‘Viewpoint Diversity’: heterogeneity is critical to the integrity of science

Abstract

This editorial discusses the importance of maintaining diversity within science, noting especially its significance to research in psychiatry. It follows a recent directive that was issued by the US administration that places unreasonable constraints on US government-funded scientific inquiry. The article draws attention to the harmful intended consequences of the directive. It also discusses its unintended consequences, which are likely to be damaging because heterogeneity is inherent in nature, and recognition of diversity in medical science helps achieve specificity. This is essential for the detection and diagnosis of disease and for tailoring therapies and developing targeted treatments.

‘…I look forward to a world in which we will be safe not only for democracy and diversity but also for personal distinction.’ John F Kennedy (1917–1963) Speech at Amherst College, 26 October 1963.

On 20 January 2025, the US government issued an executive order to all federal government agencies to terminate ‘diversity, equity, and inclusion (DEI)’ policies.¹ To comply with the notice, government organisations responsible for funding scientific research generated lists of words to screen their own grants and projects, to identify those that could potentially violate the order. They feared they would lose funding if seen to contravene the directive. For example, the National Science Foundation (NSF) listed dozens of words that they considered would draw attention to their research and cause it to be flagged for further scrutiny. Therefore, they notified recipients of NSF funding to ‘cease any activities that do not comply with an executive order’ and provided them with a list,² which was published by The Washington Post, 4 February 2025. On 7 March 2025, The New York Times published a list of almost 200 words which they described as being ‘purged’ from federal websites.³ Then, on 1 April 2025, in an open letter addressed to the ‘American People’,⁴ signed by nearly 2000 members of the US National Academies of Sciences, Engineering and Medicine, leading scientists including numerous Nobel laureates described how ‘a climate of fear had descended on the research community’ with ‘researchers, afraid of losing their funding or job security…’ and as a consequence were ‘removing their names from publications, abandoning studies, and rewriting grant proposals and papers to remove scientifically accurate terms’. They also warned that the ‘damage …could take decades to reverse’ and called on the administration to ‘cease its wholesale assault’. The plea, directed at the public, noted that ‘although some in the scientific community have protested vocally, most …have kept silent …’.⁴

Then, on 11 April 2025, the US government sent a letter outlining 10 conditions that Harvard University must satisfy to receive federal research funding already committed by the US administration. Among the various demands, the US government stipulated that Harvard undergo ‘reform’ and be subject to an ‘audit’ of its practices with the aim of achieving ‘viewpoint diversity’ if it wished to retain its financial support. In a swift response, Harvard University robustly rejected these demands and refused to ‘surrender its independence or relinquish its constitutional rights’,⁵ and pointed out that it is ‘home to the world’s most cutting-edge medical, scientific, and technological research…that impact[s] countless lives’.⁶ In response, the federal government announced it was freezing ‘$2.2 billion in multiyear grants’ to Harvard University, which is now understandably taking legal action.

What does this mean for science and psychiatry?

Kennedy’s speech delivered in 1963, a month before his untimely death, emphasises the importance of diversity of human experience and the necessity for individuals to have freedom of expression while maintaining shared values. He was speaking in honour of Robert Frost, the renowned American poet, because Kennedy regarded art as the nourishment of culture and as ‘a form of truth’. (Speech at Amherst College in Massachusetts in honour of the poet Robert Frost at the groundbreaking ceremony of the Robert Frost Library). At the same time, he championed science, having committed the USA to the space race in 1961 in his speech titled ‘Address to Joint Session of Congress’, in which he articulated his ambition and vision to have a human set foot on the moon and acknowledged the critical role of ‘every scientist, every engineer’—noting that without ‘a major national commitment of scientific and technical intellect the endeavor would not be possible’.⁷

This is true, because science, as a process for gaining knowledge, has been essential to our development and it has provided immense advances in our understanding and appreciation of the world. This is especially evident with respect to medicine, where the scientific method has informed the identification of diseases and their treatment, most evident in the recent pandemic. The impact of medical science can also be seen in psychiatry, where the treatment of serious mental illnesses has shifted from asylums to the community, with many common psychiatric illnesses being detected early and managed effectively at home.

Consequences of the DEI directive

The decree issued by the US administration and the threats to funding that have followed are already having serious consequences. Some of these consequences are intended and are political; others may be unintended but are being used to obfuscate the true intentions of the US government’s actions and are nevertheless damaging.

