I attended some talks at an international conference on science and religious conflict. What surprised me was the lack of scientific rigour in studies of this subject.
I was less interested in conflicts with a religious nature and more interested in religious conflict with science, and whether religion leads to conflict. The theologians and philosophers can talk all they like about religious doctrine, but what matters is the feeling of religiosity in the believers.
Religiosity is an accepted term in this field, it seems, but is hard to measure. It's easy to get weighed down by academic disagreements over pet theories about whether religious feeling can be divided into different classes (questing religion, for example, hardly follows the Western concept of a religion having unquestionable doctrine at all).
I would be happy with questionnaires about how often a person attends divine worship combined with a linear scale of religious fervour on which a participant must mark a cross.
The biggest problem with the research about religion and prejudice is the definition of prejudice, a point made by a philosopher (Ingmar Persson), but in a rambling and extensive way, in which he concluded that all opinion could be prejudice.
I agree with him to an extent, that the work has not identified prejudice well, but I wouldn't be so kind as to suggest that this is because prejudice is a vague, indefinable term. Measuring the effect of religious sentiment on an individual example of prejudice gives no meaningful results (despite the authors' conclusions). The study of which I am thinking concluded that religion can both create and dissipate prejudice, as was made clear in the different attitudes of religious respondents to homosexuality and Muslims.
This sort of conclusion is almost a truism. If something in which one deeply believes tells you that certain desires are sinful, you will be prejudiced against those with such desires.
What we really need to know is whether religion increases the general (or average) level of prejudice, if we can imagine such a thing. In animals the equivalent would be the level of defensive posture in response to strangers. In humans it is harder to conceive of an unbiased indicator because in-group and out-group sentiments are more complex, and so a 'stranger' might not necessarily be regarded as fully 'out-group', thereby destroying the usefulness of any experiments trying to measure attitudes towards out-groups.
If some behavioural measure could be used, without the volunteers' direct knowledge, that would truly tell us something about how religion influences people.
In order to find such a behavioural measure, we would need to assess how religion affects people's perceptions of who is 'in-group' and who is 'out-group'. Only then can we accurately provide each participant with behavioural cues that allow us to determine his responses to each type of category.
The other aspect of the study was the use of mortality salience testing, in which people were reminded of their mortality in order to make them more uncomfortable. Mortality and existential dread affect all humans, and religion certainly offers one way of coping with these inevitable aspects of intelligence. Hence religious people were less fazed by mortality salience.
An interesting counterpoint would be to examine whether religious people could be fazed (and therefore have their behaviour negatively affected) by other cues that do not affect atheists. For example, many scientific discoveries and theories directly contradict religious doctrines. Where atheists might be comfortable with such knowledge, religious people might be uncomfortable because the source of their comfort in situations including mortality salience is undermined.
The use of false comforts and the psychological conflict between knowledge and comfort therefore helps retard the progress of science.
This issue is now returning to previous, more philosophical, musings on this subject. It is the human need for comfort and familiarity, and the subordination of reason to emotions (such as this happiness with comfort, certainty, false purpose and familiarity) that is the flaw in our species.
Religion gives us purpose and absolute certainty in a world where these things do not truly exist. The need to have bedrocks on which to build our lives ruins our species.
Even in science we cannot do things properly. Instead of probabilities or likelihoods of truth we state a result as absolute truth if the result obtained passes a specific, arbitrary boundary of improbability if the conclusion were false. This arbitrary boundary allows us to state whether a conclusion is, or is not, justified in a binary manner. We should be stating probabilities of truth.
We need to accept the way science builds truth from 'truth density clouds' of results in the same field, just as physicists accept the use of probability density functions for small particles.
Science offers us accuracy, when used correctly, with increasing precision the more we use it. Religion offers us perfect precision but with completely ungovernable accuracy. And we as a species, with remarkable disregard for the truth, choose precision of knowledge over accuracy. We choose comfort over truth, emotion over sense, familiarity over curiosity and stability over progress: we choose religion.
I buck the trend of the species. I love truth. I get a little warm glow inside every time I break apart a puzzle and get the result, be it a puzzle of data, a riddle of life or analysing the foundations of a moral or political assertion. My certainty in life comes from the joy of applying logic and rigour; it comes from the truths I have so far uncovered (given the data I have) and the certainty that although the details of knowledge might change with new data, the beliefs I hold at any moment in time are the closest that I can get to the truth at that time.
As the Bible itself (almost) claims:
Magna est veritas et praevalebit
Great is truth and it shall prevail (a bit)
(I prefer the misquotation and mistranslation to the real version)
Thursday, 20 May 2010
Marriage
Someone was playing devil's advocate, and here states an argument that he's heard many people use about whether we should allow gay marriage.
What is wrong with that?
There is no well-supported justification for the promotion of marriage, other than religious beliefs. I see no reason why arbitrary religious decisions should govern society, since we're not theocracies and the US specifically guards against such interference in public affairs.
Marriage could be said to promote child welfare, except that children grow up best in extended families with large support networks, not in 'nuclear' (two-adult) families. So we're not promoting child welfare: the focus on two adults rather than many adults is detrimental to child (and adult) welfare. People need more than one social contact to live healthy, balanced lives.
So marriage cannot be said to be best for the children (although it's not worst, either, since two adults are better than one). It has no practical worth. It is simply an artefact of religious dominance of our societies. Were we truly progressive we would discard it and promote extended support networks for children and adults.
However, the concept of devotion to one other for your whole life has such a cultural resonance in our societies that the emotional reaction to discarding marriage would over-ride rational argument. It doesn't matter that throughout history humans have typically remained with a partner for (on average) 7-10 years, and that lifelong partnership is unnatural and difficult for most people.
Marriage is sacred in our culture, even to many who do not acknowledge the existence of God. They still demonstrate the responses of those for whom things are sacred when you talk about marriage. Marriage cannot be questioned; it is an 'elephant in the room'.
The fact that if we deduce certain principles about marriage from current arrangements we find some things repugnant (not allowing gays to marry) shows that the current system is flawed.
When we try to adjust it to take into account more fundamental principles, such as equal rights, we find, as I have quoted above, that the adjusted rules of marriage lead to absurdities. This is because marriage itself is an absurdity.
Obligatory Slippery Slope Argument #1
If you break with traditional marriage, where can it lead? Can the same arguments justifying same sex marriage be used to wed three or more people? Three people and a large furry animal? A man and his sex toy (android)?
What is wrong with that?
There is no well-supported justification for the promotion of marriage, other than religious beliefs. I see no reason why arbitrary religious decisions should govern society, since we're not theocracies and the US specifically guards against such interference in public affairs.
Marriage could be said to promote child welfare, except that children grow up best in extended families with large support networks, not in 'nuclear' (two-adult) families. So we're not promoting child welfare: the focus on two adults rather than many adults is detrimental to child (and adult) welfare. People need more than one social contact to live healthy, balanced lives.
So marriage cannot be said to be best for the children (although it's not worst, either, since two adults are better than one). It has no practical worth. It is simply an artefact of religious dominance of our societies. Were we truly progressive we would discard it and promote extended support networks for children and adults.
However, the concept of devotion to one other for your whole life has such a cultural resonance in our societies that the emotional reaction to discarding marriage would over-ride rational argument. It doesn't matter that throughout history humans have typically remained with a partner for (on average) 7-10 years, and that lifelong partnership is unnatural and difficult for most people.
Marriage is sacred in our culture, even to many who do not acknowledge the existence of God. They still demonstrate the responses of those for whom things are sacred when you talk about marriage. Marriage cannot be questioned; it is an 'elephant in the room'.
The fact that if we deduce certain principles about marriage from current arrangements we find some things repugnant (not allowing gays to marry) shows that the current system is flawed.
When we try to adjust it to take into account more fundamental principles, such as equal rights, we find, as I have quoted above, that the adjusted rules of marriage lead to absurdities. This is because marriage itself is an absurdity.
Friday, 14 May 2010
Love and relationships
I was chatting to a friend who was pondering the role of love in her life. She said:
I asked how affection could be idiotic:
I cannot see how affection can be betrayed. Affection is not an agreement or a promise: it's a feeling. It is my own state of feeling towards another. Betrayal needs a prior agreement; some sort of trust.
My friend's reply can be summarised thus:
I still don't think that any betrayal can take place without an agreement, nor that trust is the right word to use about expectations. Trust is an understanding that the other person will keep his word or will perform his job well, or something similar.
