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7/25/2019 Politics Bioethics Science Policy
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HEC Forum (2008) 20 (1): 2947.DOI: 10.1007/s10730-008-9062-9 Springer 2008
_____________________________________________________________________________________
Leigh Turner Ph D Associate Professor William Dawson Scholar Biomedical Ethics Unit Department
Politics, Bioethics, and Science Policy
Leigh Turner
Many commentators argue that science policy should be above or
beyond politics; they insist that science policy ought to be based
exclusively on science. However, science policy formation includesethical and political considerations. Science and scientific facts do not
determine science policy, though bodies of evidence developed by
communities of scientists play an important role during policy-making
processes. I argue that science policyparticularly policy-making related to
medicine, biotechnology, the life sciences and other areas raising basic
questions about identity, morality, and social orderis inevitably
politicized in pluralistic societies.
Introduction
A term regularly invoked in bioethics scholarship, moral consensus is
frequently elusive in contemporary societies (Engelhardt, 2002; Moreno,
2005; Powers, 2005). The achievement of consensus or wide reflective
equilibrium often seems less likely than the persistence of normative
conflict (Hampshire, 2000; MacIntyre, 1988; Stout, 1988). Several leading
approaches in bioethicscasuistry and principlist bioethics as well as other
models predicated upon the notion of reflective equilibriumemphasize
shared, common resources for ethical deliberation. Many bioethicistspromote consensus-based models in which interlocutors articulate
disagreements, provide reasons in support of particular moral claims,
respond to criticisms, and reach consensus. This model of moral deliberation
is optimistic that review of evidence or scientific findings coupled with
reasoned argumentation will end in a common understanding of what
constitutes sensible practices and policies. However, anyone who has played
a role in developing policy within institutions, professional societies, or
legislative assemblies will recognize the many challenges facing efforts to
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craft broadly acceptable policies. The difficulties facing members of policy-
making bodies at hospitals and professional associations are multiplied at the
level of provincial, state, federal, and transnational policy formation. At this
level of policy development, many constituencies must be addressed. These
groups can have different interests, objectives, and moral predispositions(Sowell, 2002). They often disagree with one another about what counts as
credible evidence and who can be characterized as reliable authorities.
Policy-making within Institutions
Within hospitals, to select just one type of social institution where policy-
making occurs, policy-makers are sometimes criticized for failing to seek
appropriate representation from members of various groups. In other
instances, policy-makers are criticized for not fully grasping thecomplexities of particular domains of medical research or clinical practice.
Criticism can come from many sources. Critiques can be particularly intense
when policy-makers are expected to address contentious, divisive moral
issues that generate considerable passion. Interlocutors can disagree
concerning what constitutes ethical practices and policies. Researchers,
nurses, doctors, hospital administrators, patients and other social actors can
all claim that their interests are inadequately represented in policy-making
arenas or incorporated within institutional policies (DeVries and Forsberg,
2002). Critiques can focus on the inclusiveness or exclusiveness of policy-making processes, fairness or legitimacy of processes of policy formation, or
the substantive content of particular policies. Issues of substance and
processinsofar as matters of process are not also substantivecan both
serve as lightning rods for conflict. Disputants can complain that they were
not properly consulted during the policy-making process. Critics can argue
that a policy emphasizes particular moral norms while paying insufficient
heed to other values. Alternatively, dissatisfied parties can claim that a
policy reflects the interests of one group while failing adequately to address
and incorporate the concerns of other social actors.To focus on policy-making within hospitals, nurses can assert that
physicians are given too much influence over policy-making processes and
organizational practices. Doctors, in turn, can argue that they are not
adequately included in various phases of policy development. They can state
that the voices of hospital administrators, rather than clinicians, are
consistently given too much weight. Social workers, physical therapists, or
occupational therapists can condemn overrepresentation of doctors and
nurses and express dismay that the voices of members of allied health
professions are neglected.
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Even if a particular category of professionals is well-represented during
the policy-making process, members of that group will sometimes claim that
their official spokespersons fail to represent diverse moral viewpoints within
the institution. For example, nurses might express satisfaction that nurses
serve on the clinical ethics committee crafting a particular policy, yet arguethat the particular nurses on this body are unrepresentative of all nurses at
the institution. Charges of authoritarianism, marginalization of stakeholders,
and unrepresentative decision-makers must be acknowledged and
addressed. In settings informed by democratic, egalitarian values, criticisms
about exclusion and lack of representation must be seriously considered.
