The COVID-19 pandemic has provided fertile ground for an ever-growing number of controversies—and an expanding list of cases of suppression of dissent. Fueling scientific and medical disputes are institutional, political, cultural, and economic factors that employ a wide range of methodologies to create their own narratives for the purpose of influencing public opinion and behaviors. Some of the more prominent controversies during the pandemic include the safety and efficacy of COVID-19 vaccines, the justification for vaccine mandates, and the use of treatments for COVID-19. The dominant narrative is that COVID-19 vaccines are safe and effective, vaccine mandates are justified to reduce the morbidity and mortality associated with COVID-19, and non-FDA approved treatments for COVID-19 are ineffective or unsafe whereas FDA approved treatments are effective and safe against COVID-19. Individuals who challenge the dominant narrative, a process known as dissent, face wide ranging consequences. Although dissent may be viewed as unacceptable or even threatening to those who support the dominant view, dissent can also be useful as it can produce divergent thinking, improve decision making, and increase innovation … [please read below the rest of the article].
Liester, Mitchell B. 2022. “The Suppression of Dissent During the COVID-19 Pandemic.” Social Epistemology Review and Reply Collective 11 (4): 53-76. https://wp.me/p1Bfg0-6Jw.
🔹 The PDF of the article gives specific page numbers.
Dissent is a double-edged sword. When suppressed or viewed as unacceptable, dissent can lead to increased conflict which, if not resolved, can produce struggle and even violence. On the other hand, when embraced and viewed as constructive, dissent can enhance scientific discovery and produce novel therapeutic interventions.
During the COVID-19 pandemic, there have been numerous instances of suppression of dissenting opinions. This review explores the suppression of dissent during the COVID-19 pandemic and the consequences of this suppression.
The Importance of Dissent in Medicine
Dissent plays a critical role in medicine (de melo-Martin and Intemann 2013; Delborne 2016). By challenging incorrect facts and outdated paradigms, dissent facilitates the acquisition of new, more accurate medical knowledge. The history of medicine is filled with examples of challenges to old paradigms producing more accurate, complete knowledge. The dissenting opinions that neurons communicate via chemicals rather than electricity (Valenstein and Valenstein 2005), ulcers are caused by bacteria, not just stress (Warren and Marshall 1983), and dietary sugar increases the risk of heart disease rather than cholesterol (Kearns et al. 2016) are just a few.
Furthermore, when a dominant narrative is created by powerful groups who promote a particular position due to their own personal interests, dissent is critical to challenge that dominant narrative (Angell 2004; Kearns et al. 2016; Martin 2014; Proctor 1995). Examples include challenges to the tobacco industry’s claim that smoking tobacco is safe and the pharmaceutical industry’s narrative about the safety and efficacy of its products. All of these views were supported by industry funded scientific studies that bolstered the industries’ desired narrative while disputing opposing views.
Dissent serves other purposes in medicine as well. For example, dissent is necessary for revealing unjustified assumptions, flawed methodologies, problematic reasoning, erroneous information, and false facts. Erroneous information and false facts may arise from published, peer reviewed research studies. But can’t we rely upon the published literature? Higginson and Muranfo (2016) claim that 50% of published studies report erroneous conclusions and John Ionnidis, Professor of Medicine at Stanford, claims that most published research findings are false (2005).
Nissen and colleagues (2016) point out that once a claim reaches a stage of widespread acceptance, it has transitioned from claim to fact. This transition, called canonization, allows erroneous conclusions and false findings to be transformed into orthodox views and canonized as facts. As Nissen aptly points out, “a claim is a fact because it is accepted by the relevant community, not because it accurately reflects or represents underlying physical reality” (1). Dissent helps challenge canonized false facts and erroneous information while generating alternative hypotheses, models, and explanations.
Problems with Dissent
Despite its importance in medicine, dissent may also be problematic (de Melo-Martin and Intemann 2014). Industries and governments use dissent to derail policies they find economically or ideologically undesirable by creating doubt, altering public policies, promoting alternative views, and influencing the public to follow their advice.
De Melo-Martin and Intemann (2014) point out that dissent can undermine confidence in existing consensus, confuse the public, prevent sound policy, and can be used to sway public opinion. Private industries and think tanks fund dissenting research for the purpose of creating doubt and stalling regulations that limit or restrict them.
