Psychology as an academic discipline in the last twenty years seems to have exhibited – I write as an external observer – two very different tendencies. The first has been one of general rapprochement among both experimentalists and clinicians. Theoretical rivalries have been muted, psychologists originally educated in very different milieus into very different standpoints have drawn gratefully upon each others' work, and even when controversy has been extended, a will to at least minimize disagreement has been evident. It is an interesting question how far this represents the outcome of rational progress in a unified science and how far it is a phenomenon to which social psychologists themselves should direct their attention. Perhaps it can mostly be explained by Heider's balance principle, by Festinger's theory of cognitive dissonance, by attribution theory, or by a mixture of all three. But happily I am not going to be concerned here with this tendency but with its counterpart, the persistence of an implacable will not to be assimilated, not to join the psychological melting pot, on the part of two groups of theoretically partisan psychologists: those who follow B. F. Skinner's prescriptions, and those who constitute the central tradition of psychoanalysis. My main concern will be with Skinner's work, and I shall be using psychoanalysis to illuminate it, rather than vice versa.

What I shall be arguing is that Skinner's work, when contrasted with psychoanalysis, reveals – in a way that is quite contrary to Skinner's own intentions – the ineliminability of philosophy from psychological science.

Each year, numerous committees of the National Academy of Sciences (NAS) provide policy-relevant scientific information in an apparently competent and reasonably disinterested manner, with only occasional charges of gross error or bias (Boffey, 1975; Schiefelbein, 1979). Thus for certain policy decisions which should be based in part on accurate technical information, adequate technical advice is obtainable if the pertinent questions fall within the state-of-the-art of our science. Increasingly, however, we see disputes between experts over the accuracy of scientific information. Usually these are complicated arguments, beyond the training of policymakers, so the only people capable of fully understanding them are other experts.

Experts involved in these disputes often have vested interests; for example, they may represent particular corporations, government agencies, or citizen action groups. It is by now well recognized that these experts' positions on what appear to be purely scientific points are correlated with their positions on related policy issues. Thus, scientists who oppose nuclear power calculate higher risks of cancer from a given level of radiation than do scientists who favor nuclear power (Mazur, 1981a).

These scientific disputes produce a clear dilemma for the policymaker. How does one make use of the expert's special knowledge without submitting to the expert's biases?

There are solutions to this problem that are currently being employed. A policymaker with personal biases may selectively depend on experts with similar biases. Or, one may simply ignore the scientific dispute, making policy on other bases, as when the courts adjudicate environmental suits on the grounds of whether or not a government agency has followed proper procedure, as specified in its enabling statute (Bazelon, 1979).

The nuclear power controversy in the United States is not very visible these days, but this is not because it has been resolved. The industry is still there, along with its effective lobbying organizations, such as the Atomic Industrial Forum, and so are the vigilant antinuclear watchdog groups, such as the Union of Concerned Scientists. They still descend upon the Nuclear Regulatory Commission (NRC) every time a new safety standard is proposed and they still slug it out in the courts over each new operating license. But lately these battles have failed to arouse the public or attract the news media to the extent that they did just a few years ago. Nuclear power's proven potential – to electrify public controversy – is still there, to be sure, but the controversy is in abeyance and it may remain so for some time to come.

This waning of public concern over an issue that so exercised us only yesterday is a remarkable phenomenon, for the technological risks that focused the controversy in the past – the risk of accidents and careless regulatory oversight, the risk of proliferation of nuclear weapons, and the risks to future generations from the accumulation of radioactive waste – have not changed significantly. The accident at Three Mile Island resulted in some changes in operating and regulatory procedures aimed at improving safety, but any reassuring effects of these changes are offset by other events. The Republican administration of President Reagan is pledged to help the nuclear industry and especially to relax and speed up licensing procedures.

The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research (the “National Commission,” for short) was set up in 1974 by the U.S. Congress as one of the provisions of the National Research Act, P.L. 93–348, and its members were sworn in during December of that year. The primary part of the commission's formal agenda comprised a series of questions about the ethical requirements to be insisted on as conditions for the federal funding of research projects involving human subjects who were recognized as belonging to certain especially vulnerable groups. (Three or four other more or less peripheral items were added to this primary agenda, but I shall not discuss them here.)