There are many ways that various organizational actors can challenge
policies and the policy-making process.
Extra-institutional Social Actors
Even if caregivers from various health-related professions develop a
consensus and agree that different constituencies are well-represented, the
policy-making process is fair, and the completed institutional policy is
reasonable, patient representatives, family representatives, or local
community leaders can argue that the interests of patients, the moral
concerns of family members of patients, or the interests of the larger local
community were insufficiently recognized during the process of crafting a
particular institutional policy. Non-clinicians with a stake in hospital policycan accuse health care professionals of being elitist, undemocratic, and
inattentive to the interests and concerns of community stakeholders.
Concerted institutional efforts to engage community members and involve
them in organizational policy formation can generate a different set of
problems. If the exclusion of various social actors from the policy-making
arena sometimes leads to charges of elitism, efforts to promote more
democratic policy-making exercises can increase the likelihood of
encountering intractable conflicts concerning what values ought to guide the
policy-making process. When interests and normative frameworks of groupsdiverge, policy-makers can find it impossible to achieve consensus.
Representatives of religious groups, ethnic groups, community
associations, political bodies, and other social organizations can have diverse
views concerning the basic, core, or foundational moral norms that
ought to guide policy formation. Even if all interlocutors share general moral
principles, they can disagree over how general moral norms ought to be
weighed, specified, and interpreted in particular circumstances (Engelhardt,
2002). Agreement about statements of principle need not lead to agreement
about specific policies or practices.
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Policy-making exercises within just a single institution can generate fierce
debates. Ethical issues related to the beginning and ending of human life are
particularly contentious. Priority setting and resource allocation exercises
must often confront competing notions of justice and fairness (Hampshire,
2000). Furthermore, professional rivalries, longstanding struggles forinstitutional power, personal conflicts, conflicting religious values, cultural
differences, basic disagreements about fundamental moral values, perceived
slights or perceptions of exclusion or marginalization, and, of course, the
satisfaction some parties feel when provoking opponents or blocking their
interests whenever opportunities arise can all serve to slow or derail policy-
making initiatives.
Making Social Policy
Challenges facing efforts to achieve consensus or wide reflective
equilibrium multiply when we move beyond the level of a single institution
to the state, province, or nation. State, provincial, and federal policies can
affect the lives of millions or hundreds of millions of individuals. Within
political entities that have relatively homogenous cultural and religious
traditions, a common normative framework can limit obstacles associated
with crafting social policy. However, in multicultural, multifaith, pluralistic
societiesmost contemporary Western liberal democracies contain multiple
religious groups, religious communities, and political partiesthere can bemany different normative frameworks in play. In most contemporary liberal
democracies, it does not make sense to refer to Christian, Jewish,
Muslim, Hindu, or Buddhist values. (The list of religious traditions
could be greatly expanded.) To the contrary, diversity will characterize
various religious traditions.
Just as moral frames can differ within and among various religious
groups, it is often a gross simplification to refer to Hmong, Korean-
American, or Chinese Canadian belief systems or worldviews.
Ethnic groups, much like religious groups, are often diverse rather thanmonolithic. Disagreements over basic moral values and the morality of
specific social practices and policies can occur within and not only between
ethnic groups. Value orientations can differ across generations, intraethnic
groupings, gender lines, socioeconomic status, and many other social
categories.
Fragmentation of Civil Religion
In countries where there is a broad, pervasive, overarching civil religion
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(Bellah, 1975), cultural and religious differences might not have much
influence on broad matters of social policy. Rather, members of various
social groupings will share a common civil religious tradition or public
philosophy (Almond and Verba, 1963; Kingdon, 1999; Sandel, 1996). This
shared normative fabric will provide common symbols, metaphors, andnarratives; there will be many resources for mutual deliberation and shared
moral convictions. However, if such a civil religion does not exist, or if this
pervasive social ethic loses its public authority over time, the presence of
multiple normative frameworks can make it very difficult to reach public
agreement on ethical issues related to childrearing, parenting and family life,
health, illness, dying, and death (Hunter, 1991). Interestingly, the bioethics
movement in the United States emerged at a time when many social
commentators suggested that the civil religion of the United States was
fragmenting (Bellah, 1975). The rise of bioethics is sometimes seen as aresponse to developments in medicine, biotechnology, and the life sciences.
