Beyond evidence versus truthiness: toward a symmetrical approach to knowledge and ignorance in policy studies

Tackling the Unknown: Medical Semiotics of Inflammation and their Legal-Epistemological Boundaries in Brazil

Do different medico-scientific understandings of autoimmune inflammation, whose carriers disobediently promote the therapeutic use of immunostimulants, have the potential to destabilize the hegemony of the standard palliative treatment based on immunosuppression? Here I explore whether and how medical paradigms in Brazil develop and expand around immunopathologies through practices of exclusion and inclusion in the context of global circulation of knowledges, therapies, and regulatory frameworks. While focusing on concurrent immunotherapeutic models within biomedicine, I discuss aspects of legal-epistemological frictions that animate controversies in which distinct ways of co-producing medical evidence affect and are affected by the biomedical establishment.

Evidence, rationality, and ignorance: Agnotological issues in COVID-19 science

Two decades ago, Robert Proctor coined the term agnotology to refer to the study of ignorance that stems from scientific research. Amid the coronavirus disease pandemic, the world is witnessing the greatest natural experiment ever, and countries have adopted different response strategies. An evaluation of the effectiveness of different policies will play a valuable role in preparing for future public health emergencies. However, controversial issues such as the timing and pathways of viral emergence, the effectiveness of social distancing and lockdown strategies, and the use of antimalarial drugs as therapy have still not been fully resolved. This serves as a fertile breeding ground for agnotological strategies, whereby scientific studies are deliberately or unintentionally designed to create distractions or draw conclusions that are not supported by research findings. Researchers, public health authorities, and healthcare workers should be equipped to identify such agnotological strategies, distinguish them from scientific fraud, and avoid drawing misleading inferences based on an irrational adherence to hypotheses and a lack of criticism of implausible results.

Reframe policymaking dysfunction through bipartisan-inclusion leadership

Persistent policy failures have been examined in recent years with a focus on the role of political systems. We evaluate the growth of dysfunctional policymaking in the U.S. and propose a countering approach. Policy failures often reflect partisan policy stalemate, errors or unintended consequences, polarized extremism or imbalance, or partisan reversals with changes in power. Extremes in partisanship are not new historically, but growing policy failures due to negative partisanship have now severely damaged public trust. More "party blind" conditions in policy formulation may be able to renew a more productive social contract. We propose a disruptive presidential leadership approach of bipartisan inclusion to seek to reframe the partisan divides, counter negative partisanship and extremes, re-establish better policymaking interactions, and improve governance and policy outcomes. Dysfunctional policymaking has been attributed to Republicans and Democrats in a Prisoner's Dilemma. Iterated Prisoner's Dilemmas often lead to higher rates of cooperation, and similarly, historical policymaking included greater cooperation, but in recent decades the bipartisan norms of governance have substantially eroded. We describe three complementary explanations, which suggest that non-cooperative partisan policymaking has become self-reinforcing, and institutional changes to promote cooperation should focus on lowering the risk-adjusted cost-benefit ratio, making cooperation safer and more attractive for policymakers.