During a throwaway thought experiment in his 1641 treatise, Meditations on First Philosophy in which the existence of God and the immortality of the soul are demonstrated, René Descartes posited the idea of an evil genius or demon that systematically deceives us to distort our understanding of the world. Contrary to first year philosophy students everywhere (a younger version of myself included), Descartes did not actually believe in the existence of an evil manipulator that was holding us back from understanding the nature of the real world. Instead, he was using it as part of a larger project to radically re-conceive epistemology in an era of rapid advancements in science that was threatening to overturn centuries of our understanding of the world. He felt that knowledge was built upon shaky ground thanks to an over-adherence on the received authorities from Greek antiquity and the Church’s use of Aristotelian scholasticism. Similar to Francis Bacon twenty years earlier, Descartes set out to focus on knowledge that stood independent of received authority.
Through Meditations one and two of his book, Descartes considers the sources of our beliefs and considers how we come to know what we think we know. He wants to find an unshakable truth to build all knowledge from, and through an exercise of radical doubt he calls into question many of the core facts we hold – first that knowledge gained from the senses are often in error, that we often can’t distinguish the real from fantasy, and through the use of the evil genius, that perhaps even our abstract knowledge like mathematics could be an illusion.
When I teach this to first year students, they either don’t take his concerns seriously because of the force of the impressions the real world gives us in providing sense data for knowledge (a stubbed toe in the dark seems to forcefully prove to us that the external world to our senses is very real), or they take Descartes too seriously and think Descartes really thought that a demon was actively deceiving him. Regardless of which side the student falls on, they will then conclude that Descartes’ concerns are not worth worrying about; that this mode of thinking is the product of an earlier, less sophisticated age.
Unless you are a scholar delving into Descartes’ work, the real purpose of teaching the Meditations is to provide students with a framework to understand how one can go about thinking through complex philosophical problems. Descartes starts from a position of epistemic doubt, and decided to run with it in a thought experiment to see where it took him. The thought experiment is a useful exercise to run your students through to get them to think through their received opinions and held-dogmas.
However, in light of my rant a few weeks back about informed consent and vaccines, I’ve discovered a new contemporary use for thinking about Descartes’ evil genius. In some sense, the evil genius is *real* and takes the form of fear that shortcuts our abilities to learn about the world and revise our held beliefs. Descartes posited that the evil demon was able to put ideas into our heads that made us believe things that were completely against logic. The demon was able to strip away the world beyond the senses and even cast doubt on abstract concepts like mathematics.
Much in the same way Descartes’ demon was able to “deceive” him into believing things that were contrary to the nature of reality, our fear of the unknown and of future harm can cause us to hold beliefs that do not map onto facts about the world. Worse yet, the story we tell about those facts can get warped, and new explanations can be given to account for what we are seeing. This becomes the breeding ground for conspiracy thinking, the backfire effect, and entrenched adherence to one’s beliefs. We hate to be wrong, and so we bend over backwards to contort our understanding of the facts to hold-fast to our worldview.
In truth, we are all susceptible to Descartes’ demon, especially those whom believe themselves to be above these kinds of faults of logic. In psychology, it’s called the Dunning-Kruger effect, of which there are all sorts of reasons given why people overestimate their competence. But in the context of an entrenched worldview that is susceptible to fear of the unknown lurks Descartes’ Demon, ready to pounce upon us with false beliefs about the world. Its call is strong, its grip is tight, and the demon is there to lull us into tribalism. We fight against those we see as merchants of un-truth and in a twisted sense of irony, the weapons of truth we yield only affect those already on our side, while those we seek to attack are left unaffected. It becomes a dog-whistle that calls on those who already think and believe as we do.
If we hope to combat this modern Cartesian demon, we’ll need to find a new way of reaching those we see on the other side.