Suppression of Dissent
Because dissent can be helpful or harmful, various strategies have arisen to deal with dissent. One of these is suppression. Delborne (2016) defines suppression as discrediting or silencing a scientist or a scientific claim in a manner that goes against the norms of scientific practice.
It is generally acknowledged that in totalitarian governments, unwanted information and ideas are censored and suppressed by the government (Moran 1998). Such censorship and suppression controls the speech of individuals, the press, and the mass media. The truth is considered less important than the control of information that supports and strengthens the government.
Democratic societies, on the other hand, claim to value freedom of expression over the suppression of information that props up the government. This freedom of expression includes the free flow of information, freedom of speech, and freedom of the press. One basic principle of a democratic society is that the government does not have the right to interfere with or limit the freedom of expression of individuals, private groups, or institutions. However, even in democratic societies, dissenting opinions may be silenced, and governments are not the only ones who suppress dissent. Organizations with special interests, such as corporations, also suppress dissent. Rasnick (2015) states, “Government and mega-business interests have always colluded to protect the status quo by crushing disruptive knowledge and innovation.”
Common tactics used to quell dissent include ostracism, harassment, censorship, denial of jobs, reprimands, involuntary transfer, denial of tenure, demotion, dismissal, and blacklisting (Martin 2014). When individuals are treated unfairly because of their dissenting opinions or actions, they are experiencing suppression of dissent.
Additional strategies may be employed to suppress dissent. Some attempt to mask dissent from the public by presenting a so-called “unified front” (de Melo-Martin and Intemann 2014). Disagreements may be minimized by presenting to the public and policy makers only those claims about which there is a consensus while omitting or minimizing those aspects where disagreement exists. This strategy has been utilized to prevent confusion or doubt about scientific consensus.
Another strategy is to silence dissenting views (Moran 1998). Silencing may occur at multiple levels. A clinician or researcher might be silenced, an idea might be silenced, or evidence may be silenced. Dissenters who challenge orthodox views with the intention of advancing medical knowledge may have their credibility undermined. They may face loss of funding or loss of their job. Additional negative consequences may include being subjected to abusive comments, threats, formal complaints, and censorship (Martin 2014).
The peer-review process can be used to silence dissent (de Melo-Martin and Intemann 2014). When papers with dissenting opinions are sent to experts in a field who hold an orthodox view on a subject and will be less sympathetic to dissenting studies, the reviewers are more likely to disapprove of the dissenting research and may reject it outright. This serves to protect against innovative ideas that challenge existing paradigms or threaten the desired narrative of special interest groups. New ideas, treatments, etc. that are successfully squelched are effectively silenced.
Another strategy to silence dissent is the Big Lie (Moran 1998). This strategy refers to the fact that when a lie is repeated frequently enough, it overwhelms opposing views and becomes accepted as true. Big Lies can produce false paradigms and the history of medicine is replete with examples of false paradigms that were widely accepted for extended periods of time before being replaced with new, more accurate paradigms.
Each of these methods, which are aimed at reducing the effects of dissent, are forms of suppression (de Melo-Martin and Intemann 2013, 2014; Delborne 2016). But is suppression of dissent ever justified? If disclosing data has undesirable effects, then suppressing the data may be appropriate (Relyea 1994). For example, suppressing the tobacco industry view that smoking tobacco does not cause health problems may appear to be a legitimate use of suppression. However, while it may look like a justified and necessary policing of the boundaries of legitimate science, the suppression of dissent can have negative consequences. As Martin (1999b) points out, the act of suppression is not inherently good or bad, but is dependent upon the perspective of the individual.
Consequences of Suppressing Dissent
Some authors suggest targeting dissent is both misguided and dangerous (de Melo-Martin and Intemann 2014; Moran 1998). Why? Because problems can arise when dissent is suppressed. In fact, silencing dissent can result in great harm.
Discouraging dissent can allow the persistence of false paradigms and dangerous treatments that can harm patients. We no longer perform prefrontal lobotomies because dissenting opinions suggested this procedure did more harm than good, despite the inventor of this procedure being granted a Nobel Prize in Medicine for his innovative work (Jansson 2022).
