Justify my existence?

Our Seed overlords demand a response:

Since they’re funded by taxpayer dollars (through the NIH, NSF, and so on), should scientists have to justify their research agendas to the public, rather than just grant-making bodies?

Ooh, boy. That’s a loaded question that depends a lot on how you interpret it.

My first reaction was similar to that of Razib, PZ, Dave, John, and GrrlScientist; i.e., no way, because the public doesn’t have a clue what constitutes good scientific research. Ah, heck, my second reaction was the same, too, and it led me to ramble on way longer than the 300 words that our Seed overlords wish us to limit ourselves to. (How typical of me, eh?)

In any case, we as scientists already do have to justify our existence to the public, only not directly. Instead we do it through intermediaries, specifically our elected officials. We are entrusted with public money, and in return we are expected to do high quality research on topics of scientific and public interest. Indeed, I see this as not unlike the way this republic was originally formulated. We are a Constitutional Republic, not a direct democracy. Indeed, the Founding Fathers intentionally made certain branches of government (the Senate, for instance, where before the 17th Amendment it was the state legislatures, not direct election, that chose Senators).

Our system for funding science is, in effect, similar. The Federal government, under direction from Congress, sets up a system for peer reviewing research proposals submitted by individual scientists. Congress determines how much money is devoted to different broad areas of research as embodied by different agencies (NIH, NSF, the military), which then disperse the money. Although not without its flaws, it is, by and large, a good system to determine what sorts of science receive funds, allowing public input through their elected officials, but (usually) not so much that it distorts the scientific process, although certainly powerful Senators, Representatives, and successive administrations have tried. Like Razib, I fear that if there were more direct involvement of the public in deciding what science gets funded, we’d have more government-funded research proposals studying the mind of God in astronomy or more studies of prayer on mortality.

Besides, politics already has a large effect on what gets studied. If you want to look at a cautionary tale of what happens when politics affects science, look no further than the National Center for Complementary and Alternative Medicine (NCCAM), originally started by Senator Tom Harkens (D-Iowa) in 1992 as the Office of Unconventional Medicine (later renamed the Office of Alternative Medicine, or OAM). What happened after its creation is described by Dr. Wallace Sampson:

The first OAM director resigned under Sen. Harkin’s pressure, having objected to Harkin’s OAM Council nominees who represented cancer scams such as Laetrile and Tijuana cancer clinics. One influential Harkin collaborator and constituent was a travel agent for a Bahamas cancer clinic. And the Federal Trade Commission fined Harkin’s bee pollen distributor, $200,000 for false claims.

In 1998, Dr. Edward Halperin, President of the North Carolina Medical Association called for disbanding OAM. Responding to objections from the scientific medical community, NIH Director Harold Varmus placed OAM under more scientific NIH control. But Sen. Harkin countered, elevating OAM to an independent Center. By 2001, the annual budget rocketed to nearly $90 million per year and by 2002, over $100 million per year. Congress, believing erroneously that public demand for unscientific services had increased, passed appropriations without a dissenting vote.

If you do the numbers, you’ll find that, since 1992, NCCAM has spent $842.1 million ($671.4 million since 2001) and has not a single real positive study to show for it. It has a couple of famous negative studies, such as the one showing that echinicea doesn’t work for common colds, but never quite seems to believe them, promising “more study.” In the meantime, NCCAM continues to fund dubious studies of distance healing for AIDS or Reiki therapy for prostate cancer–even homeopathy. (I’ve joked in the past that I have to find a way to relate my research to alternative medicine, so that I can find a way to get on this gravy train.) As a result, for the nearly $1 billion spent, we have precious little idea now of what alternative medicines might be useful than we did in 1992.

I used to be a supporter of NCCAM, thinking that a scientifically rigorous examination of altie claims would do some good and might actually allow the identification of modalities that worked that could be integrated into standard medical care and, more importantly, modalities that didn’t work and could therefore be discarded. However, I now see NCCAM as a cautionary lesson of what happens when politics influences too closely what sorts of science get funded. Another cautionary example is William Proxmire’s old Golden Fleece Award. While he often did make fun of wasteful government spending that deserved ridicule, all too often Proxmire would pick legitimate scientific studies that could be made to sound ridiculous and castigate them as “wasteful spending.” When it came to science, Proxmire often didn’t have a clue and instead used esoteric studies funded by the government as an excuse to engage in demagoguery. The NSF became a frequent (and usually undeserving) target of his ridicule.

And if you want another present day example, don’t even get me started on stem cell research.

Does any of this mean that the public shouldn’t be involved in deciding what science is funded? Of course not. Believe it or not, one model that involves the public intimately in the grant-awarding process that seems to work quite well is the Army’s biomedical research programs. For example, the Breast Cancer Research Program includes lay people from breast cancer support groups in the peer review process and requires researchers to write a detailed lay abstract specifically for these reviewers. (Let me tell you, writing such an abstract is very difficult to do well without lapsing into jargon–you scientists out there, try it sometime if you don’t believe me.) Indeed, last year at the Army’s Era of Hope Meeting that I attended, several of the speakers were interested lay people involved in helping the Army decide which projects should be funded. The generally high quality of the projects funded by the Army (in breast cancer research, at least) demonstrate that such a model could easily be adapted to, for example, the NIH review process without compromising scientific integrity.

ADDENDUM: I may very well have more to write about NCCAM in the near future, based on some literature I picked up about it at the AACR Meeting last month. As a skeptic who was formerly sympathetic to the idea embodied in NCCAM, I found what I read to be disillusioning.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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