Which US Presidential Candidate is More Anti-Science?

Prasad and Cifu debate the question. Their arguments offer readers a chance to stop and think. I insisted that they make their case in less than 500 words. (You are welcome.)

Hi everyone. It is John. I am allergic to political discourse in the public sphere but Adam and Vinay are not. The question for this column is which candidate for US president is more anti-science?

I agreed to introduce this debate for two reasons. First, Sensible Medicine is a place dedicated to medical reasoning, which cannot be unwound from science. Though medicine is not all science, you cannot be an effective clinician without appreciating the fundamentals of science. You also cannot be effective if emotions regarding policy and politicians leak into the exam room. This column, therefore, is an exercise in thinking.

The second reason I introduce these essays is that both authors are persuasive writers. So, if nothing else, what follows is a lesson in (short) writing.

I posted a poll at the end of the column. Please participate. But, please, keep the comments well argued and free of vitriol. I side strongly with one of these essays. And…Adam and Vinay are good friends who happen to disagree on many things. That is normal.

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Here is Adam Cifu

No politician “follows the science.” He or she must balance economic, electoral, and many other factors with scientific truths in making decisions. Accepting that fact, Donald Trump is the more anti-science candidate for president.

I welcomed this assignment because I know what Dr. Prasad will argue. He will laud Trump for Operation Warp Speed. I also tip my hat to Trump for backing this initiative, though I think that faced with the COVID pandemic and the bleak economic outlook, any president would have acted the same. Dr. Prasad will note some of Harris’s essentially antediluvian COVID stances in hiring guidelines while ignoring that the most egregious COVID-control overreaches occurred while Donald Trump was president.

We are doctors, so he and I will be tempted to allow COVID policies to dominate our arguments. COVID is actually the least important issue here, so I will get it out of the way. A few reminders of how President Trump elevated politics over science. He famously said we would be done with COVID once warm weather arrived in 2020 – that’s what we wanted to hear. He pitched hydroxychloroquine and convalescent plasma, treatments that were unlikely to work and were already failing in studies. (I’ll ignore his spectacular statement on UV light and cleaning solutions). The greatest irony of Trump’s COVID policy was that after supporting Operation Warp Speed, he hesitated to fully endorse the COVID vaccine. Although science supported the benefit of the vaccine, his political supporters did not.

Let’s move on from COVID. The absolute difference in deaths between a perfectly and poorly managed COVID pandemic will be a blip compared with what we can expect to experience from climate change. Pandemics, even in pre-vaccine, pre-germ theory eras, come and go. Without concerted human efforts, climate change will only progress.

Trump repeatedly dismisses climate change as a hoax. He withdrew the United States from the Paris Agreement. Not only did he not act to thwart climate change, but he willfully rolled back the progress that had been made, cancelling environmental regulations designed to reduce greenhouse gas emissions. Behind his actions are supporters positioned for short term gain from the fossil fuel status quo. In contrast, a policy that faces the facts, works to prevent the worst changes, and prepares us for the inevitable ones, is good for the health and economy of our nation as well as that of our children (not to mention and grandchildren).

This article from 2021 enumerates the 112 environmental regulations that Trump canceled.

Deciding whom to vote for is a personal decision. One must consider a candidate’s stances on myriad issues, the importance of which each of us weighs differently. Our decision also involves our expectations for future challenges and how we expect candidates will respond to these tests. I am not so self-important as to tell someone how to vote. If a candidate’s commitment to science is something you consider, Donald Trump is the more “anti-science” of our presidential candidates.

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Here is Vinay Prasad:

Harris plans to continue Biden’s agenda, as such, there are 4 ways in which she is anti-science.

Public health policy

Harris will continue approving annual COVID19 boosters, including for kids as young as 6 months old, without randomized trials. Biden-Harris’ CDC recommends boosters even for people who have had COVID 4 times before.  Under Harris, by 2028, some kids will get 12 or more doses.  In contrast, nearly all European Nations restrict boosters to the elderly.  There is no evidence to support aggressive boosting, and it may be harmful. 

Furthermore, this administration just paid for more COVID19 tests  without data that these tests improve outcomes.  On boosters & tests, Harris will transfer public money to pharmaceutical and testing companies and not know if health is improved. 

Gender identity  

Although the Biden-Harris administration  opposes surgeries in transgender minors, they support hormonal blockers.  Yet, this recommendation lacks high-quality evidence, per the UK Cass report.  That document concludes,

There are many reports that puberty blockers are beneficial in reducing mental distress and improving the wellbeing of children and young people with gender dysphoria, but as demonstrated by the systematic review the quality of these studies is poor.

Adding,

It may appear surprising that the novel use of a drug for this purpose did not require a more rigorous drug trial. This is because of the way drugs are licensed and can be used off-label.  

Harris also supports individuals born as men but identifying as females competing against women in sports.  This may discourage women from athletics, with the positive downstream effects on college attendance and women’s role in the labor force, and such a policy appears fundamentally unfair given sex differences in athletic performance.

Affirmative action  

A diverse medical labor force is desirable, but the Biden administration’s Supreme Court justices rely on faulty data. In her dissent to a case striking down affirmative action, Ketanji Brown Jackson claims that white doctors result in nearly double the risk of death when taking care of black babies than black doctors. Sadly, the referenced paper did not establish that the black doctors were even seeing the black babies on the wards (rather than being unit director), and the effect size is implausible. Discussed at length on Episode 3.08 of Plenary Session.

On both issues of gender and diversity, Harris’s team routinely offers faulty or weak science in support of their pre-existing narratives, rather than objective appraisal of data.

Censorship

You cannot have science without free exchange of ideas. Harris’s deputy campaign manager was instrumental in government censorship of dissenting views during COVID19. Mark Zuckerberg recently wrote to congress:

A government that can force you, under penalty of loss of employment, to get a vaccine that does not halt transmission, and prevent you from criticizing them on social media is not only anti-science, but arrogant and dangerous.

For these reasons, Harris is anti-science.

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Here is the final poll.

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