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Americans trust scientists. This may seem, to some, like surprising news, given the extent to which attitudes towards science were politicized during the COVID-19 pandemic. But the data bear it out—the scientific community has long enjoyed public trust. Data show that 44 percent of U.S. adults say they have a great deal of confidence in the scientific community. This trust has remained fairly stable for decades.
Underlying this trust is likely the assumption that science will do what it has historically done ever since it developed its core methodologies—pursue truth through empirical means, guided by data rather than by other incentives, be they financial or partisan. It is then worth asking—do we, in the scientific community, do this? On one level, the answer is obviously yes, we do, though perhaps imperfectly. But what if we modify the question, to ask: do we do this all the time, or at least enough to fully justify the public’s trust in us? How often do we think for ourselves, guided principally by data, and how often are our thoughts shaped by other factors? I would argue that we are susceptible to other factors, though not necessarily in the sense of being unduly partisan or subject to financial incentives. Instead, science, it seems to me, has a weakness for groupthink, for being swayed by the consensus simply because it is the consensus. If this is so, then we have a responsibility not just to be on guard against this tendency, but also to maintain a healthy level of iconoclasm, an instinct for pushing against the consensus as a means of testing our assumptions and ensuring that we are indeed thinking for ourselves.
The integrity of the scientific discipline is a key inheritance of the Enlightenment, a period which did much to support an empirical approach to problems. Such integrity, then, is kin to the principles of small-l liberalism which also emerged from the period, and which are based, in part, on empirical observations about society and human nature. Keeping science “honest”—rooted in empiricism, and as free as possible from groupthink—is therefore core to supporting the liberalism that informs a healthier world.
In 2015, I wrote a piece for Fortune about public health’s complicated relationship with salt. The impetus for the piece was the conflicted attitude towards the potential adverse consequences of salt intake in the general population among public health authorities. Opinion about sodium intake had roughly settled into two camps. One camp felt that salt is a largely negative influence on health, and the other felt that the science did not support such a view. I became fascinated by this, not because it was directly linked to my area of study, but because I could not quite understand how such divergent views could co-exist, strongly held on either side. Both camps of the salt debate leaned heavily on their own body of research from which they drew conclusions. On one side, there was a body of knowledge that supported a dim view of population salt intake, and on the other there was a body of knowledge that seems to contradict this view.
How can there be two separate schools of thought, supported by two separate data pools, each supporting the opposite conclusion? What we found, when we dug into this, was that this was indeed possible when two schools of thought effectively sealed themselves within bubbles of unquestioned groupthink, embracing only lines of inquiry which reinforce the position to which they are most sympathetic. At some point, data on salt ceased being just data to those who engaged with it and became something else. The data became a narrative—competing narratives, in fact. As scientists began to perceive a narrative—“Salt good” or “Salt bad”—they started believing only research which supported the narrative they embraced. Most consequentially, perhaps, they started to only cite research which supported that narrative. This informed the creation of parallel scientific universes, in which conclusions were regarded, by their supporters, as close to self-evidently true, bolstered by what appeared to be a robust body of evidence. This represents an entrenchment of perspective which has more in common with faith than with the empirical pursuit of evidence.
To my mind this teaches us that effective science should have—in addition to empirical rigor—a measure of healthy iconoclasm, as a means of resisting easy narratives and the groupthink that can support them. I do not mean a cranky iconoclasm that thrives on a reflexive rejection of consensus for its own sake, but rather a reflective iconoclasm that questions, asks if what we think we know is as airtight as it may seem, or if it is, instead of a reflection of our particular reality, merely a story we tell ourselves.
I suggest that such an instinct would serve us well in our efforts to find solutions to the problems that threaten health. Often, groupthink can weaken our efficiency in the face of such problems. A key challenge posed by groupthink is its tendency to give rise to untenable, absolutist positions on issues, which can stand in the way of real-world progress. During COVID, we saw a number of examples of science taking positions which emerged from dug-in, consensus-based thinking which arguably ignored critical nuance. I have written previously, for example, about the goal of “zero-COVID” (in which success against the virus is defined as nothing less than the elimination of all infections and deaths). This goal, to my mind, is impractical from a perspective rooted in pragmatic engagement with the realities of disease mitigation. However, from the perspective of scientific groupthink it makes perfect sense. For those of the opinion that COVID cannot in any meaningful sense be managed—and that the goal of public health is to eliminate risk rather than mitigate it—no other position could do.
The divide within the scientific community over COVID was well-captured by the dueling memoranda of the Great Barrington Declaration and the John Snow Memorandum. The Great Barrington Declaration argued for a “focused protection” approach: safeguarding the vulnerable, while minimizing the use of lockdowns and other restrictive measures, with an eye toward preventing the societal harms they can cause. The John Snow Memo argued strongly against such an approach, that nothing short of all-hands-on-deck efforts to contain COVID should be acceptable. These two perspectives have become, to many who hold them, more than perspectives. They have become narratives, and while there is merit in each approach to the pandemic, it has become difficult for partisans of either side to see this, once they become invested in their preferred story. A call for iconoclasm, then, is a call for being constantly aware of the other camp, so that narrative does not take precedence over data, allowing us to learn from alternative perspectives. This does not mean that we can never conclude a particular perspective is better than others. Yet this conclusion should be supported by independence of thought and the habits of mind that steer us away from groupthink and the creation of narratives of science and towards whatever the data are actually telling us about a given issue.
It is worth noting that while the intellectual debate between the two COVID camps remains ongoing, the reality of the pandemic itself has since placed its thumb on the scale of the argument, to an extent settling the issue in practice. We are now at a place where we have worked to safeguard the vulnerable, provided the vaccine to many who want it, and embraced a reopening of society. I realize the last point may be controversial, given vaccine mandates and the emergence of new restrictions in many places. But even with the Delta variant, we have not gone back to the days of peak lockdown. We have, in practice, aligned ourselves with one particular position, our actions shaped by the lived experience of the present moment.
I raise this point because it reflects a key means of escaping groupthink: an engagement with reality itself. When we fall into the gravitational pull of a consensus and do not think for ourselves, we are vulnerable to missing the reality of what we are discussing. When this reality asserts itself, it can do much to break a consensus that is not based on practical engagement with the world. Avoiding groupthink, then, can be achieved through a constant effort to see reality as it is, not filtered through the lens of how it looks to those within our professional circle. This clear-eyed perspective is not easy to maintain; as George Orwell said, “To see what is in front of one’s nose needs a constant struggle.” Orwell said this in the context of the political sphere, but he could just as easily have applied his observation to the scientific community. It may even be more applicable to the scientific community, as we so often take such clear-eyed thinking as a given, and regard a distorted view as perhaps more of a problem for less empirically-based fields.
I realize that the pursuit of a healthy level of iconoclasm in science may be more easily recommended than done. It is one matter to think a bit more critically about positions we hold; it is another to pursue a research direction which is outside conventional wisdom about what constitutes a valid line of inquiry. And it is difficult, in any context, to publicly express thoughts which go against the grain of the consensus, particularly when that consensus is supported by one’s peers and friends. I worry about that weekly in my writing The Healthiest Goldfish. But when groupthink proliferates, it can cause us to miss important details, ultimately weakening our effectiveness as public health professionals, placing lives at risk. While it may be difficult for us to see what is in front of our noses, those outside our groupthink bubbles can be in a much better position to see what we are liable to miss. When the public sees us as detached from common sense or the reality of a situation, we risk losing some of the trust they have placed in us, and on which the success of our efforts depends.