Earlier this year two senior officials from the US and UK governments got together to write a short commentary in the BMJ provocatively (but appropriately) entitled “Scientific evidence alone is not sufficient basis for health policy“. Some highlights:
Based on experience as researchers and as policy makers at the White House and United Nations, we argue that although science should inform health policy, it cannot be the only consideration.
Although it may frustrate scientists when politicians are swayed by the possible electoral consequences of various policy options, few scientists (including us) would want to live in a society in which politicians completely ignored the views of those who have elected them as their representatives. Voting, free speech, debate, and the push and pull of politics must have an important role in what free societies choose to do if the concept of democracy is to be meaningful.
To say that an advocate or policy maker is guided by more than technocratic considerations is a compliment and not an insult.
In the rapid response to their commentary someone effectively asked if it is possible to find anyone who would defend the position that science alone should determine (health) policy. Admittedly, this may be a challenge. However, the implicit assumption in so much of the writing in health policy is that policy decisions should be based on evidence. The very large literature on knowledge translation, at least as it applies to public policy, seems to assume that the problem to be solved is finding the best ways to bring to the attention of “policy makers” (who are rarely if ever defined very clearly) the best available scientific evidence.