Writing in The Saturday Paper, Martin McKenzie-Murray describes celebrity chef Pete Evans as “sneering” at the importance of medical qualifications and that the “medical industry is corrupt”. Evans continues,

What do you need a qualification for to talk common sense? Why do you have to study something that is outdated, that is industry-backed, that is biased, that is not getting the results? That would be insane to study something that you’re gonna waste your time with? That’s just crazy.

McKenzie-Murray is quick to dismiss Evans and describes his interview as “a pathetic performance”. There is much to criticise Evans for. But these are good questions.

What gives someone authority to tell others what to do in relation to their body and health? How is medical and nutrition science produced? What are we to make of the way this knowledge and advice seems to shift over time? Do scandals of corruption and bias in one area of scientific research taint other areas?

These are the kinds of questions philosophy of science and science and technology studies deals with. In fact, Ray Moynihan, research fellow at Bond University, has addressed similar questions in his occasional health column for The Saturday Paper.

As I was writing this I received an email for a conference at Georgetown University that is exploring the question “Does Industry Influence Medical Discourse?” Presenters are asking some of the very questions Evans is asking about the basis of authority, knowledge production, and different conceptions of evidence.

One presenter, philosopher and bioethicist Carl Elliott has spent much of his career critiquing the influence of the pharmaceutical industry on medical practice and research. To be sure, Elliott and other scholars are not drawing the same conclusions as Evans, but nor do they conclude that “everything is ok” in the world of modern medicine.

One only needs to glance at the newspapers (or Retraction Watch) to realise that medicine and scientific research is not a straight-forward or innocent enterprise. Recent examples include a “fake doctor” practicing in NSW with fraudulent qualifications, sugar industry influence on dietary recommendations, or Dr Anna O. Szust – the scientist who doesn’t exist but was able to get appointed as an editor to over 50 academic journals.

These examples of fraud and misconduct are extreme. The point is not that these examples discredit medicine or science, but that they raise questions about the social and commercial contexts in which science is produced and medicine is practiced.

Yet, even when there is no misconduct, there are questions about the results of science when it is “done right”. As I’ve addressed elsewhere, STS and philosophy of science shows that the “inside” of science is a messy, value-laden, emergent, trialled-and-eroded, accidentally-collective network enterprise that bears little resemblance to the smooth, authoritative discursive claims on the “outside.” This is not to say that science is a hoax and one opinion is as good as another. But there are questions about science worth asking.

Evans draws the wrong conclusion that medical and scientific knowledge is fake and can’t be trusted. But he is asking the right questions about how it is produced, who counts as an authority and what does it mean to be qualified. There aren’t always straight-forward answers to these questions. To double-down by saying “trust the experts, you’re a fool like Trump” only serves to entrench polarised and isolated camps.

As Rachel Ankeny said in an interview about Evans and the critical response from the Australian Medical Association and others

“They need to engage with the community — not just those who are pro-science — but the whole community,”

“It’s not about saying you’re a ‘whack job’ and shouldn’t be listened to,”

Instead of sneering back at people who question science – vaccinations, climate change or nutrition – it would be more productive to acknowledge the significance of their questions and provide ways of thinking that avoid the Scylla of scientism and Charybdis of pseudo or anti-science.