As a member of the National Academy of Medicine I have pledged to "advise the nation." Political discussions have raised doubts about the continued relevance of science, and as a health scientist I feel a responsibility to provide my input and advice to the public discussion. Science is the systematic search for facts and truth. Health science is the application of facts and truth to improving health.
We do not live in a "post-truth" world. Truth is an eternal value, and we de-value truth at our peril. Assertion of "alternative facts" does not make them true. Denying the scientific fact of climate change does not stop its consequences, and there is strong consensus climate change is already having negative health consequences. Attacking science to justify delaying the transition from dependence on fossil fuels to cleaner energy will increase mortality and morbidity.
The current enthusiasm to reduce regulations on business appears to ignore the health effects that were the justifications for many regulations in the first place. As a high-profile example, regulating the burning of coal was meant to reduce lung disease, other chronic diseases, harm to plants, and carbon emissions. But regulation of many chemicals, foods, automobiles, and other products were designed to prevent health problems, so removing or weakening those regulations is likely to increase mortality and morbidity.
The current proposal to reshape the health insurance system that will likely force an estimated 24 million people out of the insurance system is an unethical act that I believe health professionals have reason to oppose. That opposition should include educating decision makers and voters about the likely consequences of proposed actions.
Facts are not immutable, and scientific progress will update facts with better evidence. But we are better off making decisions based on the best facts we have at the moment rather than ignoring, denying, or using alternative facts that are often championed by those with specific economic interests. Given the expected health consequences of current government actions and proposals, we scientists have an opportunity to raise our voices to educate, and persuade when possible, in support of science-based decisions. If we believe in evidence, we must act to defend science. To be silent is to be complicit.
James F Sallis PhD
Distinguished Professor Emeritus
Department of Family Medicine and Public Health
University of California, San Diego