Wednesday 15 December 2010

What is the justification for the leadership of the PC technocracy?

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Until about a decade ago, I was fairly heavily involved in critique-ing 'Evidence Based Medicine' (EBM) and the broader movement to bring clinical practice under political and managerial control:

http://qjmed.oxfordjournals.org/content/91/5/371.full.pdf

http://www.hedweb.com/bgcharlton/journalism/ebm.html

http://www.hedweb.com/bgcharlton/cargocult.html

This was a matter of which I had some 'insider knowledge' from working as a public health physician and lecturer in epidemiology; including knowing/ working with the most recent UK Chief Medical Officers and engaging in discourse (certainly not 'debate' because it was one-sided) with leading advocates of EBM.

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These experiences provided me with what seem-like insights into the way that the politically correct technocratic elite strive to justify their position of authority.

The way that it works is arranged hierarchically - and defeat on a superficial technological level leads to immediate retreat to the level below which is moral.

So despite the most apparent and obvious 'techno-' element of technocracy, this is somewhat misleading - it is, in fact, merely a kind of propaganda, designed to fool the inexpert and uninterested.

Underlying this is the unyielding base of non-empirical and politically correct idealism.

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First line justification: Techno-procedural

The PC elite claim expertise in the techniques and procedures which they say are necessary to governance.

It would be difficult for the advocates of EBM to come straight-out and claim that they are morally entitled to rule (even though this is what they believe) - it is rhetorically much easier to claim that they are merely 'implementing' the results of impartial and intrinsically-valid techniques.

In EBM the basic technical method is to use large amounts of data (the quality of which is irrelevant) and subject it to statistical summary and analysis which is complex-enough to be boring or incomprehensible to the intended audience.

This applies more generally in PC governance: the techniques used are usually statistical - on the basis that most people regard large masses of numbers as intrinsically valid, cannot be bothered to analyze data critically and have zero knowledge of statistics.

Claims backed by large amounts of data are self-evidently validated; whereas critical analysis of the quality and applicability of data is merely abstruse technical quibbling... 

Statistics becomes the real reality - humanly-experienced reality becomes 'anecdote' - hence nothing at all. 

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Second-line justification - progressive ethical

If the validity of the data or the statistical techniques are challenged successfully, then the technocracy move back to politically correct ethics as the justification of their right to rule.

PC ethics are progressive, continually changing over time. Therefore understanding and expertise in ethics is continually becoming obsolete, continually needing to be updated, continually inverting (bad becoming good and vice versa) and thereby maintaining a rarity value for those who are competent in this discourse.

In a nutshell, the PC elite claim that only they are competent rulers, because only the PC elite understand how morality changes, only the PC elite have kept-up with these changes.

To have non-PC persons in positions of ruler-ship is therefore immoral.

(As always with PC, the morality is defined negatively. The primarily immoral is identified (racism, sexism, whatever) - and virtue is defined in terms of opposition to this. )

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So, my repeated experience in arguing with the advocates of EBM was that they would first defend their right to dictate medical decision making on the basis of their (supposed) expertise in accessing and analyzing data; then when this was exposed as illusory and irrelevant they would revert to moral arguments of a negative type.

I found that, at root, the negative moral arguments were based on visceral anti-doctor emotions (especially among doctors).

these were justified in many ways: an aversion to the 'arrogance' (which might mean mrely autonomy - or might mean resistance to political correctness)  of some doctors, or of the medical profession; or to a one-sided hatred of the abuses of medicine (focusing on doctors who were lazy or incompetent, doctors who uncritically adopted new ineffective treatments, or failed to adopt new effective treatments, or who continued to use old ineffective treatments).

It was a negative ethic because it was focused on preventing abuses, rather than stimulating good practice.

Good practice was taken for granted as something that naturally happens; so the main job of policy was forcibly to coerce doctors so that none will be able to be lazy, or do things deemed incompetent or obsolete, and all will be made to do things deemed effective or necessary.

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What counts as desirable or undesirable in terms of behavior and practice derives from techno-procedural justifications.