Burying dissent can prevent patients from receiving more effective treatments (Hess 1999; Moran 1998). For example, the radiation therapy industry and the pharmaceutical industry suppressed research in the twentieth century that demonstrated bacteria can cause cancer, thus missing an opportunity to provide more effective treatment strategies.
Physicians may be harmed by the suppression of dissent. During the 1914 pellagra epidemic, official research focused on finding the infectious agent that caused this disease. When Joseph Goldberg discovered the disease was not caused by an infectious agent, but instead stemmed from a nutritional deficiency, he was harshly criticized in medical journals and newspapers (Moran 1998).
Such suppression of dissent can have a chilling effect on other physicians who do not wish to suffer the problems experienced by the primary dissenter. Thus, suppression can discourage healthy dissent that is necessary for the advancement of medicine.
Another example of how the suppression of dissent may be counterproductive is when suppression is grossly unfair (Martin 1999). In this case, the suppression may cause greater dissent and can undermine the public’s trust in medicine. When dissenting opinions are suppressed rather than embraced, the public may lose trust in their doctors, the medical field, and the governmental agencies charged with protecting the public.
Dissent and COVID-19
The COVID-19 pandemic has witnessed significant dissent against dominant beliefs. This dissent has focused on many topics and has taken many forms. Some of the dominant views and dissenting views are listed in Table 1.
|DOMINANT VIEWS||DISSENTING VIEW|
|The SARS-CoV-2 virus originated from a zoonotic reservoir.
(Garry 2021; Vilcek 2020)
|The SARS-CoV-2 virus is a genetically modified bioweapon.
|The SARS-CoV-2 virus jumped from animals to humans in Wuhan’s wet market.
|THE SARS-CoV-2 virus leaked from the Wuhan Institute of Virology.
(Engber and Federman 2021; Maxmen and Mallapaty 2021)
|Masks prevent the spread of COVID-19.
(WHO 2022; CDC 25 Feb 2022)
|Masks do not prevent the spread of COVID-19.
(Children’s Health Defense, 2022)
|Social distancing by staying 6 feet apart will protect you from COVID-19.
(CDC 25 Feb 2022)
|Social distancing by staying 6 feet apart does not protect you from COVID-19.
|COVID-19 vaccines will end the pandemic.
|COVID-19 vaccines are not going to end the pandemic.
(United Nations 2021)
|COVID-19 vaccines are safe and effective.
(CDC 14 Feb 2022).
|COVID-19 vaccines are ineffective and dangerous.
(Stuart and Boxer 2021; Kennedy 2022).
|Covid vaccines are safe in children.
(CDC 11 Jan 2022)
|COVID vaccines harm children and cause more deaths in children than COVID.
(Davies 2022; LifeSite 2022)
|Ending the pandemic can only be achieved if vaccines are available in all countries – to all populations.
(International Rescue Committee, 2021)
|Vaccines do not prevent cases of COVID-19. Countries with higher vaccination rates have higher rates of COVID-19.
(Subramanian and Kumar 2021)
|Boosters reduce the risk of contracting COVID-19.
(Bar-On et al. 2021)
|Boosters increase the risk of contracting COVID-19.
|Vaccines should be mandated
|Vaccine mandates are ineffective
(Bester 2015; Sadaf 2013)
|Herd immunity from vaccines will stop the pandemic.
|Herd immunity is unlikely to stop the pandemic.
|The COVID-19 pandemic is a pandemic of the unvaccinated.
(Kalter and Ellis 2021)
|COVID-19 pandemic is not a pandemic of the unvaccinated.
|Vaccine immunity is superior to natural immunity.
(Cavanaugh et al. 2021; Liu et al. 2021; Bozio et al. 2021)
|Natural immunity is superior to vaccine immunity.
(Abu-Raddad et al. 2021; Leidi et al. 2021; Haveri et al. 2021; Gazit et al, 2021; Shrestha et al. 2021)
|Non-FDA approved treatments are “fake cures” or “fraudulent products”
(Cook 2020; CDC 2 Mar 2022)
|Non-FDA approved treatments for COVID-19 are safe and effective.
(Insignares-Carrione et al. 2021; Aparicio-Alonso 2021a, 2021b, 2021c, ; Ashraf et al. 2020; Kalcker 2022)
|Hydroxychloroquine does not prevent illness, hospitalization, or death from COVID-19.
