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03/23/2013

Economism and Human Robots: Why Seeing Life as a Market is Corrupting

            In the previous post I mentioned Evgeny Morozov’s recent book, To Save Everything, Click Here: The Folly of Technological Solutionism (http://www.amazon.com/Save-Everything-Click-Here-Technological/dp/1610391381/ref=sr_1_1?s=books&ie=UTF8&qid=1364074203&sr=1-1&keywords=evgeny+morozov+solutionism). While Morozov focuses on the Internet, one passage especially helps us see the flaws in the sort of thinking that characterizes economism.
            As I explained in The Golden Calf, one feature of economism is viewing all human behavior as a sort of market exchange, and arguing that economic laws should govern all social policy. Philosopher Michael Sandel, in his What Money Can’t Buy: The Moral Limits of Markets (http://www.amazon.com/What-Money-Cant-Buy-Markets/dp/0374203032/ref=sr_1_1?s=books&ie=UTF8&qid=1364075639&sr=1-1&keywords=michael+sandel+money+can%27t), calls this the move from having a market economy (which is perfectly fine)  to living in a market society (which isn’t).
            Morozov surveys the geeks who think that the Internet will solve all the world’s problems, even problems that aren’t really problems and don’t need solving, but there’s a great app for them. He finds that these geeks seem to have a love affair with rational-choice theory from economics and with providing various incentives and “nudges” to get people to behave the way social engineers want us to. He takes aim at what this approach does to social life and our sense of ourselves, worth quoting at length:
            “A scheme that wants to get children to help senior citizens by awarding them badges and game points is likely to produce very different children than a scheme that appeals to their civic duty, even if both schemes yield the same results. The problem with simplistic models imported from economics and rational-choice theory is that, whenever they tackle a novel case, they start with a new set of abstract, independent, and ahistorical citizens. Thus, children who were just helping senior citizens by playing games are forgotten and swept away, and a new set of children--like so many widgets and coconuts—is mustered up to engage in some different task, perhaps to solve math puzzles after resisting the cookies. But, of course, children can’t reboot the way computers can; we have the same children doing both—and their experiences accumulate rather than cancel each other out. Constructing a world preoccupied only with the most efficient outcomes—rather than the processes through which these outcomes are achieved—is not likely to make them aware of the depth of human passion, dignity, and respect. We don’t earn our dignity by collecting badges; we do it by behaving in a dignified manner, often in situations in which we have other options. Tinker with this spiritual pasture, and those options might go away—along with the very possibility of dignity.”

            Now, here’s a philosophical-ethical take on what the man just said. In ethics we have the old-fashioned ideas of virtue and character—that it matters what sort of person you are, and not merely how you behave at one moment in time. And what sort of person you are is shaped over a lifetime by how you are brought up and by your later experiences and values. Our goal ought to be to encourage folks to develop into morally good persons who are good citizens for our democracy and who treat those who depend on them well and responsibly. To encourage that, we have to understand the basic ideas of virtue and character, and how these are life-long attainments.
            The type of view that most undermines this concept of virtue and character is anything that reduces people to superficial packages of behavior and that forgets that people remain the same people over a lifetime, with what happened to them in the past helping to shape who they are in the future. It’s exactly such a view of replaceable, rebootable people that Morozov accuses the rational-choice-economics people of pushing on us. His conclusion: “[T]here’s something profoundly disgusting about this [rational-choice incentives] approach, for it not only tricks—rather than talks—us into doing the right thing but also gives us a fake feeling of mastery over our own actions….Trying to improve the human condition by first assuming that humans are like robots is not going to get us very far.”

Full Article

This entry was posted in Health Care and tagged . Posted by Howard Brody. Bookmark the permalink.

