(p. v) Foreword: Bridging Neuroscience and Society: Research, Education, and Broad Public Engagement
(p. v) Foreword
Bridging Neuroscience and Society: Research, Education, and Broad Public Engagement
Advances in neuroscience are reported widely in the public media, reflecting both the great pace of neuroscientific progress and the extensive interest people have in their own brains, particularly in their minds, and how well they are functioning. This should not be interpreted to imply that there is a deep public understanding of the details of brain or mental functioning, but it does reflect widespread recognition and excitement that scientists are learning more and more as the decades pass about the brain and mind. That high level of public interest in our science is, of course, generally a very good thing.
However, as the public increasingly grasps what science is revealing about the nature of the brain and mental function, some individuals will become less sanguine about what science is revealing. Moreover, the potential use and misuse of various neurotechnologies will likely raise concerns among members of the public. Much of this book is about the current and emerging issues in neuroscience that now or in the future will need attention.
A Broad Societal Context
Since neuroscience is part of the broad science and technology enterprise, some initial comments about the overall science–society relationship are relevant as context for understanding what could happen with neuroscience and its rapport with the broader public. Science and technology are embedded in every aspect of modern life, whether at work, at home, at play, or elsewhere in people’s lives. An obvious consequence is that in order to thrive in the modern world, people need a fundamental understanding and comfort with science and technology. That does not mean that all people need to understand the details of most scientific discoveries and issues, but they do need to understand the nature of science, its power and limits, and they need to be able to discriminate science from pseudo-science.
(p. vi) Moreover, every major problem or issue that modern society faces has a science and technology component—either as a cause or a cure. Obvious examples include balancing energy needs with a sustainable environment, the equitable distribution of such resources as water and fertile land, controlling the spread of infectious diseases and ensuring adequate health, and sustaining a viable economy in the world of the future. To deal with those kinds of problems on either a global or a national scale requires that modern countries have at least some significant science and technology capacity, which in turn requires broad public recognition, understanding, and support. These intersecting forces require that the relationship between science and the rest of society be mutually beneficial and strong.
In contrast, the last few decades have been rather Dickensian for science and its relationship with the rest of society—the best of times and the worst of times. On the positive side, scientific advances continue at a very rapid pace. The case of neuroscience is particularly striking; examples can be found throughout this book. For nearly 40 years scientists have been able to credibly maintain that we have learned more about the brain in the past decade than in all of recorded history. Some of these advances have been incremental in character, building systematically on past knowledge, whereas others have appeared more transformative. Many of the most transformative advances have been fueled by the availability of new technologies, like molecular genetics, information and communication technologies, and neuroimaging. The advent of these new technologies has enabled us to ask wholly new questions that could not have been approached before.
We also are seeing great progress in the diagnosis, prevention, and treatment of nervous system disorders, as basic, translational, and clinical neuroscience increasingly inform each other. And neuroscience advances have had significant public and policy implications, as we revise our conceptualization of such illnesses as mental and substance abuse disorders, recognizing their biological origins in brain dysfunction. For example, the policy implications of the recognition that addiction is fundamentally a health issue, a brain disease, are far-reaching.
That is the good news. In contrast, although the last decades have been among the scientifically most productive, they also have been among the rockiest in modern times for the overall science–society relationship. Although it is true that every attitude survey continues to show that, overall, the public has great respect for science and scientists, and that most people believe the benefits of science have outweighed its risks or harms, many people find particular scientific advances disquieting or even dangerous. This is discussed later in this Foreword.
One more set of contextual comments seem relevant. On the one hand, the purpose of science is to tell us about the nature of the natural world, whether we like the answer or not. On the other hand, only scientists are obliged to accept scientific explanations, again whether they like them or not. The rest of the public is free to disregard or, worse, to distort scientific findings at will, and with rather limited immediate consequences. Scientific understanding is only binding on scientists.
Sources of Science–Society Tension
The recent high levels of science–society disharmony come from two types of conflicts. One obvious issue is that some scientific discoveries are simply politically or economically inconvenient. The most obvious recent example has been global climate change and what to (p. vii) do about balancing energy and environmental needs and concerns. The highly expert Intergovernmental Panel on Climate Change (IPCC) has made quite clear that the earth is warming, and that the warming is heavily anthropogenic in origin and related to energy use (Intergovernmental Panel on Climate Change 2007). However, it is both expensive and politically contentious to impose energy use controls on individuals and industries. Therefore, some governments have decided to either ignore or distort the findings, and thus avoid dealing with the contentious issues in productive ways. Importantly, there are no rules that say governments are obliged either to acknowledge or act on scientific evidence and opinion.
But as implied earlier, there is another category of science–society tension that is at least as far-reaching as political or economic issues. Many scientific advances seem to be encroaching upon or abutting against issues of core human values or religious beliefs, and when that happens, values frequently trump science. As a matter of fact, 56% of Americans agree that “scientific research these days doesn’t pay enough attention to the moral values of society” (National Science Board 2008).