I think that one's expectations of others' behaviour should be thought of as being more like the expectations one has of a computer, or a bicycle. If these fail to function normally, then it can be frustrating and annoying, but they can't betray you. On the other hand, the companies that made them might have betrayed you to some extent.
In the same way, I can't be betrayed by a complete stranger on the street. I can be surprised by one, but without the law being broken, which could be considered a common agreement between everyone, there is no trust between us that could be broken. When expectations are not fulfilled it's time to learn and re-evaluate someone, but not feel betrayed by him unless he's made a commitment that's been broken (such as marriage).
My answer remains sufficient:
If I were to get upset with David Cameron for ruining the country, it doesn't matter how deeply personal my feelings are; it's wrong because he hasn't yet. Things can be wrong and be feelings. Similarly, people who feel betrayed frequently have not been, and the feeling, the resentment and any actions following from that are wrong.
I'm not denying that they might be in pain, although I do believe that the pain would be less if they didn't mix up feelings of trust and affection in the first place, but that doesn't make the justification for the pain true instead of false.
This little discussion was with only one person, but I wonder whether she is representative of many people in the world. Do many people believe that their affection is enough to warrant feelings of betrayal? Would the world be a better place if people expected nothing in return for their affection?
That sort of affection is often called love: 'true love expects nothing but gives everything' is a sentiment that is often repeated. But it seems to me that most people act as though the opposite were true: one expects nothing from one's acquaintances, but expects much from closer friends, for whom one has more love. I might even add that this is perhaps why so many people stay as my acquaintances; I do not anticipate their feelings nor respond to their expectations, but remain myself all the time.
I had another conversation this week, in which we discussed emotional closeness and courtesy. One person wanted closer emotional ties and more effusion, and as part of this expected her responses to be anticipated, and behaviour altered pre-emptively. I am of the opinion that the essence of manipulation is the anticipation of people's responses and the adjustment of one's own behaviour to control those responses. I am very much against this sort of double- and multi- bluffing and anticipation. As with any bluffing situation, it can rapidly get out of control. If I am to anticipate a response, then I must behave a certain way. And if that person is to be courteous to me, then she should anticipate that behaviour, and pre-empt it with a behaviour of her own...
and we get endless guessing games about what people mean, and whether they want something or think that you do. It's pointless and silly.
Quite apart from the risk that the ludicrous scenario that I've just described degenerates into arguments or deliberate, malicious manipulation, it makes far more sense to avoid the unnecessary complexity of multiple anticipations and behave straightforwardly.
My friends are my friends because I enjoy spending time with them and because, I assume, they do not mind me. I would not call friends people with whom I had to adjust my behaviour in order to be liked; they would then not like 'the real me', and I would be constantly alert because I would be consciously changing myself, like an actor doing his job. That's not relaxing or fun, and we'd be better off doing different things.
It's a shame that a person expects others to adjust their behaviour to account for his personal feelings, because it leads to all these different problems that I have described. The straightforward tolerance of others' actions and the acknowledgement that hopes and expectations are not the same as binding agreements would go a long way to reducing the amount of argument and disagreement that happens at a personal level all over the world.
The big problem is that I cannot break through with my attitude: people expect my behaviour to change, and if I address this expectation with this sort of direct argument, that itself often counts as offensive and against expectations. There is no way in to start change.
This issue ties in with my thoughts on speaking one's mind and adjusting speech for sensitive subjects, or avoiding jokes about such subjects.
When I say I love someone, I am certainly expressing deep affection for them as well as a level of trust that I won't be made to be an idiot for having that affection.
But I am not convinced that those phenomena are some sort of Higher Plane
I asked how affection could be idiotic:
If the person were not deserving of said affection--if i were betrayed, etc.
I cannot see how affection can be betrayed. Affection is not an agreement or a promise: it's a feeling. It is my own state of feeling towards another. Betrayal needs a prior agreement; some sort of trust.
My friend's reply can be summarised thus:
I don't think I can wholly separate affection from trust. If I can't trust someone at all, there's no way I could feel that level of affection for them. I could feel some affection, but nothing more than the affection I feel for something trivial.
I don't need someone to participate in an agreement in order for my trust to be broken, which may be unfortunate, but that's how it is.
I trust that they will behave a certain way, according to what I've come to expect.
I still don't think that any betrayal can take place without an agreement, nor that trust is the right word to use about expectations. Trust is an understanding that the other person will keep his word or will perform his job well, or something similar.
I think that one's expectations of others' behaviour should be thought of as being more like the expectations one has of a computer, or a bicycle. If these fail to function normally, then it can be frustrating and annoying, but they can't betray you. On the other hand, the companies that made them might have betrayed you to some extent.
In the same way, I can't be betrayed by a complete stranger on the street. I can be surprised by one, but without the law being broken, which could be considered a common agreement between everyone, there is no trust between us that could be broken. When expectations are not fulfilled it's time to learn and re-evaluate someone, but not feel betrayed by him unless he's made a commitment that's been broken (such as marriage).
I don't think it's wrong for someone to feel betrayed, not for something that is deeply personal
My answer remains sufficient:
If I were to get upset with David Cameron for ruining the country, it doesn't matter how deeply personal my feelings are; it's wrong because he hasn't yet. Things can be wrong and be feelings. Similarly, people who feel betrayed frequently have not been, and the feeling, the resentment and any actions following from that are wrong.
I'm not denying that they might be in pain, although I do believe that the pain would be less if they didn't mix up feelings of trust and affection in the first place, but that doesn't make the justification for the pain true instead of false.
This little discussion was with only one person, but I wonder whether she is representative of many people in the world. Do many people believe that their affection is enough to warrant feelings of betrayal? Would the world be a better place if people expected nothing in return for their affection?
That sort of affection is often called love: 'true love expects nothing but gives everything' is a sentiment that is often repeated. But it seems to me that most people act as though the opposite were true: one expects nothing from one's acquaintances, but expects much from closer friends, for whom one has more love. I might even add that this is perhaps why so many people stay as my acquaintances; I do not anticipate their feelings nor respond to their expectations, but remain myself all the time.
I had another conversation this week, in which we discussed emotional closeness and courtesy. One person wanted closer emotional ties and more effusion, and as part of this expected her responses to be anticipated, and behaviour altered pre-emptively. I am of the opinion that the essence of manipulation is the anticipation of people's responses and the adjustment of one's own behaviour to control those responses. I am very much against this sort of double- and multi- bluffing and anticipation. As with any bluffing situation, it can rapidly get out of control. If I am to anticipate a response, then I must behave a certain way. And if that person is to be courteous to me, then she should anticipate that behaviour, and pre-empt it with a behaviour of her own...
and we get endless guessing games about what people mean, and whether they want something or think that you do. It's pointless and silly.
Quite apart from the risk that the ludicrous scenario that I've just described degenerates into arguments or deliberate, malicious manipulation, it makes far more sense to avoid the unnecessary complexity of multiple anticipations and behave straightforwardly.
My friends are my friends because I enjoy spending time with them and because, I assume, they do not mind me. I would not call friends people with whom I had to adjust my behaviour in order to be liked; they would then not like 'the real me', and I would be constantly alert because I would be consciously changing myself, like an actor doing his job. That's not relaxing or fun, and we'd be better off doing different things.
It's a shame that a person expects others to adjust their behaviour to account for his personal feelings, because it leads to all these different problems that I have described. The straightforward tolerance of others' actions and the acknowledgement that hopes and expectations are not the same as binding agreements would go a long way to reducing the amount of argument and disagreement that happens at a personal level all over the world.
The big problem is that I cannot break through with my attitude: people expect my behaviour to change, and if I address this expectation with this sort of direct argument, that itself often counts as offensive and against expectations. There is no way in to start change.
This issue ties in with my thoughts on speaking one's mind and adjusting speech for sensitive subjects, or avoiding jokes about such subjects.
Tuesday, 4 May 2010
Patient Satisfaction
I have for a while been annoyed by advocates of patient satisfaction. In the past my friends and I have approached this subject from the poles of objectivity and subjectivity. I dislike involving subjective ratings (feelings) in any objective outcome (promotion, success, hospital income). On the other hand, we can point to the WHO definition of health as
'a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.'