Because the public controversies that preceded the establishment of the National Commission, in the aftermath of the U.S. Supreme Court's abortion decision, had been excited by horrifying press reports about scientific experiments on human fetuses, that was the group of vulnerable research subjects whose protection the National Commission was instructed to consider first, and a four-month moratorium was imposed on federal funding of fetal experiments while the commission dealt with this first task. Subsequent groups of vulnerable subjects consisted of young children, prisoners, and “the institutionalized mentally infirm,” to cite the idiosyncratic language of the Act. Incidentally, the National Commission was also instructed to report on the ethical requirements relevant to the performance of psychosurgery. The reasons for this addition were evidently political.

Scientists have participated in a remarkable number of controversies during the past few decades. Some of these controversies revolve around technology. Legislation to control the environmental and health risks of technology calls for decisions based on “the best scientific evidence.” Government efforts to regulate advances in technology thus engage scientific experts in lively debate over the interpretation of data and the dimensions of risk. Other controversies relate to science itself. The disputes over recombinant DNA research, animal experimentation, in vitro fertilization, or fetal research have inevitably engaged scientists in political activism to protect their own interests.

Still other disputes, including many of those discussed in this volume, have little to do with science or technology at all. Abortion legislation, the decision to ban Laetrile, and the classification of homosexuality by the American Psychiatric Association as a mental disorder are fundamentally ethical, moral, or political issues. Yet, here too science is consistently invoked as the disputes unfold, reflecting the increasing tendency to rely on scientific standards as a basis for legal and policy decisions. Indeed, science is a political resource, called upon as a source of rationality and a basis of consensus in a wide range of policy areas.

Although access to expertise provides a means of legitimating decisions, it can also provide the ability to question them. Thus, controversial public policy questions invariably seem to evolve into scientific disputes, and difficult ethical dilemmas translate into debates over the adequacy and interpretation of evidence or the appropriateness of scientific methodologies.

In writing constitutions and framing governments, the authors focus on the structure of governments (i.e., which institutions and offices of government will be formed), the powers assigned to those who will govern, the limits to be placed on rulers, and rules or criteria for reaching official decisions (e.g., that the “majority rules,” or that a presidential veto of a congressional action will stand unless two-thirds of the Congress votes to override the veto).

In the United States, particular attention has been paid to the rules for reaching official decisions. These rules have been a topic of debate or discussion since the original debates over the U.S. Constitution. In characterizing the traditions of American liberty, John P. Roche notes:

These rules of decision making providing for “procedural consensus” are not designed to dictate specific substantive outcomes; instead, they are meant to formulate a process that will ensure fair, equitable, and “democratic” outcomes.

The process specifies the mechanisms that will be employed by political and organizational actors in their official interactions.

The Laetrile controversy is an excellent example of a controversy that raises fundamental questions concerning the relation between the individual and the state. Despite the overwhelming evidence that Laetrile is of absolutely no use in the treatment of cancer, many individuals continue to believe otherwise and are vigorously pressing their claim to be allowed the use of Laetrile. From their perspective, governmental bans on the use of Laetrile represent one more instance of a powerful state imposing its views on citizens who hold minority views. The freedom to use Laetrile becomes a civil rights issue. From the perspective of most of the scientific community and from those in the Federal Drug Administration (FDA) governmental bans on the use of Laetrile represent one more way in which the government legitimately protects vulnerable citizens against fraudulent claims used by peddlers of quack cures. To them the ban on Laetrile is part and parcel of the legitimate use of the police power, and the civil rights claim is just a smoke screen to protect the use of fraud.

It seems appropriate to step back slightly from the concrete details of the Laetrile controversy and to examine the more fundamental issues that it raises about the relation between the individual and the state. In what follows, I briefly outline and explain the advantages of a certain approach to political and social issues, an approach that I call quasi libertarianism, because it is an attempt to retain the many strengths of the libertarian position while avoiding some of its obvious weaknesses.

