Book Reviews 677

Epstein, Richard A. (1992), “Property, Speech, and the Politics of Distrust,” University

Lucas v. South Carolina Coastal Council (1992), 112 S. Ct. 2886. Pennsylvania Coal v. Mahon (1922), 260 U.S. 393.

of Chicago Law Review 59, pp. 41-89.

Lisa D. Brush

Cancer Wars: How Politics Shapes What We Know and Don’t Know About Cancer, by Robert N. Proctor. New York: Basic Books, 1995, 368 pp., $25.00 cloth.

The Politics of Gun Control, by Robert J. Spitzer. Chatham, NJ: Chatham House Publishers, 1995, 210 pp., $25.00 cloth.

Smash the State!

Fertilizer bombs don’t kill people; antigovernment extremists kill people, at least the 169 people killed in the bombing of the Murrah Federal Building in Oklahoma City in April 1995. The arsenals of white separatists, antigovern- ment paramilitary organizations, and the holy warriors of ultraright congre- gations are extensions of a deceptively simple, 200 year-old text: “A well- regulated militia, being necessary to the security of a free State, the right of the people to keep and bear arms shall not be infringed.” The fact that this sentence is enshrined in the Constitution means that the gun control debate, according to Robert Spitzer, is not just about government authority to regu- late guns. At stake is government authority to impose regulations in general and to secure the common welfare through legislation, administration, and adjudication. The antitax, antiregulation, antigovernment sentiments of the 104th Congress have blasted the legitimacy of the welfare state; the “talis- manic quality” of the Second Amendment and the persistent ability of the National Rifle Association (NRA) to prevail in the face of “surprisingly con- stant public disposition favoring [gun] control” are only explicable in the context of parallel controversy over social regulatory policy (p. xii). Mean- while, gun injuries cost an estimated $14 billion in 1993, most coming directly or indirectly from taxpayers’ pockets (p. 69).

Tobacco, asbestos, radon gas, radioactive fallout, petrochemical pesticides, and saccharin don’t kill people; cancer kills people, about 538,000 people in the United States (nearly twice as many Americans as died in all of World War 11) in 1994. “Cancer is caused,“ Robert Proctor tells us, “by bad habits, bad working conditions, bad government, and bad luck-including the luck of your genetic draw and the culture into which you’re born” (p. 1). Searching for a cure for cancer is good for business. Preventing cancer, especially through government regulation of working conditions, environmental haz- ards, and tobacco products, apparently is not. The U.S . government’s war on cancer, declared by Richard Nixon in 1971 and represented by more than $25 billion in cumulative research support through the National Cancer Institute, is not going well. Indeed, Proctor notes that Ronald Reagan’s dereg- ulatory regime “may have been the most potent new carcinogen of the 1980s” (p. 100). Like gun control, cancer is a lot about the state, regulation, and the politics of policy.

Although they have written very different books about ostensibly very different policy issues, both Robert Spitzer and Robert Proctor suggest that

678 Book Reviews

key issues of social and health policy are comprehensible only in the context of U.S. citizens’ growing conviction that the greatest enemy of freedom is our own government. Smash the state! to unfetter business and promote economic growth, even if it is a t the cost of the health and lives of workers and neighbors of industrial manufacturing or mining or nuclear test sites. Smash the state! to protect God-fearing citizens from oppressive taxation, secular humanism in the public schools, busing to enforce desegregation, and police monopoly on weapons. In both cases, analysis of Americans’ feelings about the role and powers of democratic government must complement tech- nocratic criminological or medical knowledge.

Spitzer provides a straightforward, comprehensive political analysis of the furor over gun control. He joins the dissonant chorus of debate about the interpretation of the Second Amendment. Spitzer’s summary of the “crimino- logical consequences of guns” provides a strong empirical base for regulation (chap. 3). He gives readers a helpful history of the interest-group politics around gun control that goes far toward explaining the sound and fury over the issue. He concludes with a new framework for gun policy that proposes empirically grounded solutions to the dilemmas of rights, order, and regula- tion which have stymied political resolution of the gun debate. His discussion of self-defense is particularly strong, although he omits mention of social and political reluctance to recognize that what he calls “domestic anarchy” is complicated by women’s vulnerability to abusive and sometimes homicidal husbands, boyfriends, and ex-partners.

