Recommendations for improved public engagement in discussions on emerging biotechnology: Article three in the series on emerging biotechnology.

BY SAM WU, BS and KEVIN T. FITZGERALD, SJ, PhD

 

“To move ahead on important national issues without public support is to invite being undermined in the long run.”

– Daniel Yankelovich, Coming to Public Judgment: Making Democracy Work in a Complex World

 

Scientists perceive the public as both critical of and influential on the progress of science. Yet at the same time, scientists fear or distrust public input into the scientific research arena because they perceive the public as more likely to impede or misdirect the research process due to their lack of understanding of science and research.

Recent advances in science demonstrate the field’s far-reaching societal implications, from industry to medicine to what it means to be human. As Yankelovich stated, “to move ahead on important national issues without public support is to invite being undermined in the long run.” This statement makes the supposed “public mistrust crisis” all the more disturbing, and the need to do something about it all the more imperative. We are at a point where many experts would agree that there is a need to build public trust, but recommendations on how to do so vary considerably.

Some call for more inclusive discussions to help develop alternative solutions. Others blame the media and point to the need for the scientific community to take responsibility for communicating effectively with the public about their research, which can mean determining risks, benefits, and goals without public input. Still others blame educational shortcomings, calling for changes to science curriculum that will foster a greater understanding of the research process and its inherent degree of uncertainty. Various models of science communication and public engagement have been described, attempting to bring some order to the growing list of possible options (for example, see Lewenstein and Rowe and Frewer). Despite the abundance of recommended solutions to the “public mistrust crisis,” there remain significant obstacles in choosing, designing, and implementing good public engagement mechanisms.

To move forward and improve these efforts, we need first to address the prevalent and recurring opinion that most of the public is anti-science and uninformed, and therefore, incapable of participating well in science policy-making. Such narrow thinking has encouraged the development of public engagement events that focus primarily on informing the public of relevant technical information and/or benefits of specific technologies in question, with the goal of fostering public acceptance or understanding (i.e. the deficit model of science communication). Allum, et al. (2008), however, find that scientific knowledge is only one factor, and a weak one at that, among many that determine public attitudes and policy preferences on particular issues. Knowledge, whether technical or lay, is filtered by way of an individual’s social and political identities. Hence, while aiming at increasing public scientific understanding may be an important element of public engagement, it is by no means sufficient and should not be the only aim.

The next step forward would be to increase our understanding of the complex network of factors that precipitate controversy and public mistrust in particular contexts – in this case, in discussions regarding emerging biotechnologies. Such insight may, in turn, inform the selection and design of public engagement strategies that aim to address disagreements specific to that particular scientific debate. Notably, not all public engagement events should seek to achieve the same goals or to address the same issues. Different technologies can raise different questions of ethical and practical importance, and can be subject to a variety of regulations depending on the nature of the technology. These differences provide the context within which the dilemmas inherent to the design of any engagement event must be resolved: upstream v. downstream, deliberation v. decisiveness, inform v. elicit, top-down v. bottom-up, and commissioning research v. involving civil society groups (Nuffield Bioethics, Emerging Biotechnology 2014). The purpose and design of a public engagement event will, therefore, depend upon the particular technology or scientific advance in question and the factors, stakeholders, and communities involved.

Additionally, public engagement mechanisms can be designed, not merely with the goal of fostering public understanding or acceptance, but also with the goal of making diverse interests and values explicit and creating room for disagreement and consensus to inform policy-making. Rather than highlighting consensus and glossing over disagreements, both points of agreement and disagreement should be emphasized as valuable outcomes of engagement. Decision-makers can, for instance, use persistent points of disagreement as jumping-off points to refine proposals or to develop new alternatives altogether (O’Doherty, et al. 2009).

Incorporating diverse community interests throughout the decision-making process will encourage more innovative and ethical policy-making that leaves room for deliberation. One could even frame the design of public engagement methods in a public discourse ethics, which would enhance the values of equity, solidarity, and sustainability – helping to prevent biased decision-making that favors the goals of science.

Emerging biotechnologies pose new and challenging ethical questions, fraught with uncertainty and ambiguity as to how they should be answered. As stated earlier, a complex network of factors influences public attitudes and preferences, and to suggest that addressing only some public knowledge “deficit” is the best way forward ignores the dynamic, interconnected nature of our society. It is, therefore, crucial that we re-evaluate our policy-making processes and extend these processes to include stakeholders beyond science, policy, and industry. Employing this approach, we may better integrate our rapidly developing technologies into a future envisioned by our entire society, and not merely the science and technology community.

 

ABOUT THE AUTHORS

Sam Wu, BS is a research associate at the Pellegrino Center for Clinical Bioethics at Georgetown University Medical Center.

 

Kevin T. FitzGerald, SJ, PhD is a research associate professor at the Pellegrino Center for Clinical Bioethics, GUMC.