It is generally presumed that whatever merits or demerits the judicial process may otherwise possess, that process is superior to scientific debate as a process of obtaining closure in that it provides a precise, definite, and final conclusion to any controversy, within a defined time, and according to a generally understood and formally delineated procedure. It is for this reason that plaintiffs seek resolution of disputes through litigation rather than through academic debates, constitutional conventions, or the vagaries of some other less well-defined processes. The notion that a lawsuit will inevitably lead to the formal resolution of any scientific issues that litigants place before the court is, however, fanciful. It supposes a very narrow view of judicial conduct and the judicial decision-making process: It assumes that the court can, and will, weigh scientific arguments that are cast in an adversary model and then simply declare a winner.

As others have suggested, such a model would not provide an adequate way to resolve scientific disputes, even if the judiciary were willing to undertake such efforts. Fortunately, the courts have generally recognized their inability to impose solutions to scientific questions. Instead the American judiciary has generally perceived its role as one of maintaining the integrity of the technical decision-making process by requiring those institutions better able to resolve matters of science to do the careful and adequate scientific work necessary for their resolution.

In participating in the Laetrile debate, the courts have been accused of attempting to step beyond the natural limitations of their competence and to resolve a scientific dispute.

Definitions of closure

Can ethical theory be employed to close or settle controversial moral problems? Could there be a policy or method for achieving closure on these problems? Answers to these questions depend somewhat on the sense of the term closure under consideration. Accordingly, I shall first discuss possible meanings of this term. I shall not, however, confine the analysis to the ordinary English meanings of the term, which often incorporate too many senses and fail to make distinctions important to philosophical argument. The term closure fails to distinguish, for example, between termination of controversy by final resolution and termination that stops short of either final resolution or truth. Accordingly, an analysis of the complex English usages of this word would in all likelihood prove fruitless.

My procedure will be the following: I first examine five distinct senses of closure. I then concentrate on the fifth definition, which is stipulative. I make no pretense that this fifth sense is either descriptive of ordinary English, or reforming (uncovering some deeper meaning), or the only important sense of the term. Stipulative definitions do not constitute profound philosophy, but both stipulation and comparison to alternative definitions can introduce clarity and reduce misunderstanding. These are my initial purposes. I shall then take the fifth stipulated understanding of closure and use it to develop a policy for achieving closure.

In all cases, closure is an outcome, not a process, for closure is the termination of a controversy. However, we cannot escape asking what processes lead to this outcome and, correspondingly, what the different senses of closure are.

The essays in this volume all address in one way or another the subject of closure in science, technology, and public policy. In some of these papers, the primary focus is on a theoretical or conceptual question: What types of closure are there? In other papers, the emphasis is on a historical or sociological question: What forms of closure have been involved in the termination of historical and contemporary controversies involving science and technology? The aim of this concluding chapter is first, to comment on the conceptual and descriptive accounts offered by several of the authors whose essays appear in this volume. A second, related task is to offer a reply to the following normative question: What types of closure should occur or are appropriate for bringing an end to different types of controversies?

Before that normative question can be tackled properly, a systematic review of the papers would have to yield clear answers to this series of prior questions:

1. What are the different types of controversy for which closure has been sought or in which termination has occurred?

2. What forms of closure (resolution, termination) can be identified?

3. Which of those forms of closure have in fact occurred in particular historical and contemporary instances of controversy, as described in the answer to question 1?

4. What pattern, if any, defines closure reached in debates or disputes in each of the categories of controversy listed in answer to question 1?

5. Where such patterns can be identified, do they shed any light on what type of closure people have thought to be appropriate to different types of controversy?

6. […]

In 1973, after several years of bitter dispute, the board of trustees of the American Psychiatric Association (APA) decided to remove homosexuality from the Diagnostic and Statistical Manual of Psychiatric Disorders, its official list of mental diseases.

Infuriated by that action, dissident psychiatrists charged the leadership of their association with an unseemly capitulation to the threats and pressures of gay liberation groups and forced the board to submit its decision to a referendum of the full APA membership. And so America's psychiatrists were called to vote upon the question of whether homosexuality ought to be considered a mental disease. The entire process, from the first confrontations organized by gay demonstrators at psychiatric conventions to the referendum demanded by orthodox psychiatrists, seemed to violate the most basic expectations about how questions of science should be resolved. Instead of being engaged in a sober consideration of data, psychiatrists were swept up in a political controversy. The APA, according to its critics, had fallen victim to the disorder of a tumultuous era in which disruptive conflicts threatened to politicize every aspect of American social life. A furious egalitarianism, which challenged every form of authority, had compelled psychiatric experts to negotiate the pathological status of homosexuality with homosexuals themselves. The result was not a conclusion based on an approximation of the scientific truth as dictated by reason but an action demanded by the ideological temper of the times.

