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December 06, 2010

No scientists on the ACMD? Blame David Nutt. And all those who kept quiet

Scientists have only themselves to blame for the government's proposal to scrap the requirement that the Advisory Council on the Misuse of Drugs contain scientists.

In a dispute over drugs policy a year ago, David Nutt abused his role as a scientific adviser. He got high-profile support from Colin Blakemore. And the rest of the scientific community kept their mouths shut.

I argued in the Lancet, "Nutt has overstated what the science tells us and other scientists have not stepped up to clarify the position. Consequently, science itself has become a passive accomplice in Nutt's campaign, undermining the integrity of science and the goal of evidence-based policy."

And I warned in Research Fortnight, "If every scientific adviser has to be treated as an unexploded bomb, then there can be only one result: fewer scientific advisers."

I'm not unsympathetic to the difficulties of Nutt's position and what he was trying to achieve (see my analysis in Prospect). But there are serious consequences to the decisions made by Nutt, Blakemore and the rest of the scientitfic community last year. Now the chickens are coming home to roost.

Already I'm seeing a flurry of comment suggesting that this new government is turning away from evidence-based policy. But we need to be more self-critical. If that is what's happening, then scientists have only themselves to blame.

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Ha, scipolicy "linkbait" much?

Ok, I'll kick off the "flurry comments" with one saying I broadly agree with you. Arguments for evidence-based policy are a lot stronger if, as you say, science is actively self-critical.

If people are going to use the "science is self-correcting life" the it does need to actively go about doing some of that correcting (and do it in public, I'd add).

(though before I get equally as trolled as I expect you to, I should add that I'm not sure about "scientists have only themselves to blame" - I think we can still complain about "spray on evidence" and the like)

@Alice Linkbait is a bit harsh! You know I have a lot on my plate. And anyway, the argument is all here, if sketchy.

If there's one article people should read, I would say it's the Research Fortnight one.

linkbait was a joke

Blame Nutt?

Tosh, bunkum & twaddle of the first water.

In haste:

I don't think it's fair to say that the rest of the scientific community kept their mouths shut. See names at bottom of this: http://www.senseaboutscience.org.uk/index.php/site/project/421

The argument wasn't really over the quality or otherwise of his actual advice - as you know it was about whether, if you have an expert appointed to provide expert advice, is it proper to dismiss him or her either for providing that advice, or for carrying on and doing their normal dayjob.

If the government has a problem with either of those possibilities, the correct way to address it is by trying to change the guidelines. For instance, they could say that advisers should not comment on issues which fall into the scope of what they advise on - and then we could have a debate about the role of expert advice an government.

CaSE's position would be that such a change is obviously absurd - you'd be left with either yes-men or people who don't really know what they're talking about.

Your point about 'unexploded bombs' is interesting. Here it's true because there are serious questions over whether government drug policy is evidence-based or not. But in another issue - say, vaccination policy - there isn't that problem.

The problem starts when politicians attempt to claim their policy is evidence-based, when it isn't. It would be far better for them to acknowledge that the evidence suggests one thing, but they have a right, as a democratically elected representative of the people, to take it into account but go a different direction. That would go some way to defusing your bombs.

So I would still say that the problem is down to politicians, not scientists.

Rather than baiting the scientific community in to your chosen style of perssonal attacks why not highlight the cases of "overstating the facts" you claim exist.

Scientists don't overstate facts, facts speak for themselves.

@Imran Whatever the argument was over, the statement from Sense About Science on Principles for the Treatment of Independent Scientific Advice that you refer us to, doesn't deal with it. It does not make a reference to the Nutt case, let alone take a position on it. So it's just another example of the silence I am criticising.

And I don't think your claim that "The problem starts when politicians attempt to claim their policy is evidence-based" can stand here. I'm writing from memory here, but I don't recall Alan Johnson going around claiming his policy was evidence-based. I think he just said it was what he'd decided. The conflict came when Nutt said *his* position was evidence-based.

@Neurobonkers - See either the Lancet or Research Fortnight pieces I mention.

Imran,

I agree that one of the key problems is politicians claiming to be evidence-based when they are not, but it's not the end of the debate and wa-ay too much of the post-Nuttsack discourse was dominanted by this.

You say the arguement wasn't over the quality or otherwise of advice, but rather the way you treat experts. Surely William's point is that you can't divide those two issues so neatly? Indeed, isn't that point made in bits of the principles you link to on SAS?