This definitely includes feelings. So presumably a health service should aim to promote happiness as well as treat disease and physical infirmity. This is why the government blathers on endlessly about patient satisfaction, as though patients are customers shopping around for the best deal.
I've been into arguments about injustice before: about how a screaming person often gets seen before a quiet one (barring medical concerns about silence indicating inability), and how that punishes virtues such as patience, courtesy, consideration, self-control and the ability to wait one's turn. It's the same point I made in a recent post about achieving equality of outcome; it leads to unjust treatment of people. If you try to ensure that all children learn the same things at the same time you spend a lot of time and effort on the stupid ones and very little on the intelligent ones. Similarly with health-care, you can spend a lot of time on the needy. And in health-care that's appropriate because some things do need to be seen immediately. But the need must be objective, or else it leads to injustice.
This sort of inter-individual effect on justice seems a powerful enough argument to me, but some people would dismiss it as both insufficient to justify destroying a wonderful system of ratings, and a minor concern, since everyone does get medical care, even if the order is distorted slightly.
After all, if we weren't to use patient satisfaction, how else would we measure care? We'd have to rely on hospital inspections and outcomes, which we already do measure (and rely on to a fair extent). As we know, these are dangerous areas: hospital ratings and inspections do not reveal how a hospital really functions, with very highly rated hospitals suffering the two major health scandals of the last two years. Things can be hidden in a short inspection; inspectors don't see every aspect of day-to-day care, and outcomes depend on the severity of the cases and how the patients treat themselves.
If we aim for patient satisfaction, as now, or in a choice-driven NHS in which patients get easy choice of different providers, what will happen? The Conservatives say that care will improve, as those who provide poor care receive fewer patients and less money. They want more private companies, more choice and more market-like systems.
But the market won't be chasing good quality care. That's a little leap of faith. The leap is the logical deduction that patient satisfaction comes from better care, and better care alone. However, market systems require perfect knowledge. If every patient knew every range of possible treatments, their likely effect and could judge accurately surgeries and other procedures, then we'd be a nation of doctors and we could treat our own problems.
Just as companies distort the market by distorting what people know with advertising, publication bias (from pharmaceutical firms), false assurances and press releases, health-care providers can address patient satisfaction without improving care. This is more than a theoretical concern. Here is testimony from one doctor:
'When I first started practicing medicine, I had a lot of idealism about how I was going to improve care of patients in the ICU, and how some of my talent might even rub off on staff that were less talented. What I actually discovered was quite the opposite.
It turns out that healthcare in the US is set at a pretty low bar, and any attempts on my part to set it higher only caused widespread resentment. On the one hand, many resented the implication that a young physician like myself could offer anything of importance to older and more experienced physicians. After all, they've been doing it "this way" for years, and it's worked for them and for patients (so they believed). On the other hand, they also resented the implication that by making myself look smart, I made others look stupid. So, ironically, by trying to be the best physician I could be, I was actually putting myself in a vulnerable position. Since no one could support anything I did, I made enemies quickly.
There was a period in which I thought that even if I didn't have professional support, at least patients were better served by my care. All this changed with one experience that finally broke the camel's back. After rescuing a certain patient named M.S., I was dismissed from her care, by her family's request, because she was displeased that I did not treat her pain promptly enough. The fact that I had just saved her life didn't seem to concern her. This made me recognize that even patients don't necessarily want to get medical care. They only want certain petty concerns addressed -- usually issues of vanity. I decided that if neither the physicians nor the patients care about the quality of work that I do, why should I?
Since then, I have shifted my professional behavior markedly. Instead of trying to advance proper care, I have focused on image. Taking a cue from Machiavelli's statement that "people can see better than they can feel", I have made sure to portray the image that both patients and physicians expect, but avoiding making implications about others, even indirectly. I have found untold success in this method. In this world, it is better to look good, than be good. Since I have taken this route, my professional life has been much smoother. Because I portray the image expected of me, everyone thinks I'm their best friend. And because I don't act in a manner that appears to encroach on any other physician's territory, none of them see me as a threat. My personal life has also vastly improved. Since I don't have so much stress at work, I can remain relaxed at home. '
As the doctor notes, patient satisfaction wasn't about saving a life. Neither the patient nor her family knew that her life had been in danger, nor understood that it had been saved. What mattered was pain. Pain is quite subjective, and often treating pain is against best medical practice: there are endless people in hospital crying for better pain relief, calling the nurses torturers and so on, when any more will stop them breathing, get them addicted, interact badly with their other drugs or possibly a host of other medical concerns.
But even beyond the question of pain, the story demonstrates another truth: that satisfaction through ignorance is easier to achieve than satisfaction of the knowledgeable. If we introduce markets to health-care, then we will also introduce the typical market-failures and incentives, and one of the most damaging will be an even greater incentive to hide bad treatment, cover up failure, and generally rely on 'PR' over true ability.
My mother likes to tell the story of her inspection of two doctors in Liverpool. She was inspecting two gynaecology consultants, one of whom had some of the best post-natal survival figures in the country and one had a history of complications and problems (or something to that effect). One was friendly and liked by patients and staff, the other an aggressive man who told her that women couldn't be relied on to think clearly, especially when pregnant (and she was incubating me at the time), was disliked by staff and just about managed professional courtesy with patients. This second one had far fewer thank-you letters and gifts, but he was the one with the good survival rates.
Chasing patient satisfaction will not only get me seen much later than would be fair, but will give me poor care. I'll see a smart-looking doctor who is brisk and firm and projects an air of authority whilst explaining his decisions, and I'll feel comfortable that someone who knows his job is in charge. Actually, though, I'll be meeting someone who has more skill in acting than medicine, and who will skim over difficult decisions and problems because sounding uncertain will make me less confident and less satisfied. I'll meet someone who'll second-guess my responses as his main job, because my responses have suddenly become not just a secondary concern to his own actions, but more important than them, and the means by which his actions are judged.
If we return to what I've said in the past about leadership and democracy, we can see that this is the contrast between the popular and the sensible. In relationships it's the contrast between a reliable partner and a manipulative one. It's the clash between the subjective and objective; the hopes for absolute equality and the reality of equal rights. It's the same attitude that we decry as 'populism' but accept when it's coated with the sugary phrases of 'market forces' and 'economically sound'.
Economically sound means the same as well-evolved. People respond to incentives, just as creatures have responded to the environment. But evolved (in the biological sense) does not always mean improved, and a free market system in the NHS, or any pursuit of satisfaction over real care, will be the same.
If happiness is better, why don't we get everyone high on soma and let a ruling elite deal with unforseen problems?
Oh wait, things are going that way anyway... drugs, religion, apathy and plutocrats. Perhaps society is evolving after all.
We won't achieve benefits if people decide on the basis of satisfaction, not empirical statistics. And people do decide on that basis, which will affect my care too.
It's already affecting training: doctors are taught how to be nice. That's valuable time that could be spent on learning how to treat real conditions.
People are expecting to be made happy by many things, from the NHS to a shop assistant. Where that doesn't harm any other concern, that's fine with me. But aesthetics should contribute to good design, not detract from it. Where emotional appeal spoils something that otherwise functions well it's no longer something that the nation should invest in.
If the shop assistant takes longer to serve me because he's conversing with a customer then I've had my time wasted, even if it makes sound business sense. If a doctor does the same, then all the following patients will wait longer. That doctor might get good personal ratings, at the expense of the ward or hospital.
We could say that if the population as a whole wants this, then it doesn't matter that I don't want to waste my time waiting for other people to exchange life stories, or have my taxes pay them to do so.
But people are incapable of linking their individual decisions to mass effects. They will disagree with the mass effect and want to make the individual decision that causes it. They want everyone else to do what's right but to screw the system themselves. They can't cope with the Categorical Imperative that suggests that actions are judged by what would happen if everyone acted by such a principle.
That free markets, which are a version of mob rule, would lead to certain results doesn't mean that we actually want those results, nor that we should accept them. If we were to legalise drugs we'd get a lot of drug use, but that doesn't lead everyone to conclude that the population wants or ought to get a lot of drug use; the same applies to murder.
Do we want mob rule and the evolution of whatever panders to that best, or do we want a little bit of principle and insight? These are the things that supposedly distinguish democracy from anarchy (and mob rule). I can tolerate my local shop wasting my time, but I don't think that my government should do it. The government needs to be run by principles, not economics. The principle of 'give the people what they want' doesn't work when the people have conflicting wants. And when those wants are caused by a conflict of a principle with an immediate desire then the government should be governed by principle.
