Democratisation of scientific advice

BMJ 2005; 330 doi: https://doi.org/10.1136/bmj.330.7491.602 (Published 10 March 2005) Cite this as: BMJ 2005;330:602

Secrecy and democracy don't mix

  1. John R Kemm, public health physician (Kemm.cm-jr{at}tiscali.co.uk)
  1. Kings Norton, Birmingham B38 8DF

    EDITOR—Bal et al struggle to show that “concealing information from public scrutiny” is a necessary condition for “democratic function” but fail.1 The fault in their argument is the assumption that an advisory committee should alone decide how the question is framed, how different types of evidence should be privileged, and how the “performance” should be presented. Similar debates have been vigorously pursued in the health impact assessment community.

    Dissention in the scientific community is not a problem that should be hidden from an ignorant public but a fundamental mechanism in the advancement of knowledge. It is true that knowledge of temporary or continued dissention will be used naively or even mischievously and so confuse issues, but that is no excuse for hiding the process by which conclusions are reached.

    Scientific reasoning is a powerful tool for improving public decision making, but it is not sufficient. Account has to be taken of lay knowledge. Experiential evidence, which covers far more than experience of disease, is one part of this. “Irrational” concerns (better described as differently rational) and values also have to be taken into account as do all the messy considerations of political possibility. That scientists should seek to avoid the complexity of wicked problems by retreating into secrecy is understandable, but benign paternalism is no answer to mature democratic making of public policy.


    • Competing interests None declared.


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