Flouridation and the public understanding of science


Just to give some context, I wrote this in response to this tweet by Simon Singh:

“Leadership means making decisions based on available evidence, especially on emotive issues eg fluoridation” @drg1985, Simon Singh (@SLSingh) April 4, 2014

He is referring to is this Guardian article. You can read the responses yourself, but I responded that I thought I should have the right to choose what goes in my water.

What annoyed me about the article was it’s conflation of anti-vaccination and anti-fluoridation: two issues with massively different risk profiles, and the idea that we should blindly submit ourselves to the authority of science.

I’m a huge advocate of science and reason for solving the world’s problems, so I found it a little strange to see people claiming to advocate reason, whilst simultaneously lambasting anyone who dares to actually do it for themself. And worse, that their objections should be overruled with force instead of reason. In anycase, it inspired me to write a short article discussing the responsibility of scientists in communicating with the public. TLDR: the burden of proof doesn’t stop at the peer review board.

The burden is on you

In professing an understanding of science the scientist carries a great burden.

The human condition is in the majority governed by emotion and we would be fools to throw this understanding away. Are not love and compassion emotional qualities? Do we wish to throw away all emotion in a desperate attempt to fortify the vanguard of reason?

It is clear that emotions are inseparable aspects of the human condition, and thus a profession of knowledge that aims to be complete cannot deny them.

What is the ideal situation? If the person against whom you levy a reasoned argument can be wholly convinced and can see for himself that the suggested action is necessary, then there shall be no conflict. The person will carry out the action for himself with full conviction and an enthusiasm that carries his brothers along in the same. Your objective will be fulfilled.

But should the person feel coerced or ultimately forced into having the action carried out on his behalf, against his will, we will have reached a situation which speaks more of force and a lack of consent, that it does of the original benevolent and reasoned aims of the scientist.

Thus on the one hand our scientist is driven by benevolence and compassion, with a desire to reduce suffering, in this case that caused by tooth decay, by his action of fluoridating the water. But on the other, it seems he is willing to submit to his own emotions of domination, and invoke tyranny to enforce the efforts of his reason and fluoridate the water against the will of those who oppose him.

At what point does the will of the benevolent scientist stop? And at what point does he admit his benevolence has descended into wrongdoing? Is he willing to forcibly brush everyone’s teeth for them in order to enforce the “public good”? I expect, and I hope, that we can all agree that such a conclusion would be absurd.

But there is a line, and we cannot blithely ignore that it exists, whilst at the same time stamping our feet on it.

The politically shrewd may argue the case from the perspective of cost and only cost. If we concede that there is no harm from fluoridation, then the scales of cost are presented with the one side being weighted by the cost of the fluoridation process, and the other being weighted by the cost of public dentistry, which our reason tells us will be increased if fluoridation is not carried out.

In which case the argument for Fluoride seems compelling. But this argument is naive and neglects all the consequences of the action and fails to account for intangible costs. The religion of money is invoked, and reason appears to evaporate.

Consider this, what is the cost to society in creating a perception of science that ignores the feelings of people?

What is the cost to democracy in advocating force to impose the outputs of reason?

What is the cost to reason itself in advocating force, rather than relying on the force of reason itself?

Does the scientist lack that much faith in the ability of reason to convince? If he is not convinced of reason enough to trust in it completely, why should the uninitiated be?

Isn’t it a strange state of affairs, when those who hold the virtues of reason the dearest, poison the chalice of reason by eschewing it in favour of force?

Seeing the whole picture

The proponents of reason in this case seem to be blind to their own shortcomings in it. Their reasoning has excluded the emotional aspects of humanity and is therefore less complete than a reasoning which considers them.

Surely if you wish to espouse the virtues of reason, you should stick by your conviction and let reason encompass the totality of the problem?

Human beings are emotional creatures and how we are treated emotionally affects our health. If we are to prosper as a nation we cannot neglect the impact this has on the health of society as a whole.

If you care about health at all, then you will understand that mental health plays a central role, and that emotion cannot be excised from the problem so readily.

If you wish to uphold your pledge to reason, then you should accept that emotion plays a vital role in the health of our nation. And in accepting this you should resolve, not to blindly swing your scythe against the people who’s trust you hope to engender, but address their concerns until they are convinced.

If the decisions you make do not account for their emotion then you have failed in both your comprehension of the problem, and in your job in resolving it as a scientist. You have resorted to force instead.

It is your job as a scientist to convince yourself and your peers that your hypothesis is consistent with observation and that the causal agents you apportion to effect are really those responsible. You do this in wilfully submitting your publications to peer review and understand the process well.

Although the wider public are not your peers in science, you should not be so arrogant as to believe that the burden of proof you shoulder is any lighter when you carry it for them as it is for the review board. If you cannot convince the public that your suggested actions are necessary, this is not because of shortcomings in your opponent, it is because of shortcomings in you.

I implore you, do not abase yourself by abandoning the strength of the very thing you claim so vehemently to espouse: reason.

As a scientist of reason, you must persist as an educator, and as a human. You must work to build trust with the public and take the totality of the problem into account. The world of people is and never will be as clear cut as the results of a scientific study, and so you must not treat it as such.

Accept emotion, accept the difficulty, but persist anyway, and don’t give up until you have your fellow humans convinced. Not as embittered enemies, grudgingly accepting their defeat and domination, but as allies fully won over to the cause. Only then will we truly progress.