03/23/2013

Economism and Human Robots: Why Seeing Life as a Market is Corrupting

            In the previous post I mentioned Evgeny Morozov’s recent book, To Save Everything, Click Here: The Folly of Technological Solutionism (http://www.amazon.com/Save-Everything-Click-Here-Technological/dp/1610391381/ref=sr_1_1?s=books&ie=UTF8&qid=1364074203&sr=1-1&keywords=evgeny+morozov+solutionism). While Morozov focuses on the Internet, one passage especially helps us see the flaws in the sort of thinking that characterizes economism.
            As I explained in The Golden Calf, one feature of economism is viewing all human behavior as a sort of market exchange, and arguing that economic laws should govern all social policy. Philosopher Michael Sandel, in his What Money Can’t Buy: The Moral Limits of Markets (http://www.amazon.com/What-Money-Cant-Buy-Markets/dp/0374203032/ref=sr_1_1?s=books&ie=UTF8&qid=1364075639&sr=1-1&keywords=michael+sandel+money+can%27t), calls this the move from having a market economy (which is perfectly fine)  to living in a market society (which isn’t).
            Morozov surveys the geeks who think that the Internet will solve all the world’s problems, even problems that aren’t really problems and don’t need solving, but there’s a great app for them. He finds that these geeks seem to have a love affair with rational-choice theory from economics and with providing various incentives and “nudges” to get people to behave the way social engineers want us to. He takes aim at what this approach does to social life and our sense of ourselves, worth quoting at length:
            “A scheme that wants to get children to help senior citizens by awarding them badges and game points is likely to produce very different children than a scheme that appeals to their civic duty, even if both schemes yield the same results. The problem with simplistic models imported from economics and rational-choice theory is that, whenever they tackle a novel case, they start with a new set of abstract, independent, and ahistorical citizens. Thus, children who were just helping senior citizens by playing games are forgotten and swept away, and a new set of children--like so many widgets and coconuts—is mustered up to engage in some different task, perhaps to solve math puzzles after resisting the cookies. But, of course, children can’t reboot the way computers can; we have the same children doing both—and their experiences accumulate rather than cancel each other out. Constructing a world preoccupied only with the most efficient outcomes—rather than the processes through which these outcomes are achieved—is not likely to make them aware of the depth of human passion, dignity, and respect. We don’t earn our dignity by collecting badges; we do it by behaving in a dignified manner, often in situations in which we have other options. Tinker with this spiritual pasture, and those options might go away—along with the very possibility of dignity.”

            Now, here’s a philosophical-ethical take on what the man just said. In ethics we have the old-fashioned ideas of virtue and character—that it matters what sort of person you are, and not merely how you behave at one moment in time. And what sort of person you are is shaped over a lifetime by how you are brought up and by your later experiences and values. Our goal ought to be to encourage folks to develop into morally good persons who are good citizens for our democracy and who treat those who depend on them well and responsibly. To encourage that, we have to understand the basic ideas of virtue and character, and how these are life-long attainments.
            The type of view that most undermines this concept of virtue and character is anything that reduces people to superficial packages of behavior and that forgets that people remain the same people over a lifetime, with what happened to them in the past helping to shape who they are in the future. It’s exactly such a view of replaceable, rebootable people that Morozov accuses the rational-choice-economics people of pushing on us. His conclusion: “[T]here’s something profoundly disgusting about this [rational-choice incentives] approach, for it not only tricks—rather than talks—us into doing the right thing but also gives us a fake feeling of mastery over our own actions….Trying to improve the human condition by first assuming that humans are like robots is not going to get us very far.”

Full Article

This entry was posted in Health Care and tagged . Posted by Howard Brody. Bookmark the permalink.

03/23/2013

The Danger of Applying Private-Sector Efficiency Standards to Government

            Evgeny Morozov’s recent book, To Save Everything, Click Here: The Folly of Technological Solutionism (http://www.amazon.com/Save-Everything-Click-Here-Technological/dp/1610391381/ref=...

Full Article

This entry was posted in Health Care and tagged . Posted by Howard Brody. Bookmark the permalink.