My comments were typed v quickly with lots of typos this morning, but that's what I was trying to say by arguing (a) it's not entirely science's fault but (b) if science is to argue that it can/ should be largely left alone because it is so very good at self-correcting, it really must publicly show it's ability to do so. Trust is earned.

Personally, I think there's a lot to be critiqued on all sides (as ever, it's only "scientific") and I'd hope the scientific community would be leading the way by talking an open and honestly self-critical stance on this.

Will come back with a more considered reply to the broader points later, but in brief, I think you're mistaken on the silence/Principles point, William. The first sentence on the page reads:

"Senior scientists and scientific advisers issued a statement on 6th November 2009 in response to the controversy following the sacking of Professor David Nutt, chairman of the Advisory Council on the Misuse of Drugs (ACMD)."

It was very clear to the signatories and to the politicians that the Principles were a reaction to dismissal of Nutt - hence the focus on academic freedom, independence of operation, and consideration advice. That clarity that would be the case regardless of whether the link was formally written down - even though it is, here.

@Imran OK. Well if we are supposed to read the Principles as a defence of Nutt as you suggest, then they just make the behaviour of scientists worse. It means the scientific community is endorsing bad behaviour - and simply makes me believe even more strongly in my arguments.

I'm not sure what the collective noun would be for 'scientists'. But it ain't a 'flock' . . .

I'm a bit confused - you were criticising scientists for being silent on the issue, and now for speaking out?

I think we have to separate "defence of Nutt" (in legality, and in science) from "reaction to dismissal". The Principles were definitely the latter, as outlined in the text I pasted.


Reaction to dismissal:

This is fairly straightforward. If you have an expert adviser, who isn't a civil servant but actually a career scientist, then you shouldn't be able to dismiss them based on what they do as a career scientist. Anything else dramatically reduces the pool of people willing/able to be advisers, and therefore devalues the advice given.

The Principles document was an effort to underline that understanding in the wake of Nutt's dismissal - prior to which it was taken for granted. It was accepted by all the people who signed it, and indeed eventually by Labour and by the new Coalition - so I don't think it's controversial.


Defence of Nutt (the legality):

There is a very simple question here over whether Nutt broke any rules or guidelines which warranted his sacking. To date, nobody has presented evidence on this.

You may suggest that, regardless of the lack of any such breaches, he was still wrong to do what he did, and therefore scientists shouldn't. This is a weaker case, but one still worth discussing.

I still don't think Nutt claiming that his policy is evidence-based is grounds for dismissal, as you may have been hinting towards. Otherwise are we saying that in this specific case, his academic - and indeed personal - freedom of speech has to be impinged on, because otherwise the media and public can use what he says to make an inference that govt policy is not evidence-based? Again, I just don't see it as "the scientists'" problem that govt policy doesn't make sense, they should still be able to go about their careers.

Defence of Nutt (the science):

I, and most commenters on this, are hopelessly underqualified to judge whether Nutt was right on the science. Indeed, that's part of the reason why we have scientific advisory committees and mechanisms.

*"therefore scientists shouldn't support him", in 2nd para under defence of nutt.

and the coalition and labour changed the Principles to weaken them when accepting them, but they still accepted the basic premises

Interesting discussion... In my view the problem wasn't so much the silence of the scientific community as their readiness to treat Prof Nutt as a martyr on the altar of 'evidence-based policy'. Nutt was seen as having been treated badly by the Home Secretary because he kept telling the truth about the lack of an evidence base for classification policy. Hence pressure from the science lobby to guarantee the ‘independence’ of independent scientific advice. But whilst Alan Johnson certainly handled this case badly, the argument that Nutt was badly treated has always seemed to me to be flawed.

Nutt wasn't sacked for doing his job. Nutt made his own position untenable by actively campaigning against Government policy whilst at the same time choosing to remain as a Government advisor. If Nutt wanted to tell the world that the Home Secretary wasn't following good scientific advice then the way to do it would have been to resign. It seems to me inevitable that the relationship between advisor and advisee would eventually break down if the advisor regularly campaigns against the advisee’s policy. The fact is few lessons can be learnt about arrangements for scientific advice from the fact that a breakdown of trust occurred between Johnson and Nutt.

