What are your unpopular opinions about vitamins

Science in the pandemic - and the big misunderstanding

In the corona crisis, the sciences, especially medicine and biology, are receiving undreamt-of attention and are faced with the highest expectations. In the face of dramatic events, they may say how to act, and they may even develop salvation from the pandemic: vaccination.

While the advisors in pandemics of earlier centuries - the priests - hardly appear at all, the scientists, especially those with a bio-medical background, are currently in greater demand than ever before.

With strange consequences: On the one hand, the media have created new science stars who should not be missing from any talk show. On the other hand, the well-known scientists are sometimes denigrated as dictators at the demonstrations of the corona deniers. As much as they are in demand with some, they are hated by others.

The different reactions suggest that the relationship between science and politics should be clarified. There is now no doubt that sciences have important things to offer in the pandemic, but it is important to create clarity and point out the limits of what sciences, including medical science, can and cannot achieve in this situation.

Precise and verified knowledge

To do this, one must first of all consider the abilities of the sciences on a theoretical level. A simple description is: You can create knowledge from within. And not just any kind of knowledge, but precise, verified and verifiable, reliable knowledge with a transparent origin.

It must be possible for everyone to understand the paths of knowledge, to control and criticize knowledge. Medicine also has a mission in which it uses this knowledge in practical actions for its goals, namely to help sick people.

In the current pandemic, medicine and biology have provided important information about the virus, and medicine has also provided information about the treatment of infected people. No other institution could have delivered anything like it.

The corona crisis would not have been recognized at an early stage without medical knowledge. Long before eye-catching pictures of overcrowded intensive care units in Bergamo removed the last doubts about the risk, virologists described the pandemic and forecast what threatened us. The first political consequences followed an alarm on the basis of scientific prognostics, not on the basis of direct unfortunate experiences.

Medicine can identify the threat posed by the virus and predict developments, but it cannot say what political path to take to stop the pandemic.

Prof. Dr. Dr. Urban Wiesing, Director of the International Center for Ethics in Science

But can medicine and biology deliver more than reliable descriptions of the pandemic, possible countermeasures and treatments, and predictions of future developments? Above all: What can you do with political decisions?

Already 100 years ago Max Weber pointed out that sciences describe the world as it was, is and will be, and with great success. They can also describe how the world could be changed - they also do that very successfully. But strictly speaking, as sciences, they cannot say whether the world should also be changed. As a science, they cannot determine the validity of norms. They have neither the moral nor the political authority to do so.

Specifically, this means for the corona crisis: Medicine can identify the danger posed by the virus and predict further developments. She can also predict the effects of possible therapies, and she should treat her patients as best she can. But medicine cannot say which political route should be used to stop the corona pandemic.

In this regard, you only have if-then statements: If you want to limit the corona pandemic because there are very good reasons for doing so, then you should make certain decisions. In this sense, the sciences can make recommendations to political decision-makers, but these are always based on prerequisites, the validity of which they cannot determine themselves.

Pragmatic decisions

Now one has to assume, however, that most people consider such subtle distinctions to be academically exaggerated, even petty, and will not make them either. Therefore, many people will say that politicians should please follow the recommendations of medicine.

That may also be sensible. However, the clarity of the argument requires it to be pointed out that preventing the further spread of the virus is a political decision based on scientific knowledge, but not a scientific decision. Failure to recognize this would have unpleasant consequences. Otherwise one would promote a scientistic neutralization of political responsibility.

The decisions of parliaments or governments would therefore not be political decisions, but decisions of sober, objective science, which one can only follow for precisely this reason. But this is not the case. Here a cognitive authority, in this case medical science, would have a role that it cannot fulfill.

In concrete terms: whether an incidence of 50 infections or 75 infections per 100,000 inhabitants makes a region a risk area is a pragmatic, political and not a medical decision! Whether you should close restaurants because you can no longer trace the source of infection in 75 percent of all infections is a pragmatic, political and not a medical decision!

The convenient reference to virology

Anyone who does not differentiate between them runs the risk of obscuring the responsibility of institutions. The sciences, including medicine, are not state leaders. That should by no means prevent political institutions from obtaining information from the sciences, on the contrary. Nevertheless, they cannot shift their responsibility onto the sciences.

If the pandemic has catastrophic effects, the politically responsible institutions cannot pass the buck to science. At best, they could blame science for bad scientific work, but they have little evidence for that at the moment.

