Playing the Man:
The Modern Inquisition of ‘Concerned’ Science

by Andrew McIntyre*

(IPA Review, Volume 50, Number 3, 1998)

It is no coincidence that at the very time post-modernist attacks on the objectivity of science have invaded—and are indeed dominating—the humanities faculties in our most prestigious universities, political activists are increasingly misusing science as a tool of advocacy with little or no regard for objectivity or truth. The perverted use of science by the academic and political left in its service to the power elite is precisely that danger the post-modern critique wishes to address, but to which, by its own misunderstanding of science, it contributes.

There is a general expectation that to engage in the political process one also engages in compromise, consensus and the art of the possible. One could even accept that competing for research funding might involve some of the imperfections associated with that political process. But with scientific inquiry, most of us cling to the notion of rational inquiry and objectivity, of passionately disinterested research. It is perhaps symptomatic of our time that the very word ‘disinterested’ is now most often incorrectly used, so that the notion itself is disappearing.

The media supports the perception that science is done by press release, consensus and, increasingly, by ad hominem attacks on those who hold dissenting views. Although one can understand the need to deny scientific evidence in the time of Galileo, where one of the leading advocates of rational scientific thinking opposed a dominant ideology of belief, superstition and supposition, it is difficult to accept the need for the same inquisitorial process in the latter part of the twentieth century. From greenhouse and AIDS through to leaded petrol and child sexual abuse we now see the active perversion of scientific evidence through personal attack as a common feature of public debate. This is no less true in the highly politicized area of health and tobacco, and recently on the epidemiology of environmental tobacco smoke and its relation to disease. Dr Julian Lee, a distinguished NSW thoracic physician, and a tireless worker in this field, found out the hard way.

Dr Lee took a classical, and distinguished, path in his professional life. He has worked 40 years as a thoracic surgeon, starting at a time when specializing was in its infancy. He played the professional game—undertaking research, teaching at public hospitals, being elected as NSW President of the AMA—and has acted in various professional roles both nationally and internationally. He considers himself first and foremost to be a clinician, not a scientist, although he fervently believes that public health and epidemiology are central to our concerns about the way in which we use science to improve the quality of life for everybody.

These underlying principles of epidemiology were important in his work in asbestos-related disease. He became involved in litigation on behalf of workers who would bring actions against their former employers. Lee quickly became aware of the way scientific information was necessarily corrupted in court, due to an adversarial system under which supporting a case and giving satisfaction to claimants were more important than any notion of disinterested objectivity.

Through two decades of work as a member of the Dust Disease Board, his observations of the cost-benefit analysis of the US Asbestos Abatement Act and similar Acts in Australia, background incidence of the disease, calculations of the ‘strength of association’, confounding factors, and the patients’ behavioural characteristics, made him realize that the process of coming to a conclusion about cause and effect relationships was complicated. His concern for the critically important idea that scientific evidence must be judged on its merits, and should be completely independent from what hangs on it, became more urgent.

As a thoracic physician with an interest in smoking issues, he was invited to give evidence at a highly publicized case from Western Australia involving the Burswood Casino and the issue of ‘passive smoking’. Soon after, he made an independent submission to the National Health and Medical Research Council inquiry into ‘passive smoking’. It was from this point on that things became a bit rough. Covert pressure was applied to squeeze Lee out of the AMA. First, Dr Keith Woollard, President of the Federal AMA and then Chairman of its Policy and Ethics Committee, produced a new policy document on the disclosure of sponsorship by tobacco companies. It states:

‘If a doctor has accepted funding from a tobacco company, then it is mandatory that both the amount and the precise source of the funding are detailed in the preamble to any presentation of material developed as a result of the funding.’

Then Woollard attempted to have Lee disciplined by the Ethics Committee and to oppose his nomination to the Roll of Fellows. The following year, a well-briefed visiting American professor of medicine, Stan Glantz, brought out for the National Heart Foundation, was interviewed on ABC radio. Glantz attacked Lee with defamatory statements, and called for his resignation as State President of the AMA. He said Lee had ‘no business’ heading a health organization, and was ‘appalled’ at his work on passive smoking. He accused him of ‘aiding and abetting … efforts to kill people’. After the attack, the Federal AMA received written complaints from large and prominent health organizations—including the National Heart Foundation—which directly or indirectly called for Lee’s resignation. Woollard added publicly that the AMA was uncomfortable with Lee’s work for the tobacco industry.

