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com
COMMENTARY

Stem cell research, xenotransplantation and somatic and germ line gene therapy are examples of emerging technologies that, if success-
ful, will forever change the way we live. But how well does the public understand the benefits and risks of these technologies, and whose re-
sponsibility is it to communicate them? Here, Erik Millstone and Patrick van Zwanenberg of the University of Sussex, UK, discuss whether
science is suffering because of a lack of transparency in presenting scientific information to its main consumer group—the general public.

A crisis of trust: for science, scientists or for institutions?

Many in the United Kingdom, and in continental elsewhere would eat less British beef. Those reac-
Europe too, have argued that on 20 March 1996, ERIK MILLSTONE & tions, however, would not have been unreason-
when British Health Secretary Dorrell announced PATRICK VAN ZWANENBERG able or irrational; the British government simply
that a variant of Creutzfeldt-Jakob disease had did not want to accept the consequences of the
arisen that was most probably due to exposure to bovine spongi- reasonable behaviour of well-informed customers. The British gov-
form encephalopathy (BSE)-contaminated material, this admis- ernment rationalized its policy by arguing that the public naively
sion marked a watershed in public attitudes to risk and trust in expected scientists and officials to have secure knowledge and to
science. Moreover, in the United States, some are arguing that the guarantee zero risk, and since that was never attainable it was vital
reluctance of Europeans to accept genetically-modified (GM) to provide the public with reassuring narratives that would, in
foods and crops represents a loss of trust in science in favour of Phillips’ memorable phrase, ‘sedate’ the public1.
© 2000 Nature America Inc. • http://medicine.nature.com

prejudice, ideology, politics and irrationality. Our contention is When beef sales fell abruptly in the spring of 1996, British and
that both of those perspectives share a common set of misunder- European consumers were again represented as ‘irrational’, because
standings. We must understand how and why public attitudes to beef in 1996 was substantially safer than it had been ten years earlier,
risk and to science have changed and are changing, but that un- when consumption rates had been significantly higher. The abrupt
derstanding needs to be more subtle and finely differentiated than decline in demand for beef makes perfect sense when seen as a nat-
the two sets of views outlined above. ural reaction to the realization that consumers had been repeatedly
and deliberately misled over the hazard posed by BSE.
Public reactions
Before we can even talk sensibly about ‘public’ attitudes to risk, we A loss of trust
need to appreciate that there is not simply one ‘public’ but that What the consumers were indicating was that they were dissatis-
our societies are culturally, regionally, socially and economically fied, and had diminished trust in key institutions, particularly
diverse, and that different social fractions are changing in differ- the MAFF, official committees and the meat industry. But that
ent ways and at differing rates. We must also recognize that the should not be confused with, or misrepresented as, a loss of trust
BSE crisis, which began in the late 1980s and peaked in 1996, in science. There is no evidence that British and European con-
should not be viewed in isolation. It came on the back of a long se- sumers had, prior to March 1996, expected complete certainty
ries of food safety scares concerning hormone growth promoters, from the science of BSE, nor that they demanded or expected
pesticides, food additives, food irradiation, salmonellosis, botu- zero risk2. But they had expected straightforward and frank ac-
lism, antibiotics in animal feeds and recombinant bovine soma- counts of science and risk, rather than representations that were
totropin as a lactation promoter in dairy cattle. The BSE crisis calculated to sedate them.
reinforced exisiting concerns about risk and skepticism about sci- Sociologists of risk have gathered evidence showing that amongst
entific advice and public and corporate policy. many groups, there has been a decline in the levels of trust in partic-
Lynn Frewer, a research social scientist at the Institute of Food ular groups of scientists, such as those working in, or for, the compa-
Research at Norwich, believes she has evidence that indicates pub- nies or industries whose products and processes are under scrutiny3.
lic unease in the United Kingdom about the introduction of GM Research also indicates that the levels of trust in scientists working
foods as early as 1990—an unease that was barely affected by the in, or for, the government are very low, and that claims by ministers
BSE crisis of March 1996 (L. Frewer, personal communication). and senior officials that they have a comprehensive understanding of
The post-March 1996 responses, therefore, represent a broader all the issues, and that risks have definitely been shown to be non-ex-
and clearer articulation of long-standing concerns rather than istent or negligible, are very widely seen as unconvincing4.
short-term or perverse superficial reactions. Research conducted in the United Kingdom for Monsanto in 1998
One of the key findings of the study of risk in the social sciences revealed that when a sample of British consumers were told about a
is that it is unrealistic to expect the public to rank their concerns GM food product, they made certain estimates of the safety of that
about hazards against the relatively simplistic quantitative esti- product, but when told that the British government had stated that it
mates of technical experts about the probability and severity of ad- was satisfied that the product was safe, the levels of confidence in the
verse occurrences. Skiers and smokers will accept risks from their safety of that product fell sharply5. That represents a profound chal-
hobbies and habits that they would deem unacceptable from their lenge to public policy-makers and corporate strategists, but none of
hamburgers, honey or herrings because their choices are not about that amounts to a mistrust of science—just a deep suspicion of insti-
the crude quantification of risk, but about complex juxtapositions tutions with a long record of misrepresenting the science of risk, and
of many different types of risk and benefits. the nature of regulatory policy-making.
The Phillips Inquiry into BSE showed that the British Ministry of It is all too easy for those with vested interests to dismiss unwel-
Agriculture, Fisheries and Food (MAFF) was frightened that if it come policy proposals as ‘unscientific’ but the plain fact is that all
provided a straightforward account of what was known, and not policy decisions are unscientific in the crucial sense that scientific
known, about the risks from BSE, then consumers in the UK and considerations alone can never determine policy. Politicians, espe-

