Journal of Public Health Advance Access originally published online on June 28, 2005
Journal of Public Health 2005 27(3):311; doi:10.1093/pubmed/fdi040
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Book Review |
The March of Unreason: Science, Democracy, and the New Fundamentalism. Dick Taverne. Oxford University Press, 2005. £18.99 (hb).
Christopher Potter
Honorary Senior Lecturer in Public Health, University of Cardiff pottercc{at}cf.ac.uk
Public Health is vulnerable to ‘ologies’ and oddities. It is vulnerable internally to those who come into the discipline fired by their adherence to a political or religious belief and want to equate the public health agenda with their convictions. It is vulnerable externally to lobbyists and interest groups who either want to impose the rights of the unborn, trees, animals or their particular concern on the way health care is developed and practised, or want to use public health to attack perceived villains in the private sector. Encouraged by the media and mavericks the public worries about MMR, electrical power lines and carcinogenic food dyes and we have to respond with inquiries and press releases – which the press treats less reverentially than the expensively crafted sound-bites of the lobbyists. Even members of the royal family and the Cabinet have been known to support publicly the provision of untested treatments by the NHS, while we struggle to pay for even evidence-based services.
This can be distressing for a discipline that places great stress on critical appraisal, research design and statistical methodology. Consequently, Dick Taverne’s book The March of Unreason is a pleasure to recommend to all public health practitioners who still value rationality before ideology. With a measured and very readable style he promotes confidence in the scientific method and in a liberal democracy – a democracy that promotes freedom rather than our modern populist democracy, which enslaves us to (fickle) majority opinion. As he says: ‘My theme is that reliance on dogma and ideology instead of evidence is unhealthy for democracy. Reason is one of the foundations of democracy.... Both science and democracy are based on the rejection of dogmatism, and whenever and whatever ideology rules, freedom as well as the evidence-based approach is suppressed’ (pp. 9–10).
In unfolding this message he attacks those who place over-confidence in alternative medicines, ‘eco-fundamentalism’ and religious faith on the one hand, and on the other doom-mongers who from a position of dogma rather than evidence condemn GM farming, animal experimentation and globalization. He points out, for example, that the West can sleep smugly, contented that books like Rachel Carson’s The Silent Spring helped obtain a ban on DDT – but after the ban the 1963 low of 17 malaria cases in Sri Lanka quickly grew to a million cases by 1968, and annually today worldwide a million children die of the disease. He notes that organizations like Greenpeace and Friends of the Earth, ‘far from being objective commentators, have their own vested interest in spreading scare stories because they boost membership’. He reports that Greenpeace, for example, prevented Shell from sinking the disused oil-rig Brent Spar in a deep ocean location – but later had their own ship Rainbow Warrior deliberately sunk off New Zealand, claiming that as an artificial reef it would benefit marine life (p. 7).
As an ex-Labour Minister and now Liberal Democrat peer, with a long career in law, politics and international governance, Taverne is well qualified to comment on the attitudes and activities of those who seek to manipulate our fears to promote their own agendas. As an exercise is puncturing hypocrisy and promoting rationality this book is a masterpiece. Like those he attacks he can be accused of selective use of evidence, but this month as an antidote to the propaganda to which we are constantly exposed, I urge you to hold back your subscription to your favourite -ology or oddity and buy Taverne’s book instead.
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