Free Speech & the Scientific Method
2022-04-18 · Guest: Jeffrey Singer (Cato Institute Senior Fellow) · 50:56
Free speech medical science and government control
Bob Zadek and Dr. Jeffrey Singer discuss the intersection of free speech, medical science, and government control. They critique the rise of a “scientific priesthood” that suppresses dissenting views, specifically focusing on the treatment of the Great Barrington Declaration and the implications of California’s AB 2098, which threatens to penalize doctors for providing information that contradicts official government narratives.
Topics: Free Speech, Scientific Method, COVID-19, AB 2098, Great Barrington Declaration, Medical Ethics, Public Choice Theory, First Amendment
Speakers:
- Bob Zadek: Host of The Bob Zadek Show
- Dr. Jeffrey Singer: Senior Fellow at the Cato Institute and practicing surgeon
Introduction [00:00]
Bob Zadek: Hello everyone, welcome to The Bob Zadek Show, the longest-running live libertarian talk radio show on all of radio. We are now and always the show of ideas, never once the show of attitude.
This morning’s guest kind of ruined my April. There I was feeling reasonably content about what’s going on with COVID, what’s going on in the country in general. The Constitution is being honored; the dishonoring and disrespecting of the Constitution didn’t seem to be out of control, although there were foreboding signs. And then this morning’s guest sent me a link to an article. It happened to be something going on in the state of California where I happen to live. This is not a show about California; the show is about far more important institutions than the state of California, but it happens to be that what’s going on in California specifically in the subject we are going to talk about this morning offers a terrible warning to the rest of the country.
We will this morning discuss in one hour—we will combine a series of very important topics. We will discuss how one as a participant in society, in political society, how one should acquire information which we need to run our lives and to vote appropriately. We will discuss who is in charge of our health: our doctor or an elected or unelected politician or representative of the government. And we will discuss what is around the corner to offer more of a threat to the patient-doctor relationship than any other single event that I have had occasion to think about in the recent past.
You will end up angry, probably, a little scared—that would be natural, probably—and most importantly, you will end up a bit more informed so you can watch what’s going on in the country in general. And with regards to providing us with the most important and accurate information, you will understand more about the process, perhaps, than you did this morning. There’s a lot to undertake for this hour. First order of business is my favorite order of business: to welcome back to the show a dear friend, a popular guest of mine, a frequent guest of mine, Dr. Jeffrey Singer. Jeff is a practicing surgeon in Arizona and has been practicing for many years. He perhaps, I believe, has the oldest continuing general surgical practice, certainly in the Phoenix area, if not in the state of Arizona. Most importantly to this morning’s show, in addition to continuing to practice medicine at the highest level imaginable, Jeff is a senior fellow at the Cato Institute and specializes in healthcare policy. You may remember Jeff was good enough to join us for many years when Obamacare was the topic du jour in the area of healthcare, and Jeff has joined us frequently during the COVID virus to help us sort out fact from fiction as we were fed information on the evening news. Jeff, welcome back to the show this morning, although if you hear an edge in my tone, it’s because you put me into a really grouchy mood by sharing the information which you shared with me a few few days ago. But we’ll get to that in a moment. Apologies in advance to my listeners because you will end up perhaps a bit grouchy too, but don’t worry, like COVID, it will pass.
Science as a Profession, Not a Priesthood [01:31]
Bob Zadek: So first order of business, Jeff, thank you so much. Welcome back to the show. This morning’s topic is the confluence of free speech assured to us in the First Amendment of the Constitution. We live in a country which has the strongest protection of free speech of any other country on Earth now or that preceded us. So free speech is about as American as a concept can be. We are the model in the world for protecting free speech, for not allowing government to censor free speech, for interfering with our rights to say what is on our mind, and equally important, the rights of others to hear what we have to say. And I wanted to remind the audience of that because free speech is in fact two separate rights: the right to speak and the right to hear what other people have in their mind. Now, so free speech has been challenged because of the advent of COVID. And Jeff, you wrote a recent article to introduce the topic where you mentioned, and I think I’m quoting, “Science should be a profession,” which of course it is, one would expect. Jeff says, “Science should be a profession, not a priesthood.” Now, that’s as good a way as any to introduce the topic this morning. So there is a statement you appear to be stating the obvious. Why would you find it necessary to state something as obvious as “science should be a profession, not a priesthood”?
