Everyone is Biased and Conflicted, Now What?

Critical discussion and debate is a powerful tool for honing scientific ideas and developing public policy.  Intellectual disagreements can be constructive even when people have starkly contrasting views.  However, too often in our internet and social media-fueled age, honest disagreements degrade into name calling, ad hominem attacks, threats and bullying.  When that happens, people are hurt (psychologically and sometimes physically), and the community is disadvantaged because the constructive discourse is disrupted.  In this short essay I’ll draw attention to one, sometimes complicated, form of disruptive incursion – guilt by association.

A common tactic used to discredit a discussant is to claim that their views are invalid and should be discounted because they have (or had) an association with a group (typically commercial) aligned with the opposing point of view.  For example, Dr. Smith’s opinion about widgets could be discredited by pointing out that she is paid by the Acme Widget Company.  A range of associations can be used including: being an employee; being a consultant; being grant recipient; or even something as mundane as regularly attending the same professional meetings.  The implication is that any association irrevocably taints the person’s ability to be truthful.  Let’s look at some of the evidence.

There is a reasonably rich literature about the influence that gifts from pharmaceutical companies have on clinical decision making among doctors.  Alarmingly, several studies demonstrate that not only large gifts like free luxury vacations, but seemingly trivial gifts like free ball point pens can influence physician choices[i].  Similarly, a meta-analysis of 30 industry sponsored research projects found a systematic bias in reporting favorable outcomes compared to independently funded research[ii].  But potential bias is not the same as irrevocable taint.  It is also relatively easy to find examples of studies that report unfavorable findings relative to the sponsor’s perceived interest[iii].  So where do those discordant data points leave you as a consumer of information?

Wanting to understand a person’s motivation for promoting a point of view is smart.  Optimally, that should be applied in both directions.  If Dr. Smith is being criticized for her affiliation with Acme Widget Company you might ask whether that necessarily undermines the data or opinions she presents.  Sometimes it will, sometimes it won’t.  Similarly, you might be moved to question the motivation of the person who raised the connection.  Are they revealing a true flaw in Dr. Smith’s position, or are they blowing inflammatory smoke?  If the former, then the debate has been advanced and we’re all better for it.  The latter may make you wonder why they’ve been reduced to diversionary tactics and if that reveals weakness in their own position.

On the flip side, should we demand that only people who are wholly independent of any potential bias be able to speak with authority?  That seems not just unreasonable but impossible.  Our accumulated life experiences unavoidably biases all of us – that’s what opinions are and why they differ between people.  So, instead of demanding an impossible standard and demonizing people when they fail to make the mark (as everyone will do if you dig deep enough and hard enough), we should encourage people, particularly scientists, to be transparent about possible sources of bias.  Before opining on the delightful qualities of widgets, Dr. Smith should plainly and openly describe her association with Acme Widget Company and let her audience use that information as they see fit.  Similarly, Dr. Smith’s audience should applaud her transparency and judge her data and opinions through a critical but fair lens.

In summary, bias is unavoidable, but it doesn’t automatically incapacitate people from communicating truthfully, or from opposing presumed affiliates.  Vigorous engagement in public dialog should be encouraged, but participants should be expected to be scrupulously transparent. The act of transparency should serve to relieve concerns about hidden bias (and secret agendas) and facilitate constructive debate.  We have no shortage of vexing problems.  Solving them, even by disagreeing with one another with civility, rather than tearing one another down, should be our focus.

[i] Am J Bioeth. 2003 Summer;3(3):39-46.

[ii] BMJ 2003;326:1167

[iii] J Gerontol A Biol Sci Med Sci. 2013 Jun;68(6):682-90.

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