How Do You Study Science Policy Academically? (Part III)

Part III, our final installment with Shobita Parthasarathy, author of Building Genetic Medicine, follows below. All entries in the author-meets-bloggers series can be found here.

WF: I cut you off at the end of the last Part. Here, I'll let you continue with the connection between women's health movements and the rise of BRCA testing.

SP: When BRCA testing came on the horizon, US and British advocates behaved somewhat differently. In the US, NBCC and other advocacy groups were (and continue to be) skeptical about the technology. They felt that the technology was still experimental, and needed to be researched more before it was commercialized and made available for widespread use. They also felt that attention to the BRCA genes might also diminish attention to other causes of breast cancer (mutations in the BRCA genes accounted only for about 5% of all breast cancers, for example.) In Britain, activists (both breast cancer activists and groups advocating for people with genetic conditions) were more concerned with ensuring that the new technology was available throughout the country. They worked with NHS officials, scientists, and health care professionals to ensure widespread but equal access. Of course, the technologies that US and British activists were dealing with were quite different. In Britain, activists were promoting a technology that was regulated, and to which patients could only access if they had clear, severe need. In the US, activists were criticizing a technology which was relatively unregulated, and was available to consumers on demand.

WF: You know, David Hess was just here talking about social movements and scientific opportunities. He observed that social movements can shift history by focusing on current political trends that are not irreversible, such as corporate consolidation, environmental degradation, democracy deficits, and increased within-nation inequality. Does your work help that argument at all?

SP: I think it is possible for social movements to have that capacity, but I think that more often than not, social movements accept the status quo (and don't try to make big changes) because that is the best way for them to gain and maintain power. This is certainly the case for breast cancer activism. The most powerful breast cancer activists, whom I referred to above, haven't really rocked the boat all that much. They haven't criticized the structure of funding for breast cancer research, for example, and the relative lack of research into the environmental dimensions of breast cancer. (There are groups who do this, but they are not anywhere near as high-profile or powerful.) This is understandable; they don't want to be seen as extreme, because if they are, then they won't be able to influence policymakers as much. Unfortunately, it also means that the status quo doesn't really change all that much, even when civil society groups get involved. (In fact, there is research that shows that the movements that are the most successful are those that have extreme wings, because under these circumstances policymakers are more likely to work with the mainstream movements because they are, in essence, less scary!) I'd say that the breast cancer advocacy movement certainly follows that pattern.

WF: You're in a School of Public Policy and you're an STS scholar. What exactly does an STS scholar do in a School of Public Policy? A lot of folks at the Scienceblogs address policy issues - be that with Chris Mooney, who does it for a living, or a range of others, who comment on what they see as flaws or holes in public policy. Can you explain a bit about how one studies science policy academically and professionally?

SP: The Ford School of Public Policy at University of Michigan is one of the few policy schools that now offers a program in Science, Technology, and Public Policy, which I co-direct. All in all, science and technology policy is not a topic that has been traditionally taught in American schools of public policy. This is due to a number of factors, including the traditional gulf between the sciences and social sciences/humanities and the history of science and technology policy in the United States. To the extent that we have science & technology policy in the US (and in a recent issue of Issues in Science and Technology, Daniel Sarewitz discusses the lack of a focused S&T policy, in contrast to other countries), its development has traditionally been dominated by the scientific and engineering communities. So basically, eminent scientists and engineers have been asked to provide advice on science & technology policy issues (sitting on peer-review panels, government advisory committees, committees of the National Academy of Sciences, testifying before Congress on S&T policy matters, etc.) Over the past couple of decades, however, in the face of a variety of social and political changes (the environmental, bioethics, and patient advocacy movements, for example), multiple scandals in the scientific community (over issues including research ethics and conflict-of-interest) and the increasing dominance of science and technology in our everyday lives, there has been increasing recognition that scientists and engineers aren't the only people who should be weighing in on S&T policy matters. Furthermore, there is increasing recognition within the science & engineering communities that the political/policy world is incredibly important to their daily work and rather complex, and that they need guidance to navigate it (whether they plan to spend their careers in the laboratory or not.)

WF: Which means our own national context is shifting.

SP: In a way, yes. In this environment, schools of public policy (and science and technology policymaking types in Washington D.C. and elsewhere) are starting to recognize that there is a need for research and education in the area of science & technology policy. Some of this work focuses on economic competitiveness issues, and how to maximize a country's (or a state's or a locality's) innovative capacity. This kind of literature explores the circumstances (e.g., R&D policies, patent regimes) that are most likely to promote innovation (usually measured by numbers of research articles or patents) and economic growth.

WF: That's a more quantitative-methods kind of approach.

SP: Perhaps so. Other work, which is heavily influenced by the field of science & technology studies, focuses on the historical, philosophical, social, and political dimensions of scientific and technological development. This work is often qualitative and case study-based, but delves into the nuts and bolts of science and technology much more and explicitly tries to understand how S&T development is shaped by society and, simultaneously, how S&T development shapes society. So this type of research is often quite helpful in trying to develop assessment and regulatory frameworks for emerging science and technology that are simultaneously economically viable, socially beneficial, and democratically accountable. Much of this research has also explored the nature of advice and expertise (in essence, the transmission of knowledge to power), and so it can be very helpful when governments need to develop expert advisory mechanisms or determine how to incorporate the public into decision-making processes (whether the issue is S&T policy-related or not.)

WF: Beyond the academy, what kind of people do you usually talk to about this work? Who needs to hear about it?

SP: I'm hoping that this book will find multiple audiences, including STS-oriented academics, policy and public health folks, and the scientific and medical communities. I'm also hoping that it will contribute to current debates in academic and policy circles about the regulation of genetic medicine, as well as broader discussions about appropriate technology assessment (in particular, building technologies that maximize ethical/social benefits and minimize ethical/social risks).

WF: What did I miss? Go Blue?

SP: Yeah, baby! So long as you don't make any snarky comments about Appalachian State. [Or Oregon?]