Unfortunately, the lionisation of Professor Nutt hasn't helped us to have a sensible discussion about 'evidence-based’ policy. Much of the discussion which has followed seems to assume that there is an obviously 'evidence-based’ policy which is in opposition to current policy. Even Professor Nutt himself wouldn't go this far. And what has happened post-Nutt? Under pressure from the science lobby, a revised set of principles were issued by the Labour Government and later incorporated into ministerial guidance by the new Coalition Government. A victory for ‘evidence-based’ policy? Perhaps. But since then we have seen the demotion of a number of advisory bodies from non-departmental public body status, with uncertain implications for the independence of their advice, and now a change in the law which could lead to changes in the make-up of the Advisory Council on the Misuse of Drugs. It’s hard to know why exactly this is being done, and the ACMD is not a straightforward scientific advisory body – there is already a very big policy assumption made in the title of the body. Perhaps all the furore over the Nuttsack incident has achieved is to persuade policy-makers once again that scientists should be ‘on tap, not on top’.

I agree with @Kieron and @Alice. Will try and disentangle my thoughts about Imran's comments later today.

Interesting discussion. What I'd add is that plenty of senior figures in science *were* critical of Nutt -- Mark Walport is the best example. See for example quotes at the end of this pre-paywall piece of mine... http://www.timesonline.co.uk/tol/news/politics/article6899953.ece

Yes, lots of senior scientists piled in to defend him, but other very influential ones were sticking up for the principle of independent advice while being quite critical of the particular individual in this case.

@Mark Interesting point about Walport. I hadn't seen that quote before. He gets an honourable mention as someone who spoke out.

But were there lots of others? I agree that people were distant in private but @Alice's point stands, if scientists' want trust it has to be done in public, too.

For those with online access to Research Fortnight, my colleague Laura Hood is reporting on the government's moves at http://www.researchprofessional.com/#main$.Data.1014174$preview$1014042$aspect$Article$

@Kieron asserts that David Nutt "campaigned against the Government's drug policy". This is essentially part of the criticism of @williamcb as well.

It is flawed. This is why.

1) There is a code of practice for Scientific Advisory Committees with lots of rules for members and extra ones for chairs. There is an additional code of practice for ACMD with extra rules for Chairs.

Dvaid Nutt has never been shown to have breached any of those rules that the Government set and @kieron and @williamcb should clarify whether they believe he has. Alan Johnson was unable to produce an example when challenged.

2) Those codes of practice (recently updated) would prevent "campaigning against Government policy" if it needed to be sanctioned. the Government have decided not to have a code of practice that specifically and proactively restricts free speech and academic freedom.

3) What David Nutt did is publish academic research and opinion in journals and deliver lectures as any a Professor of Neuropsychopharmacology would expect to. That is his right and his job and his academic freedom to do so.

4) There is no where in the deal - and nor should there be - that says when you take an unpaid independent advisory position, you lose your academic and other freedoms.

5) If what you are allowed to publish as an academic is *dependent* on what the Government's policy is then you are not an *independent* science advisor. You are in fact *dependent*.

6) It is only called campaigning because of two factors outside David Nutt's control. First his academic work leads him to a different position to that of the Government (the same applies to the work of the Council). And second is that that difference is newsworthy and heavily reported by the press (often misreported - describing Nutt as speaking as Chair of the ACMD when he was specifically not).

It is not really "campaigning" to publish your work and have it reported in the press. It is passive public engagement turning to active public engagement when Nutt write opinion pieces in the media defending himself from media or political attack. Public engagement as opposed to retreat into silence is something we should applaud (I can hear @alicebell doing so I hope!).

7) Government shouldn't be allowed to have it both ways. They can't say both (A) and (B)

(A) "we seek and receive advice but we are big and bold enough to reject it and defend that decision on various grounds (political, economic, sending a message, etc) even though we expect the media and opposition to question us about it"

(B) "but if anyone who advises us differently then repeats that advice as an academic or as an adviser (with permission of the committee)and it is reported in the press so as it looks like we have not followed the scientific advice we will declare those people to be campaigning and sanction them even though they have broken none of the rules we set for them".

If (B) is allowed then advisers will be prevented from speaking to the opposition, to the press a=or to the opposition. That would be outrageous in a democracy.

...cont

*********************************

The scientific community rallied round the above argument, even if some were chary of making it too specific to David Nutt because of what David said *after* he was sacked, which was - rightly - critical of the Home Secretary.

Imran has very effectively demonstrated (I am proud of you my boy!) that @williamcb - even in his original post - is both criticising the scientific community for supporting David Nutt and also claiming the scientific community failed to support David Nutt!