Acknowledging the role of specific technologies in prompting questions
about moral values, the emergence of bioethics as social movement,
academic field, and occupation might also be connected to the fragmentation
of civil religion in America (Bellah, 1975; Engelhardt, 2002). As
background presuppositions about public morality were thrown into question
and a crisis of moral legitimation occurred, philosophers, theologians, and
clinicians were increasingly asked to justify particular social policies.
Longstanding norms could no longer be assumed. Particular values, policies,and social practices required justification in the face of public disagreement.
Competing Political Philosophies
Social scientists pay considerable attention to the moral discourses,
worldviews, and mores of various cultural and religious communities.
Political traditionsconservative, liberal, libertarian, and social democratic,
for examplealso transmit social norms and connect broad visions of
society to particular policy issues (Holm, 2004; Sowell, 2002). Just asreligious and cultural traditions can promote different normative
frameworks, competing political philosophies also characterize many
Western liberal democratic societies. Some countries have a well-defined
political center. Various political parties know that however much they
might wish to differentiate themselves from competing political parties, they
must try to claim the common ground of mainstream political discourse.
To surrender this common ground is to accept a place on the periphery of
power. In settings where there is a well-defined civil religion or public
philosophy, political leaders fight to define, occupy, and control the political
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center. In other countries, political discourse is far more polarized (Hunter,
1991). Common ground and possibilities for bipartisan accords shrink and
the likelihood of conflict over basic moral premises and the normative basis
of social order increases. James Davison Hunter (1991) argues that the
United States provides an example of a democratic society locked in aculture war. In fractured political landscapes, bioethicists will not have an
easy time claiming that their normative claims and arguments rise above
or beyond political conflicts. Rather, discussion of ethical issues related to
such topics as embryonic stem cell research and therapeutic cloning will
occur within turbulent social arenas (Caplan, 2005; Moreno, 2005; Powers,
2005).
Culture Wars
Moral issuesonce they shift from being perceived as personal, private
matters of conscience to matters of public policybecome swept into the
public sphere of political conflict. In polarized political arenas, bioethics
becomes enrolled in the the culture wars (Callahan, 2005; Caplan, 2005;
Charo, 2004; Charo, 2005; Check, 2005; Hunter, 1991; Mooney, 2005;
Moreno, 2005). Within such settings, some social actors assert that
scientific matters must remain uninfluenced by political values and moral
agendas. Clinging to the assumption that science must not be politicized,
they assume that scientific facts must drive public policy. However, inmulticultural, multifaith, politically diverse societies, scientific facts will
not end policy disputes and ethical conflicts (May 2006; Moreira, 2007).
Rather, studies by scientists are swept into larger social conflicts; the
meaning and credibility of various scientific claims becomes part of ethical
debate and public policy formation. Science does not solve these political
disputes and moral conflicts. Instead, scientific facts are used to lend
legitimacy to particular normative claims and policy recommendations
(May, 2006). Studies produced by scientists are used to establish credibility
and authority in the same manner that religious injunctions, exegesis ofparticular sacred texts, or other authoritative conversation-stoppers (Rorty,
1999) are used in settings where particular religious convictions hold broad
sway.
Politicizing Science Policy
At the level of national policy deliberations, policy-making often occurs
against a backdrop of partisan conflicts between political parties,
longstanding moral conflicts dividing citizens, considerable scientific
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uncertainty, and questions concerning the legitimacy of particular advisory
bodies (Barke, 2003; Green, 2006; Gutmann and Thompson, 1996; Kennedy,
2003; Moreno, 2002; Pellegrino, 2006; Pielke, 2002; Pollard, 2001; Powers,
2005; Revkin, 2004; United States House of Representatives Committee on
Government Report, 2003). At this level of policy formation, one of the mostcommon accusations directed at policy-making bodies is that they are
politicizing science and technology policy (Blackburn, 2004a; Blackburn,
2004b; Grimes, 2004; Kass, 2004; Shulmar, 2007). Critics rarely explain
what shape an apolitical policy somehow above or beyond politics
would take. The usual assumption is that political opponents are partisan
ideologues whereas the critics themselves are guided by common sense and
reasonable convictions. Accusations that science is being politicized can
emerge from all points along the political spectrum.
