John Ruffin, former head of the National Institute of Minority Health and Health Disparities wrote:
"The 19th-century scientist and pathologist Rudolph Virchow gave voice to many of our present-day concerns about disparities and went a long way toward defining the task before us. A socially minded man, he believed that science should speak the language of the common people and that medicine should serve the public's health. He wrote, 'If medicine is to fulfill her greatest task, then she must enter the political and social life…'"
Do you agree and why? Is it permissible for scientists to become advocates in the areas of their research? What steps can one take to balance advocacy with the objectivity that is considered the ideal in scientific inquiry?
I disagree! I can only sense the shock (and awe) from my classmates by my response. And the screams – How can you? I arrive at my conclusion with a very limited exposure to this field. And for the first time, I read all the responses to this thus far. And they were unanimously yes. Obviously, I am missing something.
We as physicians have an overwhelming sense of helping our patients to the best of our ability. Our primary responsibility is to attend to a patient’s medical needs. Fulfilling this role begins by establishing a trust. Political and social aspects of life can be very divisive and we as physicians risk alienating patients if we venture into these areas. Objectivity for physicians is paramount to fulfill our primary duties. Medicine, broadly speaking, is a multidisciplinary field consisting of social workers, ethicists, physicians, community advocates, to name a few. In my opinion, the political and social aspects of medicine are best left for the disciplines of medical care which are better equipped and trained to handle them.
Scientists, in my opinion, should not be advocates in the active areas of their research. All along during this TICR course, we have been warned of the pitfalls of confounding and biases and how these can lead to misleading results. Scientists can definitely be advocates for evidence-based research. For example, I feel comfortable to advocate that smoking is bad – even with a blowhorn. My other interest is to investigate the adverse effects of smoking marijuana. Smoking marijuana leads to exposure to two of the main carcinogens presents in cigarette smoke and promotes similar inflammatory responses. However, we do not have evidence-based data to say that smoking causes lung cancer. Thus, with regards to lung cancer, advocating against smoking marijuana is controversial. One needs to present the data objectively and clearly to a patient and advocate only which is evidence-based for or against a behavior or intervention in a non-judgmental manner.