How to Take Action

Dr. Kristin Shrader-Frechette is the O’Neill Family Endowed Professor in the Department of Biological Science and the Department of Philosophy at the University of Notre Dame. In her most recent book, Taking Action Saving Lives: Our Duties to Protect Environmental and Public Health, she shows how campaign contributions, lobbyists and their control of media, advertisements, and PR can all conspire to manipulate scientific information, withhold data, cover-up pollution-related disease and death, and “capture” regulators. To circumvent this mis-information she urges citizens to become the change they seek. In the excerpt below Shrader-Frechette looks at public citizens can push for reforms.

…The first step, getting information about public-health threats, is both the easiest and the hardest… It is the easiest because it may require nothing beyond reading and thinking, something people can do daily. It is the hardest because…special interests sometimes distort available information. In addition, many citizens receive their information only from limited and perhaps biased sources. Often people fail to get opinions and evidence from the greatest variety of people and groups possible. Many citizens likewise have not made the lifestyle commitments necessary to remain informed about public health. Instead, they may spend too much time on activities like television. As a result, citizens may have a false complacency that allows unscrupulous groups to “whitewash” or “greenwash” their behavior. Whitewash of course, can arise from any agenda-driven groups-environmental organizations, churches, labor unions, corporations, and even government agencies. The greater the group’s economic or social power, the greater their potential threat to legitimate information-as the recent coverup of sexual predators in the Roman Catholic Church reveals…Because corporate groups donate about 80 percent of U.S. campaign contributions and spend about 100 times more dollars on scientific research than do environmental groups, their greater power and potential for abuse suggests that their behavior out to receive proportionate scrutiny from those seeking reliable information.

Cooperating with others is the second step… Cooperation is difficult because people frequently recognize its necessity only when they see some threat before them. Yet often no threat is obvious until after people have already cooperated and thus gained public-health information…One health related NGO is Bread For the World. Promoting food assistance and child immunization in developing nations, it offers “action kits” that show citizens how to support its food and public-health programs. It is a valuable source of both health information and cooperation. As this example suggests, however, cooperatively working with such an NGO is not merely a matter o paying annual dues or reading a book. It involves keeping informed, helping to educate others, and supporting ongoing group activities and meetings. It involves commitments of both time and money-organizing, leafleting, educating, canvassing, and other activities characteristic of deliberative democracy. Without cooperation through a variety of focused groups, like Bread For the World, it is difficult for citizens to obtain accurate information, to evaluate conflicting viewpoints, to succeed in alleviating societal problems, or to sustain and motivate their own efforts to do good. The reason? If the social model of gaining knowledge…is correct, cooperation and cognitive division of labor are necessary to make much information readily available. The U.S. founding fathers and mothers recognized this point and organized New England town meetings…Such cooperative ideals identify deliberative democracy not with structures or institutions but instead with processes of wide communication among various people and social sectors. These processes are necessary both to build democratic consensus and to debate and amend conflicting social proposals.

A third step…is evaluating health threats and alternative solutions to them. This likewise is something best achieved through open interaction with a variety of other people and points of view. Yet most citizens associate only with certain groups of people and typically hear only a few points of view. As a result, their evaluations of social problems are often incomplete. To understand public-health threats, people need to hear a diversity of opinions about them. they also need emotive, narrative, and scientific or factual understanding, as well as ongoing evaluation-vigilance and criticism…One way of exercising such vigilance, at least in scientific evaluation, is to look for the characteristic errors of private-interest science…Another way is to avoid acting on the basis of unevaluated opinions that have not survived the testing and analysis…This means that people..need to aim at evaluation that is open, transparent, empirical, accessible to all, and democrative…

Evaluation is particularly necessary if citizens who hope to reform life-threatening social institutions find themselves at odds with at least some members of those institutions. If they are eventually forced into whistle-blowing…or into civil disobedience…their actions will require special evaluation…

Most ethicists believe that whistleblowing is justified only if four conditions, analogous to those for civil disobediance, are met. (1) The policy seriously threatens the public. (2) It cannot be overturned within a reasonable period of time through normal, internal channels. (3) Whistleblowing is likely to be effective in overturning the policy. (4) The whistleblowing will not violate any higher ethical obligations. Failure to meet any of these conditions typically makes whistleblowing unethical. Often this means it is unfair to the accused or endangers the whistleblower.

Organized action, the fourth step… is a natural response to the three previous steps…because individuals acting alone often can do little to help correct public-health problems, concerted and well-organized collective action usually is necessary. That is why the 50,000-member American Public Health Association (APHA) encourages “work in coalition,” including “advocacy and litigation.” Through organizations like “public-interest law groups” APHA says citizens can help exercise their “maximum responsiblity” for public health. Explaining its activities on its website, the APHA says it “has been influencing policies and setting priorities in public health for over 125 years.” It claims to serve the public not only “through its scientific practice programs” but also through its “advocacy efforts.” Showing how such advocacy and organized action can help overcome citizens’ feelings of fustration and powerlessness….organized action must build on small wins and on personal transformation-working to become virtuous onself, to become the change one seeks. Because it is so easy for advocates and any special interests to fall into bias, however, it is important to evaluate all collective actions from alternative points of view. This includes evalutating different proposed beliefs and actions, including doing nothing. In fact, organized and enlightened responses to the responsibility arguement require ongoing and iterative evaluation of alternative perspectices and actions. This continuing evaluation is important to help make oganized action less self-serving and more affirming to those who have been disenfranchised. As philosophers Hilary Putnam and John Dewey recognized, evaluation also is necessary to keep collective policies and actions inclusive, participative, and objective.