Evan

As the person who proposed and help draft the principles, I can tell you they were very supportive and remain so, as evidenced by the resignations off the ACMD and the number who joined his new truly independent committee.

If you look at what David Nutt actually said in his lecture of October 10th 2009, as opposed to what people think he said, all he was saying was supporting what the ACMD had already argued.

see my post here.

As for the idea that scientists have only themselves to blame, you seem to be saying that we're damned if we do, damned if we don't.

If we give advice, see it ignored, and keep quiet - we get to keep our jobs. And being ignored.

If we don't keep quiet, we get sacked... from our job which was to be ignored.

Self-criticism is fine, self-flaggelation is not, this seems like the latter, especially since, as you say, Nutt was fundamentally right.

Sorry: my post is here: http://neuroskeptic.blogspot.com/2009/11/politics-of-psychopharmacology.html

Also notable that the government sacked Nutt for arguing in favor of a policy (cannabis should be Class C) that they themselves had put into law just 5 years earlier.

@Evan - I am an academic. I certainly see it as one of my roles to critically appraise Govt policy in the areas of my expertise. My expertise also tells me that inconsistencies, contradictions between means and goals are inevitable in public policy - I would see it as my role to highlight them so that they are out in the open.

However, if I were a senior advisor on drugs policy and I felt that the Government was ignoring the best advice then I would feel I had no choice but to resign (which itself would send a strong signal) and argue from my very privileged academic position about the shortcomings of the policy. What I wouldn't do is continually oppose the policy in public statements whilst continuing as a senior advisor on that policy.

You haven't addressed the issue of trust between adivser and advisee - instead you've created a bogus issue of scientific indepdendence and freedom of expression or put the blame on the media for misrepresenting Nutt, who was hardly publicity-shy. At all times Nutt was free to resign.

@Neuroskeptic - I am not arguing on the content of the policy - I tend to agree with Prof Nutt on that. But I prefer my policy to be made by elected, accountable officials.

"I prefer my policy to be made by elected, accountable officials."

So do I. So does everyone. However I think it would be even better if it were made by elected, accountable officials who were willing to have a serious debate.

The government is under no obligation to accept the ACMD's advice. But equally, the ACMD should be under no obligation to agree with the government's decisions.

As I said - all Nutt was saying was things that the ACMD had already advised. In his lecture, Nutt re-stated the ACMD's position, and the reasons for it, and offered some, remarkably mild, critiques of the government's justifications for not accepting the advice.

I find it hard to see how Nutt could have done otherwise. Was he to keep quiet and not say anything about drugs policy, in any capacity, until he left the ACMD? If so, a post on the ACMD would be the one job in the country that left you *least* able to discuss drug policy - hardly ideal.

Or was he to talk about drugs policy, but only discuss the issues where the government *did* take his advice?

From my point of view, most of this discussion is at cross purposes. @Evan's starting point is what happened before Nutt was dismissed. Mine was what happened immediately afterwards, in particular the way he framed the debate as one of science vs government, a frame the media mostly adopted.

The two aspects are related of course but as @Evan as said, even those who wanted to support Nutt were chary of what he claimed afterwards. So it would be quite possible to come to the conclusion that Nutt was justified in what he was doing before he was sacked while he was not justified in what he did afterwards.

Looking at the comments from @Evan and @Neuroskeptic, I don't think they are really tackling my arguments on the post-dismissal behaviour. On the other hand, I recognise I haven't fully tackled theirs on the pre-dismissal behaviour either. I will try and come back on that next week but broadly I agree with @Kieron. Looking at @Evan's reasonable list of points of principle, I wonder whether the ACMD would be better served by scientists who are not actively working on such central questions. This would eliminate most of the scope for conflict.

@Imran says most of us are incapable of judging whether Nutt was right on the science. The wariness is fine, but should not be taken too far.

In this case, what I wanted to get at was the "science" that Nutt said ministers were rejecting. The core of this turned out to be the Lancet paper he co-authored with Blakemore. When you read this, it is clear that while the approach is reasonable, it has a number of arbitrary elements. Using a similar methodology, others could well come to quite different conclusions. In other words, the results are not compelling.

This is what I put in my letter to the Lancet and I'm not surprised they published it because I don't think I was saying anything their own editors hadn't already concluded. They were the ones who included the limiting word "rational" in the title of the paper.

