Abstract
This chapter examines the public and political contexts in which clinical research takes place, and the role the science community plays in shaping public and policymaker discourse and decision-making. As the role of the patient increasingly takes center stage, demands for more public transparency and accountability are increasing. The chapter references, controversies in clinical research, and public opinion poll data are cited to illustrate public attitudes and concerns. The important role of the media, including social media, is addressed; fiscal, ideological, and political challenges to research are described; the interactions of science and federal decision-makers are explored; and the consequences for science and scientists of continued lack of public and political engagement are outlined.
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