Interpreting evidence: why values can matter as much as science.

Despite increasing awareness of the ways in which non-epistemic values play roles in science, many scientists remain reluctant to acknowledge values at stake in their own work. Even when research clearly relates to risk assessment and establishing public policy, contexts in which the presence of values is less likely to be contentious, scientists tend to present such research as merely involving empirical questions about what the evidence is. As a result, debates over policy-related science tend to be framed as purely epistemic debates over the state of the evidence. We argue that this neglects the important ways that ethical and social values play legitimate roles in judgments about what we take to be evidence for a particular policy. Using the case of recent disputes about the relative safety of home birth, we argue that although the debate has been framed as a purely scientific one about the empirical evidence for home birth, it actually involves disagreements about underlying value assumptions. If our claims are correct, then in order to move the debate forward, scientists will need to engage in a critical discussion about the values at stake.

How do disclosure policies fail? Let us count the ways.

The disclosure policies of scientific journals now require that investigators provide information about financial interests relevant to their research. The main goals of these policies are to prevent bias from occurring, to help identify bias when it occurs, and to avoid the appearance of bias. We argue here that such policies do little to help achieve these goals, and we suggest more effective alternatives.

Regulating scientific research: should scientists be left alone?

In our current political climate, decisions about whether to fund research on new stem cell lines or do chimera experiments seem to arbitrarily depend on the religious and economic interests of the administration. Not unreasonably, many scientists believe that science should be left to its own devices in determining research priorities and conducting research. When nonscientific considerations constrain research, it is claimed that values are inappropriately dictating scientific decisions. This assumes, however, that all ethical and social values are irrelevant to such decisions. Using the case of embryonic stem cell research to illustrate the debate, we argue here that this position is untenable for several reasons. First, the aims of science, particularly in the case of the biomedical sciences, cannot be completely extricated from ethical and social aims. Hence, value judgments will be necessary to assess research priorities and methodologies. Second, maintaining this position is inconsistent with actual scientific practices. Scientists already recognize that there are some ethical values that appropriately constrain research, such as in human subject experimentation. Therefore, the problem cannot be that ethical values are brought to bear on science per se but that those values are highly questionable or are imposed by those who often lack the scientific expertise necessary to understand how ethical concerns may relate to the research. Finally, we argue that to the extent value judgments must be made, consensus about such values should be reached by a diverse group of stakeholders, including scientists, community members, policymakers, and ethicists.

Social values and scientific evidence: the case of the HPV vaccines.

Several have argued that the aims of scientific research are not always independent of social and ethical values. Yet this is often assumed only to have implications for decisions about what is studied, or which research projects are funded, and not for methodological decisions or standards of evidence. Using the case of the recently developed HPV vaccines, we argue that the social aims of research can also play important roles in justifying decisions about (1) how research problems are defined in drug development, (2) evidentiary standards used in testing drug "success", and (3) clinical trial methodology. As a result, attending to the social aims at stake in particular research contexts will produce more rational methodological decisions as well as more socially relevant science.

Can ethical reasoning contribute to better epidemiology? A case study in research on racial health disparities.

A common belief among epidemiologists and other scientists is that they ought not engage in ethical evaluation or endorse any particular ethical, political, or social values while involved in scientific reasoning. Such values are irrelevant to collecting and interpreting data and can only lead to bias. This view is also reflected in scientists' education. The authors argue that ethical values are crucial to conducting much epidemiological research. Focusing on epidemiological research on racial health disparities, they show that value judgments are inescapable when performing such research. Values are implicit in the framing of research questions, the identification of the problem, and the choices of design and methodology. By making value judgments explicit, scientists will be more likely to pay attention to them and thus assess them in critical ways. Finally, the implications that this has for scientific training are discussed. Scientific training should prepare scientists to engage in ethical reasoning not only because it will make them more responsible human beings, but also because it will make them better scientists.