8:30am–5:30pm, Wednesday June 26, 2013
Room VIC 323, University of Toronto, Toronto, Canada
Organizer and contact
The importance of science for guiding policy decisions has been a central feature of policy-making for much of the past century. But which science we have available to us and what counts as adequate science for policy-making shapes substantially the specific impact science has on policy decisions. Values play a central role in these areas, as values shape the research agendas scientists pursue, the range of plausible alternative explanations discussed for phenomena of concern, and what counts as sufficient warrant in any given case. Policy, too, shapes which science we pursue and often can have inadvertent directive effects on what we ultimately claim to know, and thus what is seen as an adequate basis for policy-making. In this workshop, we will explore the relationships among science, policy, and values, by looking at both historical and contemporary cases at this nexus, with an eye towards both describing the ways in which science, policy, and values influence each other and putting forth guidance for how they should influence each other.
Schedule of Talks & Abstracts
8:30 Coffee and Welcome
8:45 “Patents and Progress: The Current Crisis in Commercialized Medical Research”, James R. Brown, University of Toronto
In recent years a great deal of medical research, especially pharmaceutical, has been driven by commercial interests. The quality of this research is questionable, to put it kindly. On the other hand, the extensive distribution and overuse of antibiotics has lead to serious problems of a different sort. How can we improve the situation? I will examine some suggestions as well as offer and defend one of my own, the elimination of patents in this field.
9:15 “Financial Conflicts of Interest and Criteria for Research Credibility”, Kevin Elliott, University of South Carolina
The potential for financial conflicts of interest (COIs) to damage the credibility of scientific research has become a significant social concern, especially in the wake of high-profile incidents involving the pharmaceutical, tobacco, fossil-fuel, and chemical industries. Policy makers have debated whether the mere presence of financial COIs should count as a reason for treating research with suspicion or whether research should be evaluated solely on its merits, regardless of its funding source. This paper examines a recent proposal to develop “direct” criteria for evaluating the credibility of research solely on its scientific merits. It concludes that proposals of this sort are likely to be either ineffective or impractical in many cases. Nevertheless, this does not imply that all research funded by those with an interest in the outcome must be placed under a cloud of suspicion; there are conditions under which research is at much more serious risk of being corrupted than in other cases, and attention to these conditions can guide productive responses to financial COIs.
9:45-10:15 Discussion of Brown & Elliott
10:15-10:45 Coffee Break
10:45 “Detecting Harm of Medical Interventions”, Jacob Stegenga, University of Toronto/University of Utah
The ‘power’ of a clinical trial—the ability of a trial to detect a difference of a certain effect size between the experimental group and the control group—is normally thought to be pertinent to detecting benefits of medical interventions. It is important, though, to distinguish between the ability of a trial to detect benefits and the ability of a trial to detect harms. I refer to the former as powerB and the latter as powerH. Several methodological features of trials cause a direct trade-off between powerB and powerH. The decision to design a trial on one side or the other of this trade-off is not a scientific matter, but rather is a matter of values, and yet the decision influences what is later taken to be matters of fact. This supports the view that values influence science even at the level of the constitution of evidence itself. This can have nefarious consequences: harms caused by medical interventions are systematically underestimated in biomedical research. I identify three classes of factors which maximize powerB at the expense of powerH: (i) the selection of subjects in trials, (ii) the way harm is operationalized and measured, and (iii) the design of pre- and post-approval studies. Contrary to standard practice, I argue, powerH is at least as important as powerB. To mitigate the usual sacrifice of powerH, I propose several principles for the design and reporting of clinical trials.
11:15 “Philosophers’ practical conceptual work in practice: The case of ghostwriting in medical science”, Sergio Sismondo, Queen’s University
A significant number of articles in the medical literature are ghostwritten for the pharmaceutical industry. This scandal has attracted a considerable amount of attention, especially within medicine. But among the recent commentators are a number of philosophers, including myself. I survey philosophers’ discussions of ghosting, with the goal of assessing what they qua philosophers can most meaningfully contribute to understanding this and similar phenomena. Their forms of engagement, observations, and recommendations are surprisingly diverse. In this presentation, I’ll argue though that we can see some commonality to the discussions that offer the more rich understandings of the phenomenon. Philosophers can make real and distinctive contributions to practical domains, but they will best succeed by both paying close attention to practice and by stepping away from it at the right point.