Efforts were made to push Lee out of the Thoracic Society. A deliberately planned confrontation took place in a scientific meeting of that society in October 1995. Simon Chapman, Associate Professor in the Department of Community Medicine at the University of Sydney, and self-styled publicist for the NH&MRC Working Party on this inquiry, and others attacked him at the meeting.

The paper delivered by Chapman could have been a page out of the Inquisition held in Rome in 1616 attacking Galileo. The entire diatribe was concerned with discrediting Lee and those involved in his report. At no point did Chapman address the merits of the scientific evidence. He found it ‘unconventional—to say the least—that people inexperienced in a field of research should be asked to review that field, particularly when the field is a subject of controversy’. The AMA, however, saw fit to find them ‘a very eminent group of authors, including two Associate Professors of Medicine and two Professors of Statistics’. But what if the statisticians were year nine high school students, and they still got the figures correct? Chapman would apparently not understand this implication. Nor would he understand a warning given in the science journal Nature: ‘The voice of skeptics may grow tiresome, but the mainstream is in trouble if it cannot win a public debate with them’.

Not content with avoiding the issues, Chapman obfuscated with a detailed tally of each of the group member’s publications in Medline, in Epidemiology, and in smoking research generally, and compared this list with that of the NH&MRC committee, presumably as a way of assessing the scientific worth of the arguments. While his own published work appears as a part of that expertise, he neglected to explain that he himself had no medical or scientific academic background, but rather was a specialist in advocacy, marketing and the media.

Chapman’s attack then turned on funding from the tobacco industry in an attempt to discredit Lee’s work, but the rhetoric was confused, and appeared in the end, to endorse it. While he admits it would be surprising that the tobacco industry did not ‘conduct research to anticipate and refute claims about the health effects of passive smoking’ (Chapman’s emphasis) and while he agrees it is true that ‘overseas, tobacco-funded scientists have been prominent in their criticism of health agency reports on passive smoking’, he endorses the view expressed by the Journal of the American Medical Association, that ‘research into health effects of tobacco conducted by the tobacco industry has often been more sophisticated and advanced than studies by the medical community’. In the guise of a scientific debate, Chapman’s attack must be considered a low point in the Thoracic Society’s history.

Just as one can imagine that Pope Paul V and those conducting the Inquisition of 1616 would certainly have understood the evidence in Galileo’s book Dialogue Concerning the Two Chief World Systems—in which he shows that the motion of the stars and planets are inconsistent with a stationary, pivotal Earth—so Chapman realized with alarm that the research findings in the NH&MRC Report were inconsistent with his own suppositions about passive smoking. The panic of the ecclesiastical authorities must have been similar to that of Chapman when he sent an urgent fax in June 1995 to the members of the working party:

‘I am DEEPLY concerned about the implications for the credibility of our whole report arising from the calculations.… If we look at Table 7 in the way any journalist would … a reasonable conclusion will be that the idea that there is ANY lung cancer caused by ETS (environmental tobacco smoke) in Australia will be seen as a huge joke. Journalists … will be hard pressed to write anything other than ‘Official: passive smoking cleared—no lung cancer’ … our estimate of 93 deaths should be 4,247.