Sometimes, these criticisms have a straightforward meaning. Accusationsof the politicization of policy-making can mean that evidence is being
neglected, research is being ignored, and qualified individuals are removed
or blocked from advisory bodies. Accusations of politicization of science
policy can refer to the failure to include diverse voices or an incapacity to
defend particular policy claims against criticisms from reputable authorities.
Acknowledging that accusations of the politicization of science can have a
straightforward, legitimate meaning, I want to nonetheless argue that policy-
making is inevitably politicized or political in nature.
Opponents of particular public policies or advisory bodies regularly arguethat science and not politics ought to dictate science and technology
policy (Grimes, 2004; Leshner, 2003; Malakoff, 2003). In the United States,
the current Bush Administration is repeatedly excoriated by its critics for
politicizing science and technology policy formation (Blackburn, 2004a;
Boonstra, 2003; Ferber, 2002; Greenberg, 2001; Greenberg, 2004; Grimes,
2004; Malakoff, 2003; Mooney, 2005; Novak, 2003; Shulman, 2007; Union
of Concerned Scientists, 2004). At present, the Bush Administration is
accused by Democrats of politicizing science. At some point, Republicans
will lose political power and Democrats will drive national science policyformation. When this occurs, we can anticipate that Republicans will accuse
Democrats of politicizing science. I want to challenge the assumption that
science policy can somehow take an apolitical form.
Policy-making as Political Process
In democratic social orders, the formation of science policy is an ethical and
political process; science alone cannot serve as the sole basis for crafting
science policy (Barke, 2003; Powers, 2005). Though we might want to
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criticize particular policies, we should not criticize policy-makers for
politicizing questions related to science and technology. We can criticize
policy-makers for the values they hold or the way they interpret particular
values in specific contexts. Criticisms can also be directed toward the uses of
evidence, selection of scientific authorities, and exclusion of particularscientific voices from the policy-making process. The suppression or
exclusion of dissent can serve as one example of an unwiseand potentially
dangerousresponse to science and technology policy formation (Ferber,
2002; Greenberg, 2004; Novak, 2003; Union of Concerned Scientists, 2004).
However, even if dissenting voices are included in deliberative bodies,
policy formation will still be political. It will still include contestable
judgments, the search for credibility and legitimation, the marshalling and
critique of evidence, and often rhetorical appeals to the public good. Policy-
making is a key element of what politicians and their designated advisorybodies do in democratic societies. Reaching resolutionhowever
temporaryon contestable, often divisive topics is a highly political process.
Conflicts, disagreements, accusations and counter-accusations of bias, and
questions about the suitability of particular policymakers are standard
features of making public policy in pluralistic democratic societies
(Gutmann and Thompson, 1996).
Policy-making as a Value-laden Enterprise
The positivist attitude toward science policy formation rests on the
assumption that science, nature, or the laws of physics can automatically
dictate social policies. This view assumes that scientific knowledge free of
substantive ethical, social, economic, and political judgments can be used to
generate social policy. To the contrary, public policies are not based solely
on scientific research findings. For example, scientific research can provide
information concerning the risks and benefits of particular pharmaceutical
products or medical devices. However, determining what counts as minimal
risks, acceptable risks, or a reasonable risk/benefit ratio cannot bedecided exclusively on the basis of particular outcomes. The determination
of what counts as an appropriate risk/benefit threshold involves a moral
judgement; numbers alone do not set the bar for evaluating risks posed by
particular interventions or technologies.
Policy-making must address many factors, including ethical, legal, social,
economic, and environmental issues. The politicization of science is
widely characterized in negative terms, reflecting the common assumption
that value judgments should be squeezed from science policies. Such
accusations commonly make reference to the suppression of important
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scientific research, exaggerated emphasis on the significance of particular
scientific findings, Machiavellian manipulations behind closed doors, the
stacking of advisory and regulatory bodies with partisan members and the
exclusion of credible voices of dissent from deliberative processes
(Boonstra, 2003; Kennedy, 2003; Novak, 2003; Lancet Editors, 2002;Mooney, 2005). The politicization of science, in this sense, justifiably has
negative connotations. In effect, the phrase refers to breakdowns or
shortcomings in democratic processes required to craft robust, credible,
science policies. However, in another sense, policy-making will inevitably
occur as a contentious, argumentative, value-laden political process.