So what I'm contesting is not the "science" of Nutt's paper (though I don't accept the priesthood theory of scientists anyway), what I'm contesting is how much weight should be put on its conclusions. To be a reliable guide to this is really one of the key roles of a scientific adviser (and where of course I think Nutt fell down after his dismissal).

Finaly, there is my supposed incoherence in both criticising Nutt for stretching the science too far for political ends while sympathising with those ends. On this, consider a cop who fabricates evidence to convict a drug dealer.

Going forwards, I really do think it's a mistake to call the ACMD a scientific advisory committee. I don't know how, when or why it got onto that list, but in reality it has a very different job to the others.

Going back to the period before Nutt was sacked, I think we should start by describing what was going on.

Nutt was the chair of the ACMD. He also seems to have been one of if not the most senior scientist on the committee. In the committee's work developing a body of written evidence on the issues, he seems to have taken an active if not leading part. And when you go back into that evidence itself, it relies heavily on a paper of which he is the lead author.

So in my view, the ACMD had ended up being far too reliant on one man. Nutt would have been wiser to give up some of these roles, eg the chair or being so actively involved in the detail of developing the evidence. The guidelines ought to have safeguards against this and the Home Office ought to have raised this issue.

From this perspective, Johnson's problem was not just that Nutt was speaking out. It was that he had also become overmighty.

I'm afraid I don't think the merits or otherwise of Nutt's Lancet paper have much to do with it.

Nutt was not fired for writing that paper. In some ways, it would have been better if he had been, because at least that paper was fairly subversive in its conclusions i.e. if you believe it, it is telling us that current drug policy has nothing to do with drug harms.

But Nutt *wasn't* fired for that. Nor was he fired for his notorious ecstasy vs. horseriding editorial. he was fired for a lecture, in which he didn't say anything especially new, and his main point of contention was about whether cannabis ought to be class C or class B, a debate which, quite apart from anything else, is trivial because it makes virtually no difference to what the police or the courts in fact do.

I think Nutt was fired because his comments struck too close the bone: his earlier comments on the broad approach to drug policy were abstract enough to be acceptable, but when he (correctly) pointed out that the government had re-re-classified cannabis up to Class B for no especially cogent reason, he was fired, because that was a direct attack on a politically sensitive policy (Labour wanted to be seen to be 'tough', although, as mentioned, it actually makes no difference because the police and courts take a soft line on cannabis posession nowadays).

There's an interesting angle on all this - making the link with big pharma - that I missed before in comment at the bottom of this article http://bit.ly/3JAbmX

As the first person to call for Nutt to resign or for government to do it for him, I am fairly well qualified to comment. I kept data on Nutt for years before striking.

Nutt's behaviour BEFORE the XTC/horseriding comments was certainly inappropriate, given his position on the ACMD as then head of the technical committee. In his New Zealand Radio comments he tinkered with drug legalisation.

On the cannabis debate he has made very unscientific comments.

Professor Robin Murray, a real expert on cannabis and mental illness said Nutt had "played fast & loose with the statistics". This is strong stuff.

I have challenged Nutt more than once, in public and print, as to how he misrepresents the ACMD cannabis hearing. He bumbles incoherently and struggles to respond. I suggest he cannot respond.

He never says for example that the push for reclassification was led by the National Director of Mental Health, Professor Appleby.

Nutt never points out (in my hearing) that the ACMD itself was not united on classification.

There is another aspect to Nutt's behaviour.

In 2006, Nutt proposed making a replacement for alcohol, he did this in the Journal of Psychpharmacology (Editor D Nutt), he did it while holding a substantial shareholding in at least one pharmaceutical company who might have made his "Soma".

Another writer, Robin Room said (in terms) that creating the substance was not the problem, the problem lay with the lack of integration in the classification system between legal and illegal drugs.

Forthwith, Nutt, Colin Blakemore and others did their work on "an integrated scale of harms". Again markedly unscientific, it was done by "Delphic Analysis" with some of those asked failing to respond so unimpressed were they.

Nutt has consistently allied himself with the drug legalisation fringe.

He has publicly confessed to his own ilegal drug taking, (not cannabis he says).

He is of course free to hold any views and promulgate them.

Doing it from within the ACMD when his views were so much against public policy, decided by parliament, was wrong. He should never have been on the ACMD if he felt so strongly. A man of honour surely would not have been?

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