Trust and Confidence at the Interfaces of the Life Sciences and Society: Does the Public Trust Science? A Workshop Summary (2015)

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Strategies to Link Knowledge with Action

A framework for how to build, maintain, and if needed, restore the public’s trust in science does not yet exist. Workshop participants shared ideas about how the science community, including researchers, research institutions, science communicators, and policy makers, can better engage with members of the public in ways that promote trust in science.

A NEW SOCIAL CONTRACT

Marcia Kean, of Feinstein Kean Healthcare, believes that a new “trust fabric” needs to be built and should not resemble the old social contract. She said that the new fabric will need to be built through “partnership, participation, and peer groups”.

ENGAGEMENT

James Grunig of the University of Maryland emphasized that science institutions “fail to engage with the public” on issues that members of the public care about. He said that scientific organizations tend to “just push stories and not engage in true dialogue with people who need information.” In public relations, he noted, openness and accessibility are insufficient for building trust alone, science organization must “truly engage.”

Kean stressed the need to “get into the dialogue early.” She said that unlike the past when scientists did not engage with the public on social media and other non-traditional platforms, scientists will not only need to respond to questions and concerns, they will need to initiate discussions in order to become effective curators of those discussions. Not only do scientists fail to engage on these popular platforms thereby losing opportunities for discussion with the public. “In general, the more radical groups tend to enter issue arenas first, they

dominate the discussion, and then it’s very difficult for the [scientific] organization to enter,” Grunig said. Scientific organizations that react slowly to those situations end up having a “place in the audience” that prevents them from being effective messengers and diminishes their role as active participants in the contemporary scientific narrative.

RESPECTING AND ADDRESSING VALUES

Rose McDermott of Brown University underscored the need to recognize and act on the reality that cultural and religious factors compete with science for a place in the public’s value system. To be successful in communicating and building trust, she said scientists must learn to work effectively in this landscape to earn privileges in the public’s diverse and complex value systems. Grunig added that although scientists have been trained to be dispassionate observers, to report facts, and to shy away from emotion and anecdote, “logic is not always the best way or the only to address a scientific issue. Emotions are important. Organizations need to react to the emotions.” He and other presenters said that scientific organizations need to move beyond merely presenting or correcting facts about given scientific issues; they must acknowledge and act on the reality that peoples’ emotions, values, and personal experiences are important elements of these new dialogues.

SCIENCE EDUCATION

Rush Holt of the American Association for the Advancement of Science (AAAS) stressed the importance of identifying and capitalizing on opportunities to teach the public about science, and he emphasized the need to improve the public’s education about the concept of risk. With greater understanding in place, Holt said that stakeholders will be better positioned to handle challenging situations in the future. McDermott echoed Holt and highlighted the importance of improving public knowledge of “what science and research are”, what clinical trials are, and the nature of information that is gleaned from these sources.

Tim Caulfield of the University of Alberta advised that the commercialization of science must be handled better and said that the unfavorable impact that conflicting research results have on public trust points to the need for more reproducible research. Like several other speakers, Caulfield called for education to help the public to understand the role of uncertainty and how evidence is generated and evaluated. He added that teaching critical thinking to children and analysis to adults needs to be improved because these skills are at the foundation of an informed public. Scientists need to engage actively in discussions on social media as part of larger efforts to recognize and work in new ways with diverse stakeholder communities. With new strategies in place, Caulfield speculated the public would be better equipped to develop logical scientific conclusions on its own.

RESPONSIBLE CONDUCT

“If we really want the public to trust science we have to create a scientific system that is worthy of trust,” McDermott stated. She emphasized that that will require scientists to shift their values away from outcomes of research and toward the process of research—the ethics and quality of study design and research protocols. McDermott pointed out that most institutions reward the speed and sexiness of research. “We don’t have a good standard of

ethics across disciplines.” She emphasized that science community, government, and journalists should all have a high standard of ethics, and publically acknowledge the people who meet the standards.

