Pandora's Box: the dangers of politically corrupted science for democratic public policy - Part 1


Author: John Luik
Article Published: 1996



THE CONTEXT

The assumptions about the nature of persons and the legitimate role of the State (of necessity unargued for) which structure our argument are those of an unreconstructed liberal individualist, namely, that the individuals who make up democratic society are the best judges of the shape they wish their lives to take, and consequently they should be accorded the maximum liberty, compatible with similar liberty for everyone else, to think, believe, and live as they choose. This means that the State's role is at least fourfold: first, to prevent or minimize harms by one individual to another individual; second, to minimize and where necessary adjudicate the inevitable conflicts that occur between individuals and between individuals and the community; third, to defer, wherever possible, from moral judgements about how its citizens choose to shape their lives; and finally, to create the minimal institutional conditions which allow its citizens' self-chosen lives the best chance of fulfilment.
What this means is that the State will resist the impulse, however well-intentioned, to undermine and intrude upon its citizens' capacities and inclinations for autonomy by defining one vast and unassailable conception of the good life to which all must subscribe. What this means is that the state will see its citizens as persons of intrinsic worth, fully equivalent in moral standing with itself, with lives not to be managed or saved, but to be allowed to develop in ways of their own choosing.

In order to understand the ways in which science and public policy intersect in the debate over smoking -- as indeed over many other "health" issues -- it is necessary to place the smoking controversy in general and the Environmental Tobacco Smoke controversy in particular within the larger context of both governmental and nongovernmental efforts to discourage tobacco use.

For most of the twentieth century the campaign to delegitimize smoking has employed two major weapons, science, particularly epidemiology, and morality, within the general conceptual framework of what can be called health paternalism. Though the mix has varied, the conjunction of the two has been not only consistent, but also highly effective.
For example, once it was established that smoking increased the risks of ill health in smokers, the groundwork was laid for a series of moral arguments that purported to show that subjecting oneself to these risks was both so irrational and immoral as to justify government efforts to prevent one from assuming the risks. The health paternalism at work here rests on a series of assumptions about reason, autonomy, and the nature of persons that include the following:


1. autonomy is not the foundational democratic value inasmuch as considerations of happiness and welfare frequently take precedence over it;;

2. individuals are frequently irrational in that they
a. often do not understand their interests; and
b. even if they do understand their interests they do not know how best to realize those interests;

3. individual's need the State's help in

a. discovering and realizing their "true" interests; and
b. avoiding irrational courses of action that result in unhappy consequences.

What unites these assumptions is the belief that the State is justified in protecting competent adults from the allegedly harmful consequences of their actions through restricting their autonomy.
Based on these assumptions, health paternalism advances the following claims:

1. health is the preeminent value which outweighs, in most instances, all other values such that a rational person would not normally place his health at risk in the interests of some other value;
2. there is but one healthy/rational way to live one's life and such a way does not include activities that carry with them significant risks to well-being or longevity;
3. individuals have a moral obligation to order their lives in this healthy/rational way; and
4. the State is justified, indeed the State has a moral obligation, to ensure that its citizens conform to this health/rational paradigm, even if they wish not to or are unable to through their own efforts.


Health paternalism is thus a subtle shift away from the generally uncontroversial right of the State to ensure that consumers are fully informed about the risks of certain products or activities to their health to the highly contentious claim that the State is justified in attempting to manipulate and coerce. Despite its highly problematic character, health paternalism has been to some degree immune from the sorts of objections that are routinely brought against other forms of paternalism. Health paternalism's immunity from such criticism does not derive from the cogency of its arguments but from the fact that it rests not just on moral argument but on "unquestionable" scientific fact. And in a world in which science is increasingly the source of both truth and value the scientific character of health paternalism is decisive.

But, however closely aligned to science, the ability of health paternalism to secure all of the public-policy objectives of the anti-smoking movement was always constrained by the fact that, at least within democratic societies, the justifications for government intervention to protect adults from themselves -- to coerce "healthy" lifestyles -- would continue to have a totalitarian flavour about them that would ensure significant and widespread opposition. It is only by demonstrating that the dangers from smoking transcend the smoker and extend to innocent bystanders that the anti-smoking movement could move beyond obvious health paternalism and enlist unambiguous support for public-policy measures designed to restrict, ban, and criminalize public smoking. The movement away from the risks of smoking for smokers to the alleged dangers of secondhand smoke for nonsmokers does not mean that the health-paternalist arguments have suddenly disappeared from the public-policy agenda of the anti-smoking movement. Whether one is considering the policy implications of tobacco advertising or the supposedly addictive properties of nicotine, the paternalist justifications for government interventions in the lives of smokers still constitute a significant strand of the anti-smoking argument. What has changed is that arguments about harms to self have assumed a secondary place to arguments about harms to others. What has remained the same is the fact that the new arguments about harms to others, to innocent bystanders, strongly resemble the old "paternalistic" (often religious) arguments. What is new is the consideration of science and morality to justify public policy.

We wish to argue that:

1. the "science" supporting the claims about tobacco's risks to non-smokers is corrupted science, science that has been politically laundered, science that because of its corrupted status actually ceases to be science;
2. the use of such science by the government and the anti-smoking movement reveals not only the illegitimacy of their public-policy agenda but the flawed character of the advocacy as well; and
3. the existence and use of such corrupted science poses a significant threat to legitimate democratic public policy.

 

... continued...




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