Particular social actors must make decisions. Evidence needs to be weighed,
judgments defended, claims and counterclaims debated, risks and benefits
assessed. Such exercises in reasoning involve substantive deliberations; they
do not turn exclusively on scientific findings. We should expect that socialpolicies related to issues in bioethics will include substantive judgments and
commitments, and that different actors will often disagree over the particular
weight that ought to be accorded various moral principles, how guidelines
should be interpreted, and how arguments ought to be assessed. Science
policy-making draws upon substantive convictions that are not reducible to
scientific forms of knowledge even though research by scientists informs
policy-making.
Substantive Judgments
Social policies and advisory documents that recommend or characterize
policy alternatives do not simply convey data extracted from scientific
reports. They incorporate substantive judgments such as what benchmarks
should be used when establishing reasonable risk/benefit ratios, whether
short-term considerations should outweigh long-term consequences, and
whether cost effectiveness analysis or cost-benefit assessment can serve as
an adequate ethical framework for deliberation (Emery and Schneiderman,
1989; Goklany, 2002; Marchant, 2003; van den Belt, 2003). While better orworse arguments can be made when forming substantive judgments and
crafting policies, such judgments will be political and contestable. Rather
than focusing upon the politicization of science policy-makingas though
there is an alternative to political deliberationsattention might better be
focused on the dangers of suppressing voices of dissent and forms of
evidence that ought to be included in policy-making arenas. However, these
points can be distinguished. Even more inclusive approaches to policy-
making are political. To recognize the value of including dissenters or
social critics in policy debates is not to argue that science policy-making
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should be above or beyond politics and guided only by science.
Interpreting Scientific Studies
Policy documents often draw upon findings from scientific studies. Forexample, advisory reports, policy briefings, and policy guidelines related to
embryonic stem cell research, gene transfer technology, or therapeutic
cloning will utilize findings from researchers working in various fields
within the life sciences. Science policy necessarily engages scientists and
scientific research. Engagement with scientific research commonly plays a
crucial role when crafting science and technology policies related to such
topics as gene transfer technology, embryonic stem cell research,
xenotransplantation, and somatic cell nuclear transfer. However, research
findings established on the basis of research methods broadly accepted byparticular communities of scientists constrain but do not determine how to
craft regulations and guidelines. Decisions about which areas of scientific
research to fund, regulate, or prohibit, how much biodiversity ought to be
preserved, or which endangered species to protect involve considerations of
ethical, legal, social, and economic arguments. Such decisions require
debates about the risks and potential harms to which we are willing to
expose humans and other organisms. Statistical estimates of risk inform risk
analysis, but they do not automatically identify which risks to tolerate and
which ones to minimize or prevent (Goklany, 2002).Decisions about tolerable levels of risk require exercises in moral
judgment. Such judgments will draw upon cultural models of what risks are
acceptable and which ones need to be reduced. Similarly, considerations of
moral and legal norms beyond cost-benefit calculationssuch as the dignity
of the person or obligations to future generationsinvolve deliberations that
are not reducible to scientific findings. Discussions concerning the relative
significance of individual liberty, the common good, the environment, the
comparative effectiveness of market mechanisms and governments in
distributing resources, and the demarcation of particular goods as public orprivate require political and ethical debates. Scientific findings and
scientific research are important components of these debates but they are
not the only elements of social policy formation. Findings from
epidemiology, immunology, biochemistry, and physiology do not
automatically dictate how to craft social policies and regulate particular
practices. Rather than deploring the politicization of advisory bodies and
policy development, we should expect political controversies and
disagreements over science and technology policy formation for at least four
reasons.