(WHO 30 Apr 2021)
|Hydroxychloroquine reduces viral loan, hospitalization, and death from COVID-19.
(Guaret et al. 2020; Derwand 2020)
|Ivermectin is not effective against COVID-19.
(Lim et al. 2022; FDA 10 Dec 2021)
|Ivermectin reduces infection and mortality associated with COVID-19.
(Morgenstern et al. 2021; Bryant et al. 2021)
|Remdesivir reduces mortality associated with COVID-19.
(Biegel et al. 2020)
|Remdesivir does not reduce mortality associated with COVID-19.
(Abd-Elsalam et al. 2022; Piscoya et al. 2020)
Table 1: Dominant and Dissenting Beliefs About COVID-19
Suppression of COVID-19 Dissent
Suppression of dissent has taken many forms during the COVID-19 pandemic. These include suppression of data, distortion of data, attacking dissenters and non-FDA approved treatments, censorship, vaccine mandates and restrictions, and punishment of dissenters.
Suppression of Data
One way dissent has been suppressed during the COVID-19 pandemic is by withholding data. Numerous examples of concealing data have occurred during the COVID-19 pandemic. Two of the offending agencies are the U.S. Centers for Disease Control and Prevention (CD) and the U.S. Food and Drug Administration (FDA).
The New York Times (Mandavilli 2022) reported that two years into the pandemic, the CDC has published only a small fraction of the data it has collected about COVID-19. For example, the CDC has been collecting data on COVID-19 hospitalizations in the U.S. for more than one year. This data is broken down by age, race, and vaccination status, but most of this information has not been released to the public. Also, when the CDC published data on the effectiveness of boosters in adults younger than 65, it omitted statistics for 18- to 49-year-olds. This is the age group least likely to benefit from boosters, because the first two injections have provided significant protection.
The absence of data about the effectiveness of the boosters in the U.S. resulted in advisors to the FDA having to rely on Israeli data to make recommendations about the boosters. A spokeswoman for the CDC explained the agency was slow to release information because the data is “not yet ready for prime time” and there is fear the information might be misinterpreted. Furthermore, CDC officials must alert the Department of Health and Human Services [which oversees the agency] and the White House before releasing important reports or documents. Samuel Scarpino, managing director of pathogen surveillance at the Rockefeller Foundation’s Pandemic Prevention Institute, says, “The CDC is a political organization as much as it is a public health organization” [Mandavilli 2022].
The CDC came under fire in 2021 when they announced they would stop reporting breakthrough cases in individuals who had already been vaccinated for COVID-19. Their alleged justification for this action was that they would be “focusing on the cases of highest clinical and public health significance” (CDC 28 May 2021). But such a decision defies scientific logic as well as medical ethics. When in the history of medicine have we ignored the side effects associated with a new intervention and focused solely on how frequently it causes hospitalization or death? The CDC has provided no additional rationale for hiding this data.
Another example of suppression of data involves the FDA’s response to a request for information about the COVID-19 vaccines (Greene 2021). A Freedom of Information Act request filed by a group of scientists [Public Health and Medical Professionals for Transparency] in August 2020 asked for the release of records related to the FDA’s approval of the Pfizer BioNTech COVID-19 vaccine. Although the FDA licensed the Pfizer vaccine just 108 days after Pfizer started producing the records to the agency, the FDA’s response to the lawsuit was to ask a federal judge to allow them to release just 500 pages per month, which meant it would take 75 years to release all the data. The FDA, which has 18,000 employees and a budget of over $6.5 billion per year, claimed they could release only 500 pages per month due to their limited resources.
On January 6, 2022, a U.S. federal court ordered the FDA to release 55,000 pages per month (Siri 2022). Just two weeks later, lawyers for the Pfizer pharmaceutical company informed the federal judge that they wanted to intervene in the lawsuit to protect “confidential information relating to its COVID-19 vaccine” (Scarcella 2022). In other words, they claimed they wanted to help the FDA avoid “inappropriately” disclosing trade secrets and confidential commercial information. The federal judge ruled on February 7, 2022 that Pfizer would not be allowed into the case, but instead held its request in abeyance until it could show a need to intervene.