Dr. Jeffrey Singer: Thanks for having me on. And yeah, this is important for people to understand that not only is freedom of speech of course necessary to have to live as an independent, autonomous human being, but it also is necessary for scientific progress. And I had an article—it’s in this month’s issue of Reason magazine, it’s called “Against Scientific Gatekeeping,” and the sub-heading is “Science should be a profession, not a priesthood.” And what I talk about—and this has really come to a head during the COVID pandemic—there’s been a pernicious trend of late for there to be a—well, actually President Eisenhower in his farewell address warned that this would happen. He said that when government money starts getting involved with science through grants, etc., we could wind up developing what he called a “scientific technological elite.” And so we have such a phenomenon right now. And so during the pandemic, when the public health officials who are part of that scientific technological elite undertook certain policies and made certain pronouncements, anyone—and I’m talking about very well-trained people also in academy—anyone who questioned at all what the pronouncements of these elite said was subject to derision and shaming.
But worse than that, what’s happened—the other point of the article that I make, and it’s an important part—is that the digital age has changed everything. I’ve sometimes likened the digital age to how Gutenberg’s printing press changed everything during medieval European times, because up until then, basically the only people who had access to what was supposedly said in the great scriptures were the priesthood. And then when the printing press allowed for what was written in the scriptures to be written in a vernacular language and everybody else was able to read the same material, different people formulated opinions about it and came to different conclusions, and that of course led to the Reformation. So it’s the same thing right now. With the advent of the digital age, we’re seeing loads of—just about anybody who’s interested can get access to the same specialized information that the people in the academy, the professional scientists have. And many of the people who have access to that information, they may not be credentialed, let’s say, in epidemiology or even in the life sciences, but they can have a lot of expertise in, let’s say, mathematics and statistical analysis and numbers crunching. Or they could just be very smart people who are looking over these numbers, looking over these studies and reports and reading on their own and asking very intelligent questions that maybe no one else asked. Or they can come up with crackpot ideas as well. But the fact is that the establishment has, for all intents and purposes, treated all of these people from the peanut gallery as a bunch of people who should be dismissed. And even members of their own class, the scientific technological elite, who don’t agree with the narrative that is being promulgated by the people who really are dominant—and these are mostly government scientists or scientists who depend on government grants—if you do so much as challenge them now, you risk being completely derided and dismissed.
The Political Medical Establishment [04:30]
Bob Zadek: Now Jeff, before we get into the state of California, it’s important that I remind our audience that you used in the introduction of this topic—you observed that there is an elite who sort of sets policy, who speaks from the mount, who comes down with the tablets and tells us all what is going on. Now, the word “elite” would suggest—and this will be my point—they must be the best. But no, they’re not the best. There has not been some competitive exam and the highest-scoring medical professional gets to set policy. The elite means part of the political establishment. So Dr. Fauci, who—and others, and Walensky—all those people who became the font of knowledge insofar as those who watched mainstream media, they didn’t earn that through skill. They earned that through the political process. Dr. Fauci made a decision to use his skill and work for the government. That’s an employment decision he made. He didn’t score the highest on some test among all medical professionals in the country. So now we have the government, which is by no means the smartest, just it happens to be those healthcare professionals who made an employment decision to work for the government. And by that fact alone, they became—there was no testing—they became the elite. So when Jeff says when other healthcare professionals had a different point of view than the elite, I would—to make the point, Jeff—I would say they had a different point of view different than the political medical establishment. That’s the only thing that made it different. There was a political medical establishment which was not achieved because they were the smartest; they were—that was their job. So the word “elite,” when you point it out, we all know what it means and we have a negative feeling about it. But I want to be sure nobody believes for a moment that these people who became the face of the elite are that way because they’re the smartest. They’re that way because of their employment.