One example is embryonic stem cell research. The issue here is not whether people understand it in a general way, or even whether they believe this line of research likely will lead to improved diagnosis and treatment of major diseases. They do (Research!America 2009). The problem relates to when one believes life begins, and that, of course, is not a scientific question. Science cannot tell us when life begins; it is a matter of belief. And if one’s religion says that life begins at the moment of fertilization, destroying early-stage embryos for research purposes is unacceptable. If, on the other hand, one believes life begins later in gestation, embryonic stem cell research is not a problem.
The teaching of evolution in public schools is another example. Modern understanding of how humans came to be conflicts directly with a literal interpretation of the biblical account of creation. As a result, many Americans do not want their children taught evolution in schools; it conflicts with their religious beliefs. The fact that there have been tens of thousands of scientific studies, from many converging disciplines, that all lead to acceptance of evolution as a core scientific organizing principle is not relevant. For many people, religious beliefs trump science.
One more tension point seems to be emerging: the field of synthetic biology. The fact that scientists may be able to create or recreate aspects of life in the laboratory is beginning to cause some science-society disquiet which is likely to escalate in the future.
Neuroscience–Society Tension Points
Many major examples of potential pressure points for neuroscience–society tension are covered in this book. In the aggregate there are many issues leading to the conclusion that this problem merits significant attention. Some pressure points relate to new or emerging neurotechnologies, like pharmacological enhancement of cognitive abilities or lie detection using neuroimaging (Greely et al. 2008). The possibility of using neurotechnologies for defense purposes is another (Moreno 2007). Ambivalence surrounding dual-use research is not unique to neuroscience, but the possibility of manipulating minds for potentially nefarious ends seems a particularly likely point of contention.
(p. viii) The use of biomarkers to predict human behavior or mental disorders raises another set of issues where science and human values have clashed (Singh and Rose 2009). All types of concerns, including those related to personal identity, labeling, discrimination, and privacy likely will surround progress in biomarker research.
Another class of issues surrounds the implication of neuroscience advances for how people view their own humanity. Churchland has written eloquently about the implications of neuroscience findings for concepts of free will and personal responsibility (Churchland 2008). If the mind is conceptualized as simply the product of biological events occurring in the brain, what does that say about free will, a core concept of many religions? Moreover, where is one’s “soul”? Does the concept lose power if mental activity is reducible to biological events in the brain? Of course, there is no a priori reason one cannot have an integrated mind and brain and still have free will or even a soul; it just means they are contained within the brain. We have not made nearly enough progress in understanding how mental activity emerges from brain structure and function to be able to inform these kinds of questions in a meaningful way.
The Disordered Mind: Mental Illness and Addiction
We now get to issues surrounding mental and addictive disorders, and concepts such as personal or even legal responsibility. It is now widely accepted in both the basic and clinical scientific communities that mental disorders like schizophrenia, bipolar disorder, and depression are brain diseases—they come about because of brain dysfunction. Terms like “schizophrenogenic mothers” or “refrigerator parents” are almost never heard anymore. Moreover, the fact that mental disorders are brain diseases is slowly entering public consciousness and will, hopefully, lead both to reduced stigma and an increase in the number of people receiving effective treatment.
But recognizing mental illnesses as brain diseases also raises some difficult questions. For example, if a person commits a crime because their brain is disordered, what does that say about personal responsibility? Do we punish a brain-disordered individual who commits a crime in the same way we might deal with a so-called normal person? Is the person really responsible for the behavior? If not, how should society weigh that fact as an element in criminal justice decisions and policies? These issues are discussed in this book and represent special cases where advances in clinical neurobiology are presenting difficult problems for society.
The fact that addiction is a brain disease is even more complicated. Drug use does begin as a voluntary behavior, for which an individual is wholly responsible, but then that voluntary drug use is converted into addiction (compulsive and often uncontrollable drug craving, seeking, and use) as a result of the effects of prolonged drug exposure on the brain (Leshner 1997). So what level of responsibility do people with addictions have for the antisocial and criminal behaviors that often accompany being addicted? This is a question of significant complexity for society.
(p. ix) Anticipating Neuroscience–Society Tension
How should the scientific community prepare for the likelihood that neuroscience advances will result in increasing tension with the rest of society? This is not as simple a question as it may appear. First, there is the issue of whether the community should become active at all. By and large we do not have a problem now. Would raising these issues in the public’s consciousness precipitate problems? Or are they coming anyway, and, therefore, we should try to get ahead of them to help set the stage in as positive a way as possible?
We certainly do not want to cause problems, but there is some evidence that problems are on their way. For example, in 2008 the Discovery Institute—the group at the forefront of the Intelligent Design, anti-evolution movement—posted a blog article condemning “mental materialism” as antithetical to religious belief (Egnor 2008).
In addition, when other fields have acted preemptively to diffuse potential science-society tension, it has been quite successful. The best example is the preparatory work done by the genetics community in anticipation of the Human Genome Project (HGP). The HGP could have been quite threatening to the public with the specter of knowing all of a person’s genetic secrets. The National Institutes of Health’s Ethical, Legal and Social Implications (ELSI) Research Program has also done much to diffuse potential problems.
