7 Comments
User's avatar
susan chapin's avatar

Thank you. How then to temper the powerful forces now in play. The process for the creation of own Constitution was indeed a model for this. Yet Hamilton wrote “When a man unprincipled in private life desperate in his fortune bold in his temper… is seen to mount the hobby horse of popularity (passions without reason) he may ride the storm and direct the whirlwind.”

Expand full comment
Shawn's avatar

The lightbulb you turned on for me is the realization that we (all of us) so often debate normative questions in the language of empiricism, and though it leaves the normative questions unresolved, we nonetheless judge each other’s values as we walk away frustrated. We are not aligned on the “ought,” but we don’t see this, so we argue over the “is,” leading some people to reject the “is” (facts and expertise) entirely.

Expand full comment
Whit Blauvelt's avatar

Your analysis of technical expertise versus values works well.

There's a deeper question regarding how to take Hume. Neuroscientists in recent decades, particularly Panksepp and Damasio, argue with good evidence that consciousness is feelings, emotions, passions all the way down. The very curiosity which is foundational to science turns out to have its basis as the primal emotion given the largest territory of any at the base of the brain, per Panksepp, in all mammals. Reason itself is formed of passions, not merely a tool to be used in their grasp.

Our fundamental curiosity, for better or mostly worse, is instrumental in hooking the "do your own research" conspiracy nuts. Part of why our real experts' work is so little found by those so engaged in "own research" is the acceptance by too many experts of the claim that science should be dispassionate -- resulting in a failure to communicate their own passions, despite those being always integral to their work. The style of pretend passionlessness evident in the scientific journals -- but not in the conference presentations to audiences of their peers -- is a tragic error.

Expand full comment
Shawn's avatar

Since you mentioned complexity, it occurs to me that this territory is itself complex. Expanding on your COVID example, you allude to (1) bona fide experts who conducted key research in good faith and produced important findings (about masks, ivermectin, etc). Then you point to (2) technocrats who failed in many ways to involve the public in policy choices informed by that research.

A couple factors you don't mention are: (3) motivated ideologues and other bad actors who intentionally muddy the terrain to serve their own interests, and (4) a public that is largely incapable of evaluating the work of experts. When people can't grasp basic concepts like 'per-capita,' then they are more susceptible to those bad actors, and generally not very equipped to participate in informed policy discourse.

The answer isn't to shut them out, obviously, but it's easy to understand why it happens.

Expand full comment
Stephen Strum, MD, FACP's avatar

I love Mike Brock. I am many years older but would be extremely proud if he was my child. But there are things that cannot be taught to a loving heart and a passionate mind. These are the adages that by their very longevity bear truth.

"The devil is in the details" is one saying which I wish had been worded differently. Perhaps, "he who seeks the truth, or how to come closest to the truth, uses evidence to light the way" or maybe "The light is in the details."

I'll get to the issue of ivermectin in a moment, but as an oncologist (a cancer doctor) for more than a half century, I differ from Mike in "the distinction that matters."

Patients, be it their choice of governance or their choice of treatment for cancer, should not reside only in the act of "choice" but in understanding that choice after being well-informed the why's, what's, how's, etc. The angel is in the details. Knowing the reality of things, their "status" leads to an optimal outcome. The stereotypic woman that brings her ailing car to a mechanic will be taken to the cleaners if she is totally ignorant of how a car works. I am the son of a mechanic and worked in my father's gas station since I was old enough to squeeze the handle on a gas pump. Driving back to my medical school after a holiday, my 4-cylinder Pontiac Lemans just lost power heading into Omaha. A stop at a gas station and a cursory inspection resulted in a diagnosis of engine burnout. The recommendation was to sell my car for $50. Nonsense. A car does not just simply burnout, and especially not so given the context of the problems. I managed to get into Omaha, left a note and the keys to the car under the door of the Pontiac dealership. The next day, I was charged $1.98 for a loose wire from the distributor to a spark plug. Ignorance, a lack of details, not knowing, whatever you wish to call it, can cost you.

Ivermectin

The medical literature on ivermectin was reviewed by me in great depth. About 50% of the peer-reviewed papers showed no effect, versus the other 50% that showed some effect. This conundrum was not shared with the Public - among many other things about COVID-19. There was a lack of transparency and a full conveying to the Public the details of what we were learning during COVID-19.

• Masks, worn properly and of good quality (N-95 or KN-95) will reduce the viral load.

• Total isolation for 10–14 days would have allowed the virus to burn out of existence.

• UV-C has COVID-19 killing effect and could have been used (properly) to sterilize classrooms and work spaces and even restaurants if done using the proper protocols of protection, intermittent use (in the absence of people).

• Ivermectin studies are not being conducted properly. There was a need to use proper doses and routes of administration, and to have proper control groups to ascertain efficacy. If there would have been true collaboration and collegiality, such studies could have answer issues of efficacy and side effects within a matter of a few months.

• Mouthwashes containing cetylpyridinium chloride (CPC) @ 0.075% have COVID-19 killing effect lasting about 4 hours. This could have been used to decrease viral entry especially in crowded places. Peer-reviewed literature on this product and others like it existed in the early COVID-19 years.

• Humoral antibody testing at periodic intervals gives us a major clue as to how well protected an individual is. Such tests were done by National labs and covered by Medicare. I never heard of this mentioned in news stemming from the CDC.

I won't comment further on Mike's post but felt it important to say something about high quality information and how the Public could have been educated, but wasn't.

Expand full comment
JoJo Magno's avatar

I think this is exactly why some people will chase "alternative facts" and amplify misinformation. If the vaccines don't even work then they don't have to grapple with the subtler values questions. They become moot, and we, the deep thinkers, look like fools compared to their no-nonsense approach. If the vaccines work/aren't harmful, those of us who recognize the need for an intelligent debate about values will still have some standing; some worth. They don't want us to. They want to make us look gullible.

Expand full comment
Kathleen's avatar

Brilliant! Perhaps another influence/variable, is the speed of change and/or communication?

Expand full comment