Patronising the public

January 9, 2004

While I agree with Lord Winston's message to open an informed dialogue between scientists and the public ("The public pay, so give them their say", THES , January 2), the examples he chooses to support his case, and the rhetoric he employs in making it, undermine his central point. To charge that there is no "serious evidence" against the measles, mumps and rubella vaccine and that the media have engaged in "irresponsible blaming" of the vaccine, and then to infer that the perceptions of individual risk that have led parents to distrust MMR will lead to epidemics with more tragic consequences, is to display lack of "concern for the ethical dimension of what we do".

The MMR debate is not simply about the logic, methods and dogma of science, it is also about politics, economics and human rights. To patronise an educated public whose distrust of science and politicians leads them to seek informed decision-making will not solve the problem. The passion that clouds the MMR debate is not going to dissolve with the repeated invective of distinguished scientists.

The fundamental dilemma at the heart of all public-health policy (that includes genetic modification, MMR, water fluoridation, European Union directives on food supplements and more) is to find a balance between the health of a society and the health of each individual in it. Governments cannot advocate that people take more individual responsibility for their health and then condemn them for resisting imposed collective action that they regard as inadequately proven. Perceptions of public risk are quite different from perceived individual risk.

Lord Winston is right that the challenges to the public's health and its peace of mind can be removed only by systematic open debate; but scientists must resist the temptation for rhetoric and the casual scoring of points.

Ron Iphofen
Senior lecturer in the sociology of health
University of Wales, Bangor

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