(PostScript: Croakey is taking a week’s leave. See you around Oct 11 or so…)
A recent Croakey post reported on moves by the Canadian Government to stifle scientific contributions to public debate.
Daniel Vujcich, a University of Western Australia graduate who is currently on a Rhodes Scholarship to the University of Oxford, is investigating the level of government suppression of academic inquiry in Australia.
He is keen to hear from Croakey readers who may be willing to share examples of gag clauses in health policy research, even if this must be done anonymously.
Daniel Vujcich writes:
The rather unfortunately-named ‘Nutt sack affair’ dominated British news headlines in late 2009. Its namesake, Professor David Nutt, was the chairman of the UK’s Advisory Council on the Misuse of Drugs (ACMD), a statutory body established with a mandate to provide Ministers with advice on drug-related issues.
In early 2009 the ACMD prepared a report recommending that ecstasy be downgraded from Class A (most harmful) to Class B (intermediate) in the Misuse of Drugs Act, having reviewed evidence of harmfulness to individuals and society.
Prior to official release of the report, Nutt published an article in the Journal of Psychopharmacology in which he argued that “equasy” (an addiction to horse-riding) was more harmful than ecstasy use, partly on the basis that it resulted in higher rates of acute and chronic harm to person.
The article, which Nutt wrote in his personal capacity, was intended to demonstrate that “the drug debate takes place without reference to other causes of harm in society, which tends to give drugs a different, more worrying, status.” It concluded by pressing the need for more open debate about “how harms are tolerated by society and policy makers”, and called for greater use of rational evidence in assessing drug-related harms.
Nutt was pressured by the Home Secretary to apologise for the contents of the article on the basis that it went beyond the scientific advice that the government expected of him, and was insensitive to the families of ecstasy addicts.
His fall from ‘government grace’ was completed in October 2009 after a briefing paper was published containing the text of a lecture he had given to King’s College, London. In the lecture, Nutt questioned the Home Office’s decision to “err on the side of caution” and upgrade cannabis from Class C to Class B, saying, “I think, the precautionary principle misleads. It starts to distort the value of evidence and therefore I think it could, and probably does, devalue evidence.” Those comments led the Home Secretary to conclude that he had lost confidence in the ACMD chair and Nutt was asked to resign from his post.
In response to Nutt’s forced resignation, a number of academics drafted the Principles for the Treatment of Independent Scientific Advice as a guide for future relations between government and expert advisors (an almost unrecognisably revised version of which was later adopted by government).
The original Principles centre on three core pillars – academic freedom, independence of operation and proper consideration of advice.
Most relevant to the Nutt affair was the statement that members of independent advisory committees should be “free to communicate about their interpretation of evidence … subject to normal standards of professional conduct and restrictions to existing Codes of Practice, notably: respecting confidentiality, not claiming to speak for Government, and making clear whether communication is on behalf of their committees.” To the extent that advisors are required to sign non-disclosure agreements, the Principles recommended that they should be “confined to specified areas of committee work, objectively justified, publicly acknowledged and regularly reviewed.”
At the time of the controversy, Greg Barns posted a piece on Crikey suggesting that the Nutt affair had parallels to the CSIRO’s dismissal of Dr Staaper for his public views on GM crops in 2007. Health economist Gavin Mooney’s response to Barns’ post suggested that academic and scientific censorship in Australia is perhaps more prolific than the high profile cases would suggest: “I too have suffered from having my academic freedom threatened. I also resigned from an NHMRC committee because other members wanted our recommendations to be ‘acceptable’ to the then Howard government.”
It is, of course, difficult to assess the full extent to which expert comment is regulated or stifled by government representatives and agencies. The very nature of gag clauses and cultures of silence is that they are designed to keep information out of the public realm.
Anecdotal evidence such as that provided by Mooney suggests that many Australian experts are constrained in their ability to weigh into important debates due to non-disclosure agreements with government agencies, fear of professional reprisal or concerns about funding cuts. Such evidence is, however, relatively sparse and often speculative.
Until we amass a broader evidentiary base concerning the way in which academic freedoms are impinged upon by government authorities, we cannot understand the scale of the problem, nor effectively advocate for change. High profile cases like the Nutt and Staaper affairs are important, but they do not necessarily provide a representative insight into the way in which expert knowledge is used or valued by decision makers in the context of smaller advisory groups, government service contracts or funding arrangements.
If we accept that health policies are improved by frank and informed exchanges between professionals, policy makers and the public, barriers to that exchange process at all levels must be made transparent – within reasonable limits – and subjected to open scrutiny. Relevant evidence and expert knowledge should not be withheld without good cause when it comes to decisions which affect the way in which individuals live and die in our society.
The more experts are prepared to expose the constraints which bear upon them in the policy making process, the greater is their collective capacity to negotiate for greater academic freedom in their dealings with government.
I am interested in collecting examples of gag clauses/cultures in the sphere of health policy making.
If you have any examples that you can legally disclose, please email Daniel.VujcichATuniv.ox.ac.uk. Requests for anonymity will be respected; alternatively, you can send the email from the following account, taking care to delete your email from the ‘Sent Mail’ folder so that others cannot view the contents: gagclauseATgmail.com (Password: gagclause1).