IMPARTIALITY AND ADVOCACY

Science is based on systematic observations and experiments to discover the truth about natural phenomena. Good science uses methods that are fully disclosed and as free as possible from biases and confounding factors. It is objective, and therefore it ought to be impartial. When all the pertinent facts about a scientific issue have been discovered and verified they are displayed unemotionally in the public domain in a suitable peer-reviewed scientific publication. In these respects, science, including all the public health sciences, can claim to be value-free or value-neutral.

The interpretation of much scientific fact, however, and conclusions based on interpretation, often involve value judgements, which are influenced by nonscientific factors such as emotions, economic considerations, and political positions. For example, the interpretation of the scientific evidence on the effects of cigarette smoking, and the sometimes confusing and equivocal scientific evidence on health consequences of exposure to chemical substances in the environment, and in particular whether these chemicals can cause cancer, congenital malformations and the like, has led to much debate and controversy.

Epidemiologists, environmental toxicologists, and other public health scientists often discover dangers to health. Does their role change at this point, from public health scientist to public health advocate? Many public health scientists are willing to become advocates, taking a public position in favor of actions that will reduce or eliminate risks to health that their scientific studies have disclosed. But many other public health scientists are not prepared to become advocates, arguing that by doing so they would compromise their scientific objectivity. They assert that if they become public health advocates they cease to be impartial and thereby compromise future scientific studies that they may undertake. Some put it more strongly, asserting that a conflict of interests will arise if they become advocates for a particular cause in public health practice. Scientific objectivity is often equated with impartiality, which, by definition, is incompatible with advocacy, which necessarily adopts a position in favor of or against a particular cause. This is a difficult balance, and can be one of the most challenging ethical problems in public health science.

John M. Last

(see also: Conflicts of Interests; Ethics of Public Health; Health Promotion and Education; Virchow, Rudolph )

Bibliography

Engelhardt, H. T., and Caplan, A. L., eds. (1987). Scientific Controversies. Cambridge: Cambridge University Press.