Spitzer’s analysis has in some ways been overtaken by events, the height- ened activity of right-wing militias and the bombing in Oklahoma City fore- most among them. It is a testimony to the strength of his concluding analysis, however, that Spitzer’s argument does not require much tinkering to accom- modate the added vehemence of resistance to gun control on antigovernment grounds. The policy point, and Spitzer’s key innovation, still holds: We should apply to gun control the insights from international relations about the dis- tinction between arms control and disarmament, and should slow the domes- tic arms race and “impose a greater degree of security by controlling guns’ deployment, characteristics, use, safety, and the like” (p. 196). The attractive- ness of the metaphor to international relations is probably limited, unfortu- nately, when Americans’ antigovernment sentiments extend to contempt for the United Nations and suspicions of an international Zionist conspiracy to kneecap patriotic local autonomy.

Cancer Wars is a wonderfully rich and compellingly written book. Proctor asks why, if the causes of cancer are largely known, the best and the brightest of the medical world have made so little progress in the cancer wars. His answer, not surprisingly, is “politics.” In example after detailed example, from tobacco to radiation to natural toxins, Proctor shows how interest group politics and the politics of science itself shape not only what we know and do not know about cancer, but what we try to do about it. Proctor’s argument is enhanced by his evenhandedness and credible skepticism in the face of the deeply polemical character of science in general and oncology in particular. My favorite example is the chapter on “the political morphology of dose- response curves,” which skillfully skewers the politics of doubt, caution, and risk. The policy issues, as always, are a t the fore; he shows again and again that it is our willingness to use the power of the state to govern ourselves to promote the general welfare that is a t stake.

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As Proctor puts it, the politics of cancer is about “what it means for citizens and collectivities to act prudently in the face of ignorance” (p. 173). Many forms of cancer are largely preventable. In contrast with the search for a cure, however, effective moves for prevention require powerful political ac- tions: “bans on smoking on commercial aircraft and in other indoor spaces, regulation of asbestos in the workplace, bans on certain pesticides and food additives,” plus “support for personal-injury litigation against the tobacco industry,” increased supervision of worksites, “modifying trade practices at home that encourage cancer abroad,” and perhaps above all cultivating “the political will to translate knowledge into policy” (pp. 258-270). In a political culture characterized by both an irrational faith in medical science and deep suspicion of government intervention in commercial and private life, not to mention government reliance on “sin taxes” (and therefore tobacco consump- tion), such political actions are unlikely. That is the politics of the cancer wars.

Neither Proctor nor Spitzer tells us why Americans are so reluctant to use the power of the people to regulate ourselves or so eager to discredit the instruments of self-governance. But they both provide important examples of the cost, in human lives as well as democratic integrity, of the prevalent urge to smash the state. Spitzer’s book is probably written in an idiom more familiar to people thinking about “reinventing government,” and certainly presents a useful policy-analysis-derived approach to political resolution to the gun control debate. Proctor’s book is not only a significant contribution to the history and social studies of science but a great read with a political sensibility that should leave no reader unmoved (with or against him). To- gether, they begin the difficult work of reestablishing the basis for democratic government as the heart of social responses to collective problems, and our political discourse is the richer for their efforts.

LISA D. BRUSH is Assistant Professor of‘ Sociology at the Universitv of’ Pitts- burgh.

David C. Wilhelm

Ethics in Congress: From Individual to Institutional Cowuption, by Dennis F. Thompson. Washington, DC: The Brookings Institution, 1995,256 pp., $34.95 cloth, $14.95 paper.

Dennis Thompson, the director of Harvard University’s Program in Ethics and the Professions, is either a brave man or a man with a good sense of humor. Or perhaps he is both. But anyone who names a book Ethics in Congress deserves some points for chutzpah. Even the press release issued by the Brookings Institution accompanying the release of the book notes that the title represents the ultimate oxymoron: congressional ethics, jumbo shrimp, military intelligence, get it?

It is certainly an academic pursuit where one has to stay constantly alert: Even though the book was published late last year, Thompson was unable to cover such late-breaking new stories as Speaker Newt Gingrich’s book deal with Rupert Murdoch, David Bonior’s emergence as the ethics tiger for the Democrats, Me1 Reynolds’ conviction for illicit sex with a minor, and the denouement of Senator Bob Packwood’s political career.