LEARNING BY DOING

The workshop included three breakout sessions whose goal was to identify ideas about how the scientific community could restore, maintain, or build trust in synthetic biology, vaccination, and breast cancer screening (Box 6-1). During each breakout session, a facilitator was joined by a case presenter who provided the group with societal context of the topic. The case presenter’s role was to help participants to discuss public perceptions of the topic and to promote discussion of potential mechanisms for restoring, maintaining, or building trust. The presenters did that by providing information on what is known about stakeholders in societal discussions and how scientists have engaged in public discussions of the topics. After the sessions, facilitators were responsible for reporting summaries of key points to the entire workshop audience.

The reports from the breakout groups added topic-specific suggestions to many of the ideas that had been offered throughout the workshop. Reporting for the synthetic biology breakout group, Erika Shugart of the American Society of Microbiology said that her group engaged in a lively discussion that started with defining synthetic biology and summarizing what is known about the public’s understanding of this field. She said that the group defined the field as “the capacity to engineer biology—applying engineering concepts to biology.” She noted that the group first addressed the basic question of whether it should engage in the issue of public trust and decided that it was important to do so. Shugart provided several reasons for the group’s decision. Although current regulatory policies may not apply well to

this novel field, she said, companies are bringing new products to market—a consideration that suggests that the public will soon see the application of this technology. These issues led the group to agree on the importance of starting a public conversation. Shugart added that there have been calls from the scientific community to initiate a more active discussion of this emerging field.

The synthetic biology group reported that there are probably varied degrees of trust about the field and that how the technology is used is probably one of the strongest correlates of public trust. Shugart said that if synthetic biology were applied to food, it might have a lower level of public trust than if it were used for a medically oriented application. As part of the group’s efforts to suggest mechanisms for promoting public trust in this technology, it first considered what is known about the public’s understanding of the field. This discussion resulted in agreement that such activities as monitoring, surveys, and focus groups around the topic of synthetic biology have been conducted in an episodic manner. However, because the field is generating public attitudes and perceptions that are developing quickly, the group believed that a more structured approach to assessing public knowledge of synthetic biology is needed and that these efforts would help scientists to follow evolving conversations and public attitudes as they develop.

Shugart conveyed the group’s belief that because of uncertainty about the field in the scientific community there is tension about whether communication efforts should aim to get the public to “embrace the technology” or the efforts should simply convey information. The group decided that scientists should approach discussions with the public as “honest brokers” and address difficult issues together rather than trying to “sell” the technology. Shugart said that new case studies and scenarios could be developed and used as platforms to engage the public in the discussions. An important aspect of the new communication tools would be inclusion of diverse examples of synthetic-biology applications so that the public can understand the far-reaching applications of the technology. She said that the process by which the discussions occur needs to be considered carefully, and she conveyed the group’s belief that the public must be part of them. Shugart’s report addressed the question of who in the scientific community would be tapped to communicate about synthetic biology. White men dominate the field today, and the group believed that it was important to learn which people could communicate key messages effectively to different segments of the public. Once they have been identified, they would need to be trained in the skills needed to engage the public fully rather than skills aimed at advocating one point of view over another. Shugart said that those communicators would need to be proficient in explaining scientific uncertainty and the limitations of synthetic biology. She also said that specific efforts should be made to find and enlist the assistance of key intermediaries, such as religious leaders.

Reporting on the childhood-vaccination breakout session, Mary Woolley, of Research!America, said that her group identified a number of ideas that were similar to the ones that Shugart presented. Citing a “landscape of concerns” about the current status of public trust in vaccination, Woolley said that one step that the scientific community can take toward building public trust is to avoid promoting the idea that we are in “a crisis state”. She noted that although more than 90% of children are being vaccinated, “pockets of trouble” remain a legitimate cause for concern, and these are reflected in such events as the recent

measles outbreaks. Nevertheless, the group agreed that controversies about vaccination are amplified by people who are “too casual” about referring to a vaccination crisis when, as now, there is none. Woolley reported that the group indicated that enhanced efforts to test messages about vaccinations are needed. It is important that messages are accurate, actionable, and sensible. Wooley pointed out that sometimes scientific words have different meanings to layperson that they have for a scientist. . She cited the example of the Centers for Disease Control and Prevention announcement that measles was “eliminated” in the United States. To most people eliminated would meant that the disease “is gone”, but in the public health community eliminated means that new cases of the disease are no longer arising. A more effective public message would be to say that the spread of measelse is “under control,” she said.