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Moral Politics of Technologies
First, different political parties commonly have different core values, social
agendas, and policy platforms (Sowell, 2002). In some countries, differences
between mainstream political parties are quite minimal. A shared civilreligion or common public philosophy provides a bounded space within
which mainstream political actors must function (Bellah, 1975). In other
social contexts, various political parties offer markedly different visions of
social order and the public good (Sowell, 2002). Even in countries where the
political center is relatively easy to identify, political parties still offer
somewhat different policy platforms to the voting public. These values and
policy orientations are connected to scientific research, but include
substantive ethical, legal, social, and economic judgments about how society
ought to be organized. For example, more liberal or progressive politicalparties typically emphasize the role of government in promoting social
justice and addressing social inequities. Progressive political parties have a
history of crafting policy initiatives intended to redistribute wealth from
wealthier to poorer members of society. In contrast, contemporary
conservative parties tend to be less supportive of government exercises in
redistributing wealth. They often seek to promote the role of markets in
distributing goods and services. Democrats and Republicans, Liberals
and Conservatives, and members of other political parties are concerned
about justice, but what justice means and how justice is pursuedcommonly takes different forms when representatives of these parties debate
matters of public significance.
Scientific issues are debated within social, political, and economic
environments in which different political actors are informed by distinctive
normative convictions (Sowell, 2002). However, these social actors do not
all have equal access to political power. In many political arenas, particularly
in settings where one political party does not overwhelmingly dominate the
political apparatus, bipartisan support is consequently an important
component of gathering public legitimacy for a particular policy. In settingswhere major political parties offer quite different substantive agendas,
dominant parties will often be susceptible to criticisms that they are paying
insufficient attention to the concerns of voices outside the center of power.
Here, politicization of policy-making refers to the exclusion or
marginalization of competing claims.
Policy frameworks and normative commitments do not always neatly map
onto traditional political divisions. Debates and conflicts exist both within
and across political parties. Many Republican politicians oppose embryonic
stem cell research but some Republic politicians support increased federalfunding for this area of research. However, taken as a whole, different
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political parties are typically informed by particular constellations of norms.
The presence of different substantive moral traditions in pluralistic liberal
democracies means that policy issues are charged with ethical and political
significance. Scientific findings do not directly address questions about
whether stem cells should be obtained from embryos and used to developnovel stem cell therapies. Public policies concerning embryonic stem cell
research, gene transfer technology, and xenotransplantation need to address
ethical, legal, social, economic, and, in some social settings, religious
considerations. Studies in elite scientific journals by experts in regenerative
medicine, gene therapy, stem cell research, and other scientific domains will
not tell policy-makers everything they need to know about how these
technologies ought to be subject to legislation and regulation. Scientific
research is not self-interpreting or self-regulating. In multicultural,
multifaith, politically pluralistic societies, particular values used to shapepublic policy will often not be shared by all social actors (Powers, 2005;
Sowell, 2002).
Decisions about how to regulate particular technologies involve
considerations about safety, risks, harms, benefits, respecting core moral
norms, and protecting the public good. Such questions are political matters.
The policy-making process involves many individuals engaging in public
debate, relying upon different experts, drawing upon sometimes diverse
bodies of evidence and argumentation, and making claims for alternative
regulatory models. There are few instances where all social actorsimmediately agree upon the specifics of complex social policies.
Disagreements can occur over general frameworks, particular guidelines, the
interpretation of regulations and laws, the credibility of specific scientific
claims, or the long-term implications of implementing particular policies.
Scientific studies might reveal that specific technologies are unfeasible or
have low rates of success. However, where evidence exists that technologies
are practically feasible, questions will remain about whether the technology
ought to be permitted and how it should be regulated. We might refer to
substantive conflicts over core social norms and the use of particulartechnologies as the moral politics of technologies. Often, different social
actors will disagree over whether a particular technology is ethically or
legally justifiable. They will disagree over what they regard as reasonable
regulatory frameworks. Legislation and social policy are crafted in the
political realm. Scientific expertise addresses just one domain of questions
about the regulation and appropriation of technologies.
