Science and social policy problems: resolution of some, creation of others.

The scientist has two jobs: to do good science, and to be a spokesperson for science in the creation of rational social policy. Three categories of interaction between science and policy are described and examples given. The first is where science has provided data that were decisive in causing policy to be enacted. The second is where science is capable of resolving equity issues that have arisen from problems that science itself created. The third is where the issues are ultimately resolved by extra-scientific considerations. Two major issues where it is hoped that science can make a significant contribution include outcomes analysis, a new approach to dealing with health care costs and variations in clinical practice; and the disease concept of alcoholism, with questions it raises of volition, personal responsibility, and punishment. However, science alone is never the dominant force in the shaping of policy, which is determined by the interaction of many social forces, such as morals, values, politics, and economics.