Dr. Jeffrey Singer: And that’s exactly what Eisenhower’s point was in his farewell address. He said he worried that when money gets intertwined, government money gets intertwined with science, we could create this special class of people. And he called them a “scientific technological elite” class of people. And the other part point to mention, Bob, if you’re a researcher in an academic medical school or a scientific research [institution] and you depend on grant money from, let’s say, the National Institutes of Health or something like that, and you know that what you want to do research on may go against the conventional wisdom of the people giving out the grant money, that may make you less inclined to go against the conventional wisdom because you don’t want to jeopardize the money flow. It also influences what studies get the grant money. So for example, if you’re going to do a study that’s going to—that if it comes out the way you think it will, it’ll reinforce the narrative that is prevailing, then you’re more likely to get a grant than if you get a study that challenges what all of the scientific technological elite, the consensus among them, has been for the last several years and might actually shake people’s confidence in it.
The Great Barrington Declaration and Focused Protection [07:12]
Dr. Jeffrey Singer: So that all influences the culture and the zeitgeist. For example, during about by October 2020, so we were several months into the pandemic. In the early days of the pandemic, I don’t think it’s 20/20 hindsight is very fair because we didn’t know much about this virus. For all we knew, it could have been as deadly as Ebola, and we didn’t know how quickly it spread. We could—I don’t think it’s fair to criticize the very early responses of maybe overreacting. But by the summer of 2020, we knew a lot more. We knew who was most vulnerable, who was spared, what were the precautions that seemed to make a difference. And a group of epidemiologists—a professor at Stanford Medical School, MD PhD, Professor Jay Bhattacharya; a professor at the time at Harvard Medical School, an MD PhD, professor of epidemiology; and a professor of epidemiology at Oxford University, Center for Evidence-Based Medicine, Sunetra Gupta (the Harvard professor was Martin Kulldorff)—they met in Great Barrington, Massachusetts and authored a statement that was signed by thousands of medical scientists across the world, including a recent Nobel Prize winner in chemistry, that basically said that now that we know about more about the virus, we should focus our efforts on protecting the most vulnerable, which tend to be people with certain immunodeficiencies, elderly people in nursing homes, and we should—and it seems to be relatively harmless for the young, particularly the very young. In fact, it’s more like a cold or something like that for the very young. And we have to take into consideration the tradeoffs of public health policy, that public health doesn’t just involve controlling a virus; it involves a lot of other things. It involves mental health, it involves the socioeconomic determinants of health. There’s a whole lot of aspects to public health. And so when considering the tradeoffs, what we should do is focus our protection on the people who are most at risk and that the risk-benefit tradeoffs favor restrictions and protection, and allow the least vulnerable among us to resume as normal life as possible. And in fact, the least vulnerable among us will eventually get the virus because the virus cannot be stopped. This is what they said in October 2020.
