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Controversies Scientific and Moral
In a recent piece in Discourse, I called attention to diverse moral communities whose distinct visions of the good life limit the moral authority of policy makers to fashion healthcare policies for diverse populations.
High-profile battles over abortion, physician-assisted suicide or other issues display moral diversity for all to see. Yet to the casual observer the boundaries of diverse moral communities more often than not remain invisible, creating the false impression that moral diversity rarely presents a serious challenge for healthcare policy
The prominent role of science in medicine reinforces that false impression. We are invited to believe that healthcare policy disputes are centrally disputes about facts — that is, disputes that can be neatly settled as soon as experts establish the facts in question by applying valid scientific procedures.
A closer look at the anatomy of scientific controversies with moral overlays suggests otherwise. Such controversies almost never swirl around facts alone, for the facts turn out to be inseparable from values. For one thing, the diverse histories, cultures, and philosophical frameworks in which scientific disputes arise themselves embody values. Inasmuch as those factors set the terms of scientific debates and frame how scientists seek to resolve them, so too does moral diversity.
The historian of science Loren R. Graham has discussed how scientific disputes over the same issues assumed different shapes in the United States as compared to the Soviet Union. For a deeper dive, see his chapter, “How history and politics affect closure in biomedical discussions: the example of the Soviet Union,” in Scientific Controversies: Case Studies in the Resolution and Closure of Disputes in Science and Technology.
Arising in the context of a commercial republic, disputes in the U.S. asked whether new developments in science or technology posed unique risks requiring special regulations. Graham recalls how, during the early years of debates about recombinant DNA research in the 1970s, the concern in the U.S. was “the possibility of pathogenic organisms being accidentally produced … and then being allowed to escape from the laboratories.”
In the Soviet Union, however, scientific disputes unfolded against a history of strict state control of science. The main concern for Soviet scientists participating in disputes over recombinant DNA was therefore to avoid attracting the attention of political authorities. Hoping to fly under the radar, Graham explains, leading scientists insisted recombinant DNA was “just one more technology that could be used for good or evil, depending on social motivations.” Thus, controversies around the same biomedical technology were differently framed within historical contexts embodying different values.
Philosophical frameworks rooted in different theories of value likewise shape scientific controversies differently, changing the way they move toward resolution, as well as the odds of resolving them at all. Historically, the dominant philosophical paradigm in the U.S. included a sharp distinction between facts and values. These were thought to be different in kind from each other, with values falling outside the domain of scientific inquiry. Whatever its philosophical merits, the path to the resolution of scientific disputes ran through that paradigm. Scientists disclosed their discoveries, while inviting people with philosophical, religious or even theological backgrounds to opine on the compatibility of the new science with traditional values. The result was a compromise among diverse interest groups and their values.
The predominance of a different philosophical paradigm, Graham explains, made the same sort of approach impossible in the Soviet Union. Ethics and values no less than facts were treated as objects of scientific study. Moreover, viewpoints based on religion, mysticism, or dualism were officially invalid and not to be published in the press, included in debates, or cited as arguments in scientific disputes. With negotiation off limits, disputes could be resolved only by seeking the “correct” solution according to scientific Marxism-Leninism. The inability of Soviet scientists to broker compromises with diverse interest groups, Graham observes, may explain why the U.S. tended to resolve scientific controversies long before the USSR.
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Those charged with shaping healthcare policy should pay attention when moral diversity surfaces in headlines, but they should also take the measure of the iceberg that lies beneath. As shown by the historical context of scientific disputes in the U.S. and the Soviet Union, the very assumptions on which disputes are founded and the procedures by which scientists seek to resolve them are subject to moral diversity. For better or worse, neither those disputes themselves nor public policy debates surrounding them can be summarily resolved by appeal to “the facts.”