The conflict between immediate desire and long-term goals is well known:
http://www.ted.com/talks/lang/eng/dan_gilbert_researches_happiness.html
http://www.ted.com/talks/daniel_kahneman_the_riddle_of_experience_vs_memory.html
And just as well known is that giving in to immediate desire when it conflicts with long-term goals is bad for you:
http://www.ted.com/talks/lang/eng/joachim_de_posada_says_don_t_eat_the_marshmallow_yet.html
Sometimes we need government regulation to control short-term interests. We need the government to stop banks using the stock markets to take money from the economy and unbalance it. We need the government to take money from us to pay for upkeep of the infrastructure, because otherwise we'd not bother with repairs and we'd put it off indefinitely. Similarly, we need the government to prevent us from judging health care by patient satisfaction.
'a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.'
This definitely includes feelings. So presumably a health service should aim to promote happiness as well as treat disease and physical infirmity. This is why the government blathers on endlessly about patient satisfaction, as though patients are customers shopping around for the best deal.
I've been into arguments about injustice before: about how a screaming person often gets seen before a quiet one (barring medical concerns about silence indicating inability), and how that punishes virtues such as patience, courtesy, consideration, self-control and the ability to wait one's turn. It's the same point I made in a recent post about achieving equality of outcome; it leads to unjust treatment of people. If you try to ensure that all children learn the same things at the same time you spend a lot of time and effort on the stupid ones and very little on the intelligent ones. Similarly with health-care, you can spend a lot of time on the needy. And in health-care that's appropriate because some things do need to be seen immediately. But the need must be objective, or else it leads to injustice.
This sort of inter-individual effect on justice seems a powerful enough argument to me, but some people would dismiss it as both insufficient to justify destroying a wonderful system of ratings, and a minor concern, since everyone does get medical care, even if the order is distorted slightly.
After all, if we weren't to use patient satisfaction, how else would we measure care? We'd have to rely on hospital inspections and outcomes, which we already do measure (and rely on to a fair extent). As we know, these are dangerous areas: hospital ratings and inspections do not reveal how a hospital really functions, with very highly rated hospitals suffering the two major health scandals of the last two years. Things can be hidden in a short inspection; inspectors don't see every aspect of day-to-day care, and outcomes depend on the severity of the cases and how the patients treat themselves.
If we aim for patient satisfaction, as now, or in a choice-driven NHS in which patients get easy choice of different providers, what will happen? The Conservatives say that care will improve, as those who provide poor care receive fewer patients and less money. They want more private companies, more choice and more market-like systems.
But the market won't be chasing good quality care. That's a little leap of faith. The leap is the logical deduction that patient satisfaction comes from better care, and better care alone. However, market systems require perfect knowledge. If every patient knew every range of possible treatments, their likely effect and could judge accurately surgeries and other procedures, then we'd be a nation of doctors and we could treat our own problems.
Just as companies distort the market by distorting what people know with advertising, publication bias (from pharmaceutical firms), false assurances and press releases, health-care providers can address patient satisfaction without improving care. This is more than a theoretical concern. Here is testimony from one doctor:
'When I first started practicing medicine, I had a lot of idealism about how I was going to improve care of patients in the ICU, and how some of my talent might even rub off on staff that were less talented. What I actually discovered was quite the opposite.
It turns out that healthcare in the US is set at a pretty low bar, and any attempts on my part to set it higher only caused widespread resentment. On the one hand, many resented the implication that a young physician like myself could offer anything of importance to older and more experienced physicians. After all, they've been doing it "this way" for years, and it's worked for them and for patients (so they believed). On the other hand, they also resented the implication that by making myself look smart, I made others look stupid. So, ironically, by trying to be the best physician I could be, I was actually putting myself in a vulnerable position. Since no one could support anything I did, I made enemies quickly.
There was a period in which I thought that even if I didn't have professional support, at least patients were better served by my care. All this changed with one experience that finally broke the camel's back. After rescuing a certain patient named M.S., I was dismissed from her care, by her family's request, because she was displeased that I did not treat her pain promptly enough. The fact that I had just saved her life didn't seem to concern her. This made me recognize that even patients don't necessarily want to get medical care. They only want certain petty concerns addressed -- usually issues of vanity. I decided that if neither the physicians nor the patients care about the quality of work that I do, why should I?
Since then, I have shifted my professional behavior markedly. Instead of trying to advance proper care, I have focused on image. Taking a cue from Machiavelli's statement that "people can see better than they can feel", I have made sure to portray the image that both patients and physicians expect, but avoiding making implications about others, even indirectly. I have found untold success in this method. In this world, it is better to look good, than be good. Since I have taken this route, my professional life has been much smoother. Because I portray the image expected of me, everyone thinks I'm their best friend. And because I don't act in a manner that appears to encroach on any other physician's territory, none of them see me as a threat. My personal life has also vastly improved. Since I don't have so much stress at work, I can remain relaxed at home. '
As the doctor notes, patient satisfaction wasn't about saving a life. Neither the patient nor her family knew that her life had been in danger, nor understood that it had been saved. What mattered was pain. Pain is quite subjective, and often treating pain is against best medical practice: there are endless people in hospital crying for better pain relief, calling the nurses torturers and so on, when any more will stop them breathing, get them addicted, interact badly with their other drugs or possibly a host of other medical concerns.
But even beyond the question of pain, the story demonstrates another truth: that satisfaction through ignorance is easier to achieve than satisfaction of the knowledgeable. If we introduce markets to health-care, then we will also introduce the typical market-failures and incentives, and one of the most damaging will be an even greater incentive to hide bad treatment, cover up failure, and generally rely on 'PR' over true ability.
My mother likes to tell the story of her inspection of two doctors in Liverpool. She was inspecting two gynaecology consultants, one of whom had some of the best post-natal survival figures in the country and one had a history of complications and problems (or something to that effect). One was friendly and liked by patients and staff, the other an aggressive man who told her that women couldn't be relied on to think clearly, especially when pregnant (and she was incubating me at the time), was disliked by staff and just about managed professional courtesy with patients. This second one had far fewer thank-you letters and gifts, but he was the one with the good survival rates.
Chasing patient satisfaction will not only get me seen much later than would be fair, but will give me poor care. I'll see a smart-looking doctor who is brisk and firm and projects an air of authority whilst explaining his decisions, and I'll feel comfortable that someone who knows his job is in charge. Actually, though, I'll be meeting someone who has more skill in acting than medicine, and who will skim over difficult decisions and problems because sounding uncertain will make me less confident and less satisfied. I'll meet someone who'll second-guess my responses as his main job, because my responses have suddenly become not just a secondary concern to his own actions, but more important than them, and the means by which his actions are judged.
If we return to what I've said in the past about leadership and democracy, we can see that this is the contrast between the popular and the sensible. In relationships it's the contrast between a reliable partner and a manipulative one. It's the clash between the subjective and objective; the hopes for absolute equality and the reality of equal rights. It's the same attitude that we decry as 'populism' but accept when it's coated with the sugary phrases of 'market forces' and 'economically sound'.
Economically sound means the same as well-evolved. People respond to incentives, just as creatures have responded to the environment. But evolved (in the biological sense) does not always mean improved, and a free market system in the NHS, or any pursuit of satisfaction over real care, will be the same.
If happiness is better, why don't we get everyone high on soma and let a ruling elite deal with unforseen problems?
Oh wait, things are going that way anyway... drugs, religion, apathy and plutocrats. Perhaps society is evolving after all.
We won't achieve benefits if people decide on the basis of satisfaction, not empirical statistics. And people do decide on that basis, which will affect my care too.
It's already affecting training: doctors are taught how to be nice. That's valuable time that could be spent on learning how to treat real conditions.
People are expecting to be made happy by many things, from the NHS to a shop assistant. Where that doesn't harm any other concern, that's fine with me. But aesthetics should contribute to good design, not detract from it. Where emotional appeal spoils something that otherwise functions well it's no longer something that the nation should invest in.
If the shop assistant takes longer to serve me because he's conversing with a customer then I've had my time wasted, even if it makes sound business sense. If a doctor does the same, then all the following patients will wait longer. That doctor might get good personal ratings, at the expense of the ward or hospital.
We could say that if the population as a whole wants this, then it doesn't matter that I don't want to waste my time waiting for other people to exchange life stories, or have my taxes pay them to do so.