But they’ll be contributing to the pool of the population that will have a degree of immunity, and they will have not paid a big price for it. And at the end, that’ll kind of in the long run, when we all reach a point where enough people have immunity that the pandemic is—that the threat has receded—that will have contributed. Well, for that, they—and now we know from Freedom of Information Act requests, and I get into this in my article in Reason—they were just attacked viciously, mainly not by the scientific literature but by the mainstream literature, like The Nation magazine or Atlantic Monthly or Wired. But they weren’t attacked by—they weren’t attacked on the science. And we now know from Freedom of Information Act requests that when this document was released, Francis Collins, who at that time was the director of NIH, emailed and a couple of other members of the task force advising the presidency on COVID and said, “Something has got to—we have to do a rapid takedown of this—these fringe scientists who are questioning our policy. What is being done?” And a response came back said, “We’ve already got people about to write stuff,” which of course were written in the lay press. So interestingly, these fringe scientists, like I said, were epidemiologists at distinguished institutions. And for the record, Dr. Fauci’s not an epidemiologist, neither is Dr. Collins. But in any case, we now know—in fact, I had the pleasure of hearing Dr. Bhattacharya, one of the authors from Stanford, last week speak about it. And he said, “You know, when we wrote the Great Barrington Declaration, as it became called, it wasn’t like something we had to devise de novo. This was what the consensus among epidemiologists had been right up until COVID-19 hit. This was through 2019. The idea of lockdowns as was instituted initially in China and then became like the model for the rest of the world—and now is being done in China again, and it’s horrible what we hear is going on there—that was considered some sort of crazy idea.” So he said, “Really all we did was just restate what had been the conventional wisdom up until January 2020.” And so it didn’t take a lot of deep research; we just restated what we were all taught to believe right up until then. But that’s the way it was attacked.
The Importance of Off-Label Use and Scientific Progress [10:42]
Dr. Jeffrey Singer: Another important thing I point out is the priesthood, as I call it—the scientific technological elite—oftentimes attacks critics by using, resorting to credentials. “You’re not an epidemiologist,” or “You’re not a physician. Who are you to say this?” Now, credentials are important because for us it’s a way of kind of screening. If I don’t know anything about you and you’re telling me stuff about science, let’s say medicine, and I see you have a medical degree, okay, that credential gives me some information that you probably know something about what you’re talking about. So it’s useful, but it doesn’t necessarily mean that you’re good, and people without the credentials aren’t necessarily ignorant. So it’s just a useful kind of screen. The famous story: what do you call a person who graduates in the bottom of his medical school class? Doctor. So you got the credential. And so you had people attack, for example, who were PhDs in economics at Brown University or elsewhere, who as a part of their daily work, they’re always looking at statistics and crunching numbers. And they see some of these epidemiological reports and say, “I don’t agree with your methodology here. I don’t think you made enough adjustments for, let’s say, covariates,” and they were immediately shouted down as “You’re an economist, you’re not an epidemiologist. Shut up.”
Bob Zadek: And they were shouted down, right, not on the merits, but because they were offering a point of view that was inconsistent with the official—air quotes—with the official point of view. And the government behaved as if anybody who was challenging what the government was saying was an existential threat to the country, that somehow the country had to blindly follow the public officials for the mere fact that they made an employment decision to work for the government. And so the point is, the permitting of other points of view to be presented to the public—there was a profound negative reaction by the government. “Shut up,” the government says. And the government was saying exactly that: “Shut up. We do not care about your point of view, and we do not respond on the merits. Just—” and that’s the point. When the government was doing so, government was able to say “shut up” not because they won the argument intellectually, but because their employer carried guns.
Dr. Jeffrey Singer: And well, and the point of my article for Reason, “Against Scientific Gatekeeping,” is that this is not going to stop. The scientific technological elite, or as I call it, the priesthood, has got to get used to the fact that the digital age is the real game changer. And they’ve got to learn to come to an accommodation, have a rapprochement with a world in which there’s going to be a lot of people out there who have access to the same information as them. They see exactly the same statistics they’re seeing. They’re seeing that in other countries they’re doing things differently and having different results. And some of the people that are going to be having opinions are going to be wrong, and some of them are going to be right. Some of them are going to raise questions that sometimes only a person who’s not in the middle of the problem and is looking at it from the outside could come up with a question like that. It could be valuable. So my article’s point is that it’s not going to change, and the solution is for the scientific profession to get more tolerant. My concluding section is “A little tolerance goes a long way.” This doesn’t mean you have to respect and entertain every single hypothesis coming from the peanut gallery. We don’t have to spend time considering that the Earth is flat, for example, and there’s only a certain amount of hours in a day. But if you welcome heterodoxy and you give—you entertain suggestions and comments from people outside of the orthodoxy, it becomes obvious over time that you’re tolerant and welcoming of outside comments. Then when you reject some, they won’t be taken as being just dismissive and being told to shut up; they’ll be taken as “Well, they thought about it and they rejected it. That happens to a lot of people.” And that’s basically my solution.
