03 April 2012

The Politics of Drawing Lines

Today's NY Times has a lengthy article by Gardiner Harris on conflicts between the Obama Administration and the Food and Drug Administration over decisions over food labeling, drug safety and regulation. Some of the personalities discussed in the article are pictured above. Here is an excerpt that gets to the nub of the issue:
[T]ussles have erupted between top administration officials and the F.D.A. over issues from the regulation of sunscreens and asthma inhalers to the enforcement of an agency decision on a drug to prevent premature births.

Should makers of lotions that do not prevent skin cancer be prohibited from calling them sunscreens, as the F.D.A. advocated, or should the lotions just be labeled ineffective, as the White House insisted? Should regulators weigh the cost of a drug or only the drug’s efficacy and safety?
All of the conflicts involve judgements about where to "draw a line" in policy implementation that segregates products into different categories which may then result in different regulations or treatment. often such judgments involve considerations of science. For instance, debates have included:
  • how to differentiate between products called "sunscreens" and those not called "sunscreens"
  • in which contexts should it be required to disclose nutritional content of certain foods
  • which drugs should be allowed to sold over-the-counter and which require a prescription
  • at what age women should be recommended to have an annual mammogram
All judgments that involve "drawing a line" between one thing and another are inherently political judgments, in the sense that trade-offs between competing values are unavoidably involved. If there are no disputes above values, then the issue does not show up on the front page of the NY Times. While interesting and newsworthy to be sure, there is nothing unexpected or unusual about the fact that the Obama Administration and a federal agency find themselves at odds over such judgments.

Hugh Heclo, a famous scholar of the federal bureaucracy, analyzed the complex tensions between political officials and bureaucrats in his classic book A Government of Strangers (1977, The Brookings Institution). Heclo explains
If democracy is to work, political representatives must not only be formally installed in government posts but must in some sense gain control of large-scale bureaucracies that constitute the modern state. (p. 4)
A commitment to the orderly transition of governmental control via elections necessarily means that those in charge will change (p. 109):
Any commitment to democratic values necessarily means accepting a measure of instability in the top governing levels.
For FDA and other agency employees such instability can be maddening. After eight years of the Bush Administration imposing their particular brand of political considerations on the federal agencies, the Obama Administration comes in and does the exact same thing, but this time the political winds are blowing from a different direction.  Welcome to democracy.

Where both administrations and their respective critics get into trouble is when they try to hide political judgments by invoking science to justify or crticize decisions that are ultimately grounded in values. A perfect example is the debate over the so-called "emergency contraception" which is inherently political as a battleground for the US abortion wars. Combatants on all sides of the debate invoke science as justification for their political positions.

So long as we live in a democracy rather than a technocracy, such debates are to be expected. Bringing the values at stake out into the open will not only help to depoliticize science, but will also help to improve the practice of democracy.

1 comment:

  1. What irks me about the government and its minions is its gross over simplification and unintended consequences. Today, there seems to be a war on sugar (and I don't doubt we eat too much) but 20 years ago it was a war on fat. Tha war on fat saw companies re-formulating products left and right in order to get that low-fat laber. Unfortunately, the reformulation usually meant pully out fat and replacing them with sugar, carbs and sodium. The result was a sharp uptick in the number of poeple with type 2 diabetes as more people and food suppliers jumped on the low fat bandwagon.
    There seems to be no one who likes a fad more than government beaurocrats but often those fad lead to really bad policies. Unfortunately, I don't see restraint or humility as a quality in many government agencies.

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