.
Oresekes, N. and Conway, E. [2010]: Merchants of Doubt: How a Handful of Scientists Obscured the Truth on Issues from Tobacco Smoke to Global Warming, London: Bloomsbury Press.
Reiss, J. [2017]: ‘Fact–Value Entanglements in Positive Economics’, Journal of Economic Methodology, 24, pp. 134–49.