Extending Expertise as a Response to Bioethics Controversies

For those interested or curious, here is the abstract of the presentation I’ll be giving at the Extending Expertise? conference this weekend.

In 2000 then President of South Africa Thabo Mbeki shocked the world’s HIV/AIDS experts by publicly questioning the link between HIV and AIDS. Mbeki’s doubts were apparently sparked by the work of two American “dissident” AIDS scientists, both of whom deny the link between HIV and AIDS. Mbeki reportedly came across the dissidents’ work while personally researching AIDS on the Internet in an attempt to better understand the disease and to develop his government’s policy response to the epidemic. Mbeki’s actions opened a public health controversy in South Africa that had presumably been closed in the context of developed nations. Bioethicists criticized Mbeki, and characterized the controversy as stemming in part from Mbeki’s lack of expertise and the lack of expertise of the dissident scientists. Critics also described the controversy as stemming from the illegitimate, unscientific, actions of dissident scientists who used the mass media and Internet to spread “bad science”. I argue that this characterization rests too heavily on inaccurate assumptions about scientific and technological knowledge production. More specifically, by adopting this mode of analysis, I argue Mbeki’s critics cannot fully explain why the controversy (re)opened in the South African context. I provide an alternate explanation why the controversy (re)opened that focuses on the way that technologies can represent working solutions to a problem in one context, but only partial solutions in another. A corollary of adopting a problematic mode of analysis is that bioethicists have difficulty drawing normative conclusions about how best to close such controversies, as the Mbeki case exemplifies. I argue that we have good reasons to adopt models that maximize public legitimacy by extending expertise as a means of closing bioethics debates.

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