‘I think we had better get out a thesaurus and find a lot of words to express the words ‘conservative estimate’ in hundreds of different ways…. We are looking down the barrel of a MAJOR public relations problem … I STRONGLY recommend that we convene another face-to-face meeting to discuss what to do about this.’ (emphasis in the original)

On the evidence, one would think that the science had won the day, but in the case of Galileo, his opponents were infuriated by his alleged impiety, and his success in communicating widely his novel ideas. They did denounce him to the Inquisition, and he was forced to recant. In the case of the NH&MRC, when it released its draft report The Health Effects of Passive Smoking, important scientific evidence had simply been suppressed, and not even considered, notably the results in Table 7 mentioned above. Fortunately for us in Australia, and for Lee, we have an effective temporal authority that sits above those who cry ‘apostate’. In a widely-reported case where the NH&MRC was taken to court by the tobacco industry for deliberately suppressing scientific evidence, Justice Finn’s findings were eloquent:

‘It is clear that the NH&MRC has fallen well short of meeting … the obligation to have regard to submissions received … to take them into account and to give positive consideration to their contents as a fundamental element in its decision making.…

The community is not to be excluded from that participation simply because, for whatever reason, the NH&MRC does not wish to give consideration to some part of the contents of submissions.… It had unilaterally excluded from consideration material which it previously had determined to be relevant by virtue of the Terms of Reference it had approved.…

What was objectionable in what the Working Party did was to adopt this exclusionary discriminator without bringing to the notice of the public that this was what they were going to do. They misled the public.’

Justice Finn made subsequent orders that the recommendations contained in the draft report on the estimated costs to the community of passive smoking, and for the elimination of environmental tobacco smoke in public places be taken out, as those recommendations could not be inferred from the evidence contained in the report.

The dangers posed to scientific objectivity by health bodies becoming captive to these modern day ecclesiastics is clear in the case of the NH&MRC but it is also an international problem. The British Medical Journal, in an editorial, has questioned the wisdom of a recent decision by the American Thoracic Society, the scientific arm of the American Lung Association, for not publishing scientific research financed by the tobacco industry. The editorial went to the heart of the issue of funding in relation to conflicts of interest. It asked, ‘What does taking government money imply if acquired through unjust taxation policies? Will smokers be banned from the pages of the journals?’ Conflicts of interest do not have to be monetary. They can be personal, political, academic and religious.

The greatest irony in the vilification of Lee is that he himself is a non-smoker (like the author of this article), and has helped patients over his entire professional life with their smoking induced lung disease. His conviction on the obvious links between smoking and cancer has had him appear in an anti-smoking promotion sponsored and organized by the NSW Anti Cancer Council. To be completely clear about Lee’s personal interest, he has stated publicly that he supports the introduction of smoke-free work-places and smoking bans in public places. ‘I am totally opposed to tobacco products whether they’re in the ground, the mouth, the environment or the ashtray’. He is unequivocal in saying that the tobacco industry has been ‘demonstrably devious, deceptive and totally reprehensible in its behaviour.’ His concern is about the abuse of science. ‘To achieve that goal of a smoke-free society, it isn’t necessary to invoke junk science. It’s social science, it’s science in a good cause, but it’s not good science’.

The Economist recently questioned the World Health Organization, where critics have accused it of bowing to political pressures rather than publishing unpalatable research findings. The WHO commissioned one of the biggest single pieces of research conducted into the issue of lung cancer and passive smoking, which found that non-smokers married to, working with or growing up with smokers were not at significantly more risk from lung cancer than anyone else. Instead of being released with a barrage of publicity, it was quietly filed away in a few paragraphs of a bulky WHO internal document. The Economist concluded, ‘It is dangerous to become involved in campaigns that are not solidly based on scientific evidence.… The organization ought rather to concentrate on where its research, rather than politics, leads it.’ The problem for WHO, and for national health authorities like the NH&MRC, is that they are not exempt from being captured by zealots or lobby groups, just because their funding is from the public sector. The risk of capture, judging from the Australian experience, it would seem, is greater.

Scientific inquiry rests on investigation that is presented to other scientists for their review and judgment. For this to happen effectively, all scientific evidence, regardless of source, must be considered on its merits. To attack the individual because of the findings or the source of funding of that research is an argumentum ad hominem. The approach may work in advocacy, but has no role to play in science. Clearly Lee is motivated by this concern—‘It is axiomatic that good public health be based on good science and that, therefore, bad science leads to bad public policy’. If public institutions like the NH&MRC are to remain credible, they should heed this advice.

*Andrew McIntyre is a freelance writer based in Melbourne

 

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