Where and how do forms and practices of strategic ignorance come to matter in policymaking? To better illustrate how a notion of strategic ignorance can help policy scholars understand ignorance in and for policymaking, we present three case vignettes from our own research. Our vignettes are rooted in past and ongoing research in the domains of health and medicine policy and concern: (1) the maintenance of convenient uncertainty in assessing vaccination programs; (2) the convenient skimming of research complexity in environmental and health standards for product label regulation; and (3) the systemic asymmetries in clinical knowledge on medication and drug prescription.Footnote 1
Vignette 1: convenient uncertainty in evaluating vaccination policy
National immunization programs have been under particular scrutiny in commentaries on “posttruth politics,” with vaccine skepticism depicted as one of its prime symptoms. While in this public discourse the lack of scientific literacy is problematized as a malignant form of public ignorance, other forms of ignorance have gone unnoticed, such as how evidence becomes filtered and used to inform policy. Data infrastructures known as vaccination registries appear to be key instruments that guide these decisions as they are used for epidemiological surveillance, monitoring, enabling early interventions in the case of an epidemic, and policy evaluation. Registries are thus not only technical but also sociopolitical tools. In an ongoing research project, we discovered early on that individual-level data on vaccination was either not collected or not shared across regions in Austria in the current case study. Therefore, there is a remarkable absence of data (and knowledge) on the ways in which residents make use (or not) of public vaccination programs, and this makes any comprehensive evaluations of vaccination policy fairly difficult. This absence of data seems in stark contrast to the prominence of vaccine uptake rates in policy discourse and media reports. As statisticians and epidemiologists have reported in the study, the data collected in Austria, even when aggregated, are imprecise at best. While a number of disparate actors, such as women’s groups concerned with the vaccine against human papillomavirus (HPV), epidemiologists, and medical doctors, have urged for political action to harmonize these divergent registries, government and local officials privilege financial considerations in their accounts: a central digital registry that allows for individual-level data would be too expensive.
Notwithstanding the evident financial intricacies of public health policy in federalist settings, we propose that a central data infrastructure would not only generate financial but also symbolic and political costs but would also facilitate a more comprehensive and detailed evaluation of not only individual new vaccines but policy instruments. Harmonization would lead to more effective monitoring of vaccine behavior across regions but also to more effective performance of the national immunization program overall, including better data on the compliance of medical professionals with vaccination guidelines. Indeed, we see such a model used in contexts such as Denmark, Finland, and the Netherlands, and Austria has a generous public health system that is similar to those of its European counterparts. To be clear, we cannot discern an intention to deliberately ignore precision as a rationale of public health policymakers in Austria. Nevertheless, the inertia encountered in this case illustrates a type of strategic ignorance that we might describe as a “convenient uncertainty.” The fractures in the vaccination data landscape are neither the outcome of a strategic agenda nor merely accidental. Rather, it appears as an institutionalized and ritualized form of neglect that seems to be serving a different political calculus. It is thus here that we see a need for the kind of policy research that we propose: to focus not only on what and how policymakers know but also on the kind of knowledge that is absent and how it is possible that they (oftentimes quite easily) do not know. This form of ignorance is different from those discussed in Perl et al. (2018): it does not originate from malicious intent but from agnotological convenience.
Vignette 2: convenient complexity skimming in standards making: from knowledgeable research dossier to an ignorant “one-pager”
In earlier research, we were interested in regulatory policymaking, particularly with regard to how environmental and health safety standards are negotiated and settled in EU governance processes. For this reason, we met with Natasha, a lobbyist at a Brussels-based environmental NGO, who offered an intriguing account of how strategic ignorance is produced and processed in the deliberations on regulatory standards.
To determine the threshold values for health and environmentally friendly product characteristics, industry lobbyists commission scientific studies that assess the “life cycle” of a particular product at stake (shampoos, detergent, dishwashers, etc.). The results of these studies are a lengthy research report that typically, when conducted rigorously and responsibly, includes several paragraphs concerning the limitations of the study (as any good research report typically would). As this research report travels up the politico-administrative ladder, it becomes infused with different meanings and, more simply, it becomes shorter. Therefore, the originally extensive, even if always-already selective, body of evidence is handed over to decision makers in what Natasha refers to as a “one pager,” which features an agreeable graph of the product life cycle (with vivid colorful bars, pie charts and trend lines). What is lost in the process is not only the complexity of the study but also information on its biases and selectivity, some of which was originally discussed in the aforementioned sections on methodological limitations and/or guiding research assumptions.
As Natasha’s account makes clear, the industry does not actively interfere with the results, and the study does not necessarily lack methodological quality. Rather, strategic ignorance is produced in the course of information processing and an apparently “necessary” abstraction in the service of complexity reduction to provide a handy evidence base for decision makers. The crucial point, however, if we are to believe our NGO-based informant, is that industry lobbyists are well aware of this apparently naturally occurring process of skimming the complex report and hence happily “play along” in the language game of science-based policymaking. Paradoxically, their knowledge of how convenient ignorance is produced along the way in the policy process—somehow “nonsubjectively,” i.e., without malicious intent and willful action—and the structural frameworks that govern these kinds of governance processes constitute powerful strategic resources in the “negotiations” over desirable evidence-based standards. Moreover, this strategic move is particularly effective because it is exacerbated in this particular example by material resource differentials: as Natasha recounts, these processes typically involve 2–3 bureaucrats, 6–10 industry-based lobbyists, and Natasha as the only NGO-based lobbyist. On top of this, industry lobbyists hold substantial budgets at their disposal to commission various different scientific studies (that eventually turn into several handy “one-pagers”), whereas NGOs only have sufficient resources to finance one or two at most.
