As I read Mark Henderson’s new book “The Geek Manifesto” I found my mood alternating between enormous optimism and nagging pessimism. Perhaps this is spot on for a book that seeks to inspire geeks (and I would count myself within this group) to action; at times it is inspiring, at others the challenge to make a difference seems overwhelming. But while in some senses the book covers familiar ground, it does an excellent job in bringing together material and arguments in a form that is clear and inspiring. As I read, there were some broad issues that I kept returning to. These aren’t criticisms of the book, as such, but areas were I think there is some room for further reflection and debate.

  • Science or evidence? A key thrust of the argument in the book is that policy-making should be better informed by assessment of the evidence, and Henderson is careful to remind us on a number of occasions that this evidence often stretches beyond the boundaries of the natural sciences. The word ‘science’ is often, though, used as a shortcut for ‘evidence’ and there is a risk that some will take this shortcut seriously. Similarly, the importance of factors beyond the evidence in guiding political decision-making are mentioned, but the take-home may again be that science trumps everything else. And there is certainly a strong thrust through the book that the scientific method is centrally important, especially in the guise of randomised trials. While I don’t disagree that there are opportunities to use these approaches more in public policy, it is also important not to discourage other types of analytical approach (qualitative social science, or historical analysis, for example) and to avoid developing a false hierarchy of approaches to evidence.
  • Ethics. This is a book about ethics in the sense that it is concerned very much with ‘doing the right thing’. For me, a strong utilitarian ethic underpins the argument suggesting that we need to formulate policies that are in the interests of the majority. I am sympathetic to this argument, but I think it is important to acknowledge that there is considerable debate about this ethical approach and it is relatively easy to construct scenarios where a strict adherence to utilitarian ethics raises real dilemmas. Alternative ethical approaches, like rights-based ethics, would take a rather different approach to many of the issues covered. For example, should people have the right to choose homeopathic treatment if that’s what they want? I think we need to open up debates like this, which sit uncomfortably with the strict evidence-led approach.
  • Evidence-based science policy. A really important point that Henderson stresses, but that bears repeating, is that it is essential that the geeks are themselves always strictly evidence-led. Nowhere is this more important than in the field of science and innovation policy, where we need to be zealous in demanding the highest quality evidence to inform policy. And implicit in this, is that we need to follow the evidence even if it disagrees with our preconceptions and prejudices. This is, after all, what being evidence-led is all about. I am not convinced that the scientific community is always as open to evidence about its own practice as it ought to be. I also wonder whether the research community would be supportive of randomised trials if, say, the Research Councils were to suggest that a new policy approach would be applied to a random sample of research grant applications to investigate how well it worked. But maybe I am wrong about this.

Overall, I would strongly recommend “The Geek Manifesto“. It’s a good read, very thought-provoking and an excellent contribution to the debate about evidence and policy.

I will be debating these and other points with Mark Henderson, James Wilsdon and others on Tuesday 29 May at the Science Policy Research Unit in Sussex University. Come and join in!

No one can spend very long learning about life science without hearing about HeLa cells, but the story behind this cell line – where the cells came from, why they behave the way they do, and even why they have been so useful scientifically and medically – is more of a mystery. It is this story which Rebecca Skloot (@RebeccaSkloot on twitter) tells in The Immortal Life of Henrietta Lacks.

I approached this book with high expectations, given the praise and awards it has received. And on one level I was not disappointed. The human story of Henrietta Lacks and her family is compellingly told and the fortunes of Henrietta’s immortal cells are drawn into sharp contrast with those of Henrietta herself and her descendents. The book also contains some fascinating portraits of the scientists and clinicians involved in the story. It would have been very easy to portray these (mostly) men in a negative light but Skloot manages to strike a balance between their laudable motives, the influence of business and an often amazing lack of concern for the donor of the cells and her family. The story of the scientists is a vignette of the complex motives that underpin research, a case study to disprove the idea that research is a cold, objective activity carried out in isolation from the pressures of the world.

I also think Skloot deals very effectively with many of the complex ethical issues surrounding the use of human subjects and tissues. The lack of appropriate regulatory safeguards as the new research into human cell lines developed is striking, especially given the tight restrictions on using human tissue and the requirements for consent that now operate. On one level this is shocking but also reflects the challenges of ensuring that regulation keeps pace with technological developments. And I couldn’t help but have slightly mixed feelings on this point. Would the research have progressed so quickly and effectively had there been a comprehensive and effective regulatory system in place? Of course we can never know, but given the apparently unique properties of Henrietta Lack’s cells, had she or her family refused consent many of the benefits that came from the research would have arrived much more slowly. These are complex ethical questions.

There is much to enjoy in this thought-provoking and well written book. But I can’t help thinking there is also a missed opportunity. I was disappointed not to learn more about the science of HeLa cells. What is special about them? How have they been used in research? What are they telling us about how non-cancerous cells divide and grow? Issues like these are not explored in any detail: for me the book over-emphasises the human story, interesting and compelling as it is, without providing enough of the science. This is just a personal preference, though, and I would certainly encourage anyone who is interested in the relationship between research and society to read this book.

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