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February 2010

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Evidence-Based Policy: Good? Bad?

Written by , Posted in Random

On Tuesday this week one of the groups at the LSE brought in Claire Fox to discuss the issue of evidence-based policy. Ms. Fox was formerly involved in the revolutionary communist party, and contributed to the Living Marxism magazine for two decades, so she obviously has some views that aren’t mainstream, and yet while I didn’t end up fully agreeing with most anything she said, I think a lot of what she argued was interesting and had some merit.

Now, some of you may be familiar with the idea of evidence-based policy in the medical field; there it’s known as “evidence-based medicine.” EBM claims that only medical procedures/drugs should be accepted that are ‘proven’ thought a specific means of gathering evidence. Usually this means randomized controlled trials. Now, there are actually some pretty significant problems with these trials that make using them as the main source of support for health care policy a serious issue, and we’re exploring that in one of my courses.

But that’s not exactly what Ms. Fox was discussing, although I think it lends some support to her thesis. She is basically concerned about the current trend where politicians and policy-makers will simply say “well, the science says X, so we have no choice but act in this way.” She’d rather us have an actual dialogue about why we think acting in that way would make sense. One quote was that she thinks “the political elite are outsourcing their authority.”

One example she used, which I think was quite effective, was the case of Professor Nutt (yep, that’s his name). Professor Nutt was an advisor to Gordon Brown (the prime minister here in the UK) who pointed to studies suggesting that cannabis is less dangerous than alcohol and so should be reclassified on the drug schedule. When Brown and his Labour party colleagues disagree, Nutt spoke publicly against the administration, saying they were ignoring the science. He was fired (or, as they love to say in this country, sacked. Yes, I believe if the NY Post wrote headlines for the UK, that week it would have said NUTT SACK in bold letters. But I digress.).

Ms. Fox appeared to be somewhat sympathetic to his firing, but she was more sympathetic to the idea that Brown might not want to make his decisions solely based on the science. There are many things science can tell us, but I do not think it can always, or even often, tell us what we need to do with that information. If cannabis is less physically harmful than alcohol, that’s certainly one thing to consider. But a policy-maker isn’t just concerned with physical health. He may be concerned about the impact the use of cannabis would have on his country. I don’t agree that it is good to keep it illegal, but I also don’t hold that opinion just because of the science on it’s health impacts. There are other things that inform my position, and I think this is what Ms. Fox wants politicians to consider.

As an aside, I also liked that she doesn’t like the acceptance of policies she supports without discourse. For example, she is a vehement supporter of open borders – allowing people to live and move where they choose. That was imposed onto the people of the EU without much debate about the legitimacy of it, and even though she supports the theory, she was annoyed that there wasn’t a real conversation about it

She’s worried that science is being used as “a blunt instrument to censor debate.” And that’s an interesting discussion that I don’t see loads of people having right now. My favorite quote of hers from the talk was this one: “You can’t say ‘The science says SHUT UP’.” And I think she’s right – I don’t believe it works that way. Whatever science is telling us, I do not agree that it is the be-all end all of any discussion. And that doesn’t mean that I don’t think that the science is right about things. For example, if the science says the climate is changing, that doesn’t to me tell me the policies that need to be implemented. It tells me that we need to have a discussion about how we’re going to address what the science is saying, and see about how our options fit with our values.

I can see that some of you might be thinking “but values are subjective; science is objective.” And I have to say that I don’t necessarily agree. Values enter into science at all levels, in many ways. They affect the types of tests that are run, the way the results are interpreted, and how the information is used to promote one view over another. If objectivity is what we’re looking for, it’s pretty difficult to find.

Of course I would say that. I’m studying philosophy.

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