Thanks Sandro, very insightful post. It would be great to hear you elaborate on some of the tensions between public health and medicine: understandings (e.g. does the medical community understand and value public health); to what degree does medical thinking dominate public health decision-making; how does industry's heavy influence on medicine play out in the public sphere; do we need to unpack the ‘trusted professionals’ figures - e.g. one can trust their doctor in so far as they may have nobody else to look after them, and, at the same time, they can mistrust the medical field for its close ties to the pharma industry. Appreciate all of your insights.
Really thoughtful essay — thanks for sharing this. It’s something we’ve talked about a lot as we reflect on the lessons from COVID. I do wonder what the financial burden would be to build the infrastructure needed for adversarial collaborations, dissent-recording panels, and rapid-response evidence reviews. In public health especially, that level of systematized heterodoxy could be hard to support without new funding.
I would say this (as I consult to Juul Labs on tobacco harm minimization), but I think the clash around nicotine without smoke would make for an important and worthy example where polarization and the legacy of the cigarette companies' efforts to distort the scientific process have combined to lead to a lack of forward progress.
I can provide more inputs, but this 2021 paper on polarization in the field would be a useful starting place.
Exposure to dissenting views does not make one weak; instead, it strengthens the credibility of our own perspectives and prepares them to withstand future challenges
Sandro: Thank you for this essay on structured heterodoxy in medicine and public health. It made me wonder what a fair and organized way to handle evidence-based dissent would look like for fluoridation. The public is far more open to questioning fluoride than the medical and public-health communities, which are often reluctant to revisit emerging evidence that fluoride may be neurotoxic, provides less benefit than once believed, and was, in part, promoted through the influence of the sugar industry. Fluoridation would make a telling case study in how we handle scientific disagreement. The only solution I’ve been able to imagine is a NASEM consensus report. How else might we create a clear, trusted process for evaluating dissenting evidence?
Thank you. This is an interesting topic indeed. I shall read.
A report to articulate how this would work is an interesting idea; I had not quite worked that out in my mind.
Thanks Sandro, very insightful post. It would be great to hear you elaborate on some of the tensions between public health and medicine: understandings (e.g. does the medical community understand and value public health); to what degree does medical thinking dominate public health decision-making; how does industry's heavy influence on medicine play out in the public sphere; do we need to unpack the ‘trusted professionals’ figures - e.g. one can trust their doctor in so far as they may have nobody else to look after them, and, at the same time, they can mistrust the medical field for its close ties to the pharma industry. Appreciate all of your insights.
Really thoughtful essay — thanks for sharing this. It’s something we’ve talked about a lot as we reflect on the lessons from COVID. I do wonder what the financial burden would be to build the infrastructure needed for adversarial collaborations, dissent-recording panels, and rapid-response evidence reviews. In public health especially, that level of systematized heterodoxy could be hard to support without new funding.
I would say this (as I consult to Juul Labs on tobacco harm minimization), but I think the clash around nicotine without smoke would make for an important and worthy example where polarization and the legacy of the cigarette companies' efforts to distort the scientific process have combined to lead to a lack of forward progress.
I can provide more inputs, but this 2021 paper on polarization in the field would be a useful starting place.
https://academic.oup.com/ntr/article/23/1/36/5890529
Exposure to dissenting views does not make one weak; instead, it strengthens the credibility of our own perspectives and prepares them to withstand future challenges
Sandro: Thank you for this essay on structured heterodoxy in medicine and public health. It made me wonder what a fair and organized way to handle evidence-based dissent would look like for fluoridation. The public is far more open to questioning fluoride than the medical and public-health communities, which are often reluctant to revisit emerging evidence that fluoride may be neurotoxic, provides less benefit than once believed, and was, in part, promoted through the influence of the sugar industry. Fluoridation would make a telling case study in how we handle scientific disagreement. The only solution I’ve been able to imagine is a NASEM consensus report. How else might we create a clear, trusted process for evaluating dissenting evidence?