July 8, 2011

Experts, Expertise, and Impure Science

Yesterday we finished our discussion of The Honest Broker by asking ourselves some very provocative questions about the future of science policy advice. We asked questions like, "why is science privileged as a tool in decision-making, and scientists privileged as experts on matters that are often about values?" Involving scientists in policy-making about issues as diverse as breast cancer research to environmental controversies often results in one outcome: "we need more science!" Yet I made the point that we are often operating outside the bounds of "normal science"- this is something that STS scholars have called "post-normal science." The late Stephen Schneider has an excellent explanation of post-normal science with regards to climate policy. Post-normal science is the antithesis of "normal," but it is also the opposite of the ideal of "pure science." And pure science, of course, is often even regarded by scientists to be unachievable in practice. Pure science plays straight into the linear model of science.

So is "impure science" the same as "post-normal science"? We're about to find out. If I had one book to recommend from all of the reading I did last year, it would be Steve Epstein's Impure Science (Amazon, Google books). Epstein’s book is all about how the boundaries between expert and activist become blurred as each shape the other. It's about how a group of AIDS activists worked to challenge the biomedical model of drug testing that required slow, precise double-blind experiments, in order to more rapidly treat AIDS patients with experimental drugs under the "community-based" research model.

The chapters I've read gave brief history of AIDS clinical trials and the associated ethical issues; the emergence of community-based research and the breakdown of expertise and power in medicine; and the landscape of AIDS activism and how activists framed AIDS and their own expertise of the science of AIDS drugs (see also this related article by Epstein). Epstein’s argument is that AIDS activism both produced legitimate results (from community-based research) as well as challenged the structure of FDA regulation, and thus challenged the norms of “pure science.” This, I think, is the perfect example of post-normal science, and what STS scholars call "extended peer communities"- opening the research and decision-making process to non-scientists, including activists, patients, and community health practitioners. The figure above is supposed to show how in cases of post-normal science, the group of experts must be expanded beyond just scientists. I believe that this model could be applied to other issues of health and environmental issues that have high uncertainty and values that need to be reconciled.

If you'd like to read more about experts and activism in environmental controversies, I wrote a paper about it last semester. It's more or less a literature review of STS things, but hopefully you can find some nuggets of sapience.

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