Friday, May 15, 2015

Money, Power, and "Science" as Policy

I'm so very appreciative of those who do scientific research, whose work helps to better lives and deepen understanding.

But we have to be very careful when science is used to demand conformity, or when its use in policy arguments can clearly be tied to financial gain by the parties involved. There's a difference between independent research used to help people inform their practice, and scientific conclusions that are tied directly to corporate profits, or that establish governmental powers, or that are used as arguments for political policy and as part of that bestow very direct financial benefits.

For example, the USDA dietary guidelines: which don't require that we have a degree in nutrition to see how the claims of "science" have changed over the decades, or how politics and money have influenced science-based claims, or even how much those authoritative guidelines may actually have been a part of tangible harm because of their influence. (See A Fatally Flawed Food Guide by Luise Light, Ed.D, the fascinating USDA Food Pyramid HistoryGovernment “Help” Makes Nutrition Worse: Fats, or Time to Retire the USDA's Dietary Guidelines?)

"Science," in the hands of lobbyists, or paid-by-industry employees or experts, ends up showing how easy it is for results to mirror that which produces a profit, and not that which is credibly and independently verifiable.

Malicious intent, willful blindness, or the benign unawareness from demanding task work--whatever the causal cognitive mechanism at play with individual actors in this game, it doesn't make any sense for us to allow food companies and their agents to set food guidelines, or bankers to help set banking policy, or ... you get the picture, right? ... or testing companies to influence education policy.

Even worse is when we allow these companies to perform their own studies, or to pay for others, without decent checks and balances. If you know your paycheck comes from someone, and they have an expected or hoped-for result, it takes an incredibly strong ethical backbone to deliver the opposite or contradictory results and be willing to walk away from the money.

And then there's the lobbying. Why do we let this go on?

So, the next time you hear someone tell you that we should adopt some policy decision because there is scientific proof, I hope you'll think about the following (boldface type is mine):
Peer review is a sacred cow that is ready to be slain, a former editor-in-chief of the British Medical Journal has said...

Richard Smith, who edited the BMJ between 1991 and 2004, told the Royal Society’s Future of Scholarly Scientific Communication conference on 20 April that there was no evidence that pre-publication peer review improved papers or detected errors or fraud. 
Referring to John Ioannidis’ famous 2005 paper “Why most published research findings are false”, Dr Smith said “most of what is published in journals is just plain wrong or nonsense.” (more)
Or this, from Drug Companies + Doctors: A Story of Corruption in the New York Review of Books, by Marcia Angell, Senior Lecturer in Social Medicine at Harvard Medical School and former Editor in Chief of The New England Journal of Medicine.
The problems I’ve discussed are not limited to psychiatry, although they reach their most florid form there. Similar conflicts of interest and biases exist in virtually every field of medicine, particularly those that rely heavily on drugs or devices.  
It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.
Whatever the policy field (and especially in education and when children are involved), when we pretend that conflicts of interests don't exist, that motivations are not influenced by money, that financial actors don't collude for financial gain, or that money doesn't try to influence legislation, we run a terrible risk. By not recognizing the corrupting power of money in politics and policy, we risk overshadowing or shutting down the actual honest and healthy dialog where research and science can truly help inform our understanding of the world and how we improve it. 
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