This the final instalment of a series that began with Being Black, and went through I Can’t Breathe, I Can’t Breathe II, I Can’t Breathe III, To the Last Breath, and Algorithms are from Mars. There was a delay as the series has spun off a lot of other ideas that will hopefully bear fruit in time. In mid-series, George Floyd got justice but this is clearly just a beginning. The tens of thousands yearly killed by medicines given by their doctors need recognition and justice also – people like Stephen O’Neill, and Sam Morgan.
Algorithms and procedures risk being authoritarian rather than democratic. They call on us to follow rules. When these work as in cars or computers they can be good for each of us, even conveying a degree of freedom, but the extension of this If X then Y thinking into every nook and cranny of our lives leaves us in systems that inevitably end up managed by someone other than us – managed essentially by bureaucrats.
At one point, Rulers stood in contrast to democracies. The democracies that replaced them became representative democracies rather than the androcracies for which Athens was famous. Thanks to science, these representative democracies have now been captured by technocrats and related special interests. We are told we have no option but to do as we are told because our leaders are following the science when in fact science opens up doubts rather than provides rules we should blindly follow.
Ultimately robots and 3-D printers and A.I. could take care of everything that is If X then Y-able leaving us free to explore the universe, be artistic, pursue scientific questions that will overturn the answers we are told to follow today, focus on things that are not programmable or perhaps engage in the question of ruling ourselves through something more like citizens’ assemblies where each of us has a vote.
Medicine stands as one domain where a great deal, all the important things, are not If X then Y-able or should not be handled as though they were. At its heart lies an element of magic – bringing good out of the use of a poison or a mutilation. Mention the word poison now and liberals – progressives hiss. They buy into a sacramental vision of the drugs we use. Sacraments are something that can only do good and cannot harm (although the Catholic Church had a recent oops moment and removed gluten from the Eucharist).
The idea of bringing good out of the use of a poison or mutilation does not compute for health insurers or managers of health services.
A consumer ‘right’ to access poisons doesn’t compute either.
The magic is not about correcting some blood levels of something – it lies in bringing a person out of the mix, enabling someone to live the life they want to live.
This cannot be done without a relationship. No one can help someone live the life they want to live if they don’t engage with that person and find out what it is they want. They may not be bothered about living an extra few months compared with having enough mental clarity to ensure a child, or grandchild, or friend gets the input now that only they can give.
Relationships stand beyond procedure. They offer a matrix in which the rules can be made to work for a person rather than having the person bent to fit the rules. They create trust without which no procedure can ultimately work – a trust that for millennia has been known to give a brother supported by a brother the strength of a walled city.
Is it economic to spend time getting to know people? It is. It’s the difference between having a doctor handle 100 what are often called heartsink patients or having 100 free research assistants. People with problems or conditions or a problem from some drug have skin in the game and this gives them a motivation worth at least as much as expertise.
Anne Marie who discovered the role of SSRIs in causing alcoholism is a great example of this as are the many people with enduring sexual dysfunctions like PSSD, PFS, PRSD or PGAD who have done so much testing of treatment options and so much pushing against doors to get these conditions recognitions and who should get recognition by whoever wins a Nobel Prize for work in this area when an answer comes as it surely will.
At some point in the not too distant future it looks like robots will let us produce pretty well all If X then Y-able goods for free. There will at least be no labour costs. Money will lose a lot of its relevance.
The focus will turn to the production of the most valuable asset we have – other persons. While we can be nudged and surveilled and often controlled far more than we might like to think, ultimately each of us retains a spark of something that is not If X then Y-able. Whether you call it the divine or just the human, it is a spark of something that is not one dimensional.
If there is to be money, and perhaps even power, in this new world, it makes the most sense that it should lie with those who produce people. Whether literally those who labor to produce people. Or those who work on transforming infants into people initially at home but later in schools and then ensuring the survival of the person when faced by illness – this doesn’t mean ensuring they live as long as possible it means ensuring they have a chance to bring something out of the situation they are in and that they remain seen and heard as persons in the midst of it.
This applies in spades to the elderly. These are the people with the most experience and often wisdom who should be enabled to live as full a life as possible and contribute as much as possible rather than be warehoused. When they complain about being tired, this should not be put down to old age, if they have for instance recently been put on some medicine for osteoporosis or hypertension.
Perhaps not exclusively, but largely, in this new world women would hold the power and the money. As things stand, the whistleblowers to everything from corporate misdeeds to drug wrecks are more likely to be women. When it comes to drug wrecks, it’s not women standing up for their own rights but women as the daughters of parents, mothers of children, and occasionally the partners of men or possibly more often other women.
Too used to being overlooked, they often don’t stand up for themselves. But, perhaps because they are more used to being gaslighted than men, and having to distinguish gaslighting from the genuine thing, they aren’t as easy to palm off when others in their care are affected.
One hundred and fifty years ago, in Venus in Furs, Leopold von Sacher Masoch made the case that for relations between the sexes to be on a sound footing there needed to be equality of education, income and power. Power has been the most elusive element in the mix. But in algorithmythising so much and putting so much weight on algorithms, men may have painted themselves into a corner. The most worthwhile thing to do – making people – will become almost the only thing to do and they are way behind when it comes to being able to do this.
Making people requires affection or perhaps love or care. The correct word should connote something tough and muscular. It involves standing up with someone else for what looks like its happening when Dalek-like the algorithms are saying Does Not Compute, Does Not Compute.
There is more in heaven and earth, more in the world of people, than was ever dreamt of by your algorithms Horatio.
This is not just a matter of Mercy. In the final analysis this applies to Justice also which relies on collective judgement calls by groups of women and men who are given a chance to weigh the testimony of others in front of them.
I shop therefore I am needs to become Decernimus ergo Summus – it is in making judgement calls together that we are.
This is the message of Shipwreck of the Singular.