Another example of suppression of data involves blocking information about treatments for COVID-19. Such treatments have been used successfully throughout the world. For example, Bolivia approved chlorine dioxide [ClO2] as a prevention and treatment for COVID-19 in August 2020 (Insignares-Carrione 2021). However, internet postings about this action were rapidly removed and the U.S. press responded by claiming Bolivians were drinking a toxic bleach (Porter 2020; The Guardian 2021) or a toxic disinfectant (Gigova 2021). These misleading statements are contradicted by the fact that the U.S. Environmental Protection Agency [EPA] approved ClO2 to purify drinking water. Furthermore, ClO2 is used to purify water in North America, Europe, Scandinavia (Lenntech 2021), Africa (Parker 2016), and Australia (Natural Water Solutions 2021). Furthermore, subsequent to the approval, cases of COVID-19 in Bolivia dropped 93% and daily deaths decreased 82%. Also, as of February 11, 2022, despite having a vaccination rate significantly higher than Bolivia [64% vs 47%], the U.S. COVID-19 case rate was more than four times the rate in Bolivia [62 per 100,000 vs 15 per 100,000] and the death rate was more than 4 times higher as well [0.78 per 100,000 vs 0.18 per 100,000] (New York Times 2022). Bolivia and Honduras continue to use ClO2 safely and effectively to treat COVID-19.
Still another example of the suppression of data involves the peer review process suppressing scientific data regarding effective treatments for COVID-19. According to the former editor of the British Medical Journal, Richard Smith (2010), “Perhaps one of the most important problems with peer review is bias against the truly original” (3). One example of this type of bias involves a double blind, placebo-controlled study carried out by Dr. Sohaib Ashraf and colleagues that demonstrated Nigella sativa and honey were effective against COVID-19 (Ashraf 2020). Ashraf and colleagues found this treatment resulted in:
1. 50% reduction in time taken to alleviate symptoms as compared to placebo;
2. Clearance of the virus 4 days earlier in the treatment group than the placebo group in moderate [6 versus 10 days] and severe [8.5 vs 12 days] cases;
3. Hospital discharge in 50% versus 2.8% in severe cases;
4. Four-fold lower mortality rate in the treatment group than the placebo group in severe cases.
Despite these positive findings, Ashraf’s study was repeatedly rejected by medical journals and has yet to be published. Currently, this study is available only as a preprint. Yet as of February 27, 2022, Pakistan’s case rate of COVID-19 is 1/40 the rate in the U.S. [0.5 per 100,000 vs. 20 per 100,000] and death rate is less than 1/50 the U.S. rate [0.01 per 100,000 vs. 0.57 per 100,000] (New York Times 27 February 2022). While Nigella sativa and honey may not be the only factors responsible for the reduced case rate and mortality rate in Pakistan, this study and its findings certainly appear worthy of publication.
Attacking Dissenters and Non-FDA Approved Therapies
Another approach used to suppress dissent during the pandemic has been to attack those who express dissenting opinions or who suggest treatments that are not approved by the FDA. Attacks on dissenters include labeling individuals who question the safety or efficacy of COVID-19 vaccines as anti-vaxxers (Ashton 2021) or conspiracy theorists (Hornsey et al. 2021) and people who choose not to get vaccinated are called criminals (Lovelace 2021) or murderers (Schmidtke 2021). These labels are contradicted by evidence demonstrating the vaccines can be associated with significant adverse effects (VAERS 2021) and studies demonstrating that vaccinated and unvaccinated individuals with COVID-19 carry equal viral loads, and therefore are equally likely to transmit the virus (Acharya et al. 2021; Singanayagam et al. 2021; Pouwels et al. 2021; Chia et al. 2021; Riemersma et al. 2021).
Therapies that have not received FDA approval for the treatment of COVID-19 are disparagingly branded with derogatory monikers such as horse dewormer (Kertscher 2021) or fake cure (Goodman and Carmichael 2020). Such epithets attempt to discredit dissenting opinions about the value of such treatments. Meanwhile, evidence for their safety and efficacy [FLCCC 2021] is ignored (Henderson and Hooper 2021) or may be repeatedly declined for publication (e.g. see Ashraf et al. 2020; Zambrano-Estrada et al. 2020).
