I believe that advocacy is an important part of advancing health. As a clinician, my justification for advocacy is rooted in the bioethical principles of beneficence, non-maleficence, justice and autonomy. This is generally framed as part of a binary relationship between clinician and patient i.e. I, as a physician, will be my patient’s advocate. I think the role of advocacy in research is a bit different as the principles of scientific research are historically rooted in objective examination and data collection. Using research to make effective arguments in order to advocate for a health issue or policy change is both crucial and laudable. For example, we have good evidence that syringe exchange programs reduce HIV infection rates without increasing IV drug use, thus I will visit my congresswomen to present this information and ask her to vote for legalizing syringe exchange programs.
However, I do believe that strongly-held views, whether they be personal or scientific, have the risk to create a conflict of interest that may bias the conduct of research. We often focus on financial conflicts of interest (i.e. if this trial is successful my company will get FDA approval and make lots of money) but personal stakes whether they be career related (if I publish more papers I will be promoted) or strongly held beliefs (there is no way we should be provide syringes to injection drug users – any research on this is unethical) are just as great a risk to the scientific process. Thus, one step to protect objectivity is that research papers and presentations should not include advocacy stances but should reporting evidence. However, this does not mean the same journal cannot present opinions and advocacy as perspectives or that the same author should not meet with their congressional officials or give opinionated speeches.