In Reply:--I am grateful to Smith for providing members of the anesthesiology research community with a timely reminder of how those of us involved in biomedical research must strive to educate the public about that complicated process. There are several points raised by Smith to which I would like to respond, in the order in which they are raised in his letter.
Smith infers that I consider market forces to be evil. That is not the case. Unlike Smith, who appears to attribute an inherent good to market forces, I simply view them as one of many forces with which we interact. Most reasonable individuals, when approaching the edge of a cliff, will exercise caution. Although the force of gravity assists them in maintaining a firm footing, should they lose their balance, that same force of gravity may draw them over the edge to an uncertain fate. It is the result of the application of the force, rather than the force itself, that should lead to a judgment of value. Appropriate application of market forces will continue to strengthen academic settings. Misapplication will destroy them.
Smith recognizes the importance of both basic and applied research but does not seem to be aware of the symbiotic relationship that exists between taxpayer-supported and private, investor-supported research. Federal and state grants and nonprofit organizations fund much of the basic science research aimed at a better understanding of natural phenomena. Small biotechnology companies, in recent years, have grown from those academic settings and, in turn, sold or licensed their discoveries to larger companies. The large companies, with resources necessary to undertake long-term product development, acquire this knowledge base and work to bring a new product to market. It is this model of symbiosis, not as described by Smith as parasitism, that has contributed to profound advances in medical care. The for-profit companies continue to rely heavily on the knowledge base developed through public support of basic research.
Smith asks whether citizens of the United States should be asked to pay for research "if the aim of the research is purely knowledge acquisition. . . ." The following question was asked in polls taken in 1985, 1988, and 1990: Do you agree or disagree with the following: "Even if it brings no immediate benefits, scientific research which advances the frontiers of knowledge is necessary and should be supported by the Federal Government." More than 80% of the respondents in each of the years agreed that basic research should be supported by the government.* Smith asked an important question, one that has been asked before. We in the research community cannot assume, however, that the public will continue to support federal funding of basic research. It has been suggested that a proposed federal tax cut could result in a 30% reduction in funds for the National Institutes of Health.**
In recent years, the research community has been called on to educate the public about the process of science. We must explain the value of animal models in biomedical research. We must inform our neighbors about the importance of radioactive materials in both clinical and research endeavors so that they may make reasoned decisions about storage of low-level radioactive waste. We must educate the public about the long-term value of investing in basic biomedical research. Had an effective polio vaccine not been developed it has been suggested that current annual costs for that disease would be $30 billion.
My colleagues in the research community may ask why, at a time of increased competition for potentially shrinking research dollars, we should take on these additional responsibilities. My answer is simple: We cannot expect Big Bird or Barney to do it all.
J. G. Collins, Ph.D.; Department of Anesthesiology; Yale University School of Medicine; 333 Cedar Street; New Haven, Connecticut 06510.
*National Science Board: Science and Engineering Indicators 1991. Washington, D.C., U.S. Government Printing Office (NSB 91-1), p 12.
**Marshall E: Nobelists make a pica for NIH budget. Science 267:1415, 1995.
(Accepted for publication March 28, 1995.)