Rasnik (2015) explains that dissidents may be slandered or libeled as a way to devalue their arguments. They may be criticized as being incompetent or corrupt. Rumors may be spread about their mental state or private lives. Physicians may be threatened with the loss of their jobs or licenses. This fate has befallen two physicians in the U.S. A doctor in Arkansas is under investigation by the state medical board for prescribing Ivermectin for inmates at the jail where he works (Sissom 2021). Similarly, a Maryland physician and congressman had a complaint filed against him for prescribing Ivermectin (Wiggins and Flynn 2021). These actions occurred despite FDA regulations that allow physicians to prescribe medications for uses other than their approved uses (FDA 5 Feb 2018).
Despite reports of clinical safety and efficacy, a novel, non-FDA approved treatment being utilized to combat COVID-19 has been characterized as pseudoscience (Mostajo-Radji 2021). Chlorine dioxide is employed throughout Latin America for the treatment of COVID-19 (Mendoza 2020), yet Mostajo-Radji (2021) makes numerous inaccurate claims related to the use of ClO2 in an effort to support his claim that the use of this molecule is pseudoscience. One such statement is “… chlorine dioxide is not safe for human consumption” (1). However, this statement is contradicted by the fact that chlorine dioxide is used as a water purifying agent in municipal water treatment plants throughout the world and is sold in retail outlets in the U.S. as a water purifying agent. The FDA has approved chlorine dioxide for use as an antimicrobial agent and the EPA has registered ClO2 based upon its ability to eliminate pathogens including viruses, bacteria, and parasites from surface water, thereby rendering it safe to drink (Liester 2021).
Another strategy employed to suppress dissenting opinions is to remove information from the internet or social media sites that counters the dominant narrative (Niemiec 2020). For example, YouTube acknowledged removing 800,000 videos that contained COVID “misinformation” (BBC News 2021). Social media sites such as FaceBook, Twitter, and Google have canceled the accounts of individuals who present opinions that counter the dominant narrative regarding COVID-19. Mercola, JFK Jr, and others who oppose the dominant view have had their FaceBook accounts canceled (De Vynck 2021; MuNulty 2021). Also, information about Bolivia’s approval of ClO2 for the prevention and treatment of COVID-19 was rapidly removed from the internet.
Mandates and Restrictions
An additional method for discouraging dissent involves the use of mandates to increase compliance with political decisions (Reuters 2021). This has occurred with regard to COVID-19 vaccine mandates.
Dissenting opinions about COVID-19 vaccines have fueled vaccine hesitancy (Machingaidze and Wiysonge 2021) and the response of many governments to this hesitancy has been to impose vaccine mandates. These mandates, which come with a wide range of restrictions, penalties, and fines for noncompliance (Reuters 2021), require individuals to get vaccinated for COVID-19 regardless of their immune status, age religious beliefs/practices, or their natural immunity. In some cases exemptions are turned down despite doctor’s letters supporting such exemptions. Individuals who refuse to get vaccinated face a long list of restrictions and punishments including loss of employment or educational opportunities, restricted access to social opportunities such as restaurants, concerts, and travel, as well as financial penalties.
Still another method used to suppress dissent is punishment. Rasnick (2015) points out that dissenters may be denied promotions, jobs, threatened with legal action, banned from scientific meetings, prohibited from teaching courses, vilified in scientific and popular media, and generally ostracized.
Brook Johnson was employed as a regional director by Ventavia Research Group, a research company that managed Pfizer’s COVID-19 vaccine trial sites. When she witnessed numerous problems with the Pfizer vaccine trials, she repeatedly informed her superiors of the problems, and when they failed to take action, she notified the FDA via email. She was fired later that same day (Thacker 2021).
Consequences of Suppression of Dissent
While suppression may be effective to some degree at squelching dissent [e.g. people may get vaccinated to keep their jobs], it also creates new problems. Martin (2014) points out that suppression of dissent suppresses contrary views and inhibits discussion. During the COVID-19 pandemic, this has led to what Dr. Vinay Prasad (2021) calls “vaccine tribalism.” Prasad explains that lumping people into pro-vaccine or anti-vaccine camps is dangerous. In fact, he refers to vaccine tribalism as “poison” because it hampers scientific progress.
Suppression may be especially potent when there is a near-monopoly of scientific credibility (Martin 2014). For example, in the area of immunization, the view that vaccinations are a safe and effective way to save lives has faced only minor opposition within the medical community. Attacking dissidents serves to protect the monopoly by discrediting critics and warning others not to follow their example.