California Assembly Bill 2098 and the Death of the Doctor-Patient Relationship [13:08]
Bob Zadek: Your article caused me to immediately jump to the lesson from the Nobel Prize-winning economist James Buchanan with his discussion of public choice. And the point I’d like to make, and it’s an obvious point but often lost, and that is that government lies to us. Now, not government lies all the time, not government is per se mean-spirited, but government has its—collectively, the humans who are government, they are driven by the same human frailties, the same drive that those in other segments of society are. They want to get raises, they want to get promotions, they want to have more power, they want to be respected, they want their kids to be proud of them. Now, but sometimes you make mistakes. Now, in government, government has the power to suppress speech that those in other segments don’t have. So if we just say government doesn’t get the benefits of any presumption—it is a point of view of a human being who made a personal decision to have the government be his or her employer. That’s all we know about Dr. Fauci or Rochelle Walensky or all of the others. We know they made an employment decision to work for the government. Do not give—if we simply don’t give government any presumption that we are not willing to give to everybody else, that’s an important lesson. Government simply carries guns; they’re not smarter.
Now Jeff, where what really got me in a dither was when you pointed out what’s going on in California, only because it is the most frontal attack—I know there have been many others and you have taught our listeners about it—where government invites itself into your consulting room when you are with a patient. The government is right there monitoring what you say and ready to yank your license if you don’t toe the line. We’ve discussed that in other shows; we may come back to it. But here is the most, dare I say, blatant example. And California is in many ways the first to do bad things, and then other states say, “I never thought of that, let’s try it.” So those of you in the other 49, don’t you dare get smug. “Ah, it’s only California.” So Jeff, tell us about how you scared the heck out of me with what you pointed out to me about legislation that is, by the way, actively being considered. It’s not some lunatic backbencher who is claiming some press. This has captured the attention, so this has a chance of being law. So tell us, scare the audience and make them as unhappy as you made me.
Dr. Jeffrey Singer: I actually read about this on a post on Bari Weiss’s Substack site, and it was a post by Professor Jay Bhattacharya at Stanford. He says that—I’m going to quote it—according to California Assembly Bill 2098, which is being authored—was authored by Assemblyman Evan Low, it’s currently making its way through the California legislature, and physicians who deviate from an authorized set of beliefs would do so at risk to their medical license. It’s motivated by the idea that practicing doctors are spreading, quote, “misinformation” about the risks of COVID, its treatment, and the vaccine. It declares that physicians and surgeons who, quote, “disseminate or promote misinformation or disinformation related to COVID, including false or misleading information regarding the nature and risks of the virus, its prevention and treatment, and the development, safety, and effectiveness of COVID-19 vaccines”—this is from the legislative language—“shall be subject to disciplinary action, which could result in the loss of the doctor’s medical license.”
Bob Zadek: Now translate that from what you just read. Here you are, Jeff, you have a license to practice medicine, without which you’re breaking the law. What does it tell you as a practicing physician? What are physicians who read that saying to themselves about how they inform their patients?