In the ethics of conducting research with human participants, there is the concept of “informed consent.” At its foundation, informed consent is the process of communicating a sufficient amount of information about a research project to a prospective participant so that the prospect is able to decide whether they want to consent to being a participant in a study. There is a lot of nuance that can go into selecting what gets communicated because you have a lot of necessary information that needs be shared but you don’t want to share so much information that the participant is overwhelmed by the volume of information.
When I review research ethics applications, I am privy to a lot of information about the project. In the course of reviewing the project, I have to make judgement calls about what should be included in the informed consent letters that participants read. It would be counter-productive if the participant had to read all the documentation I am required to read when reviewing an application, so we use certain best practices and principles to decide what information gets communicated as a standard, and what is left in the application.
There is, of course, some challenges that we must confront in this process. As I said, when reviewing a research project, you have to balance the needs of the project with the needs of a participant. All research, by virtue of exploring the unknown, carries with it an element of risk. When you involve humans in a research project, you are asking them to shoulder some of the risk in the name of progress. Our job as researchers and reviewers is to anticpate risk and mitigate it where possible. We are stewards of the well-being of the participants, and we use our experience and expertise to protect the particpants.
This means that one challenge is communicating risk to participants and helping them understand the implications of the risks of the research. In many instances, the participants are well aware of risks posed to their normal, every-day lived experiences and how the research intersects with it. The patient living with a medical condition is aware of their pain or suffering, and can appreciate risks associated with medical interventions. A person living in poverty is acutely aware of what it means to live in poverty, and understands that discussing their experiences can be psychologically and emotionally difficult. Our jobs (as reviewers and researchers) is to ensure that the participant is made aware of the risk, mitigate it as much as we can without compromising the integrity of the research program, and to contextualize the risk so that the participant can make choices for themselves without coercion.
The concept of informed consent is hugely important, arguably the most important component of research projects involving humans as participants. It is an acknowledgement that people are ends in themselves, not a means to furthering knowledge or the researcher’s private or professional goals. Indeed, without a respect for the autonomy of the participant, research projects are likely to not be moved into action even when research funds are available.
All of this is a preamble to discuss the anger I felt when I read a recent CBC report on how anti-vaxxer advocates are using the concept of informed consent as a dog-whistle to their adherents, and are using informed consent as a way of both furthering their awareness and raising money with well-meaning politicians and the public.
In fairness, I can see the chain of reasoning at play that tries to connect informed consent with concerns about vaccines. For instance, in the article there is a photo of supporters of a vaccine choice group with a banner that reads “If there is a risk there must be a choice.” This sentiment is entirely consistent with the principles of informed consent. The problem with this application is that the risk is not being communicated and understood properly within context, and instead fear, misinformation, and conspiracies that lead to paternalistic paranoia are short-cutting the conversation. Further, the incentive structures that are borne out of the economics of our medical system are doing little to address these fears. Because so little money is flowing from the government to the medical system, doctors are forced to maximize the number of patients they see in a day just to ensure enough money is coming into the practice to pay for space, equipment, staff, insurance, and supplies. Rather than seeking quality face-to-face time with a patient, doctors have to make a choice to limit patient time to just focus on a chief complaint and address questions as efficiently as they can.
I don’t think it’s all the doctor’s fault either. I think we as patients, or more specifically we as a society, have a terrible grasp of medical and scientific literacy. I don’t have a strong opinion about what the root cause of this is, but some combination of underfunded schooling, rapid technological innovation, growing income disparities, entertainment pacification, a lack of mental health support, increasingly complex life systems, and precarious economic living in the average household are all influencing the poor grasp people have about what makes the world around us work. Rather than being the case that we are hyper-specialized in our worldviews, I think it’s the case that “life” is too complex for the average person to invest time into understanding. Let’s be clear, it is not the case that the average person isn’t smart enough to grasp it (even if sometimes my frustration with people leads me to this conclusion). Instead, I think that people are pulled in so many directions that they don’t have the time or economic freedom to deal with things that don’t immediately pay off for them. People are so fixated on just making it day-to-day and trying not to fall behind that it becomes a luxury to have the leisure time to devote to these kinds of activities.