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Politics of Authority
Second, science advisory boards and other committees intended to provide
recommendations and policy alternatives to government agencies are staffed
by particular individuals. Typically, only a small subset of the available poolof possible participants will be invited to participate in the policy-making
arena. For example, in the United States, The Presidents Council on
Bioethics currently includes just seventeen members. Many other qualified
citizens and professionals could serve on this body. Scientists, lawyers,
physicians, economists, and other citizens who are equally qualifiedand
doubtless viewed by their supporters as better qualified than existing
memberswill inevitably be excluded from participation in the policy-
making arena. Critics of the membership of particular bodies can quite
credibly claim that politics was a factor in deciding who gets to sit at thedeliberative table (Anderson, 2004; Blackburn, 2004a; Kass, 2004; Weiss,
2004). The process of selecting participants in the policy-making and
advisory process is inherently political. Even where government
administrations strive to seek balance and fair representation, some
qualified individuals are bound to be excludedintentionally or
unintentionallyfrom the deliberative arena. Even if representatives of
various groups are given opportunities to present their concerns to advisory
boards and policy-making bodies, they can legitimately charge that they are
excluded from the powerful role of setting the agenda, defining the terms ofdebate, and playing a decisive role in decision-making processes. We might
think of this realm as the practical politics of who gets to have authority
within the arena of deliberation and policy-making. Complex social and
technological issues are not assessed by neutral social actors. Rather, they
are explored by particular human beings with personal histories, community
roles, interests, preferences, and goals. Policy-making involves the view
from somewhere. Policy-making does not occur behind a veil of
ignorance. Particular humans make specific choices at concrete historical
moments. Democrats and Republicans, social democrats and libertarians,progressivists and conservatives, all have interests, predispositions, and tacit
values. In societies where significant social cleavages exist over matters of
public policy, we should expect to see controversies over which individuals
are excluded from the policy-making arena. In large, complex societies with
different forms of representative democracy, most citizens have very limited
access to policy-making arenas. The qualifications of those individuals who
make it into the inner circle of policy formation can usually be challenged.
Other individuals could take the place of those individuals granted access to
the corridors of power. Social actors on the margins of debate will often takeissue with not just the substance of particular policies. They will also ask
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why those individuals in positions of power have authority and a place at the
debating table.
Politics of Knowledge
Third, in some areas, disagreements exist among both scientists and
nonscientists about what constitutes reliable, accurate, credible knowledge.
Conflicting knowledge claims are quite common even though many
individuals like to think of science as providing definitive, unambiguous
answers. Some social actors will lay claim to a particular body of research
and rely upon its data and expert scientists. Other social actors will turn to
competing data and alternative claims to expertise. In domains where
conflicting values and policy alternatives are present, different bodies of
scientific research can often be used to legitimate divergent practicalconclusions. Various groups all claim that scientific research validates
their preferred social policies or recommended guidelines. Different political
actors will call upon scientists to support or oppose particular policy
frameworks. Disputants will seek to use science and scientists to their
advantage. In social settings where scientists have considerable cultural
capital, supporters of particular policies know that they need to find
respectable scientists to support their cause. To have the weight of
scientific authority on the side of the opposition is to suffer a major loss of
public credibility. We might think of this realm as the politics of knowledgeand claims to scientific expertise.
In complex policy disputes, we can anticipate that participants in the
debate will claim that their preferred policy has scientific backing and
support from credible scientific experts. They will not just challenge the
ethical framework or policy recommendations of their opponents. Often, a
powerful strategy to undermine alternative policy options is to challenge the
scientific claims used to support particular conclusions. In disputes about
global warming and the emission of pollutants, we can see one example
where social actors engage in fierce battles over which bodies of scientificresearch are credible and who can serve as reliable, trustworthy experts. In
contemporary democratic societies, to fail to make a case for the credibility
of claims to scientific expertise is to suffer a major crisis of legitimation in
public debate.
Politics of Uncertainty
Fourth, when crafting guidelines for novel technologies or responding to
other developments, existing scientific research can provide only limited
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insight into the long-term consequences of particular policies. Often, little
will be known about the long-term implications of promoting a particular
initiative. Policies commonly have unforeseen consequences. Technologies
can be used in unanticipated ways; unexpected problems or benefits often
emerge. For example, important questions about therapeutic cloning andxenotransplantation will need to be addressed before these biomedical
technologies can ever become normal, relatively routine components of
the clinical management of patients. Even if such technologies proceed
through clinical trials and become routinized aspects of medical care,
unresolved questions will likely remain about the long-term biological and
social consequences of such technologies. Years will need to pass before the
long-term benefits and harms of particular technologies become apparent.