Intended consequences: Employing the anti-DEI directive to flush out supposed inefficiencies and stop discriminatory practices, the policy has been duplicitously foisted on organisations to sabotage a broad range of activities. For example, the composition of government grant funding panels has been altered by removing so-called ‘DEI hires’ but in essence they have been interfered with to expunge dissenting views; for instance, by limiting the involvement of women.⁸ University websites, statements and programmes as well as hiring practices have been coerced to comply with the directive and reluctantly many have altered their selection procedures and their language. Both publishers and editors of scientific journals have experienced similar pressures. Additionally, researchers supported by government funding have been compelled to realign their scientific interests and may be further constrained as to where they can publish their research.⁹

The desire to control what to study, where to publish findings and when such ‘knowledge’ should be available underscores the nature of the anti-DEI directive as being a Trojan horse; one which evades public scrutiny of the true political agenda of wanting to govern the narrative and prevent any criticisms.^{10 11}

Unintended consequences: Returning to the first word of the directive, and how its portended removal from scientific inquiry could potentially impact psychiatry and mental health research, it is important to note that diversity can simply mean a ‘difference’, or ‘distinction’, but also ‘variance’ or ‘heterogeneity’, and that all these meanings are necessary for science, which takes a systematic approach to understanding reality.

A fundamental objective is determining the distinctiveness of that which is being studied so that we can make sense of reality, which by its very nature is diverse and variegated. In medical research, we are particularly interested in the features that make us different with respect to health and disease. Therefore, the ability ‘to discriminate’, and to do so reliably and effectively, is critical both for identifying disease and then treating it successfully.

For example, cancer is not a single entity but a group of diseases that have a core process in common. However, because cancer ‘can start in almost any organ or tissue of the body’,¹² in practice, it means there are many kinds of cancers and ‘each cancer needs to be treated differently’.¹³ Therefore, cancer is not ‘one’ thing and there is no ‘one cure for cancer’.¹³ This diversity of ontology means diverse treatments are needed.¹⁴ And while this poses challenges,¹⁵ it is this diversity, at a cellular level, that permits targeted treatment by exploiting molecular biomarkers of disease.¹⁶ Therefore, diversity is essential to both first describing cancers and then successfully treating them.

These same considerations apply to psychiatric disorders except that there is no known pathophysiology for mental illnesses and hence there are no biological markers that are sufficiently specific for diagnosis or treatment. Therefore, to separate mental illness from health and define psychiatric disorders, various symptomatic and functional thresholds are employed. At the extremes of mental illness, such as severe mania, the status of psychiatric disorders as illnesses is clear and their disease provenance with roots in the genetic make-up of individuals cannot be questioned. This is because genetic variations and mutations are essential both to our development and subsequent adaptation to an ever-changing environment, and reciprocally, our environment influences our genetic expression.¹⁷ Hence, even severe mental illnesses are shaped to some extent by life experiences, which nuance their manifestation further, and thus treatments must be fashioned accordingly.

The fact that psychiatric disorders have fuzzy boundaries and are multifaceted illnesses means that understanding their causes and mechanisms requires greater appreciation of their inherent diversity. This insight also applies to their treatments, which must be multipronged and operate within multiple domains. Similarly, there is also significant variation in responses to treatment among patients who suffer mental disorders. Awareness of these differences and knowledge of how they transpire is essential if we want to be able to identify vulnerable individuals of all backgrounds and implement effective treatments.

Conclusion

People are inherently different, and only by capturing their natural diversity can we describe the many manifestations of human disease. Decades of research have proven that population features, such as age, sex, gender and socioeconomic status, play a crucial role in the development and trajectory of mental disorders. By recognising the diversity and uniqueness of mental illnesses and by developing specific treatments that are increasingly bespoke, we can ensure that our treatments only affect those who need them. To achieve these goals, we must protect the integrity of science,¹⁸ and this means protecting its principles and the words that make up its lexicon, such as diversity. Therefore, it is important that we keep in mind the true intentions of the anti-DEI directive, and like Harvard University, remain committed to our research ambitions. Thus, it is time to take inspiration from its motto, veritas and have the courage to maintain our commitment to seek the truth.

The views presented in this manuscript are solely those of the authors and do not reflect the views of any organisation or institution. None of the authors participated in the peer-review of this paper.