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 © 2000 Nature America Inc. • http://medicine.nature.com
COMMENTARY
cially ministers, like nothing more than to hide behind scientific
experts, because then they can pretend that they have not been re-
sponsible for any risky decisions. Risk-policy decisions are always
taken in the face of incomplete, uncertain and equivocal evidence,
and they always involve judgments about what kinds of risks and
what kinds of uncertainties might be deemed acceptable in ex-
change for some anticipated, or presumed, benefits; but those is-
sues are all strictly non-scientific—a fact which large sections of
the general public can readily understand.
British and European citizens are not increasingly rejecting
science qua science by arguing that the Earth is stationary at the
center of the universe, or that antibiotics provide effective
treatments for viral infections. It is not science that is being disbe-
lieved6. Trust in partisan scientists may have declined, but indepen-
dent academic scientists, and scientists working for
non-commercial consumer and environmental groups, are often
deemed highly trustworthy. GM foods may be far less popular
among European consumers than among those in North America,
but it is in the US, not in Europe, where over 60% of adults
believe that creatures from elsewhere in the universe have recently
© 2000 Nature America Inc. • http://medicine.nature.com
been in personal touch with human beings (http://cnn.com/US-
/9706/15/ufo.poll/index.html). Few European consumers doubt
that GM crops really do withstand herbicides, but they remain to
be satisfied that the foods derived from those crops have been ade-
quately tested for safety, or that they provide benefits that out-
weigh the possible risks, the residual scientific uncertainties, or the
possibility of entirely unforeseen effects.7
Many groups of European consumers have indicated that, given
a choice, they are very reluctant to accept the current generation
of GM foods. This should not be seen as reflecting an exaggerated
view of the risks they pose, nor as a deep-seated rejection of
biotechnology or genetic engineering as a whole, but as a judg-
ment that the risks which might be borne by consumers would
not be outweighed by any evident benefits to them. If, instead of
genetically modifying soy beans or corn, an enterprising company
had genetically modified grapes to produce delicious wines, at low
prices, which had the added advantage of having been modified
so that large amounts of those wines could be consumed without
provoking hangovers, they would probably receive a widespread
acceptance, except amongst teetotallers.
Meanwhile, US consumers have indicated to researchers working
for the Food and Drug Administration that though they are not
currently able to make a choice—because the use of GM ingredients
does not have to be labelled in the US—they would like to be able
to do so8. If a GM labelling rule were introduced, we might find that
a majority of American consumers was prepared to accept them.
That would not constitute evidence that they were more scientific
or trusted science more than their European counterparts, though
it might indicate that they had greater levels of trust in biotechnol-
ogy companies and their federal policy-makers
It would, moreover, be a mistake to presume that European op-
position to GM foods extends to a hostility toward medical applica-
tions of biotechnology. Although Europeans are hesitant about
accepting herbicide-tolerant crops, there are few reasons to doubt
that they would welcome a genetically engineered cure, or even
treatment, for AIDS, cancer, Creutzfeldt-Jakob disease or arthritis,
just so long as they perceived the innovations to provide benefits to
themselves that outweighed the personal risks. They would proba-
bly not expect those treatments to be risk-free, but given a choice
between an otherwise untreatable condition and a GM-based treat-
ment with acceptably low levels of side-effects, they will probably
accept the medical innovations enthusiastically.
1308
Presenting science at face value
If biotechnology companies and government departments want