Some individuals will likely argue that the immediate needs of desperately
ill patients ought to be given greater weight than concerns about the eventualspread of an unanticipated virus as a result of xenotransplantation. Other
individuals might argue that we should set a high threshold for safety
standards and not let the care of contemporaries potentially jeopardize the
health of future generations. Such policy disputes involve conflicts over how
to weigh individual goods and community goods, and possible short-term
consequences versus potential long-term consequences. Calculations about
costs and benefits are difficult to make; considerable uncertainty about
future outcomes often permeates debates. Just what current generations
owe future generations is a matter for discussion; science does not tellus how to weigh the interests of future citizens.
Uncertainty about the ethical, social, economic, and environmental
consequences of particular technologies will often generate different policy
conclusions. Risk averse individuals will perhaps rely upon a version of the
precautionary principle and insist that a technology should be deemed unsafe
until it is proven safe (van den Belt, 2003). Here, the regulatory bar is placed
quite high. All new technologies are subject to intense critical scrutiny and
evidentiary standards. Other individuals will argue that, on the basis of
existing research, a technology should be deemed safe, ethical, andpermissible until such time as evidence leading to a different conclusion
emerges. Here, new technologies are seen in a more optimistic light and the
regulatory bar is lowered. We might think of such debates as involving the
politics of uncertainty and time-horizons. To focus on the immediate or
long-term consequences is to shift the terms of debate. Even where scientific
evidence offers reliable insight into the short-term implications of particular
technologies, there will sometimes be considerable uncertainty about the
long-term consequences of permitting a particular technology to proceed. In
the early years of the 20th century, for example, it would have been difficult
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indeed to envision how aircraft would be used in the 21st
century.
Technologies are often used in ways unanticipated by their early proponents.
Existing knowledge does not provide a crystal ball allowing clear visions
of the future. Often, scientific studies provide little insight into important
questions about the practical consequences of a particular technology as it isused over time. Decisions must still be made, notwithstanding the
impossibility of knowing the consequences of developing a particular
technology over years and decades. The view from the present invariably
differs from retrospective analysis. In retrospect, problems often appear
obviously recognizable and easy to anticipate. At the time decisions are
made, even the most insightful specialists often have difficulty envisioning
in fine-grain detail future benefits and problems. Policy-making occurs in the
present; policy-makers lack the benefit of hindsight though they can look to
past events as a source of guidance concerning how to think about currenttechnologies. Anticipated benefits and harms can be factored into analysis.
However, policy-makers are not all-knowing. Interlocutors will often
disagree about the long-term implications of particular policies.
Conclusion
Many commentators insistently claim that science and not politics must
drive science policy. Science, nature, or scientific experts can supposedly tell
us how to proceed. However, it is misguided to think that science orscientific facts alone can drive science and technology policy. Rather than
criticizing the politicization of science policy, it makes more sense to
question the substantive content of particular policies. Calling particular
committees or policies politicized is a red herring; there are more effective
allegations to make when opposing a particular public policy or advisory
board recommendation. Similarly, if suppression of voices of dissent is at
issue, or credible bodies of research are being neglected in policy
deliberations, then arguments need to be made about the value of permitting
dissent in democratic societies, responding to the concerns of dissenters, andrecognizing the extent to which legitimacy flows from inclusion of diverse
social actors in policy-making processes. In instances where the concerns of
significant portions of the public are not incorporated into policy-making
arenas, a key problem is that policy-making is being shaped in ways that are
at odds with the core norms of large segments of the populace. In such
instances, policy-makers should be criticized not for politicizing social
issues and particular technologies, but for ignoring the moral concerns of a
significant portion of the citizenry. Of course, in settings where consensus
cannot be reached and basic moral norms are in conflict, ignoring the moral
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concerns of significant numbers of citizens is precisely what happens when
social policy is established. The price of resolution is social exclusion. Wide
reflective equilibrium amongst interlocutors is not reached. There are
political winners and losers in the policy-making struggles. Politicization
is the word marginalized participants in public debate use to refer to theprocesses whereby their intellectual leaders, bodies of evidence, and modes
of reasoning fail to set the terms of debate, define policy, and shape social
order. The term politicization carries considerable rhetorical power even
though the crafting of science policy is a thoroughly political matter in
democratic societies where various political actors often have very different
views about what constitute ethical practice.
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