Prestige and Practicality: How Infeasible Policy Recommendations Can Undermine the Credibility of Scientific Expertise

Casey Petroff, University of Rochester

How do policymakers select experts to advise them on technical subjects when they cannot themselves understand the evidence those experts use? This paper examines policymaker-expert relationships using evidence from the early history of public health. It models the fundamental problem of expert-policymaker relations: policymakers, as laypeople, cannot directly evaluate the quality of experts’ predictions. Instead, they rely on imperfect signals – experts’ relevant prestige within the broader expert community and their own ability to translate experts’ advice into outcomes. Even if the fundamental quality of experts’ technical evaluation is sound, if policy outcomes that are not sufficiently effective given their costs, policymakers may choose to switch to a competing scientific theory. I use primary evidence from British parliamentary debates and a large database of medical history writing to examine the case of cholera in the 19th century. In the face of this novel public health threat, policymakers selected the most prestigious members of the medical community to advise them, and, on the basis of these experts’ advice, imposed national and domestic quarantines. However, due to imperfect implementation, the quarantine measures failed to prevent the arrival of infected cases from Europe. The policymakers then switched to a less prestigious set of experts, who espoused a different causal model of the disease based on a theory of “miasma” – and a different set of policy solutions – to address subsequent waves of disease.

No extended abstract or paper available

 Presented in Session 42. Governing Health under Uncertainty