the British and European publics to trust their assessments and
evaluations of the risks of GM-based medical products, they will
have to learn to acknowledge the uncertainties and limitations of
scientific knowledge, the range of different kinds of risks and ben-
efits which might accrue to different sections of society, and to op-
erate with open and inclusive decision-making systems that can be
shown to be scientifically and democratically legitimate.
This can only be achieved if several key conditions are fulfilled.
First, a genuine ‘freedom of information’ regime will be required,
not one which permits ministers and departments to withhold in-
formation and data because firms find it commercially advanta-
geous or because policy-makers find it politically convenient.
Second, there needs to be a clear separation between those in gov-
ernment responsible for the protection of public and environmen-
tal health and those responsible for industrial and commercial
sponsorship. And third, there needs to be a clear separation be-
tween those responsible for the scientific aspects of risk assessment
and those responsible for the political aspects of risk management.
In practice that would mean that instead of giving prescriptive
and monolithic advice, scientific experts should provide, and
publish, pluralistic and conditional advice. Decisions-makers are
faced with a range of options, and scientists may be able to indi-
cate what is, and what is not, known about the likely conse-
quences of those options, but politicians need to take
responsibility for deciding which options to adopt, and be held
accountable for, given their choices and rankings of competing
social, economic and political objectives.
So long as consumers suspect that assessments and scientific rep-
resentations of risk are being covertly subordinated to commercial
or political considerations, they are unlikely to trust those who seek
to reassure them. They do not want ‘sedation’; they want to be
privy to what is known, what remains uncertain, and where we
might remain ignorant. They want to know the extent to which
scientists can and do disagree, and they want to know how assess-
ments of risks are constructed by expert advisory committees from
the fragmentary and equivocal evidence available to them. Under
those conditions science will be seen for what it is—indispensable
but nonetheless incomplete and uncertain—and scientists, firms
and policy-makers will be trusted only if they acknowledge the
strengths and limitations of the available science, and the choices
that they make.
1. Phillips, Lord of Worth Matravers, Bridgeman, J., Ferguson-Smith, M.. The BSE
Inquiry Vol. 1, Findings and Conclusions, 233 (The Stationary Office, London, 2000).
2. Irwin, A. & Wynne, B. (eds.) Misunderstanding science?: the public reconstruction of
science and technology. (Cambridge University Press, Cambridge, UK, 1996).
3. Frewer, L.J., Howard, C., Hedderley, D. & Shepard, R. What determines trust in infor-
mation about food risks? Underlying psychological constructs. in Reader in Risk and
Modern Society. (eds. Lofstedt, R. & Frewer, L.) 193,(Earthscan, London, 1998).
4. Grove White, R., McNaughton, P., Mayer, S.D. & Wynne, B. Uncertain world,
Genetically Modified Organisms, Food and Public Attitudes in Britain. (CSEC,
Lancaster University, Lancaster, UK, 1997).
5. Greenberg, S. The British Test (Report to Monsanto, 5 October 1998).
6. May, R. Bringing science into governance. (presented at the conference, Science and
Governance in a Knowledge Society: the Challenge for Europe, Brussels, Belgium,
16–17 October 2000).
7. Millstone, E. et al. Beyond the ‘substantial equivalence’ of GM foods. Nature 401,
525–526 (1999).
8. Derby, B. & Levy, A.S. Consumer perceptions of GM food labelling issues in the
United States: a focus group study. (presented at the Joint Conference of the Society
for the Social Studies of Science and the European Association for the Social Studies
of Science and Technology, University of Vienna, Austria, 30 September 2000).
SPRU—Science and Technology Policy
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