But at this level of discourse, the techno-procedural aspects are not defended in terms of being correct (indeed, they have usually already been proven incorrect by this point in the discussion); but are defended in terms that they are anti-abuse.

The rhetorical move is that if you are truly against abuses (if you hate them as much as the EBM advocates do - and they are merciless in their flagellation of imperfection) then you must be in favor of bureaucratic systems of preventing abuses; if you are against bad doctors, then you must be in favor of bureaucracy.

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It is not claimed that the bureacrats are necessarily good as individuals - rather the implicit claim is that bureaucrats do not matter as individuals - because systems are better than individuals.

The idea is to replace doctors - whose personal qualities do matter, hence doctors can damage things by their selfishness and corruption - with bureaucrats who are mere functionaries following rules, and whose personal qualities therefore do not matter because virtue is located in the system, not in the person.

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But in the end, EBM was able to emerge and grow for no better reason than that it served an agenda of power: it combined surface plausibility with a rationale for expanding power.

EBM survived not be being able to win arguments, but by being able to ignore arguments.

http://charltonteaching.blogspot.com/2009/08/zombie-science-of-evidence-based.html

Merely by being part of the general trend of PC bureaucratization, moral inversion, progressivism - EBM had instant and unstoppable inertia.


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3 comments:

Bill said...

PC ethics are progressive, continually changing over time. Therefore understanding and expertise in ethics is continually becoming obsolete, continually needing to be updated, continually inverting (bad becoming good and vice versa) and thereby maintaining a rarity value for those who are competent in this discourse.

This particular aspect of PC is endlessly fascinating. It is fun, for example, to say (confidently) things which are not quite consonant with the current iteration of PC "morality" and watch the drones get worried that they have missed some subtlety in the current iteration. Also, it is fun to watch the acute embarrassment generated in more intellectually adroit PC-ites when less intellectually adroit PC-ites say things from the previous iteration. Extra bonus fun occurs when the less adroit are members of mascot groups. I mean, what are they to do? It just doesn't sound right to say "No, no, yesterday we were always allied with Eastasia, today we were always at war with Eastasia." Especially if they are "talking down" to their alleged betters.

It is not claimed that the bureacrats are necessarily good as individuals - rather the implicit claim is that bureaucrats do not matter as individuals - because systems are better than individuals.

This is true, but it lives in a strange tension with the belief that the bureaucratic process is itself corruptible. For example, the US Food and Drug Administration assembles expert panels to evaluate the evidence for new drugs' safety and efficacy (this is the apex of the new drug approval bureaucratic process). It is considered a big problem if members of these panels have "conflicts of interest." Of course, at this point in the process, approximately everyone with actual experience with the drug has a conflict of interest, because the only way to have experience is to be involved in a drug-company sponsored trial.

Bruce Charlton said...

Interesting observations.

You will notice that the increased discussion of conflicts of interest has made precisely no difference at all to anything among the scientific leadership - except that there is now a new conflicts of interest expertise, and new bureaucratic procedures to go through, and another way of 'getting' weak or marginal opponents.

Indeed the increased focus on conflicts of interest is itself a marker of the death of science; because 'real' science, working properly, is immune to conflicts of interest (they are dealt with mostly at the level of the 'invisible college' - anyone suspected of this kind of dishonesty is excluded).

I wrote a bit about this back when I was deciding that Medical Hypotheses would NOT have a policy asking authors to declare their conflicts of interest.

http://medicalhypotheses.blogspot.com/2007/07/conflicts-of-interest-in-medical.html

dearieme said...

"large amounts of data (the quality of which is irrelevant)" did you see the telly prog on Statistics by a Swedish cove recently? The first half was quite good, but what struck me was that he paid no attention at all to the quality of the data - it was merely accepted as data and plotted. (Even though two bits of economic data were drivel - the comparison of a stock with a flow. But it was, to be fair, a PC comparison.)


But the later part of the show was potty - he explained that now "we" have so much data that Science can give up crude, old experiments and advance onto the higher plane of number-crunching. Delusional and decadent.