However, sometimes the suppression of dissent may backfire by increasing the visibility and support for dissidents (Martin 2014). A historical example is the case of Galileo, who was suppressed by the Catholic Church for his science-based heretical claim that the Earth was not the center of the universe. Despite or because of his persecution, Galileo subsequently became a symbol of freedom of scientific investigation.
Suppression of dissent may occur in the form of reprisals. Individuals may experience destruction of their credibility, may be forced out of their careers or may lose their jobs (Flynn 2021; Li 2021; Thacker 2021). Martin (2014) calls these results the primary effect of suppression. Examples from the COVID-19 pandemic include the aforementioned doctors in Maryland and Arkansas who are being investigated for prescribing Ivermectin, which is not illegal and falls within FDA guidelines, and the Pfizer whistleblower who was fired after reporting problems with Pfizer’s COVID-19 vaccine trials.
Reprisals against individuals can have a powerful effect on others who observe what happens if they raise objections or concerns and subsequently become afraid of suffering the same consequences. This can lead to a fear of speaking out against the dominant narrative. Martin (2014) calls this a secondary effect of suppression.
Attempts to suppress dissent can have other negative consequences as well. For examples efforts to force individuals to get vaccinated against COVID via mandates have generated large protests of tens of thousands of people in countries around the world including Canada, Australia, New Zealand, France, Austria, Germany, Belgium, Spain, Finland, Greece, the United Kingdom, Sweden and the United States (Austen and Asai 2022; Kelly 2022; Olmos 2022; Aljazeera 2022; VOA News 2022; Hart 2022; The Associated Press 2022; Mettler et al. 2022). Similar protests against vaccine passports in Italy and France have drawn more than 100,000 protesters (Paterlini 2021; Aljazeera 2022).
When threatened with sanctions or severe consequences, some dissidents acquiesce. This is apparent, for example, among healthcare workers and military personnel who initially refused to get vaccinated for COVID-19, but ultimately acquiesced and got vaccinated to protect their jobs. Although some appealed to professional bodies or government agencies, this approach was generally ineffective.
Delborne (2016) offers several strategies for combating suppression of dissent. These include engaging directly and respectfully, fostering free speech and free inquiry, maintaining awareness of the political economy of science, and recognizing the diverse roles scientists play in policymaking.
Another approach is what Martin (2014) calls an activist approach in which those who attack dissent are exposed to wider audiences, demonstrating they are unfair and refusing to give in to intimidation. However, many people may be uncomfortable criticizing their employers or others in positions of authority for fear of reprisal.
Martin (2014) suggests the best approach to counter attacks on dissidents is to prevent them in the first place by maintaining a culture of openness to controversial ideas with respectful debate.
Why is Dissent Being Suppressed?
If dissent is a normal and critical component of medicine, the question arises, “Why would anyone suppress dissent?” Several possible explanations exist.
First, opposition to dissent is common in medicine. There are always people who prefer to maintain the status quo rather than adapt and change. It can be difficult to give up attachments to cherished beliefs and practices. As physicist Max Plank famously said, “A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it.” (Planck 1949, 33-34). Resistance to change may lead some to suppress dissenting opinions as a way to maintain orthodox views.
Although dissenting opinions play a crucial role in medicine, dissent can be uncomfortable. The discomfort engendered by dissent may spawn attempts to manage this discomfort by suppressing dissenting opinions. However, without dissent, flawed paradigms can emerge and persist. Such paradigms can be difficult to replace. Nissini (1989) called this conceptual conservatism and explained
Although we are all indisputably capable of changing our beliefs, everyday experience suggests that such changes are hard to make; we often cling to old and familiar conceptions of reality, disregarding or explaining away contradictory evidence (19).
Nissini (1994) similarly describes “…the human tendency to cling to strongly-held beliefs long after these beliefs have been decisively discredited” (307). Nickerson (1998) calls this belief persistence and explains “Once a belief or opinion has been formed, it can be very resistant to change, even in the face of fairly compelling evidence that it is wrong” (187).
The tendency to interpret new evidence as confirmation of one’s existing beliefs or theories while discounting evidence that does not support these same beliefs or theories is known as confirmation bias. Confirmation bias occurs when researchers give more weight to evidence that supports their prior theory while giving less weight to evidence that contradicts their prior theory (Schumm 2015).
