Why anatomical scientists need to practice science advocacy (1999)

Basic biomedical research, the sort of research most anatomists conduct at academic medical centers throughout the United States, was supported last year by the US tax payer to the tune of $15 billion from the NIH alone. The work we engage in at the laboratory bench enjoys unprecedented bipartisan support in Congress and the White House. Research!America, a grassroots advocacy organization, has reported time and again the results of polls and focus groups, all of which clearly demonstrate a deep appreciation of the American people for the notion of basic biomedical research as the basis for concrete advances in public health. It is not surprising that many scientists are somewhat uncomfortable with the notion of advocating basic biomedical research to the general public. Nevertheless, we have both an ethical and practical obligation to do so. With all of this good news, why should anatomists even worry about such mundane activities as public outreach and advocacy? From my perspective, this question has both ethical and practical (read political) components. Those of us who receive federal support for our research often forget that the budget process is complex, hard fought and often involves very difficult choices. It's easy at the bench, while working towards understanding the etiology of a devastating disease, to lose sight of the alternative ways that the taxpayer dollars supporting the research might have been allocated. But in Congress and the Executive Branch, decision-makers carefully weighed the opportunity cost of your research against other seemingly worthwhile programs: perhaps in the area of education, perhaps in the area of environmental safety, maybe even a program related to national defense. Ultimately, a fiscal road that began with a proposal from the NIH Director, continued to the Secretary of Health and Human Services and the Office of Management and Budget, then subsequently meandered through both houses of Congress on Capitol Hill, across the President's desk, finally lead to your NIH study section and delivered your grant award. In short, the elected representatives of the people and your peers have chosen to fund your program. That is a heavy responsibility indeed. In an interview1 in this issue of The New Anatomist, Congressman John Porter (R-Ill) makes the point that in the end, our elected representatives simply reflect the collective will of the American public. I would like to submit, as a corollary, that there is an unbroken fiduciary chain of responsibility between your fellow citizens (many of them non-scientists) and us (as biomedical researchers). As with other fiduciary relationships, this results in special responsibilities over and above the conducting of your research in an ethical manner. For one thing, it means communicating both the substance and related context of our research in a manner that is useful to each of the many elements of that fiduciary chain. We already do that for our peers (both at the level of journal publications and when we write a grant). But all to often we ignore the folks in the fiduciary chain for whom a reprint is next to useless, because they are not trained in basic biomedical sciences. The key here lies in our ability to convey scientific substance and our enthusiasm in a manner that can be readily understood by the lay public. In doing so, we fulfill our ethical obligations to the general public that supports our work. There's a practical side to advocacy as well. One thing that I have learned over the last five years or so is that working scientists have a much greater level of credibility with decision-makers (such as members of Congress) than professional lobbyists. When a lobbyist succeeds in buttonholing a senator or congressperson, the interaction is often forced and fraught with distrust. Usually the message gets lost. In contrast, I have found that when I talk about my own research, or that of my colleagues—particularly when I do so in lay terms—the senator or congressperson listens closely and, more often than not, the communication results in a concretely positive course of action. Thus, we can't afford, as anatomists, to simply turn over advocacy to hired guns. If we are to make our best case to support biomedical research over other priorities, then we must make that case ourselves, over and over if need be, to the folks who are ultimately tasked with making those decisions. As I mentioned before, we already do this with the front end of that fiduciary chain—at the level of peer review. But from a practical standpoint, to ensure that the appropriate NIH or NSF study section gets the funding it needs, we also must go to the decision-makers and ultimately the general public directly and convince them exactly why such funding is essential, not only for Science, but for America. Training in the anatomical sciences, particularly from a research standpoint, requires a constant level of respect and rigor towards the interpretation of data. We learn early on how important it is to present a clear and convincing argument, but to not go beyond our experimental results. We must also be scholarly in our citations. It is not surprising, therefore, that many scientists are somewhat uncomfortable with the notion of advocating basic biomedical research to the general public. Nevertheless, we have both an ethical and practical obligation to do so. By being clear and convincing, we are credible—but it is through our enthusiasm that we will make our best case. In doing so, we'll ensure that this country continues to be the world leader in basic biomedical research.