Objectives

1. Examine contemporary processes that undermine the Enlightenment values of reason, science and humanism, as they affect attitudes to science and medicine.

2. Assess the impact of the degradation of public discourse in relation to the credibility of evidence and the practice of medicine.

3. Propose defensive measures against the assault on truth.

Methods This year’s work extends the thinking and research behind last year’s presentation at EL – The impact of the conflicting paradigms of Western scientific and traditional medicines. The canvas this year is much broader: the effects of social movements and individual behaviour on perceptions of medicine and engagement with healthcare.

Interim conclusions The rise of ‘identity politics’ has had a profound effect on the social and political landscape. It has tended to reduce individual freedom to hold or express views that are at odds with a prevailing group norm and has, in some cases, induced a bunker mentality. Multiple social and political factors have resulted in fragmentation and polarisation, and a loss of reason and nuance in public discourse; there is a headlong drive to binary choices, driven by belief, encapsulated by the fallacious maxim, ‘If you aren’t with us, you’re against us’. The corrupting forces of unreason are most obvious in relation to climate change; vaccination, evolution, homeopathy, other alternative therapies, and dietary fads are other concerns in our field of interest. A ‘conservative bystander culture’ has allowed serious damage to be done to the public case for science. In response, forceful arguments and cascading data do not work; we must find other points of entry to the beliefs, emotions and preoccupations of sceptics and antagonists, wherever truth and reason are under threat. Patients trust their doctors far more than any other profession (except nurses). The patient consultation is a critical place to start the dialogue of science in the human context of individual values and preoccupations. Beyond that, we need to seek areas of common ground, especially in terms of values and feeling, with those who oppose us and Enlightenment values and to build rapport, in stark contrast to the bluster of public health rhetoric and data. We have to understand that the nuanced and incremental nature of science is a process that is largely alien to contemporary popular culture, and that uncertainty and ambiguity tend to inspire anxiety and retreat rather than wonder and delight. [395 words].

Biography Bruce is a communications specialist and writer and teacher in the fields of healthcare practice, risk and crisis management. Working as a consultant for the Uppsala Monitoring Centre, he has specialised in pharmacoviglance and patient safety for more than two decades. He has a background in literary and social studies, criminal justice, public transport, and marketing and has published work in all of those fields and others. He has written about gender disparities in healthcare and the deadening impact of bureaucracy on professional and patient communications. He lives in Oxford and Chiang Rai, Thailand.

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