But people are incapable of linking their individual decisions to mass effects. They will disagree with the mass effect and want to make the individual decision that causes it. They want everyone else to do what's right but to screw the system themselves. They can't cope with the Categorical Imperative that suggests that actions are judged by what would happen if everyone acted by such a principle.
That free markets, which are a version of mob rule, would lead to certain results doesn't mean that we actually want those results, nor that we should accept them. If we were to legalise drugs we'd get a lot of drug use, but that doesn't lead everyone to conclude that the population wants or ought to get a lot of drug use; the same applies to murder.
Do we want mob rule and the evolution of whatever panders to that best, or do we want a little bit of principle and insight? These are the things that supposedly distinguish democracy from anarchy (and mob rule). I can tolerate my local shop wasting my time, but I don't think that my government should do it. The government needs to be run by principles, not economics. The principle of 'give the people what they want' doesn't work when the people have conflicting wants. And when those wants are caused by a conflict of a principle with an immediate desire then the government should be governed by principle.
The conflict between immediate desire and long-term goals is well known:
http://www.ted.com/talks/lang/eng/dan_gilbert_researches_happiness.html
http://www.ted.com/talks/daniel_kahneman_the_riddle_of_experience_vs_memory.html
And just as well known is that giving in to immediate desire when it conflicts with long-term goals is bad for you:
http://www.ted.com/talks/lang/eng/joachim_de_posada_says_don_t_eat_the_marshmallow_yet.html
Sometimes we need government regulation to control short-term interests. We need the government to stop banks using the stock markets to take money from the economy and unbalance it. We need the government to take money from us to pay for upkeep of the infrastructure, because otherwise we'd not bother with repairs and we'd put it off indefinitely. Similarly, we need the government to prevent us from judging health care by patient satisfaction.
Thursday, 29 April 2010
Efficiency
I grew up treasuring efficiency. I wanted the remote-controlled car that lasted longest, not the flashiest one (yes, I realise that's not necessarily the most efficient, but from a child's point of view in which charging is not a cost it is. It gave me the most time for each 'play'). I wanted games which I'd use a lot. And once I had something I used it. I was even known to choose sweets based on how long they took to eat, since there was no point in the expensive sherbet dips which took 2 seconds to eat.
It was an essential feature of who I was. Maybe that's why I turned to science; the concept of parsimony is simply requiring theoretical efficiency. I was good at efficiency. When we ran around the mountains to reach various markers I planned the route. No other group took our route, and we won comfortably (also due to running the 26 miles rather than hiking).
When we spent two lessons in geography not learning about either tectonics or flooding in Bangladesh, and tried to guess from maps where to put a big city for best resource use, or how to link a number of cities in the best network, I was almost interested in geography. Nowadays we have computer programmes that do this (via iterative methods: no-one's found a programme to solve this better), or else we use slime mould.
As I grew older, we got into more complex problems. When we were asked how we'd guess a fraction if we could only be told that it was higher or lower, a load of people were stumped because they didn't understand the question. One guy said he'd go up in 0.1 intervals. He was thinking of ruling out each decimal in turn on a calculator display screen. I rolled my eyes. I would always start with 0.5, then halve the possibilities each time. It needs fewer guesses, which saves time.
Enough of the background. You can all see that fewer guesses is a good thing if, for example, it's an integral part of a computer programme. We don't want to spend three times as long watching our computers process things because the programmes are inefficient. Efficiency is hugely important.
Why do we have markets? We have markets because, we're told, they're the most efficient way to distribute goods and services. History shows us that all alternatives that have been tried (at a state level) are indeed distinctly worse. Hooray for efficiency! I can buy what I want cheaply because everyone else wants one cheaply too.
So let's look at housing. Yes, it's a bit of a jump in subject. This country's housing stock is hugely inefficient, requiring the architectural intelligence and insight of a chimpanzee. We have the ability to design buildings that need neither air conditioning nor heating, because they create and use draughts and sunlight.
Instead we stick a load of bricks together (or perhaps embed some steel in some concrete and encase it all in glass) and call it modern. Spanish haciendas and the old stone churches needed more ingenuity!
I've mentioned the incredibly backward nature of housing before. It amazes me that in the modern world we have the ability to save resources (both natural resources and money: heating or air conditioning are a large proportion of running costs for most buildings) but we don't use them. It hurts deep inside. Efficiency, I love you much too much (http://www.youtube.com/watch?v=hcH-qRUvGlQ).
Well, I've clearly got a problem with housing. Thankfully, technology is used so much more in other industries, like... motoring?
I'm an efficient driver. In fact, when I started to learn, I was told that I was being dangerously efficient. I would coast everywhere, and we are told that it's best to have the engine engaged in order to have more control (and prevent safety mechanisms locking the steering wheel). I only really started leaving the engine engaged when my instructor told me that engine braking uses less fuel than an idling, disengaged engine (and saves brake wear). I love efficiency! Not for me the thrills of over-revving just for the sound, nor speeding right up to the junction only to brake hard.
We can make engines that run 40 mpg. We can even make vehicles that run 80 mpg. We can make vehicles so efficient that I could do the Oxford-Cambridge-London circuit with a quarter of a tank (rather than the half that I did use). We can fit more people into vehicles, and we even have specialised vehicles, called buses and trains, designed to do just this.
But do we? No.
Europeans are better at it than the wasteful Americans, who, despite needing to travel further, prefer their cars and engines huge and hugely wasteful. Not for me a money-saving, petrol-saving (gas-saving, for those of you not up with the hip lingo), world-saving vehicle. I'll waste my money on destroying the world, thank-you very much. I like the place that much. Well, with people like that around, I can sympathise.
We spend fortunes on paint jobs and bodywork, on getting the latest model and cleaning. Is any of this for efficiency? Do we improve the bodywork for better aerodynamics? Do we see that the latest model can squeeze out an extra few miles every day?
Do we do all this for comfort? Does the next model have a reclining, cushioned chair but our old one just the hard wooden seat? Sometimes convenience might play a part: a new CD player, better air conditioning, new upholstery, a gearbox that doesn't stick on 5th, but mostly this is all for one thing: style.
We waste money because we're buying respect. I don't know from whom these people are buying respect, because I can't see the reasons for admiring desperation and waste.
In fact, the more look around many industries, the more waste we see. People buy guzzling engines, cheap light bulbs, inefficient homes and refrigerators, endless new clothes etc. I can't really complain about some effects of fashion, like bars that charge as much for a measure spirits as the whole bottle costs. It's frustrating if people I know want to go there 'because it's nice', but it's a different issue.
This drive to waste is an inherent quality of capitalism. This is hardly a new observation: we've had complaints about consumption and consumerism for decades. Why does capitalism value short-term interests?
Firstly, the mobility of capital, and the nature of the stock market, means that at any one moment investors want to see an immediate improvement in stock values. They can sell when they want, and invest elsewhere, so if they have to wait, they won't.
Secondly, people have problems with future-discounting. They don't buy a product that costs twice as much and will last ten times as long. Having wealth now is given disproportionate value over wealth in the future. Maybe this is a psychological trait we have because of the nature of nature: life is nasty, brutish, uncertain and short. However, we don't live in nature any more, and life is more dependable. You can depend on regretting frittering your money away pointlessly.
Thirdly, at the intermediate level, companies have no incentives to prioritise long-term plans. Companies are run by individuals. They need make an immediate, individual impact, in order to be promoted (or not get fired). They need to get things done now. If you judge people on a month's results, but it takes a year to form a good relationship with a customer through friendly and efficient provision of follow-up services, then you'll have very pushy and unfriendly staff. CEOs can sack hordes of staff to cut costs and leave the company before it runs itself into the ground.