Woolley reported that scientist–communicators should not “stand alone” when talking about scientific issues that are controversial in the public eye. The group believed that it is better and more effective for scientists to form alliances with other groups that can convey trustworthy messages to their own communities. She pointed to Shugart’s earlier suggestions about the need to work with religious institutions and other communities as an example of this collaborative strategy. Woolley said that other allies, such as trusted celebrities and political figures, can also serve in this role.

Like many of her colleagues, Woolley shared her group’s support of engaging fully with the public and “avoiding scientific invisibility”. She said that the more that scientists can do to become visible in the community before a crisis occurs, the easier it will be for them to act as trustworthy information brokers when a crisis does occur. Also in line with other presenters was Woolley’s suggestion that research on factors that influence when and why people trust the scientific community is most useful before a crisis occurs. Woolley concluded her report by emphasizing the importance of context in understanding parents’ decisions about vaccination and calling for greater understanding of the social, political, and public context around vaccination as a means of building trust.

Barnett Kramer of the National Cancer Institute reported on the breast cancer screening breakout session. He provided context for his report by saying that the group focused not on the value of breast-cancer screening itself but on issues related to trust in messages related to breast-cancer screening and the scientific methods underpinning the research that generates the messages. Kramer said that his group agreed that there is a need to ensure that “the strength of messages matches the strength of the actual evidence.” He explained that if evidence concerning a particular breast-cancer screening-related issue is equivocal, messages related to the issue should reflect the uncertainty. Kramer emphasized the importance of tailored messages of that kind: it is difficult for organizations to back away from health messages that were initially too strong and are later found to be lacking in evidence. One strategy that the group identified to improve public trust related to breast-cancer screening was for the scientific community to work toward improving methods of presenting different levels of evidence to the public. Like the other breakout groups, this group felt that it is important to engage the mass media to a greater extent on these issues than is now the case. He added that because the media’s role is to be an honest broker, they need to have the tools to convey messages accurately and respectfully, and more can be done to

facilitate the process. Kramer reiterated earlier observations concerning the need for scientists to understand and respect the public’s values and the need for health-care providers to be trained better to explain the tradeoffs of screening to patients in a respectful manner.

During the question and answer period that followed the breakout session reports, Phyllis Pettit Nassi of the Huntsman Cancer Institute said that if scientists do not engage with people who work with communities and bring member of the public to the discussion table, scientists end up talking to themselves. This observation was consistent with much of the workshop’s discussion of the importance of improving scientists’ ability to communicate effectively with diverse segments of the public.

FINAL THOUGHTS

Jamieson recalled McDermott’s explanation that higher oxytocin levels can increase trust: “What is the rhetorical equivalent of increasing oxytocin levels?” Jamieson believes that to ensure the voice of science is a dispassionate voice that focuses on knowledge (but is not cold), scientists “should care about knowing the best they can and carefully specify the limits of what is not known according to scientific norms,” she said. Scientists also have to trust that a public audience is capable of understanding the science, she said, “at least as much as they need to engage in the public debate.”

Jamieson thinks that too often the public experiences the voice of science as disdainful—a voice that says, “We have a consensus; now accept it.” That is an appeal to authority, which she knows from her research does not go over well in the modern world. The modern world reacts poorly to authority, she said, but is responsive to a voice that lets the audience participate in the process of understanding and draw its own conclusions. Scientists should also confront disconfirming evidence to help people learn about science, she said. Scientists who engage rather than only disseminate, Jamieson believes, can become more effective in the public arena.