In an analysis of scientific controversy, Collins and Pinch have suggested that it can be useful to distinguish between struggles waged in what they call the "constitutive forum" and those that are enacted in the "contingent forum." The constitutive forum is the world in which scientific knowledge-production is traditionally believed to unfold—the world of "scientific theorising and experiment and corresponding publication and criticism in the learned journals." The contingent forum, by contrast, includes everything that is supposedly "external" to real science: "popular and semi-popular journals, discussion and gossip, fund raising and publicity seeking, the setting up and joining of professional organisations, the corralling of student followers," and so forth. Collins and Pinch's point is emphatically not that one domain is "scientific" while the other is "extra-scientific." Rather, they seek to show how scientific debates are advanced through recourse to different types of arguments, some of which seek to create the appearance of being "based on universalisable non-contingent premises," while others do not.
Clearly, the AIDS causation controversy has heavily depended on both modes of argumentation. Working within the constitutive forum, AIDS dissenters such as Duesberg have highlighted inconsistencies in the orthodox position, enumerated predictions that have not been fulfilled, pointed to violations of "classical methods" such as Koch's postulates, and made use of medical analogies that compare the conventional wisdom about AIDS to that of other diseases "mistakenly" thought to be caused by microbes. In response, the proponents of the orthodox position have spelled out specific lines of rebuttal, defended the mainstream position through "clarifications" and auxiliary hypotheses, and invoked their own medical analogies that compared AIDS to other conditions where Koch's postulates have not been satisfied. In Susan Leigh Star's terms, both sides have manipulated "hierarchies
of credibility" through "claims that one procedure or approach is more scientifically viable, or technically astute, than another."
At the same time, scientists and medical doctors, not to mention lay participants in the controversy, have been quick to employ the contingent forum to assail the credibility of their opponents. Their mechanisms for doing so have been surprisingly familiar, as revealed by a comparison with the controversy in the 1970s and 1980s over fluoridating public water supplies. In that controversy, as Brian Martin's analysis makes clear, the mainstream position has enjoyed a near-monopoly of scientific credibility, but dissenters have found ways to undercut the credibility of their opponents.
Certainly the most obvious tactic available to the dominant group in such controversies is to try to ignore their opponents—as scientists successfully did with Sonnabend but had more trouble doing with Duesberg. When this tactic fails, the dominant group is typically confronted with the question of whether or not to engage in public debate. Defenders of fluoridation expressed the same sorts of concerns that Fauci and others did about debating Duesberg. One fluoridation enthusiast wrote in the American Journal of Public Health: "A debate simply serves to give more credibility to fluoridation opponents." As Martin has observed, experts who refuse to debate risk being perceived as arrogant, yet simply by engaging in debate they risk undercutting their own expert status by being viewed as partisans. Scientists supporting the dominant position walk a tightrope in trying to retain both their scientific credibility and their moral authority.
In the AIDS causation controversy, as in that over fluoridation, actors on all sides have sought to undermine claims by venting ad hominem attacks against their opponents. In doing so, they have attempted to tarnish their opponents' credibility by challenging either their expert status or their motivations or both. As Martin has noted, supporters of the mainstream position tend to work especially hard to attack the credibility of those opponents who have the most legitimate credentials; and the intensity and range of criticism directed at Duesberg—that he's just a chemist, that he's never worked on human diseases, that it's all a "game" with him and "he has to know he's wrong" —would seem to bear out the general point. Although "more than one can play the game of attacking the credentials, motivations, and honesty of those with opposite views," Martin has said in reference to fluoridation, the majority position tends to win this "battle over reputation in an overwhelming fashion because they have
the preponderance of professional support and especially the backing of professional societies."
In the case of AIDS, defenders of the HIV hypothesis could point not only to all the prominent national and international organizations that agreed that HIV causes AIDS (as Gallo, for example, was apt to do), but could even invoke the general consensus among grassroots activists, who were themselves typically critical of established authority. As ACT UP member Michael Botkin wrote in his column in the Bay Area Reporter , what "bugged" him about the fans of Duesberg was "the way they completely ignore the opinion of the AIDS movement." Noted Botkin: "ACT UP is no dupe of either the federal government or the medical mainstream. Everyone loves a good conspiracy theory, and certainly it's easy to believe that the government is blind, incompetent and corrupt. But if Duesberg's theory has some substance to it, why hasn't it garnered some interest, if not support, in the savvy, skeptical AIDS movement?" This move on Botkin's part might be described as the "monopolization of oppositional credibility."
Some of the most powerful weapons available to the defenders of the dominant position in scientific controversies are the sanctions they can exercise against dissenters. Through control over professional organizations, funding institutions, and journals, they can suppress heretical views and even those who dare voice them. Martin has recorded a variety of examples in the case of fluoridation. When a Minnesota dentist spoke out against fluoridation, his local dental society suspended him for one year without giving him a chance to speak in his own defense. In 1964, when a U.S. sociology student conducted a survey of a group of doctors and discovered that only half the respondents favored fluoridation, the student reportedly was chewed out by an assistant dean "for abusing the good name of her school." An Australian chemistry professor claimed in 1973 that "his staff and equipment had been taken away because of his public opposition to fluoridation." When an article critical of fluoridation was submitted to an Australian journal, it was rejected over the telephone by an editor who claimed "it might encourage the antifluoridationists."
Arguably, these examples are reminiscent of the experiences of Duesberg. The Berkeley scientist has indeed had increasing difficulty getting his views represented in prominent scientific journals, while some of the comments by reviewers and editors have suggested that political considerations (such as protecting the journal's reputation)
have been one factor in the process. He has seen his funding terminated in circumstances that invited suspicion. And he has reported being ostracized by his colleagues and former friends. At the same time, as Martin has pointed out, dissenters in scientific controversies can use such experiences of "unjustifiable" scientific behavior as "a resource in their struggle": "Opponents of fluoridation frequently raise these cases of 'suppression' as showing the political rather than the scientific basis for the promotion of fluoridation."
Criticizing instances of suppression and gatekeeping is one example of a more general tactic that both sides in the causation controversy have employed—what Martin has described as "highligting discrepancies between the stated norms of scientific behavior and the actual behavior of certain scientists." Duesberg has made frequent reference to the charges of fraud that have been brought against Gallo, while opponents of Duesberg have argued that, by speaking to a lay audience, he has sacrificed his scientific integrity. And each side has accused the other of a dogmatism that is antithetical to the true spirit of scientific inquiry: their predictions have been falsified, their arguments have holes in them, yet they refuse to forswear their beliefs. "A powerful hypothesis has to explain and predict," dissenter Harvey Bialy has told Spin: "I ask you, what kind of scientist continues to support a hypothesis that fails to explain and fails to predict?" Writing in the San Francisco Chronicle , Martin Delaney has turned the argument back against Duesberg: "Duesberg is well aware of [contrary] evidence, having been briefed regularly by his faculty peers. Yet he clings to his views, in spite of any and all data, while presenting no original AIDS-related data of his own, a puzzling pattern for someone who claims devotion to science."