Dr. Jeffrey Singer: It tells me that, for example, if I’m a California doctor and I go on—and the governor says that all everyone under the age of 12 must have a vaccination in order to be able to be admitted into a public place, they should have to show proof of vaccination. And I’m interviewed by a local TV station in California and I say, “Well, the risks of COVID, the fatality rate for children under the age of 18 is close to zero, and almost every one of those fatalities—and that’s under the age of 18—and almost every one of those fatalities involves some serious pre-existing condition like leukemia. And so a strong case can be made for not getting vaccinated if you’re under the age of 12 because we don’t know that there are reported cases of myocarditis, particularly in males, and I can understand you saying ‘I don’t want to take that chance with my child’ when my child’s really not at any significant risk of dying from COVID, and we already know from the way the vaccines wane over time, their effectiveness wanes, they don’t prevent spreading COVID. I don’t think that’s a—that was a wise idea to require that everyone under the age of 12 must be vaccinated in order to enter any public place in the state of California.” For saying that, I guess I could be—I could have my license revoked. So what I would therefore do is not say that. I’d be afraid to say that because I don’t want to see my career destroyed. So there’s an example.
The Digital Age and Information Control [15:53]
Dr. Jeffrey Singer: Okay, and if there’s anything we’ve learned over these last three years now—I knew this anyway as a doctor, but a lot of the general public may not have appreciated it until now—is that medical science is not a dogma. In fact, our understanding of things—we’re learning almost continuously, and our understanding of what works, what doesn’t work, what’s going on, what isn’t going on—is changing on an almost daily basis. So that when you basically—even assuming that the understanding that we have today is correct, and in the context of what we know today, if you take that and make that code by putting it in concrete, by casting it into law, then tomorrow when our understanding changes—which didn’t mean we were wrong yesterday; we were correct given the information we had, but now we got more information, so our understanding changes—now we’re stuck. It doesn’t matter that our understanding changed. What we understood yesterday with that information is what we have to follow unless we amend the law. So even aside from the rights aspects of this, the right to free speech, etc., but just from a practicality standpoint, how could you be dumb enough to freeze a moment in time’s understanding of a scientific issue and say “This is the truth”? And then tomorrow when we say, “Oh, I didn’t know that, okay, then it’s not really that,” now we got to go back to the legislature to say “The truth needs to be updated.” That’s crazy.
Bob Zadek: I started the show with reference, your reference, to the so-called elite. Now, what is happening broadly in our country, perhaps in the world, is that government is telling us collectively: we are incompetent to make decisions. We at the core—voters, citizens, patients, clients of lawyers—we are incompetent to make an independent decision in whom to trust our medical health. We pick a doctor, but we’re not competent. The doctor is incompetent. I.e., the only source of competence is the government, and we are dependent upon the government, not on ourselves, not on each other, not on the professionals we hire. And it’s to me, because of my psychology perhaps, the lesson by my government that I am not competent to run my own affairs, and the government must control whatever information I have access to. That’s what caused me to have the profound personal reaction that I had to your piece. Jeff, end on a high note. Are the physicians as a group reacting in any way to this effort in California and perhaps elsewhere, or are they in general either concerned about bad publicity, concerned about what might happen to the licensing regime, or are they as a group—and it’s hard for you to speak to that as we close—or are they simply unaware of it at the moment?
Dr. Jeffrey Singer: I wish I could give you a good answer to that question because I’d like to end on a high note, but I’m not—I don’t know how many people are aware of this. I’m not sure if the California Medical Association has taken a position on this or not. I think not only should the California Medical Association oppose this, but everyone who’s concerned about the right to free speech, the right to hear other opinions, and also concerned about scientific progress—because shutting down discussion shuts down progress—they need to speak out against this. This is just the latest example of efforts that have been underway for quite some time to shut down heterodoxy. Now, the high note of this is I think the digital age makes it impossible to stop heterodoxy. You cannot prevent people from getting access to information, and as you try to put roadblocks in, clever people will find workarounds. So that’s the high note.
Bob Zadek: That’ll have to do, and thank heaven that Galileo wasn’t dependent upon government grants. We’d be in a much different place. Thanks so much to my dear friend, Dr. Jeff Singer, for his information and highlighting us as to what’s going on as we sleep quietly in our beds. That’s what they are doing to us or threatening to do, and we must stop them. Jeff, thanks so much. Thank you to my friends out there and enjoy the rest of this weekend.