Anti-microbial resistance and citizen science

This month the AMR Research Champion blog hosts a piece on the role of citizen science in AMR by an Oxford research team who have been exploring microbes in English kitchens. Their work is illustrated in a short film: Good Germs; Bad Germs. What 14 households in Oxford tell us about public understandings of the microbiome has yet to be seen, but check out our guest writers’ reflections on creating a citizen science project below and their valuable tips on what anyone planning participatory research on AMR needs to consider.

by Timothy Hodgetts, Jamie Lorimer, Richard Grenyer and Beth Greenhough

Citizen science projects have grown in number and ambition over recent years. In part that growth has been made possible by online networks that make it easier to contact and communicate with large groups of interested people. But there has also been a notable shift in the politics of science. The shift has happened through two forms of opening.

First, there has been an opening-up of laboratories from the inside. This movement starts from within scientific laboratories and moves towards an outside of concerned publics. The outward shift has been variously motivated: education for its own sake, a desire to ‘get people excited about science’ and to make an ‘impact’, a concern around communicating the uncertainty inherent in (most) scientific outputs, a recognition by funders that public funding requires public support, and an understanding that scientific futures require inspired apprentices. Furthermore, there has been a realisation amongst some practitioners that taking certain (but by no means all) forms of science out of the laboratory can lead to better science. Such research is ‘better’ in the sense that results are more accurate, or more reflective of the ‘real-world’ situations that they seek to inform.

Second, there has been opening-up of laboratories from the outside. This move is slightly different. It rests on the political claim that ‘better science’ involves the inclusion of interested publics from the earliest stages of scientific endeavour. Not only because including non-scientists might make the resulting research more robust, by voicing the contingencies of real-world situations that laboratory scientists might overlook. But also because the early stages of research are inherently political. There is always a politics involved in deciding what questions get asked, and what kinds of answers are deemed admissible. Excluding publics from this process amounts to an elitist exercise of undemocratic power. Including non-scientists in the early stages of research allows participation in setting the agenda, direction, and means of scientific practices. Such democratization is valuable in itself, but is also desirable if it makes the outputs of research (and their assumptions, caveats, and uncertainties) more translatable and palatable to a sceptical public.

Of course, none of this is new. These various opening-up movements have been occurring for many years now, albeit to differing extents depending on the context. These forms of participation seem particularly relevant for contemporary research into anti-microbial resistance (AMR), given the intersection of scientific and social uncertainties that characterize current concerns around public health. But the question of how to facilitate these trends – for more accurate and grounded research, and for more democratic and participatory public science – in the context of AMR is pressing and not (as yet) fully answered. Incorporating citizens simply as data gatherers is less complicated. Indeed, some projects have already been designed and enacted on these lines, although there are some real and not inconsequential ethical issues involved in so doing (as we will discuss more below). But incorporating citizens as scientists, who are involved in formulating the aims and objectives of research, in designing research interventions, and in evaluating their outcomes poses greater challenges. After all, microbiology can be complicated. The methods involved can be difficult to understand, the tools require specialist knowledge, and interpreting results can be an exercise in navigating ambiguity.

How then to facilitate a participatory form of research into contemporary anti-microbial resistance? Drawing on our current work in participatory microbiology, we suggest there are three key issues that need to be addressed:

(1) Mapping multiple understandings. Public understandings of microbiology differ. People in the UK have been educated in different eras of scientific knowledge, and to different levels of detail. Popular media have a tendency towards alarmist, and often contradictory, messages. Microbes, bacteria, and germs carry differing meanings for people and shape public practices in various ways. Horizontal Gene Transfer doesn’t get much airtime, or perhaps as much as it deserves. Future participatory research into AMR needs to take account of this heterogeneous context without simply seeking to ‘educate’ participants.

(2) Democratising methods. Democratising scientific practice requires involving public participants ‘upstream’, in question-setting and methodological design, not simply in collecting data. Microbiology tends to rely on specialized methods that assume significant pre-existing knowledge. The onus here thus falls on microbiologists and their academic co-investigators, to reflect critically on their methods and communicate the capabilities of these methods to participants. The co-production of research (assumed in democratized forms of science) relies on both publics and scientists to work together in order to make sense of experimental possibilities.

(3) Engaging with ethical challenges. Researching anti-microbial resistance through participatory methods poses some significant ethical challenges. The most pressing relate to the implications of emphasizing to public participants the extremity of the threat posed by resistant pathogens in particular circumstances; combined with the ambiguous state of knowledge around the social and ecological factors that generate AMR. The message: this is very scary, and we don’t know how to fix it (yet). There is a very real risk that in seeking to develop participatory forms of science, researchers may inculcate significant and health-altering fears and anxieties in participating publics; and not even have the prospect of a ready ‘solution’ to serve as antidote. In part, these concerns can be addressed by strict protocols that exclude at-risk participants with relevant health histories. They also need to be addressed through managing the narrative of scientists and the tools made available to publics. Researchers must therefore tread a line between the lofty goals of democratic science articulated above, and the grounded reality of avoiding harm to participants; and the latter concern must always come first in this form of research.

In our current research, we have had to navigate all three of these issues. Rather than AMR, our project revolves around public understandings of the microbiome – both the ‘good’ and ‘bad’ bacteria found in the human built environment (and inside humans). Working with 14 households in Oxford, we have been piloting a form of ‘participatory metagenomics’ in order to help people explore the microbial communities of their kitchens. We enable our participants to use cutting-edge microbiological tools, and to design their own experiments. We work together to make sense of the methodological possibilities, and to interpret the results. There are, of course, all manner of subtle and hidden power dynamics that structure this co-production. Our scientists retain a position of knowledge with respect to the dark arts of metagenomic sequencing. Our social scientists have a not inconsequential hand in steering the group’s overall direction. We have had to navigate different levels of formal microbiological education amongst the group, whilst making space for diverse forms of practical knowledge, experience and beliefs. We have deliberately avoided using microbiological tools that can identify specific pathogens (despite the call for their inclusion from some of our participants) in order to avoid unnecessary anxieties and to focus the discussion on wider microbial ecologies. We thus continually tread the lines between science-education and multiple knowledges, and between science-democratization and the avoidance of harm.

We think participatory forms of science of the kind outlined here have much to offer the AMR research agenda. Instrumentally, we suggest they might lead to ‘better’ research: more applicable to the challenges faced by people in their everyday lives. Ethically, we suggest they may lead to more inclusive forms of public science that work to dissipate the contemporary distrust of ‘experts’. Economically, we suggest that such methods therefore represent excellent value for money. We hope that the guidelines above might aid researchers embarking on this route.

You can read more about our project, and watch a short introductory film, at www.goodgerms.org. We have drawn on a wide-range of work in the argument above, but key resources include:

Callon M, Lascoumes P & Barthe Y 2009. Acting in an uncertain world: An essay on technical democracy, Cambridge, Mass., MIT Press.

Whatmore, S 2009. Mapping knowledge controversies: science, democracy and the redistribution of expertise. Progress in Human Geography, 33, 587-598.

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