What this results in, then, is the perfect storm of ignorance and fear that congeals into a tribal call to rebel against the paternalism of a system that is ironically also too cash-strapped to allow the flexibility to educate people on the nature of risk. People don’t have the time and ability to educate themselves, and doctors don’t have the time to share their experiences and knowledge with their patients.
Within this gap, opportunistic charlatans and sophists thrive to capitalize on people’s fears to push their own agendas. This is why bad actors like the disgraced former doctor Andrew Wakefield and movement leader Del Bigtree are able to charge fees to profit from speaking at anti-vaccination events. I’m not saying a person who spreads a message should do it for free. What I am saying is that they are able to turn a personal profit by preying on people’s fears while doing little to investigate the thing they claim to worry about.
We must find a way to communicate two simultaneous truths:
There is an inherent risk in everything; bad stuff happens to good people, and you can do everything right and still lose. Nevertheless, the risks involved when it comes to vaccines are worth shouldering because of the net good that comes from it and the risks themselves are vanishingly small.
In the 22 years since Wakefield published his study and the 16 years since its retraction, there has not been any peer-reviewed credible evidence that supports many of the claims given by the anti-vaxx movement. The movement is predicated on fears people have of the probability of something bad happening to them or their loved ones. The motivation behind the fear is legitimate, but the object of the fear is a bogeyman that hides behind whatever shadows it can find as more and more light is cast on this area.
The anti-vaxx ideology knows it cannot address head-on the mounting scientific evidence that discredits its premise, and so it instead focuses on a different avenue of attack.
This bears repeating: the anti-vaxx ideology cannot debate or refute the scientific evidence about vaccination. We know vaccines work. We know how they work; we know why they work. We understand the probabilities of the risk; we know the type and magnitudes of the risks. These things are known to us. Anti-vaxx belief is a deliberate falsehood when it denies any of what we know.
Because of this, the anti-vaxx ideology is shifting to speak to those deep fears we have of the unknown, and instead of dealing with the facts of medicine, it is sinking its claws into the deep desire we have for freedom and autonomy. It shortcuts our rational experience and appeals to the fears evolution has given us to grapples with the unknown – the knee-jerk rejection of things we don’t understand.
Informed consent as a concept is the latest victim of anti-vaxx’s contagion. It’s seeping in and corrupting it from the inside, turning the very principle of self-directed autonomy against a person’s self-interest. It doesn’t cast doubt by calling the science into question. Instead, it casts doubt precisely because the average person doesn’t understand the science, and so that unknown becomes scary to us and we reject or avoid what brings us fear.
Anti-vaxx ideology is a memetic virus. In our society’s wealth, luxury, and tech-enabled friction-free lives, we have allowed this dangerous idea to gain strength. By ignoring it and ridiculing it until now, we have come to a point where it threatens to disrupt social homeostasis. Unless we do something to change the conditions we find ourselves in – unless we are willing to do the hard work – I fear that this ideology is going to replicate at a rate that we can’t stop. It will reach a critical mass, infect enough people, and threaten to undo all the hard work achieved in the past. We have already seen the evidence of this as once-eradicated diseases are popping up in our communities. The immunity and innoculations have weakened. Let’s hope those walls don’t break.
Recently, a lot of things circulating through social media and my podcast feeds have been enraging me. I try to mitigate these things through a number of strategies – limiting my time on social media, intentionally targeting positive messages, not reading comments, not engaging, reminding myself that it is ok to disagree about things, etc. The hardest things for me to let go are cases where my thought-processes seem to wildly diverge from others about the framing of the same set of facts.
Initially, I wanted this blog post to be my master rebuttal. I wanted to lay out my case for why the conclusions others are drawing from this or that event are wrong and why. I wanted to emphasize what the important, salient points are that we should keep in mind.
But I know in my heart that would be an exercise in futility. A blog post is easy to skip; easy to ignore. I won’t change hearts and minds by arguing against a strawman average of the viewpoints expressed in my network of known-people. It would be antagonistic, hostile, and unproductive towards my goals. In all likelihood, it would backfire and entrench or alienate friends.
