Active and Passive Academic Freedom

Should the NIH consider Universities commitment to free expression as it gives out funds?

In a NYTimes op-ed by former NCI and NIH director, and Nobel Laureate, Harold Varmus, Varmus argues that future NIH director Jay Bhattacharya is wrong to tie NIH funding to academic freedom. He calls the plan “outlandish”

Varmus’ claim begs the questions: What is academic freedom? Is there a public interest to incentivize universities that honor it? How can the NIH practically consider it in grant giving?

I consider academic freedom to come in two forms: passive and active.

Passive academic freedom means that Universities should take no disciplinary action towards faculty based on their point of view or speech (as long as it is legally permitted), while active academic freedom means University should actively encourage debates and discussion on important, disputed topics, particularly those with relevance to ongoing policy decisions.

The reason we need universities to foster such freedom is to ensure the Overton window is wide, and faculty are free to offer unconventional ideas. We need this not because every bold idea will be correct, but because without this protection, many may self-censor, and we may miss out on some important ideas and truths, which is the central goal of the academy, the pursuit of veritas.

During the pandemic, both passive and active academic freedom were violated. Universities punished faculty who opposed masking children, lockdown, mandatory vaccination. These punishments included, removal from teaching duties, removal from administrative roles, and even academic censure.

Bob Harrington, Chair of Medicine at Stanford, told Eran Bendavid, an ID doctor, to stop speaking to the press with his view that school closure and lockdowns were misguided. Bob was rewarded by being promoted to Dean of Cornell. Eran went silent.

Scott Atlas, a radiologist, underwent academic censure for stating that kids should not wear cloth masks, that covid-19 posed low risks to children, and that school closure was misguided.

Pre-pandemic, Norman Wang was an electrophysiologist (EP) at University of Pittsburgh, who ran the EP training program. He was removed from this duty when he wrote a peer-reviewed article in the Journal of the American Heart Association arguing, broadly, that race based preferences in medicine admissions and hiring decisions were misguided, counterproductive, possibly illegal, and ultimately unhelpful. Wang’s view would later be validated by the US Supreme Court. Wang was punished for holding this view, and not allowed to direct the electrophysiology fellowship.

There are many other examples cataloged by FIRE — foundation for individual rights and expression group, which ranks universities based on their commitment to passive academic freedom.

On the issue of active academic freedom, universities failed even more spectacularly. There were no debates on school closures, masking children, vaccine mandates, and other health policy of incalculable significance at major universities, including Johns Hopkins, Harvard, or Stanford. These discussions were simply not held.

We did not have debates about whether children should return to school in the fall of 2020, whether vaccines should be mandated, and whether community masking should be mandated. Podcasters filled the role that Universities should have.

To my knowledge, no group ranks active academic freedom, but some institutions are better at it than others. I think of Princeton’s commitment to encourage debates on controversial social and political issues, as an example.

Some argue that for settled matters debates create the false idea that both opinions are valid. We should never have a debate for instance on whether smoking is bad for you— of course it is bad.

And yet, I am inclined to think that the far more dangerous error would be, just as often it is in medicine, early closure. I won’t debate that smoking is good for you— of course, I also agree it is bad and avoid tobacco products, but years ago I heard a Harvard professor say that “every oncologist should counsel every lung cancer patient to quit”. I found it absurd to imagine that I would tell a person with, for instance, extended stage small cell lung cancer on topotecan to stop smoking, if cigarattes brought them pleasure. My patient has 4 months to live. There is no evidence that quitting smoking will increase that to 5, and who am I to tell a dying man what pleasures to seek in last moments of his life? I would happily debate this, modified proposition, and in fact go further, defending the strong proposition: it is a mistake to tell a patient with metastatic lung cancer to quit smoking.

In the case of COVID-19, it is clear that the Overton window was wrongly sealed shut. We weren’t allowed to speak honestly about masking, vaccines and the lab origins at my university and many others.

Now, let me turn to the central question posed by Dr. Varmus: Is there a public good to incentivize universities to honor academic freedom, and should NIH grants consider it?

Yes, just as there is a public value to funding science, and ensuring universities follow title IX (don’t engage in discrimination), there is a value to ensuring they passively and actively promote academic freedom.

And yes, just as NIH grants currently consider the university’s ability to provide lab space, and central core laboratory facilities, NIH grants should consider a university’s ability to provide an environment of open inquiry. FIRE rankings or a modified alternative may serve as a starting point. Creating an NIH hotline to report instances of academic freedom being threatened, perhaps anonymously, would also discourage universities from these actions.

In short, there is nothing “outlanding” about Jay Bhattacharya considering academic freedom alongside other facilities and opportunities present at universities in deciding whether federal funding should be invested. We already ensure universities treat women fairly, lest they loose funding. We already ensure universities have the physical space to conduct the work that is being funded. We now ask only that universities offer the intellectual environment that is conducive to free and open thought. That is not only in the interest of universities, it is directly in the public interest as well.