So much for the theory, but in practice the matter is more complicated. Because all sorts of interests and misunderstandings come into play. Let's start with the interests: Numerous political decisions in the pandemic are extremely uncomfortable for those affected. They are therefore unpopular. Politicians naturally have an interest in pointing out that unpleasant measures stem from virology.

At times she would like to attest to her measures that there is no alternative based on medical knowledge. This is supposed to relieve the political decision-makers. However, if you look at the differences between politics and medicine, it becomes immediately clear: The responsible political institutions cannot discharge themselves from their responsibilities. Even if virology recommends certain measures, the political responsibility for their implementation remains with the constitutional organs.

Science doesn't rave about

So much for the interests of the decision-makers. On the other hand, it should not be overlooked that one or the other scientist likes to bask in the splendor of the importance that has suddenly come to him. The disciplines, the sciences, also have an interest in social recognition - and also in financial support. Media attention is sometimes quite right.

In these situations, the scientists are also exposed to very specific expectations. It is well known that the media are interested in concise, concise statements that are often allowed to provoke, which often runs counter to the scientific complexity of the issue. Nonetheless, one should remain faithful to the principles of science even in the public interest spotlight.

Admittedly, not everyone has mastered the fine art of bringing complex information to the point in a media-appropriate manner and yet correctly. In addition, as a scientist you have to warn against excessive expectations, which is not always popular. Nevertheless, the same applies here: Skepticism and criticism are the basic virtues of science, not enthusiastic euphoria.

Knowledge is greater than ever and yet limited

The relationship between medicine and politics is also characterized by a number of misunderstandings. The knowledge that medicine has accumulated is immense, greater than ever before. Only in the current pandemic has it become clear what actually always applies: The scientific findings are always incomplete and, moreover, cannot provide any in-depth information on important, very specific questions about the pandemic.

Simply because there is often no experience or studies available. Where also from, there weren't many challenges before! In the first wave of the COVID-19 pandemic, how should you know precisely how the virus is spreading in schools, daycare centers and in the opera? How should you know exactly how high the infection rate with SARS-CoV-2 is in the catering trade? Nobody had investigated that beforehand because it wasn't even possible.

Medicine cannot be blamed for not being able to answer all of the questions in a pandemic due to a new virus. The essence of research is that it takes time if it is to be really good. The relationship between science and politics therefore requires complete transparency of knowledge on the part of science.

No matter how much political institutions want precise information and instructions for action - if they don't exist, scientific honesty demands that they say so. Therefore, in many cases, doctors could only make assessments in public that were based on their previous experiences, but were not based on current studies. These assessments were uncertain and some of them have changed over the course of the pandemic. Think of the changing assessments of what the mouth and nose protection actually does.

This in turn met with displeasure in politics, which saw their strategy of declaring the respective measures as unalterable scientific guidelines endangered.

And the revision of knowledge was a welcome template for those who deny the pandemic or its dangerousness, for their rejection of science: They are divided and also constantly change their minds. Last but not least, some media were disappointed when it came to revisions of knowledge, because it contradicted their strategy of emphasizing the expectations of salvation in science.

Limit expectations of medicine

All of these allegations are based on a misunderstanding of science and are unjustified: Anyone who accuses medicine of having revised some findings in the last few months has not understood science.

The fact that the treatment of COVID-19 patients has changed over the past few months is not a failure, but a learning. It is deeply scientific and a virtue of these disciplines that they revise their findings when they have a factual reason to do so. This is not a weakness, but a strength. It may unsettle outsiders, but science is an ongoing process. Medical knowledge is not infallible and not beyond doubt; in addition, it is constantly growing and renewing itself - but the fact remains that we have nothing better.

Using knowledge from medicine and biology in the pandemic means nothing other than giving political decisions the most rational possible basis. They should enable sensible political action. But political decisions have to be made independently, and they have a different character from scientific findings.

This in no way speaks of arbitrariness in political decisions. It's all about clear responsibilities and political responsibility. For a prosperous relationship between science and politics, expectations of medicine must be limited to what medicine can do, and scientists must resist the temptations of the limelight. Medicine must not deviate from its scientific principles when communicating with politics and the public.

Prof. Dr. Dr. Urban Wiesing is Director of the Institute for Ethics and History of Medicine at the University of Tübingen and Director of the International Center for Ethics in Science. Wiesing, born in Ahlen in 1958, studied medicine, philosophy, sociology and medical history in Münster and Berlin. From 2004 to 2013 he was chairman of the Central Ethics Commission at the German Medical Association, and since 2009 he has been a member of the Medical Ethics Committee of the World Medical Association.