Scientists have the ability to influence policy in important ways through how they present their results. Surprisingly, existing codes of scientific ethics have little to say about such choices. I propose that we can arrive at a set of ethical guidelines to govern scientists' presentation of information to policymakers by looking to bioethics: roughly, just as a clinician should aim to promote informed decision-making by patients, a scientist should aim to promote informed decisionmaking by policymakers. Though this may sound like a natural proposal, I show it offers guidance that conflicts with standard scientific practices. I conclude by considering one cost of the proposal: that it would prevent scientists from acting as advocates in a way that is currently common in certain fields. I accept that the proposal would restrict scientists' political advocacy rights, but argue that the benefits of adopting it -promoting democratic governance -justify the restriction.
I. A PUZZLEThe Global Burden of Diseases, Injuries and Risk Factors Study (GBD) is "the single largest and most detailed scientific effort ever conducted to quantify levels and trends in health." More than 2300 researchers from more than 130 countries collect 1 and analyze data on more than 300 diseases and injuries, aiming to put together a comprehensive picture of global health from 1990 to the present. Not surprisingly, its 2 results are widely reported and discussed by scientists, policy-makers, and the public at large. Probably the most high-profile of its results is its summary ranking of the world's largest health problems, ranked by disability-adjusted life years (DALYs): 3A striking thing about this list is the absence of cancer. One might conclude from this that, perhaps contrary to our preconceptions, cancer is not a major global health problem. That, however, would be the wrong lesson to draw. Cancer is a major global health problem. According to the GBD, it was responsible for 213.2 million DALYs in 2016 -far more than ischemic heart disease. Why, then, is it missing from the list? Because the GBD team chose to rank cancers separately by site. Thus, lung cancer ranked 19th, liver cancer 32nd, stomach cancer 36th, and so forth. Adding all cancers together, however, would see them rise to the top.
rank Disorder
DALYs (millions)