A framework to guide policymakers on the use of science to inform public health policy and law: Immunisation as a case study

Abstract

This thesis examines the incorporation of science into public health policy/law. The key problem that the thesis tackles is the blurring of science and values arguments in the creation of policy/law. To overcome this problem, a decision-making framework is proposed that draws a distinction between arguments based on science and those based on values. The framework suggests categorising science as information obtained by adherence to the scientific method. Values, then, are those legally protected rights, freedoms and principles that do not follow scientific methodology. Examples include public health as a community value, informed consent, freedom of choice, and religious beliefs. The idea is that the acquisition of scientific knowledge through the scientific process provides the platform from which debate about values can begin. It is acknowledged that scientific methodology does not entail an absence of values, and the reality may be the separation is more of a continuum than two distinct groups. The shorthand labels (values and science) are used for functional purposes to describe the stages of the proposed framework. There are three stages to the framework. The first stage acts as a gatekeeper, preventing non-scientific components being confused with science. The second stage addresses values, particularly rights and freedoms protected by law. The third stage looks at whether a health policy option (which could involve new law) that restricts existing rights protected by law can nevertheless be justified. Examples relating to the immunisation of children are used to help describe how the framework could work when applied to a real-world public health policy issue.