To those who viewed the 1973 decision sympathetically, psychiatry had displayed a remarkable capacity to acknowledge the significance of new research findings and to rethink its approach to sexuality.

Epidemiological studies are of limited value in detecting agents that can induce neoplasms. There are, however, a series of procedures that can be performed in high-risk populations that have the potential to identify carcinogenic and mutagenic chemicals in our environment. Here I will discuss the incidence of cancer in the workplace; the limitations of classical epidemiological studies; available relevant short-term procedures for detecting carcinogens or mutagens in the workplace; the Dow Chemical Company experience with these methods; and the reasons why they are not being routinely used in industry to screen workers for exposure to carcinogenic and mutagenic agents.

Cancer and the workplace

The prevention of cancer and genetic diseases, as opposed to their treatment, is based on three premises: (1) Cancer and genetic diseases are caused, in part, by exogenous factors such as chemicals in the workplace; (2) such factors can be identified; and (3) once identified, these factors can be eliminated, or measures can be taken to minimize exposure.

At the present time the debate is particularly active about how much our life-style causes or contributes to our overall cancer burden – that is, how much our personal habits (including nutrition, smoking, and alcohol consumption), as opposed to factors not under our personal control (such as air pollution, food additives, and the occupational environment), contribute to the development of cancer.

Cancer is a disease caused by many factors and such factors as smoking and occupational hazards can act in an additive or synergistic fashion with other elements in the genesis of a specific neoplasm.

One of the most remarkable features of the Laetrile controversy is its persistence. Although public attention and support of Laetrile treatment clearly reached a peak in the 1970s, Laetrile has a long and colorful history in the United States. Attempts to resolve the controversy surrounding it have been numerous and strikingly unsuccessful. In 1953 the Cancer Commission of the California Medical Association issued a document that concluded that “no satisfactory evidence has been produced to indicate any significant cytotoxic effect of Laetrile on the cancer cell.” Ten years later the Cancer Advisory Council to the director of California's Department of Public Health issued a report that found that Laetrile was of “no value in the diagnosis, treatment, alleviation or cure of cancer.” Upon the council's recommendation, in 1963 the California Department of Health banned the treatment of cancer with Laetrile.

Agencies of the federal government have also attempted to bring closure to the Laetrile controversy. As early as 1960, the Food and Drug Administration (FDA) conducted seizures of Laetrile and banned its shipment in interstate commerce. The FDA's right to regulate Laetrile was, however, challenged in a series of court cases in the late 1970s. As part of that controversy, the FDA commissioner, in a lengthy 1977 decision, ruled that Laetrile is not generally recognized by qualified experts as a safe and effective cancer drug and that it is not exempt from FDA regulation. Despite this decision, a judge issued a permanent injunction forbidding the FDA from restricting the importation and use of Laetrile.

Why study controversy?

Widespread public controversies involving science and technology have been a prominent feature of American public life since World War II. At first these controversies were concerned mainly with military technology: fallout, the test ban treaty, the antiballistic missile. More recently, controversies have developed over civilian technology (nuclear power, the supersonic transport) and even over the conduct of scientific research itself (race and IQ, molecular biology). These controversies have contributed substantially to public awareness of the increasing role of science and technology in modern societies and have quite naturally become the subject of scholarly research. Indeed, case studies of particular controversies provide an important part of the literature of the new academic field of “Science, Technology and Society” (or “Science and Technology Studies”). After a decade of such research, it is important to reconsider the question. Why study controversy?

One motivation for such case studies is fairly clear. It is obvious that science and technology interact with other components of society in many important ways, but the nature of these interactions is elusive. However, the points of interaction tend to be obvious in the context of specific controversies. Moreover, the record is mostly public and easily accessible. Major controversies, then, can be regarded as a microcosm in which the interactions between science or technology and the rest of society can conveniently be observed and studied.

Although the literature is dominated by case studies, there have recently been several attempts to move beyond the particular cases toward more general accounts of the nature and dynamics of controversies involving science and technology.