One way to think about the Glenda Gray/DoH/SAMRC controversy is through academic work on social epistemology. Hold on - I promise its not that dull. A thread...

My friend @katfurman has published extensively on how "suppressed disagreement" leads to a heightened level of moral culpability for poor decisions. See: http://eprints.lse.ac.uk/100006/1/Furman_moral_responsibility.pdf

I will hazard an application of Katherine's argument in the Gray/DoH/SAMRC case. The question of culpability for decisions by public officials (Katherine's work focuses on Mbeki's Aids denialism as a case in point) is about how they deal with experts.

An agent must figure out what to do. There are procedural mechanisms that allow you to do so. One is to find consensus among experts, but that consensus must be of the right sort - it can't emerge from suppression of competing views.

You can't achieve consensus because dissenters are *suppressed*. i.e. if someone finds an argument inconvenient, they are shut down. Then two types of culpability arise:

culpability for the wrong decision, and additional culpability for suppressing disagreement. In the approach to Dr Gray, the DoH and SAMRC must ensure they are not walking the path of creating moral accountability for themselves in suppressing disagreement, if

their actions lead to any of their peers, including Dr Gray, choosing silence. Here is where the DoH and SAMRC are treading on thin ice.

This is not to say that Dr Gray has no accountability of her own. There was at least one factual error in the interview she gave to @News24 . It may also be the case that she has not followed the proper procedure for disagreement with her epistemic peers, which DoH may claim

But that depends strongly on the "proper procedure" actually providing a substantive platform for peer disagreement. If, instead, it is loaded so as to suppress disagreement in particular ways then DoH/SAMRC can't say it is the right forum.

And if the MAC is not being consulted, then it is failing to bring out disagreement between scientists by design. Dr Gray, of course, famously and publicly clashed with the gvt on HIV treatment during Mbeki's denialism.

Had she then chosen to stay silent or stay in officially endorsed channels, she would have been suppressed and Mbeki could have claimed he could not have known better (though he would still be culpable for the suppression of dissenting views)

I am, anyway, not sure the debate should be about whether MAC is the proper channel. We are a participatory democracy in which citizens must hold their gvt to account and decide how to vote. On those grounds they should have direct access to scientific disagreement, as agents

Clearly, if the DoH's actions amount to suppressing disagreement they should be held accountable. To the extent that Dr Gray should also be accountable for the errors in her interview, this accountability is delivered through the mechanism of peer argument

Key point: The DoH is using political power to deal with an epistemic issue. The DoH is taking a voice out of the debate, rather than replying to it. The DoH could instead engage in the epistemic debate - which minister Mkhize did robustly, and appropriately.

That should have been the end of it.

Given the crisis, it is important for the public to have access to the best science available, including where there is disagreement between scientists. The efforts by DoH to channel such disagreement into forums it controls is undemocratic and suppressive. Ends.