03/23/2013

The Danger of Applying Private-Sector Efficiency Standards to Government

            Evgeny Morozov’s recent book, To Save Everything, Click Here: The Folly of Technological Solutionism (http://www.amazon.com/Save-Everything-Click-Here-Technological/dp/1610391381/ref=sr_1_1?s=books&ie=UTF8&qid=1364074203&sr=1-1&keywords=evgeny+morozov+solutionism) is mostly about the Internet, but has a couple of points of value to the topic of this blog. There’s a similarity between economism and the view Morozov calls “Internet-centrism,” which he defines as a nearly religious worship of “the Internet” (as if the Internet is one thing), and an assumption that “the Internet” somehow embodies divine truth and natural law, so that instead of changing any feature of the Internet we find to be harming society, society has no choice but to get with the program and change its ways to coincide with “the Internet.” (Sound familiar?)
            One good point Morozov makes has to do with the relationship between private-sector standards of efficiency and government programs. It’s commonplace today, of course, to badmouth anything pertaining to government; but it’s especially common to look at the private sector, see what sorts of efficiencies are possible there, and then beat up government because its programs don’t demonstrate that same level of efficiency. And to most of us in America, any such argument makes perfect sense and needs no support or explanation. It’s just self-evident that if it wasn’t for government incompetence or corruption, anything in government would work just as efficiently as anything dine in the private sector. Just one more argument for turning all government programs over to private enterprise.
            But Morozov reminds us, “Most public institutions should not be held to the same standards as their private counterparts simply because their mission is to provide goods and services that markets cannot or should not provide.” We might grumble about the post office all we want, but the fact remains that no for-profit firm is about to deliver letters, in a few days, to any address in the country, and do so for a price that almost everyone in the country can afford, with a near-100 percent chance to the letter getting to where it’s supposed to go.
            Champions of economism, however, love to take advantage of our sloppy thinking on this point, as we then use the lack of ideal efficiency as further reasons to distrust government. Morozov quotes Catherine Needham: “The fundamental danger is that consumerism may foster privatized and resentful citizens whose expectations for government can never be met, and cannot develop the concern for the public good that must be the foundation of democratic engagement and support for public services.” And he adds, with a further quotation from Matthew Flinders, that “treating citizens as consumers leads them to think that politics can deliver the same ‘standards of service that they would commonly expect from the private sector…[which] is the political equivalent of suicide.’”
            If average citizens get disgusted with government because it fails to come up to some impossible standard of efficiency, they’ll ignore politics, which is just what economism-boosters want, so that the lobbyists and technocrats can take over and run government in the way that favors the corporate world. Anyone who visited Great Britain during the early years of the Margaret Thatcher regime saw this program in action—the Thatcher recipe was to cut funding for Britain’s public services, so that they’d deliver poorer and poorer performance for the average citizen, to get them demanding change, and therefore allow Thatcher to announce that the only solution to the problem was to privatize all these programs.
            It’s hardly popular today to try to re-educate all of us to realize that private-sector standards of efficiency might not be the right way to judge government programs that serve needs that the private sector doesn’t want to touch (except maybe to cherry-pick the few parts that turn a nice profit, and let all the rest go to seed). But then, it’s not popular to try to educate people about the illogic and flaws of economism generally.

Full Article

This entry was posted in Health Care and tagged . Posted by Howard Brody. Bookmark the permalink.

03/23/2013

Who Should Be Held Responsible for Your Unhealthy Lifestyle?

Unfortunately, unhealthy lifestyles are all around us and maybe even some of them belong to us. Iam writing about eating practices leading to obesity and associated diabetes or heart disease, smoking leading to chronic lung disease and cancer, alcohol ...

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This entry was posted in Health Care and tagged , . Posted by Maurice Bernstein. Bookmark the permalink.

03/22/2013

Comparing British and American Approaches to Medical Futility

Elizabeth Dzeng has a nice article in today's Independent comparing British and American approaches to medical futility.  Here are two brief excerpts: "Unlike the US, here in the UK the ultimate decision regarding resuscitation lies with the doct...

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This entry was posted in Health Care and tagged , . Posted by Thaddeus Mason Pope. Bookmark the permalink.

03/21/2013

Bioethics in the Media

Craig Klugman, Ph.D.

The way that the media reports on bioethics issues can have a strong influence on how information is presented and what conclusions the reporters offer to their readers and viewers. For example, this week, the Presidential Commission for the Study of Bioethical Issues released a report that examined whether trials on an anthrax vaccine in children should be undertaken. The idea for the trial came about from a 2011 bioterrorism exercise in San Francisco based on the scenario of an anthrax attack. The exercise suggested that 8 million people would die, including 2 million children. Federal plans in the event of such an attack call for the immediate distribution of anthrax vaccine.…

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This entry was posted in Cultural, Featured Posts and tagged . Posted by Craig Klugman. Bookmark the permalink.

03/20/2013

Shared Decision Making and Patient Decision Aids

My latest legal briefing for the The Journal of Clinical Ethics is out:  “Legal Briefing: Shared Decision Making and Patient Decision Aids."  It was a pleasure to write this with Melinda Hexum with whom I prepared the last legal briefing on...

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This entry was posted in Health Care and tagged , . Posted by Thaddeus Mason Pope. Bookmark the permalink.

03/19/2013

A Peaceful Death or a Risk to People with Disabilities?

William J. Peace

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This entry was posted in Health Care and tagged , . Posted by Susan Gilbert. Bookmark the permalink.

03/19/2013

A Peaceful Death or a Risk to People with Disabilities?

William J. Peace

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This entry was posted in Health Care and tagged , . Posted by Susan Gilbert. Bookmark the permalink.