Another reason dissent may be suppressed is a fear of the potential negative consequences resulting from dissenting opinions. The CDC has acknowledged suppressing information about COVID-19 vaccines for fear this data might be misinterpreted as showing the vaccines are ineffective, which could encourage people not to get vaccinated (Mandavilli 2022).
A third potential cause of suppression of dissent is financial gain. Some of the treatments currently being used to reduce morbidity and mortality associated with COVID-19, such as Nigella sativa and honey, ivermectin, and ClO2 are inexpensive. If these treatments were to gain widespread acceptance, the need for vaccines would be reduced or eliminated. Nobody asks for a vaccine for bubonic plague these days. Why? Because this once devastating disease can now be easily treated with readily available, inexpensive antibiotics. How much do pharmaceutical companies stand to lose if effective antiviral treatments are found for COVID-19? Pfizer and Moderna estimated their profits from the vaccines for 2021 at $36.7 billion and $17.7 billion respectively and their estimated profits for 2022, which are based on contracts already signed around the world, are $32 billion and $19 billion respectively (Kimball 2022).
A final potential reason for suppressing dissent is political. In the U.S., the pharmaceutical industry donates by far the most money to political candidates. Thus politicians stand to lose their most lucrative financial support if they enact laws or support policies that go against the wishes of these generous donors.
Also, the FDA, which is the very agency responsible for approving COVID-19 vaccines in the U.S., receives billions of dollars annually from pharmaceutical companies in the form of “industry user fees.” In 1992, the U.S. Congress passed a law known as the Prescription Drug User Fee Act (PDUFA) and President George H.W. Bush subsequently signed it into law (White 2021). PDUFA, which was intended to speed up FDA approvals, allows the FDA to collect fees from companies that produce certain drug and biological products (FDA 15 Feb 2022). Previously, the FDA was funded totally by the U.S. Treasury, but this changed significantly after PDUFA. Now pharmaceutical companies pay fees when they submit applications to the FDA for drug review and they also pay annual user fees based on the number of approved drugs they have on the market. These “industry user fees” have become a significant part of the FDA’s annual budget. For example, in 2019, 46% of the FDA’s budget, or $2.8 billion, was paid to the FDA by pharmaceutical companies in the form of industry user fees (FDA 18 Nov 2020). Can you imagine if your doctors received 46% of their salaries from pharmaceutical companies? Do you think they would be impartial in their decisions about which treatments they recommend?
Thus, several motives exist for the suppression of dissent as it relates to the COVID-19 pandemic. How much each of these motives contributes to the total suppression that is occurring remains to be determined. But these motives must be acknowledged rather than ignored if we are to embrace dissent rather than suppress it.
If an honest discussion of controversial issues is to occur, everyone’s right to free expression must be valued and respected, particularly in academic settings, even if it is uncomfortable. Dismissal of dissenting opinions risks converting medicine into a religious orthodoxy.
The suppression of dissent can produce negative consequences. Job loss, loss of career, and tribalism are just a few. Suppression of dissent may also discourage others who witness the negative effects of dissent from coming forth to express dissenting opinions of their own. Suppression of dissent may also backfire, resulting in increased visibility and support for dissidents. Thus, suppression is not a weapon that should be wielded indiscriminately.
While uncomfortable, dissent is an essential component of scientific inquiry. If we are to continue expanding medical knowledge while at the same time building trust among those we are committed to helping, dissent must be respected, not suppressed, and healthy debate must be encouraged, not eliminated. Dissent is an essential component of medicine. It must be embraced if we are to continue expanding our knowledge and discover new treatments not just for COVID-19, but other illnesses as well.
The author wishes to express his deep gratitude to Dr. Brian Martin for his sage advice and invaluable editorial assistance with the preparation of this manuscript.
Statements and Declarations
The author declares no competing interests.
Mitch Liester, email@example.com, is an Assistant Clinical Professor in the Department of Psychiatry at the University of Colorado School of Medicine, U.S. Previously, Mitch served as an Assistant Clinical Professor at the University of California, Irvine School of Medicine. A practicing psychiatrist for more than 36 years, Mitch has published on topics including psychedelic medicines, addictions, near-death experiences, and the use of persuasion and coercion to overcome COVID-19 vaccine hesitancy.
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