Get ready for the backlash against scientific expertise, especially against public health experts, writes Damon Linker. The line will be: "We deferred to the geniuses for no good reason, and now they have the blood of the economy on their hands."
Many will be grateful to the experts for saving thousands or millions of lives. Many, Linker notes, will draw different conclusions: "Maybe the lower level of mortality is largely a result of the novel coronavirus being less deadly than we were led to believe. Maybe we shut down the social world — and set ourselves up to pay the potentially stupefying economic and psychological costs of having done so — for no good reason. Yes, more people would have died had we continued to work, travel, shop, socialize, and go to school and church. But how many? Millions more? Or merely several thousand more?"
It's already starting. The protests in Michigan and elsewhere are protests against the extended shutdown, but the ire is focused on the health experts who have been guiding global policy for the past two months.
It's hardly a surprise. Americans have long shown "insubordination" toward experts and now, Linker notes, the rebels have an ally in the White House.
To his credit, Linker doesn't cast blame on American irrationality. The experts aren't "beyond reproach. They have made and continue to make serious mistakes that need to be examined and hopefully learned from. That goes, too, for the mistakes of elected officials."
But Linker doesn't consider the back story of the American public health establishment, and the reasons Americans might be suspicious. Back in 2016, Ari Schulman examined the ways "scientific authorities occasionally earn some of this mistrust." It's worth reviewing.
One factor is the "risk aversion" of public health leaders. The CDC once recommended, for instance, that "women of childbearing age abstain from alcohol" since they may be pregnant without knowing it. The uncertainty of the question justified the absolutism: "There is no 'proven safe' level of alcohol consumption, and so, in the succinct explanation of CDC deputy director Anne Schuchat, 'Why take the chance?'"
In this case, as in the treatment of e-cigarettes, Schulman detects a public moralism "that strikes people of many political backgrounds as paternalistic." And now Dr. Fauci is seriously mooting the proposal that we never shake hands again. After all, who knows? Your handshake might make your hand the hand of a murderer. And thus we revert to the taste-not, touch-not regime of the old covenant.
Paternalism is one source of distrust. Inconsistency is another. Schulman points out that there's no proven "safe level" of caffeine consumption for pregnant women either. And does anyone know for sure how safe it is for a pregnant woman to have sex? Why take the risk?
All this takes health choices away from individuals. We aren't permitted to assess risk for ourselves. Public health advisories sometimes err on the side of over-caution, sometimes on the side of complacency, but the one constant, Schulman says, is "an abiding anxiety among public health authorities about the exercise of individual agency - the legitimacy of the public’s concerns about disease threats; the capacity of members of the public to make lifestyle decisions based on health information."
This elision of the individual is baked into the methods of public health policy-making: "The aggregated, statistical way in which the agencies conceive of public health outcomes does not clearly articulate at all any role for the individual."
Public health, further, has been imperialistic, taking over large swathes of public policy by labeling them as "public health" concerns: gun violence, loneliness, drowsy driving, pornography. All these are genuine threats to our social well-being. The question is whether they are best treated as problems capable of "scientific" solution.
Science has become a political weapon. You gain some powerful leverage if you can brand opponents of policy X as enemies of reason. But Schulman thinks the opposite problem is equally acute: "we are immersed in worry about the politicization of science when we should be worried about the scientization of politics."
The practices and instincts of the public health establishment foster distrust, but that distrust is made worse because the paternalistic moralism is presented under the guise of neutral science. Political and moral decisions must be made, but they aren't presented as political and moral decisions, but as the decisions of rationality itself.
Among other things, such a screen of rationality glosses over the reality of scientific disagreement. Schulman notes that some of the large disputes about public science can't be explained by such binaries as secular/religion, educated/uneducated, progressive/conservative. Rather, disputes reflect territorial battles among different scientific disciplines. Each side of the debate over GMOs, for instance, has a growing body of scientific evidence to back it up; but the evidence comes from different disciplines, molecular genetics, on the one hand, and ecology or nutrition, on the other.
Many of the habits Schulman identified in 2016 have been evident in the response to the COVID-19 pandemic: Risk aversion, paternalism, suppression of individual agency, moralistic meddling. Linker is right that there will be a backlash. But Schulman is right that the experts haven't helped themselves.
Schulman isn't an opponent of public health agencies as such, nor of expertise. Neither am I. But public health experts will win trust only if they acknowledge the political and moral dimensions of what they're doing.
In fact, they dispel suspicions further when they aren't the ones driving decisions. Schulman suggests, "Federal and state agencies . . . might more fully defer decisions about quarantines during disease outbreaks to elected leaders, who have a clear mandate to balance the economic and other non-health factors that inevitably go into making such decisions."
As Schulman says, "What we need is not a depoliticized science but a more political science - that is, a science unembarrassed about the legitimate role of politics in resolving what we now call scientific disputes."
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