Vignette 3: systemic ignorance as an effect of epistemic particular interests: pharmaceutical nonknowledge beyond scientific bias and willful manipulation
So far, we have illustrated how different forms of ignorance come to matter in public policy infrastructures and how convenient ignorance emerges in the policy process due to factors of organizational complexity reduction. The following case illustrates how strategic ignorance takes shape at the systemic macrolevel of society as an aggregate effect of various strategic micro- and mesolevel decisions regarding knowledge production. Let us consider, once again, the example of pharmaceutical regulation and the concerns over drug safety and efficacy.
Clinical trials are systematic studies typically run by pharmaceutical companies that produce data on a drug’s safety and efficacy to establish an evidence base serving clinical and regulatory decision making. However, as critical scholarship has shown, the contemporary political economy of clinical trials offers multiple ways for inscribing bias, selectivity and ignorance into the trial design (Will and Moreira 2010; Abraham 2008; McGoey 2012a, b). In this literature, the analysis often focuses on a particular clinical trial and/or the regulatory science interface between drug developers and authorities. While this scholarship at the micro- and mesolevel has been essential to rethinking the role of Big Pharma, we want to point to yet another type of ignorance produced at a different, systemic level.
Reading Dumit’s (2012) seminal ethnography of pharmaceutical value creation through the lens of strategic ignorance (McGoey 2012a, b) helps to demonstrate how ignorance is produced in the translation process from the individual to the systemic level of knowledge production and circulation. Due to their high costs, most clinical trials are run by private corporations and only an infinitesimal share of clinical trials is mainly sponsored by public health agencies. In pharmaceutical R&D departments, tough choices are made to determine where to allocate money, that is to say, which clinical trial is going to be funded and which is not. As pharmaceutical companies are first and foremost capitalist enterprises that are compelled by the imperatives of profit, growth, and shareholder value, research decisions are closely tied to economic calculations of the return on investment; put differently, the priority levels of competing epistemic interests are adjudicated by the firms’ assessments of financial profitability. Consequently and unsurprisingly, clinical trials that might expand a drug market are thus preferred over those that might narrow its market. In other words, this means that many studies are funded to investigate whether and when exactly it is advisable to commence or continue medication in a given direction, but only a few studies explore the rationale for discontinuing medication (i.e., the clinical rationale to stop treatment). For sure, there are clinical trials that investigate the latter, and recent trends toward valuing the effectiveness of treatments paid for by public health systems further direct research interests in this direction. However, given the sheer number of corporate-run trials and their role in the expansion of drug markets, medical professionals and society as a whole come to know much more and have much better information about when to begin or continue a medication and much less about when to discontinue medication even when the knowledge of both is equally relevant from a scientific, clinical and public point of view.
This selectivity in research interests at the micro-level of the individual company translates into a broadscale ignorance at the systemic or macrolevel of medical and public health knowledge and has vast implications for public health policy.
Extrapolating conceptual sensibilities for strategic ignorance
In our own work, these vignettes have constituted “ethnographic moments,” or research epiphanies, that have brought the problematics of knowledge and ignorance to our attention. As policy scholars, we have mostly paid attention to questions of knowledge practices in policymaking and were thus puzzled not only by the ways in which nonknowledge and ignorance are generated and channeled into strategic deployments to serve particular interests and by how closely policy ignorance is related to the production of policy knowledge. Across the cases, two conceptual points that correspond to the concerns raised by sociologists of ignorance are paramount for laying the groundwork for advancing an analytical approach to policy ignorance.
First, the forms of ignorance explored here have almost nothing to do with any kinds of misinformation, manipulation, malice, “truthiness,” or alternative fact-making; that is to say, those phenomena that seem to haunt contemporary policymaking and policy sciences, respectively. Second, whereas ignorance has commonly been conceptualized mainly in terms of a negation as the undesired “void” of knowledge, these cases show that ignorance is far from a mere “residue” of epistemic neglect or of “knowledge not yet produced.” In contrast, the vignettes point to the very tangible effects of selective processing of research-based knowledge, in which ignorance emerges as a by-product in knowledge-making processes. It seems fruitful therefore to conceptualize ignorance as a product and a valuable good that has a materiality on its own.
As such, ignorance precisely amounts to, following and going beyond Foucault, a form of power complementary to the notion of productive and dispersed “knowledge/power” that is at the same time “intentional, but nonsubjective” (Foucault 1976). We hold that this nonsubjective dimension of strategic ignorance is key to understanding both its workings and its productivity as a strategic resource, or as McGoey describes it, a “strategic weapon” in the complex battles that shape both the form and the material substance of public policies; or to put it in Lasswell’s famous words, the battles that determine “who gets what when and how” that characterize the politics of policymaking.
Having laid out these ethnographic vignettes and their conceptual value, we next contrast them with how policy scholars have dealt with questions of knowledge and ignorance and highlight the blind spots that the epistemological bias of the discipline has produced. In doing so, we seek to provide the basis for a long-needed discussion within the field and to show the value of agnoto-epistemological sensibilities for policy scholarship.