Of course, not all capital is as mobile. Those who can't keep up lose. Private investors and ponderous pension funds invest for the longer-term, fighting the other pressures to short-term considerations. When short-term considerations are given priority, long-term investors lose, along with everyone who has long-term interests: the workforce, customers (whose customer service might suffer if a company fails) and related business that work with that company (and have invested in future business). And who gets their money out first when a company goes under? Is it done under a length-of-investment basis, so that those who put their money in first get something? No, because that might lead to pyramid schemes (even though these are outlawed separately). Is it those with business relations? No, it's the big lenders. It's the people who invest short-term and could have bought the debt the day before. So there's even more reason that big banks with short-term investment outlooks thrive. We even have supercomputers buying and selling within fractions of a millisecond of each other. That hardly seems like a useful activity. The big banks make money, and we need to ask ourselves where this money comes from. Is it enough to say 'well, they pay taxes, so it's alright' (leaving aside their ingenious tax avoidance schemes which become so much more worthwhile when done on behalf of enormous amounts of capital)? If they're a tax on business itself, it's no good to allow it because some of the money goes to the exchequer. When businesses fail because of stock market games, employees and medium lenders lose out. When a stock-market investor makes money, it must come from somewhere. Do we, as a society, think that the supposedly more efficient distribution of capital is worth this tax of greed that costs billions of pounds?
That's enough getting side-tracked. The point is that capitalism is geared for as short-term an outlook as possible. This is partly because people are that way too. But we expect our societies to be run with some consideration for the future. So government needs to step in and impose long-term considerations. Not just environmental externalities, but incentives for people to make sensible long-term decisions.
We wouldn't be in a mess if people actually cared about efficiency and sustainability. Capitalism can never fully value efficiency of the sort I'd naturally want to value, because efficiency gains in resource management will always be outweighed by efficiency in resource consumption. Why make it stretch further when it's cheaper to use more?
The only time capitalism can value efficiency is when there's nothing left to consume. By it's nature it can't account for finite resources until they are gone, which is the height of stupidity. We need a hefty penalty on taking things that can't be replaced. Not just an environmental penalty because most of these things generate pollution, but a penalty that takes into account the incredible externalities of depriving everyone in the future of using that good for any and every possible future use.
Since we don't even know all the possible future uses of any good, the penalties need to be large to allow for possible very useful uses. That's efficiency. Why is it good to burn as much as possible now? If they knew what underlies modern economies, would most people really accept the sort of nihilism that says the future has no rights and that destroying the planet now is acceptable if it gets us better lives for a day or two?
I want to see futuristic houses where the draughts are treasured parts of the architecture. I want to see a world where the amazing insights in mathematics are applied to everyday problems; where we travel in electric cars and have oil left to make plastics. But long-term visions require planning, and if you mention planning, you raise the dread shadow of state-planning and control, feared before anyone even sees what it actually looks like.
So we're stuck with the belief that out of chaos comes order. It's true; evolution proves the tautology that things that best survive survive best. Until a shock, like running out of resources, or meeting something new. Evolution shows that the order from chaos is only responsive, and never predictive. The dodo, the dinosaurs, the kiwi... there are endless examples of the losses incurred by the 'it'll work out without interference' attitude.
But not bothering to anticipate the future is incredibly inefficient. If we only ever respond, we'll always lag behind, dragged along by the forces we create. We need to get cleverer. We need efficiency.
Where can we find it? State planning is dead, a catastrophic failure, like the introduction of the cane toad. An impossibility that is too complex ever to work. Wait! What? We don't understand the problem well enough, so we dismiss it, but when it comes to problems like what to do when the resources run out we're told 'we'll solve it, even though we haven't yet'. I detect some bias in the levels of optimism.
As it happens, I think we should have great optimism about state interventions. The cane toad was a failure in adjusting complex market-like systems, but there have been hundreds of successful instances of biological control since then. Our understanding improved, and so did our success rate. Biology is leading the way. We just need economists and politicians to follow.
It was an essential feature of who I was. Maybe that's why I turned to science; the concept of parsimony is simply requiring theoretical efficiency. I was good at efficiency. When we ran around the mountains to reach various markers I planned the route. No other group took our route, and we won comfortably (also due to running the 26 miles rather than hiking).
When we spent two lessons in geography not learning about either tectonics or flooding in Bangladesh, and tried to guess from maps where to put a big city for best resource use, or how to link a number of cities in the best network, I was almost interested in geography. Nowadays we have computer programmes that do this (via iterative methods: no-one's found a programme to solve this better), or else we use slime mould.
As I grew older, we got into more complex problems. When we were asked how we'd guess a fraction if we could only be told that it was higher or lower, a load of people were stumped because they didn't understand the question. One guy said he'd go up in 0.1 intervals. He was thinking of ruling out each decimal in turn on a calculator display screen. I rolled my eyes. I would always start with 0.5, then halve the possibilities each time. It needs fewer guesses, which saves time.
Enough of the background. You can all see that fewer guesses is a good thing if, for example, it's an integral part of a computer programme. We don't want to spend three times as long watching our computers process things because the programmes are inefficient. Efficiency is hugely important.
Why do we have markets? We have markets because, we're told, they're the most efficient way to distribute goods and services. History shows us that all alternatives that have been tried (at a state level) are indeed distinctly worse. Hooray for efficiency! I can buy what I want cheaply because everyone else wants one cheaply too.
So let's look at housing. Yes, it's a bit of a jump in subject. This country's housing stock is hugely inefficient, requiring the architectural intelligence and insight of a chimpanzee. We have the ability to design buildings that need neither air conditioning nor heating, because they create and use draughts and sunlight.
Instead we stick a load of bricks together (or perhaps embed some steel in some concrete and encase it all in glass) and call it modern. Spanish haciendas and the old stone churches needed more ingenuity!
I've mentioned the incredibly backward nature of housing before. It amazes me that in the modern world we have the ability to save resources (both natural resources and money: heating or air conditioning are a large proportion of running costs for most buildings) but we don't use them. It hurts deep inside. Efficiency, I love you much too much (http://www.youtube.com/watch?v=hcH-qRUvGlQ).
Well, I've clearly got a problem with housing. Thankfully, technology is used so much more in other industries, like... motoring?
I'm an efficient driver. In fact, when I started to learn, I was told that I was being dangerously efficient. I would coast everywhere, and we are told that it's best to have the engine engaged in order to have more control (and prevent safety mechanisms locking the steering wheel). I only really started leaving the engine engaged when my instructor told me that engine braking uses less fuel than an idling, disengaged engine (and saves brake wear). I love efficiency! Not for me the thrills of over-revving just for the sound, nor speeding right up to the junction only to brake hard.
We can make engines that run 40 mpg. We can even make vehicles that run 80 mpg. We can make vehicles so efficient that I could do the Oxford-Cambridge-London circuit with a quarter of a tank (rather than the half that I did use). We can fit more people into vehicles, and we even have specialised vehicles, called buses and trains, designed to do just this.
But do we? No.
Europeans are better at it than the wasteful Americans, who, despite needing to travel further, prefer their cars and engines huge and hugely wasteful. Not for me a money-saving, petrol-saving (gas-saving, for those of you not up with the hip lingo), world-saving vehicle. I'll waste my money on destroying the world, thank-you very much. I like the place that much. Well, with people like that around, I can sympathise.
We spend fortunes on paint jobs and bodywork, on getting the latest model and cleaning. Is any of this for efficiency? Do we improve the bodywork for better aerodynamics? Do we see that the latest model can squeeze out an extra few miles every day?
Do we do all this for comfort? Does the next model have a reclining, cushioned chair but our old one just the hard wooden seat? Sometimes convenience might play a part: a new CD player, better air conditioning, new upholstery, a gearbox that doesn't stick on 5th, but mostly this is all for one thing: style.
We waste money because we're buying respect. I don't know from whom these people are buying respect, because I can't see the reasons for admiring desperation and waste.
In fact, the more look around many industries, the more waste we see. People buy guzzling engines, cheap light bulbs, inefficient homes and refrigerators, endless new clothes etc. I can't really complain about some effects of fashion, like bars that charge as much for a measure spirits as the whole bottle costs. It's frustrating if people I know want to go there 'because it's nice', but it's a different issue.
This drive to waste is an inherent quality of capitalism. This is hardly a new observation: we've had complaints about consumption and consumerism for decades. Why does capitalism value short-term interests?
Firstly, the mobility of capital, and the nature of the stock market, means that at any one moment investors want to see an immediate improvement in stock values. They can sell when they want, and invest elsewhere, so if they have to wait, they won't.
Secondly, people have problems with future-discounting. They don't buy a product that costs twice as much and will last ten times as long. Having wealth now is given disproportionate value over wealth in the future. Maybe this is a psychological trait we have because of the nature of nature: life is nasty, brutish, uncertain and short. However, we don't live in nature any more, and life is more dependable. You can depend on regretting frittering your money away pointlessly.
