Objectives

1. To demonstrate that perceptions of evidence and reality are fundamentally driven by beliefs and values

2. To examine the delusional self-confidence of influential figures and the vulnerability of populations in the communication of complex issues

3. To review the systems of values and belief that supersede or challenge science and scientific evidence

4. To argue that failures in scientific communication and influence are, amongst much else, failures in imagination and implementation of the art of rhetoric

5. To propose radical changes in regulatory and scientific communication and engagement with citizens

Method This project is part of an ongoing examination of the contemporary political, social and communications contexts in which scientists and bureaucrats exist and must explain themselves to the world. The early fruits of this work have been presented at various meetings around the world, including EBM. The research entails daily scanning of national and international printed and broadcast media, and examination of professional journals and the latest books for insight and evidence about perception, opinion-formation and decision-making in the digital age. It includes philosophical consideration of the nature and impact of bias. The material for this proposal represents the latest stage of that journey and offers some radical new insights. The ‘Resurrection’ of the title (an actual recent event in Soweto) is taken as emblematic of the profound issues at stake, especially audience vulnerability to deception, and the crisis facing us.

Results

1. Perceptions of science and the credibility of evidence, even among some scientists, are driven by values and beliefs that may be inaccessible to scientific discourse

2. In an increasingly polarized world, where identity politics drives loyalties, ‘facts’ become determined by group consensus or ideology, and fake-news sustains and consolidates prior beliefs. These powerful forces are generated by political, economic and religious processes and realities, which must be factored into any public communications and determine their every detail

3. Regulatory, bureaucratic and many scientific communications fail to take this complexity into account in both the presentation of evidence and in its defence

4. Exploiting some of the wisdom of Aristotle’s Art of Rhetoric, and using some of the insights of modern sociology, psychology and neuroscience, specific reforms in medical and scientific communications and public engagement are proposed. The resurrection we need is that of genuine social discourse.

Conclusions With few exceptions, scientific, regulatory and bureaucratic communications in medicine, have fallen far behind the dynamism and diversity of modern popular culture, especially digital media. Scepticism about vaccination (and climate change, of course); the embracing of alternative and charismatic practices and therapies; the dismissive attitudes to causality and evidence; the vast failures in adherence; the seemingly irresistible trade in fake and substandard medicines; the opioid crisis; infant and maternal mortality; medical and medication errors and the worldwide abuse of antibiotics – hardly any of these are either countered with the skill, energy, creativity and seductiveness of their promotion, or equal in response to the intensity of their entrenchment.

Proposals for debate and change radical community engagement; nurturing of ambassadors for science; prioritisation and ranking of core issues; creation of evidence stories; revolution in use of language; exploration of the causes of scepticism; dynamic exploitation of digital devices and channels.