I have argued elsewhere (Leshner 2005) and reiterate here that it is time to “go public” with neuroscience and neuroethics issues. It would be better to anticipate the issues rather than only react defensively once they arise. However, this would need to be done in a strategic and measured way.
Approaching the public in a proactive way should only be done with very clear goals. What is the desired outcome, the purpose of “going public”? The straightforward answer is that the goal would be to diffuse potential tension as much as possible, without precipitating more. It is the only way the public can reap the full benefits of the products of neuroscience advances. Moreover, it would be important to ensure that the neuroscience community will not lose public support as a result of the discomfort the work could produce. The most productive goal is to find common ground between the scientific community and the rest of society so that potential conflicts can be pre-empted, recognizing that some issues just cannot be resolved. With these goals in mind, then, what strategy should be taken?
The Public Engagement Approach
The traditional response by the scientific community to tension with the rest of society has been to work on increasing public understanding based on the belief that most problems result simply from a lack of understanding on the part of the populace. “If only they understood us, they’d accept all we have to offer.”
However, over the last decade, it has become clear that this approach is not enough. In many cases, the general public does understand enough about the science to know whether it will like it and will accept it or not. The cases of embryonic stem cell research and teaching evolution in the schools discussed earlier are excellent examples of this point. (p. x) Oftentimes individuals generally understand the issues but do not like the implications of the science.
An expanded or alternative approach, widely advocated in Europe and by many in the US, has been termed “public engagement with science” and includes but extends attempts to educate the public about scientific issues (Yankelovich 2003). The public engagement approach may begin with public education, but then, using discussion formats and with each community listening and learning from the other, it strives to find common ground and work through contention, as much as possible. Through this approach, the public comes to understand the science better, scientists come to understand the public, and then both groups can work toward common goals.
Different public engagement formats have been used, with varying success. The most popular in the US seems to be a town meeting-type format, where a single expert or panel of experts first presents the science and then offers open microphones for members of the public to respond. But these kinds of events, although often feeling successful, rarely stimulate genuine discussion and mutual learning. It is not uncommon that the microphone becomes usurped by extremists on either side of an issue.
Smaller group discussions seem most productive, particularly if there is a concrete problem to work through. This approach has been used widely and successfully by groups specializing in civic or public engagement, like Public Agenda, often working in partnership with scientific organizations (Wooden 2006).
Principles of Public Engagement
Although scientists, particularly those who are academics, are quite experienced at educating people about science, public engagement involves a different set of skills, and they are learned, not innate. One needs to be trained explicitly in public engagement with science (Illes et al. 2009; Morein-Zamir and Sahakian, 2010). Many scientific organizations, like Research!America, the Aldo Leopold Fellowships program, and the American Association for the Advancement of Science’s (AAAS) Communicating Science project (http://www.aaas.org/communicatingscience), have developed training programs for communicating with the public. In addition, many individuals and groups have thought about what works in public engagement and what does not. These include Public Agenda, AAAS, the Royal Society (London), and the European Commission. A recent social issues roundtable on neuroscience and society at the October 2009 Society for Neuroscience annual meeting also discussed many principles of effective public engagement with neuroscience. Henry Greely articulated a list of such principles there. The following is an aggregated and distilled list of some fundamentals from these discussions and groups’ writings, which include:
• Listen carefully to what members of the public are saying. Tone must attend to people’s concerns, and that requires understanding them. Scientists’ understanding the public is as important as the public understanding science.
• Work to improve the understanding of the nature and process of science. Use the opportunity to clarify the enterprise, its potential, and its limits.
• Make the issue personally or locally meaningful for members of the public. People only care about things that affect them directly or closely.
• Only scientists care about the integrity of science or are bound by it. If people do not like what science is showing, they are free to disregard or distort it.
• Never debate an ideologue. Scientists are bound by the data; others are not. People can and will say anything they want to make a point.
• Do not be intentionally or overly provocative. The issues are provocative enough, and one should not try to force one’s point of view on others.
• Pay attention to the subtleties surrounding issues. Most issues are not as blunt a conflict as that between evolution and creationism.
• Be humble. Humility is a powerful tool for scientists to use in public engagement. Members of the public often think scientists are arrogant and condescending, and therefore they need to be convinced we mean to engage with the public. It is important to be sincere in this effort.
Neuroscience has provided great insights into the nature of the brain and mind, and many of those insights have been translated into improved diagnosis, prevention, and treatment of nervous system disorders. Some of those insights, on the other hand, are likely to threaten core values and beliefs that have long been held by many people in the broader society. Not all points of conflict will be resolvable. However, genuine dialogue and engagement between neuroscientists and the broader public can go a long way toward discovering common ground and will yield much greater likelihood that our work will be broadly put to use for the benefit of humanity. And that, of course, is the ultimate goal of all of science.