11:45-12:15 Discussion of Stegenga & Sismondo
12:15-1:30 Break for Lunch
1:30 “Different types of objects of scientific expertise demand different types of justification”, Frédéric Bouchard, Université de Montréal
Recent public debates about science-based issues have strengthened the necessity to appeal to some form of scientific expertise. Social scientists have addressed this phenomenon, usually focusing on describing how expertise is marshaled, not why it is legitimate to invoke it. Philosophers have offered a different take, which can be grouped into two broad families: some (e.g. Hardwig) offer moral underpinnings for expertise while others (e.g. Goldman) offer a detailed epistemic analysis of the types of epistemic asymmetry in expertise relationships. While helpful, neither shows how the heterogeneity of the types of objects for which scientific expertise is invoked affects the epistemic authority of said expertise. I will show how the types of values involved in scientific practice buttress its authority for some objects and weaken it for others. Thus, the authority of scientific expertise must be contextualized relative to the risk involved in the process it examines. This affects the ways one can defend the epistemic authority of scientific expertise. By understanding the diversity of genuine epistemic justifications for different kinds of scientific expertise, we are better equipped to assess when and where scientific expertise is unfairly maligned and when it is overenthusiastically trumpeted.
2:00 “Public Fear of Vaccines: Implications of the MMR-autism scandal and rebuilding public trust”, Maya Goldenberg, University of Guelph
Despite the scientific community’s unequivocal rejection of the alleged link between the MMR vaccine and autism, and the finding that the science first alleging that link was fraudulent, public fear of childhood vaccination regimens persist. This is evident in reduced vaccination rates in many developed countries and rising rates of serious illnesses like measles and whooping cough among children. This talk borrows from two bodies of philosophy of science literature—the first, “trust in science”, and the second, “public understanding of science”—to examine the seeming disconnect between scientific consensus and public opinion and to consider policy implications.
2:30-3:00 Discussion of Bouchard & Goldenberg
3:00-3:30 Coffee Break
3:30 “On the Use of Public Deliberation to Foster Increased Public Participation in Science Policy”, Kieran O’Doherty, University of Guelph
The case has been made for greater public engagement with science and science policy. Here I focus on a recent deliberative public engagement conducted on the topic of RDX pollution. RDX is a powerful explosive commonly used in military and civilian operations, but is implicated in adverse environmental and health outcomes. One possible technological solution involves microbes used for bioremediation of RDX. The development and eventual deployment of microbial genomics illustrates science emerging into existing social fabrics with difficult to predict outcomes. In the public deliberation, lay individuals took into account technical information from multiple areas. They were also asked to listen to each other’s perspectives to come to collective positions acknowledging the plurality of values of different communities and stakeholders. Public deliberation offers not only the promise of meaningful public engagement; it also offers a valuable resource for the study of the intersection of science, values, and policy.
4:00 “Global bioethics? Insights from Taiwan and China”, Jennifer Liu, University of Waterloo
Scholarship in anthropology and STS has shown that even as science is conceptualized as universal, it takes on local and situated meanings and practices. If sciences themselves incorporate and manifest specific local characteristics, then what might we expect regarding the possibility of creating agreement within bioethical regimes? Or, more broadly, what are the possibilities for a global bioethics in a world in which situated sciences and cultural differences are taken seriously? This talk considers some of the problems that emerge in treating bioethics as a global form and in the pursuit of global consensus. Drawing on cases from Taiwan and China, I suggest that we can gain greater insight by reframing the question as one of what bioethics does. Finally, I suggest that bioethics increasingly serves to facilitate and legitimate research and to mitigate risk. As such, it can indeed serve as a site of international cooperation and agreement despite provocative rhetorics of difference.