Thirdly, at the intermediate level, companies have no incentives to prioritise long-term plans. Companies are run by individuals. They need make an immediate, individual impact, in order to be promoted (or not get fired). They need to get things done now. If you judge people on a month's results, but it takes a year to form a good relationship with a customer through friendly and efficient provision of follow-up services, then you'll have very pushy and unfriendly staff. CEOs can sack hordes of staff to cut costs and leave the company before it runs itself into the ground.
Of course, not all capital is as mobile. Those who can't keep up lose. Private investors and ponderous pension funds invest for the longer-term, fighting the other pressures to short-term considerations. When short-term considerations are given priority, long-term investors lose, along with everyone who has long-term interests: the workforce, customers (whose customer service might suffer if a company fails) and related business that work with that company (and have invested in future business). And who gets their money out first when a company goes under? Is it done under a length-of-investment basis, so that those who put their money in first get something? No, because that might lead to pyramid schemes (even though these are outlawed separately). Is it those with business relations? No, it's the big lenders. It's the people who invest short-term and could have bought the debt the day before. So there's even more reason that big banks with short-term investment outlooks thrive. We even have supercomputers buying and selling within fractions of a millisecond of each other. That hardly seems like a useful activity. The big banks make money, and we need to ask ourselves where this money comes from. Is it enough to say 'well, they pay taxes, so it's alright' (leaving aside their ingenious tax avoidance schemes which become so much more worthwhile when done on behalf of enormous amounts of capital)? If they're a tax on business itself, it's no good to allow it because some of the money goes to the exchequer. When businesses fail because of stock market games, employees and medium lenders lose out. When a stock-market investor makes money, it must come from somewhere. Do we, as a society, think that the supposedly more efficient distribution of capital is worth this tax of greed that costs billions of pounds?
That's enough getting side-tracked. The point is that capitalism is geared for as short-term an outlook as possible. This is partly because people are that way too. But we expect our societies to be run with some consideration for the future. So government needs to step in and impose long-term considerations. Not just environmental externalities, but incentives for people to make sensible long-term decisions.
We wouldn't be in a mess if people actually cared about efficiency and sustainability. Capitalism can never fully value efficiency of the sort I'd naturally want to value, because efficiency gains in resource management will always be outweighed by efficiency in resource consumption. Why make it stretch further when it's cheaper to use more?
The only time capitalism can value efficiency is when there's nothing left to consume. By it's nature it can't account for finite resources until they are gone, which is the height of stupidity. We need a hefty penalty on taking things that can't be replaced. Not just an environmental penalty because most of these things generate pollution, but a penalty that takes into account the incredible externalities of depriving everyone in the future of using that good for any and every possible future use.
Since we don't even know all the possible future uses of any good, the penalties need to be large to allow for possible very useful uses. That's efficiency. Why is it good to burn as much as possible now? If they knew what underlies modern economies, would most people really accept the sort of nihilism that says the future has no rights and that destroying the planet now is acceptable if it gets us better lives for a day or two?
I want to see futuristic houses where the draughts are treasured parts of the architecture. I want to see a world where the amazing insights in mathematics are applied to everyday problems; where we travel in electric cars and have oil left to make plastics. But long-term visions require planning, and if you mention planning, you raise the dread shadow of state-planning and control, feared before anyone even sees what it actually looks like.
So we're stuck with the belief that out of chaos comes order. It's true; evolution proves the tautology that things that best survive survive best. Until a shock, like running out of resources, or meeting something new. Evolution shows that the order from chaos is only responsive, and never predictive. The dodo, the dinosaurs, the kiwi... there are endless examples of the losses incurred by the 'it'll work out without interference' attitude.
But not bothering to anticipate the future is incredibly inefficient. If we only ever respond, we'll always lag behind, dragged along by the forces we create. We need to get cleverer. We need efficiency.
Where can we find it? State planning is dead, a catastrophic failure, like the introduction of the cane toad. An impossibility that is too complex ever to work. Wait! What? We don't understand the problem well enough, so we dismiss it, but when it comes to problems like what to do when the resources run out we're told 'we'll solve it, even though we haven't yet'. I detect some bias in the levels of optimism.
As it happens, I think we should have great optimism about state interventions. The cane toad was a failure in adjusting complex market-like systems, but there have been hundreds of successful instances of biological control since then. Our understanding improved, and so did our success rate. Biology is leading the way. We just need economists and politicians to follow.
Wednesday, 28 April 2010
Equality
The following post is an amalgamation of some responses I made to an interlocutor who was promoting the doctrine of equality.
The idea that we can dismiss all characteristics as irrelevant to a person's worth is a circular argument. We start of with the supposition that everyone is of equal worth, and then use this premise to discard any factor that might make people of different worth, and then finally conclude that everyone is of equal worth.
The statement that everyone is of equal worth is false. There is obviously no practical justification for such a statement, so we turn to moral justification. I can't think of any moral premise that can lead us to the conclusion that 'everyone is of equal worth' except by arbitrarily assuming this to be so.
This assumption leads to some interesting conclusions. If everyone deserves the same amount of life satisfaction, then people like myself who are not particularly excitable or happy deserve far more resources than those who provide these things for themselves; or, in contrast, people like myself who are never depressed deserve less simply because of who we are.
Similarly, a hunter who catches three rabbits for every one rabbit another catches is in effect being told that his rabbits are of less value if both get the same outcomes. That's hardly fair treatment.
Finally, ability is not simply inherent to some people, but is multiplicative with effort. If I make the effort to achieve more, giving me the same reward is telling me that effort is worthless. If everyone deserves the same outcomes as everyone else, we are telling people that character and virtue are worthless. This is in stark contrast to many moral theories, whose main aim is to justify the labelling of virtues as virtues.
I know that invoking Karl Marx will make some people automatically disagree, but he agreed with me:
Marx is saying that we can have equal rights or equality, but not both. If try to change the natural differences in ability, desire and need then we will treat people very unequally, which would contravene a doctrine of equal rights and equal worth in the eyes of the law. I won't touch further on the idea of taking into account people's subjective wants and desires in order to try to give everyone the same amount of life satisfaction. There are enough problems with that for a post on its own.
People are not practically equal. This is an undeniable fact (as long as you accept anything about reality at all). If we grant them equal moral worth then we make sure that we don't have universal rules that specifically grant more rights or punishment to a pre-defined group of people. That is the essence of giving everyone equal worth: that all are equal in the eyes of the law (to start with).
If we start dealing in resources, rather than simply moral rights such as which actions a person can and cannot take, we move into defining material worth. If we are defining material worth, we cannot escape the fact that people are not materially(/practically) equal.
I refuse to accept that equal moral worth necessitates a jump to enforcing equal material worth. Moral worth is about not denying a person a place on a bus simply because of skin colour. Material worth is unconnected. If a person cannot pay for the bus ride, then skin or not he doesn't get a ride.
If someone is so materially lacking that he is unable to fulfill basic moral rights, such as voting, getting public services that are theoretically available to all and so on, then these things are not available to all, despite the moral contention that they should be, and so our society has passed laws to ensure that they are more accessible. This requires material investment, but it is not a statement of material worth.
A lot of unhappiness and dissatisfaction comes from the equation in people's minds of material and moral worth and the observable differences in material worth. The solution is not to attempt to make everyone of equal material worth despite the manifest injustices that would be involved, nor simply to state that it's a theoretical goal that can never be achieved (what a system of morality that would be, that states that the world is immoral, even before any free agent has taken his first action!).
The solution is to accept that it is fallacious to link material and moral worth. If we can expunge this foolish notion from people's heads a great many aspects of life would be avoided. Things like the hero worship of rich men, the hesitance to challenge and stand up to the old and established, the deference to irrationality because it's spoken by a successful businessman... all these things are partly caused by foolish people linking moral worth to other factors. A simple excision of the fallacy of 'the appeal to authority' from the world would be a nice start, including removing the use of (and need for) endless references to old philosophers (like Karl Marx).
is the refrain of the Peasants' Revolt (of 1381). These people were not arguing about whether they ought to receive as much life satisfaction as everyone else. They were simply stating that 'Jack's as good as his master', not in terms of material worth, but in rights. They wanted to be able to travel to different farms and get paid what they could get (because labour was in short supply after the plague), rather than be constrained by area or by fixed prices. This line of radical politics has long been an English tradition, but I don't see it as leading necessarily to equal material worth.
