Science established small- pox vaccination’s efficacy, but municipal authorities decided to prioritize this efficacy over the proposition

[GoodTaste]

Judges stand on shakier ground when they press a second kind of medical argument — the claim that biomedical research compels a legal or policy judgment. “Follow the science,” it’s often said, but as the Court observed a century ago in Jacobson v. Massachusetts, science alone can’t command policy. Science, the Court noted in 1905, established smallpox vaccination’s efficacy, but municipal authorities decided to prioritize this efficacy over the proposition that personal liberty should preclude mandatory vaccination. The Court affirmed these authorities’ constitutional power to require vaccination. For both the authorities and the justices, science was the substrate; municipal authorities’ valuing of public safety over vaccine resistors’ freedom was the decision’s mo- tive force.

Source: The New England Journal of Medicine (Medicalising the Constitution?)

I don't understand the use of "but" here. The sentence seems actually meaning "Science...established small- pox vaccination’s efficacy, but (what's equally or more important was that) municipal authorities decided to prioritize this efficacy over the proposition", and thus echoes the previous claim that "science alone can’t command policy". If my guess is right, then the part of "(what's equally or more important was that)" would not be omittable. The omission would express the opposite meaning.

I checked out the definitions for "but" in Merriam-Webster Dictionary and found that "but" can mean "if not; unless", which might solve the problem here. But I am not sure.

What does "but" mean there?

 

[tedmc]

"But" is used because of the conflict between policy and science. While policy advocates personal freedom/liberty, science advices making small-pox vaccination mandatory because of its efficacy in preventing the disease.

 

[GoodTaste]

"But" is used because of the conflict between policy and science. While policy advocates personal freedom/liberty, science advices making small-pox vaccination mandatory because of its efficacy in preventing the disease.

"But" is applied there to describe the quality of policy-making or deciding of municipal authorities that overrode the policy of personal freedom. It's a situation of policy A overriding policy B. Here, B represents the policy of personal freedom. So, I am afraid that you've got the situation in a wrong way.

Policy A is not in conflict with vaccination; policy B is.

Hence the use of "but" is puzzling.

 

[Skrej]

In this context, read 'but' as 'however'.

The Supreme Court acknowledged that vaccines work in the 1905 case. However, it was local municipalities (the lowest level of the judicial system) not the highest court in the land, which prioritized vaccination over personal liberty (the choice to not get vaccinated). The Supreme Court merely acknowledged that the local municipalities did have the legal (constitutional) authority to require vaccination.

The sense of conflict imbued with 'but' is contrasting where the decision to require vaccination over personal liberty was made: at the local level, not the Supreme Court.

 

[GoodTaste]

The sense of conflict imbued with 'but' is contrasting where the decision to require vaccination over personal liberty was made: at the local level, not the Supreme Court.

In the next sentence the author said "The Court affirmed these authorities’ constitutional power to require vaccination". So it appears that the SC was consistent with the local authorities without apparent conflict.
And so the use or the intention of "but" keeps elusive, hard to understand.

 

[Skrej]

I think you're focusing on the wrong part, because I'm not sure why this is so confusing for you.

'But' is just contrasting that the decision to require vaccination was made at a local level, not the at the Supreme Court. The fact that the Court later agreed that was okay is a separate matter.

This is just emphasizing that science alone doesn't determine policy.

Perhaps a parallel example will help:
John told the group that the restaurant's apple pie was very good, but (it was) Susan (who) insisted everyone order it for dessert.

 

[GoodTaste]

I think you're focusing on the wrong part, because I'm not sure why this is so confusing for you.

'But' is just contrasting that the decision to require vaccination was made at a local level, not the at the Supreme Court. The fact that the Court later agreed that was okay is a separate matter.

This is just emphasizing that science alone doesn't determine policy.

Perhaps a parallel example will help:
John told the group that the restaurant's apple pie was very good, but (it was) Susan (who) insisted everyone order it for dessert.

So it follows the same pattern:
Science, the Court noted in 1905, established smallpox vaccination’s efficacy, but (it was) municipal authorities (that) decided to prioritize this efficacy over the proposition that personal liberty should preclude mandatory vaccination.

It becomes much clearer now.