Instead, I will offer a different approach that I want to continuously remind myself of. When I feel compelled to dig in my heels for an argument, I should remind myself of the following.
First, remember what Aristotle (via Will Durant) tells us about virtue and excellence. It doesn’t matter what others say or share/post online; we are what we repeatedly do. Excellence, then, is not an act, but a habit.
Second, turning to fiction, remember why The Doctor helps people.
“Winning; is that what you think it’s about? I’m not trying to win. I’m not doing this because I want to beat someone or ‘cause I hate someone, or because I want to blame someone. It’s not because it’s fun. God knows it’s not because it’s easy. It’s not even because it works because it hardly ever does. I do what I do because it’s right! Because it’s decent. And above all, it’s kind. It’s just that. Just kind.”
Series 10, Episode 12: “The Doctor Falls”
Ultimately, it’s not about what I will say, or argue. Arguing with other people doesn’t make me a decent person; picking fights online doesn’t put me on the high road. If I want to bring about change in people I care about, it’s important to remember to be kind. Always be kind and help people, because it’s the right thing to do.
I recognize that being kind doesn’t give a lot of direction and can seem cowardly when meeting the systems that do real harm to the vulnerable and oppressed. In fact, espousing kindness can easily slip into inaction or forced neutrality. It’s hard to be prescriptive in this case at a granular level.
However, if I start with the core values of kindness and action, that what is important is doing things that are kind to others, then you can use your values as a filter for determining what you will choose to do.
Instead of arguing online, I choose to try and lead by being kind.
I’ve noticed an annoying trend in the podcast marketing of new books. The marketing itself works quite well – I’ve purchased a number of books based on authors who appear on podcasts I listen to and discuss the main ideas of the book with the host.
The problem I have is when it seems like a significant amount of the content discussed in the podcast accounts for large chunks of the book’s main ideas. For instance, I picked up a book recently and all of the key ideas (the theoretical framework and main argument for why the topic is important) laid out in the first 70 pages were discussed on a podcast. I’m curious whether the rest of the book will be similarly spoiled, but I’m holding out to be surprised. From what I’ve seen so far, though, the next 150 pages are presented as tactics and strategies to apply the main ideas, so I’m not overly optimistic.
I understand that this is part and parcel of the marketing format for these books. An author is invited onto a show with a certain audience reach, the two discuss the book as a common framing device for the conversation, and everyone is happy – the author gets promoted, the publisher gets advertising, and the podcast generates revenues on sales kickbacks and sponsored content. The only person that loses is the reader who pays for a book that was effectively summarized an hour-long conversation for free. This is doubly bad when the book is an animated bibliography, and you’ve read enough books in the genre to get the punchline from the stories cited.
I can’t put all the blame on the author. After all, they are just trying to sell their book and there is going to be a lot of repetition of the talking points if you do a lot of interviews. A lot of the blame, instead, falls on the quality of the podcasts. I find that podcast hosts tend to stick to a common format of teeing up questions based on key points from the chapters. Sometimes this is handled smoothly, as in cases where the host poses an interesting question that the author uses to circle back to something discussed in the book. But I have listened to podcast episodes where the host states a thesis from the book without a question, and the author then just elaborates on that point.
In an ideal world, I would want an interview the way it used to be when I watched Jon Stewart’s run of the Daily Show, where the author would be invited as a guest to the show on the pretense of discussing the book, however the conversation would be about whatever Stewart wanted. Often the conversation was an excuse to catch up, swap stories, and bore little direct connection with what the book was about; the book was usually mentioned as an afterthought as the interview wrapped up. Maybe this wouldn’t sell as many books, but at least I wouldn’t feel cheated reading through a book I already had the conclusions for.
Or maybe I have too high of expectations of free content, which runs counter to the content farming that needs to occur to regularly post stuff for consumers.