In contrast, I can see an English tradition for pricking pomposity and arrogance. The English as a nation have for a long time had a tradition of marked irreverence for status and authority. It is this radical notion that moral (and intellectualand logical) worth is not linked to social status, power or wealth that has been particularly well-incubated in England, and it is this fact that continues to escape philosophers, politicians, the rich, wealthy and powerful all over the world.
Radicalism need not delve into strange notions of absolute equality. Simple confirmation of what peasants knew 600 years ago would be a good start for modern politics.
The idea that we can dismiss all characteristics as irrelevant to a person's worth is a circular argument. We start of with the supposition that everyone is of equal worth, and then use this premise to discard any factor that might make people of different worth, and then finally conclude that everyone is of equal worth.
The statement that everyone is of equal worth is false. There is obviously no practical justification for such a statement, so we turn to moral justification. I can't think of any moral premise that can lead us to the conclusion that 'everyone is of equal worth' except by arbitrarily assuming this to be so.
This assumption leads to some interesting conclusions. If everyone deserves the same amount of life satisfaction, then people like myself who are not particularly excitable or happy deserve far more resources than those who provide these things for themselves; or, in contrast, people like myself who are never depressed deserve less simply because of who we are.
Similarly, a hunter who catches three rabbits for every one rabbit another catches is in effect being told that his rabbits are of less value if both get the same outcomes. That's hardly fair treatment.
Finally, ability is not simply inherent to some people, but is multiplicative with effort. If I make the effort to achieve more, giving me the same reward is telling me that effort is worthless. If everyone deserves the same outcomes as everyone else, we are telling people that character and virtue are worthless. This is in stark contrast to many moral theories, whose main aim is to justify the labelling of virtues as virtues.
I know that invoking Karl Marx will make some people automatically disagree, but he agreed with me:
But one man is superior to another physically, or mentally, and supplies more labor in the same time, or can labor for a longer time; and labor, to serve as a measure, must be defined by its duration or intensity, otherwise it ceases to be a standard of measurement. This equal right is an unequal right for unequal labor. It recognizes no class differences, because everyone is only a worker like everyone else; but it tacitly recognizes unequal individual endowment, and thus productive capacity, as a natural privilege. It is, therefore, a right of inequality, in its content, like every right. Right, by its very nature, can consist only in the application of an equal standard; but unequal individuals (and they would not be different individuals if they were not unequal) are measurable only by an equal standard insofar as they are brought under an equal point of view, are taken from one definite side only -- for instance, in the present case, are regarded only as workers and nothing more is seen in them, everything else being ignored. Further, one worker is married, another is not; one has more children than another, and so on and so forth. Thus, with an equal performance of labor, and hence an equal in the social consumption fund, one will in fact receive more than another, one will be richer than another, and so on. To avoid all these defects, right, instead of being equal, would have to be unequal.
Marx is saying that we can have equal rights or equality, but not both. If try to change the natural differences in ability, desire and need then we will treat people very unequally, which would contravene a doctrine of equal rights and equal worth in the eyes of the law. I won't touch further on the idea of taking into account people's subjective wants and desires in order to try to give everyone the same amount of life satisfaction. There are enough problems with that for a post on its own.
People are not practically equal. This is an undeniable fact (as long as you accept anything about reality at all). If we grant them equal moral worth then we make sure that we don't have universal rules that specifically grant more rights or punishment to a pre-defined group of people. That is the essence of giving everyone equal worth: that all are equal in the eyes of the law (to start with).
If we start dealing in resources, rather than simply moral rights such as which actions a person can and cannot take, we move into defining material worth. If we are defining material worth, we cannot escape the fact that people are not materially(/practically) equal.
I refuse to accept that equal moral worth necessitates a jump to enforcing equal material worth. Moral worth is about not denying a person a place on a bus simply because of skin colour. Material worth is unconnected. If a person cannot pay for the bus ride, then skin or not he doesn't get a ride.
If someone is so materially lacking that he is unable to fulfill basic moral rights, such as voting, getting public services that are theoretically available to all and so on, then these things are not available to all, despite the moral contention that they should be, and so our society has passed laws to ensure that they are more accessible. This requires material investment, but it is not a statement of material worth.
A lot of unhappiness and dissatisfaction comes from the equation in people's minds of material and moral worth and the observable differences in material worth. The solution is not to attempt to make everyone of equal material worth despite the manifest injustices that would be involved, nor simply to state that it's a theoretical goal that can never be achieved (what a system of morality that would be, that states that the world is immoral, even before any free agent has taken his first action!).
The solution is to accept that it is fallacious to link material and moral worth. If we can expunge this foolish notion from people's heads a great many aspects of life would be avoided. Things like the hero worship of rich men, the hesitance to challenge and stand up to the old and established, the deference to irrationality because it's spoken by a successful businessman... all these things are partly caused by foolish people linking moral worth to other factors. A simple excision of the fallacy of 'the appeal to authority' from the world would be a nice start, including removing the use of (and need for) endless references to old philosophers (like Karl Marx).
When Adam delved and Eve span,
Who then was the gentleman?
is the refrain of the Peasants' Revolt (of 1381). These people were not arguing about whether they ought to receive as much life satisfaction as everyone else. They were simply stating that 'Jack's as good as his master', not in terms of material worth, but in rights. They wanted to be able to travel to different farms and get paid what they could get (because labour was in short supply after the plague), rather than be constrained by area or by fixed prices. This line of radical politics has long been an English tradition, but I don't see it as leading necessarily to equal material worth.
In contrast, I can see an English tradition for pricking pomposity and arrogance. The English as a nation have for a long time had a tradition of marked irreverence for status and authority. It is this radical notion that moral (and intellectualand logical) worth is not linked to social status, power or wealth that has been particularly well-incubated in England, and it is this fact that continues to escape philosophers, politicians, the rich, wealthy and powerful all over the world.
Radicalism need not delve into strange notions of absolute equality. Simple confirmation of what peasants knew 600 years ago would be a good start for modern politics.
Bayesian inference
http://en.wikipedia.org/wiki/Bayesian_inference
'One of the crucial features of the Bayesian view is that a probability is assigned to a hypothesis, whereas under the frequentist view, a hypothesis is typically rejected or not rejected without directly assigning a probability.'
Most people have a truth and change it when enough evidence has accumulated. Some people learn to treat truths as more or less probable, but have to do this consciously. This leads to paradigm-shifting, because people stubbornly resist new evidence until it's really overwhelming.
Some experiments on belief revision have suggested that humans change their beliefs faster when using Bayesian methods than when using informal judgement. If I say I am intuitively Bayesian, I am claiming that I more naturally accept a certain level of uncertainty in statements of 'fact'; that my informal judgement typically involves subconscious assignation of probabilities of truth to certain statements rather than a binary system of accepting or rejecting it.
I'm sure that most people do this to an extent. But studies show that it's certainly not an everyday mode of thought.I believe that this approach to science is very important. Scientists currently test whether a hypothesis is true by seeing if the data pass an arbitrary limit of probability. If, given that the hypothesis is not true, the probability of getting the data is too small, they conclude that the hypothesis is true. The Bayesian method would be to assign a probability of truth to that hypothesis, using the data to measure that degree of probability.
'One of the crucial features of the Bayesian view is that a probability is assigned to a hypothesis, whereas under the frequentist view, a hypothesis is typically rejected or not rejected without directly assigning a probability.'
Most people have a truth and change it when enough evidence has accumulated. Some people learn to treat truths as more or less probable, but have to do this consciously. This leads to paradigm-shifting, because people stubbornly resist new evidence until it's really overwhelming.
Some experiments on belief revision have suggested that humans change their beliefs faster when using Bayesian methods than when using informal judgement. If I say I am intuitively Bayesian, I am claiming that I more naturally accept a certain level of uncertainty in statements of 'fact'; that my informal judgement typically involves subconscious assignation of probabilities of truth to certain statements rather than a binary system of accepting or rejecting it.
I'm sure that most people do this to an extent. But studies show that it's certainly not an everyday mode of thought.I believe that this approach to science is very important. Scientists currently test whether a hypothesis is true by seeing if the data pass an arbitrary limit of probability. If, given that the hypothesis is not true, the probability of getting the data is too small, they conclude that the hypothesis is true. The Bayesian method would be to assign a probability of truth to that hypothesis, using the data to measure that degree of probability.
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