Scientists Behaving Badly
The zeal to recommend extreme reductions in sodium…is a case of ideology replacing good science.” Is this the statement of some right-wing newspaper columnist or food industry executive? No. This is Dr. Salim Yusuf, the Heart and Stroke Foundation chair in Cardio- vascular Disease at McMaster Univer- sity, arguing that there has been far too much focus on the policy of sodium reduction as a means to curb cardio- vascular disease. Immediately, another leading Canadian scientist, Dr. Norman Campbell of the University of Calgary, came out swinging, not only disputing Yusuf’s science as having “fatal flaws,” but getting down in the scientific gutter questioning his competence in the field by claiming that Yusuf “is way off his expertise…he doesn’t have a strong understanding of what the evidence is.” Not to be outdone, Yusuf countered that while he considers that Campbell is well-meaning, the poor chap is basing his dramatic public health measures on “scant” evidence. Moreover, “Norman has been one of those — in polite terms — evangelists about sodium — in impolite terms, Talibans about sodium.” Them’s fighting words!
With this level of “scientific” debate, what’s the consumer or policy-maker to do? Only two years ago sodium reduction was widely presented as an area of relatively settled science, and senior managers (and the minister) were criticized for not follow- ing more aggressively their scientists’ advice to get tougher with the food industry.
Interestingly, the tide seems to be shift- ing. Hypertension Canada reviewed the science and announced just this month that Health Canada should significantly back down from its target for sodium reduction. And the respected U.S. Institute of Medicine (IOM) reviewed 10 studies and concluded that there is insufficient sci- entific evidence to advise major cuts in salt ingestion (Campbell avers that the IOM study is “not one of their stellar efforts”).
I’m just an old lawyer not qualified to assess the science underlying this exchange, but it provided an excellent basis for an interesting discussion with my food science students on the relationship be- tween science and policy. As my students know, scholars of science have long ago shown that you can’t take policy out of science. As Harvard’s Sheila Jasanoff has concluded, “Studies of scientific advis- ing leave in tatters the notion that it is possible, in practice, to restrict the advi- sory practice to technical issues or that subjective values of scientists are irrelevant to decision making.” This is especially true for public policy issues where the science is uncertain and complex such as in much of nutrition science and, dare I say, climate change. Science, policy and politics cannot be separated: they are in- extricably intertwined. Yet it is surprising how much our public discourse is still dominated by the quaint Utopian view that science and policy can be separated.
Consider, for example, the current kerfuffle over the government’s suppose “muzzling” of science, triggered by govern- ment scientists marching in the streets. Media portrayal of these scientists as apolitical nerds in white lab coats with no economic interest in the level of science funding was naive, at best. Aided and abetted by mainstream liberal media looking for controversy, government scientists and their highly partisan unions have managed to frame the debate as one between their neutral, objective, evidence-based decision making versus decision making on the basis of ideology or just crass politics, conveniently ignoring that all science risk assessments are replete with policy considerations and that science is only one factor to consider when policies are developed. While we need science-based risk assessment, in our democratic system it is the responsibility of senior govern- ment managers and their elected political masters to carry out policy-based risk management, which involves making a judgement after the weighing of social, environmental, economic, political, and ethical considerations. Science is important in policy making but rarely determinative, especially when the science is uncertain, as it so often is.
The salt controversy clearly reveals how much we need to engender a broader debate about the role of science and scientists in policy-making. We need to better understand not only how science is politicized, but how policy is scientized.