The public pay, so give them their say

January 2, 2004

The future of British science may rest on our ability to engage the population in an informed discussion about what research is done and how it is used, argues Lord Winston

Two weeks ago in this journal, I was "lambasted" by some eminent colleagues because I suggested how we might tackle the increasing public mistrust of science. I argued that the way we communicate with the public was inadequate and scientists such as myself have not helped this situation. For the future of science, and the reputation of scientists and scientific advice, is in crisis. This was the conclusion of the House of Lords select committee on science and society more three years ago.

If anything, matters are now even worse. Since that inquiry, we have seen the costly muddle over foot-and-mouth disease, the dubious decision to invest in wind energy while excluding any suggestion of developing nuclear power, the debacle over genetically modified crops, and the potential disaster threatened by failure to vaccinate many children against measles, mumps and rubella.

There is no serious evidence that the triple vaccine MMR causes autism, bowel diseases or any other obscure illnesses for which it has been irresponsibly blamed in the media. Yet, partly because of distrust of scientific advice given by government scientists, uptake of the vaccine in some cities has dropped to 60 per cent of children at need. So measles epidemics are likely, some children will develop irreversible brain damage unnecessarily, and others will die from a preventable condition. And an increase in rubella infection will mean more women will pregnancies and more children will be born with congenital defects.

The scientific community once believed that public distrust of science would change with better communication. Our establishment invested in various endeavours to promote the "public understanding of science". I was part of this somewhat patronising movement. In common with many colleagues, I thought the "misunderstanding" of scientists would be dissipated by promoting the kind of excitement we feel at the wonders of science and the use of this knowledge.

But it is now clear that communication alone is inadequate; indeed, as Lord May, president of the Royal Society has said, the evidence exists that "the more the public know about science, the less they trust it".

I am not saying that science communication is pointless - it is vital. But it must be without the unrealistic enthusiasm that we tend to enjoy. Above all, grandiose promises of undeliverable benefits must be avoided. And in the long term, stimulation and education of children - especially young children - may be the best investment to ensure an advanced society that can make logical, informed choices about technology. But unless we understand the public and learn some important lessons ourselves, support for scientific endeavour may be increasingly eroded.

We must recognise that we do not own the science with which we work.

Scientists are servants of society, not its masters. Nearly all of us were educated and gained skills as a result of funding from the state. Our research grants, our university support, the charitable donations and even much of our commercial funding results from public investment. So once we have generated our knowledge, we have to find ways of closely involving the public.

It is not for us alone to decide how technology is used. We may invent the ability to modify plants genetically, but people may not want these crops for food. We may argue the case for their use but may need to step back in promoting them - even though we may feel that the public response is illogical.

We also need more concern for the ethical dimension of what we do. The great majority of scientists altruistically want to help humanity or life on earth and I do not question their values. But our reputation is frequently damaged by a handful of mavericks.

Reproductive medicine, my own field, is a good example. Severino Antinori and Panos Zavos boasted of their "successful" attempts at human cloning yet were not treated like pariahs by all my colleagues. We must universally condemn such individuals. And this year, different learned societies allowed the presentation of scientific papers at their meetings that could not pass ethical scrutiny. These papers included trials of human "cloning" procedures and the transfer of genetically modified embryos to a patient's uterus. Such announcements gain massive press publicity but threaten the general standing of scientists. No presentation should be scheduled that has not undergone strict ethical review.

There is also a perception of increasing closeness of the scientific community to government. This is double-edged. We certainly need the government to fund good research and support scientific education and training. But too close a liaison risks scientists being seen as political pawns.

In the case of MMR vaccine, many parents believed that the scientists were not giving dispassionate advice. The press stated that they were following government policy by attempting to save the National Health Service money in insisting that a triple vaccine is given in one shot. And government did not recognise the ethical tension for parents. A mother's first responsibility is to her child. She may naturally feel that the "risk" means it is not in the child's interests to be vaccinated, even though she can see that it is in society's interests that every other child is.

Commercial involvement in science is another serious source of distrust.

Monsanto's involvement with GM crops was a major reason for this agriculture being questioned. People are naturally suspicious of the profit motive, and both big business and government need to show greater sensitivity. This will be even more necessary with increasing globalisation.

Politicians declare vigorously that investment in science generates wealth.

So nowadays, science departments in universities are under increasing pressure to gain income through exploitation of intellectual property and academics are expected to chase patents.

Hardly surprising, then, that there is the perception that scientists have vested interests that conflict with those of society.

I am not suggesting that the public control science or, ultimately, decide which research is done. That is the domain of the scientists, though funding bodies need to ensure that sufficient relevant research is conducted to meet the particular needs of society. While the public should not control what science is undertaken, they should certainly have a major input into how scientific knowledge is generated and, with government, should decide what and how technology is used.

We must engage with society to develop more dialogue. This will be difficult as it requires a huge change of our thinking. But dialogue works - one rare example where controversial science was accepted was the case for embryo research. We showed its potential benefits, demonstrated strong ethical values and an absence of commercial motive, and the public and then Parliament voted overwhelmingly in favour.

For good dialogue, scientists will need more training in listening as well as explaining in lucid language. And good public engagement by scientists should be recognised and rewarded by better university funding for it. Then perhaps we might react more appropriately to the concerns of our fellow citizens and learn to be less arrogant with our opinions. We also need to comprehend that people often need more time to appreciate the implications of what we might achieve. Above all, we need to recognise that the public have a far better understanding of what we do than we sometimes admit.

Lord Winston is professor of fertility studies, Imperial College London, and director of NHS research and development, Hammersmith Hospitals Trust.

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