Dan Bednarz
“The greatest good is the knowledge of the union
which the mind has with the whole of nature.”
Spinoza
Ian Mitroff and Abraham Silvers’ book, Dirty Rotten Strategies: How We Trick Ourselves and Others into Solving the Wrong Problems Precisely, addresses the inability, prevalent among political, economic and cultural elites and the highly educated who serve them, to think critically and properly formulate problems. This incapacity results in Type 3 Errors, which
“is the unintentional error of solving the wrong problems precisely. In sharp contrast, the Type 4 Error is the intentional error of solving the wrong problems.” (Pg. 5)
Their book offers insight to those who share my conviction that our society is arrantly unsustainable yet unable/unwilling to recognize the natural ecological and fiscal/economic sources of our predicament. Those of us who think we are not a dead species walking will be enlightened and challenged by the thought exercises in epistemology (how we know what we know) and ethics (what we ought to do) found in this book.
The authors offer an integrated range of explanations for why political, corporate, military, medical, educational and cultural leaders end up honestly asking (Type 3 Error) or deceitfully devising (Type 4 Error) the wrong questions. Their framework is applicable to the economic contraction –and potential social collapse- now underway whose root or distal cause –in my view- is a decline in cheap net energy flows resulting from peak oil.
For me, Mitroff and Silvers’ prominent observation is that, “Problems always require us to stand above them to better formulate them” (Pg. 177). They write:
“One of the fundamental forms of Type Three and Type Four Errors occurs when … we elevate our preferred way of looking at the world [which no matter how “objective” and empirical remains a socially organized and sanctioned account] over all other ways of looking at it.”
These errors are endemic because –despite all remonstrance to the contrary- Americans are not consistently socialized, educated and rewarded to value thinking in terms of systems and complexity. As a child I would naively ask adults, “What about…?” questions, and on occasion –usually by a teacher- I was rewarded for my inquisitiveness; but my vivid memory is of being told to “stop being a pest.” Everyone who has worked in a group knows the tacit bounds of discourse beyond which discussion is verboten. Indeed, organizations pursuing innovation consciously attempt to eliminate or attenuate this tendency towards what goes by various names such as, groupthink, institutional thinking, herd mentality, conformism, and so on.
The authors conclude that in contemporary America, especially in politics, the facile solution –“kick the can down the road”- is the most likely option to be undertaken or propagated.
Tellingly, Mitroff has written about Type 3 Errors for many years. His and Silvers’ sobering reflections upon spending their respective careers in the corridors of government, corporations and academia has led them to develop the concept of Type 4 Errors. A bit dramatically, they observe:
“…modern capitalism has a number of the critical characteristics associated with sociopathology, for example, the commission of unethical acts intentionally designed to hoodwink the public; the glorification of unethical behavior, such as unrestrained greed; and little or no guilt associated with deceptive and unethical behavior.” (Pg. 18)
They title their chapter on the US healthcare system, “Organized Meanness” and point out,
“…solving the problem of how to provide the best medical care for those who can afford it is not the same as solving the problem of how to provide the best health care for all Americans who increasingly are unable to afford it and are denied access to it.” (Pg. 44)
The fundamental deceit, Type 4 Error, of the healthcare crisis, therefore,
“…can be boiled down to the following question: How can the AMA, the big HMOs, the insurance companies, and other powerful interests solve the problem of getting the public to accept the notion that maximizing profits at the public’s expense is the problem worth solving?” (Pg. 61-62)
This past year I’ve watched “health policy analysts” on PBS’s NewsHour, read articles in the New York Times, New England Journal of Medicine and the Journal of the American Medical Association, and so forth. Not one has broached this formulation of the healthcare problem.
This leads us to the work of C. West Churchman, a mentor of Mitroff, who calls for a “meta-system of inquiry” to surface the relationship between epistemology and ethics. Churchman argues ethics are embedded within epistemology, but this is rarely acknowledged when system design and public policy are considered, especially in healthcare or, for that matter, climate change policy, where world population reduction and lowering consumption are taboo to consider as mitigation factors. Rare is the article in this past year’s mainstream “healthcare debate” that discusses in whose interests the medical system operates, and absent is contemplation of the environmental degradation and ecological constraints rapidly making the current health system –actually our entire society- ecologically unsustainable.
For Churchman, knowledge is not cumulative, self-correcting and value-free; “facts” discovered by science are organized/created (similar to Kuhn’s paradigm and Foucault’s episteme) within the ethical parameters of a system of scientific inquiry.
His four ostensibly enigmatic -actually rooted in American pragmatism- principles of systems theory inspire the epistemology/ethics of “Dirty Rotten Strategies:”
- A systems approach means seeing the world through the eyes of another –sociologically, “taking on the role of the other”
- Every worldview is partial –it suffers and gains from its location in time and context
- There are no systems experts, only students who should be ever eager to learn
- Systems thinking is a good and humbling idea
All those earnest health policy analysts laboring over the pros and cons of a Public Option have made an unacknowledged ethical decision about how to allocate resources –distribute medical care and, in fact, life chances. They intellectually/ethically are constrained from asking Mitroff and Silvers’ question.
Likewise, I believe that public policy makers are locked in a stance that perpetuates the illusion that the current healthcare system can be “reformed.” Most important for me, this epistemology treats as a separate issue from healthcare –not part of an inclusive macro-system- the fiscal/economic crisis and the Bottleneck of ecological consequences and constraints E.O. Wilson has observed will be the defining human dilemmas of the 21st century.
In conclusion, I want to use Type 3 and 4 Errors to explain why the wrong formulation of sustainability has come to pervade discussions about our society’s future. What is called “Sustainable Growth” or “Smart Growth,” typifies the nadir of systems thinking because these formulations “elevate our preferred way of looking at the world.” I suggest that the notion of “Supply-side Sustainability,” which necessitates creating human systems -especially medicine- aligned with the natural limits of the earth’s resources and the rhythms of its ecosystems, is the pinnacle –thus far- in systems thinking.
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February 15, 2010 at 8:35 pm
jaggedben
As one of those rare people who actually studied contemporary epistemology at the academy, I can’t help but comment.
The theory I formulated in reaction to the literature argued that knowledge cannot be understood in the absence of a desire or objective. (You can call an “American pragmatist” like Churchmen, if you like). Those of us who interest ourselves in sustainability issues – such as future energy supply or biospheric health – tend to desire the long term survival on our planet of either the human species or diverse biological life, or both.
While this desire seems to stem from a deep and (hopefully, to me) undefeatable aspect of human nature, it’s neither universal nor universally expressed in the same way. There are a great many people who not only don’t share our desire for survival, but are self-aware enough to explain or justify why. I can think of at least two major categories. First, there are those who are self-admittedly selfish; those who say “I only care about enjoying life in the present, not future generations, or even necessarily the rest of my life.” Then there are those who transfer their desire to survive into the spiritual realm: those who believe in endtime prophecies (Christian or otherwise) and/or the immortality of the spirit but not the body. These latter folks may go so far as to explicitly wish for something like the collapse of the biosphere, because they think that will bring the second coming, or some such spiritual catharsis for humanity. (See Jeremey Legget’s book “The Carbon Wars” for just such an anecdote.)
It makes sense to talk about your “Type 3” and “Type 4” behaviors as “errors” if one shares the worldview that this life and this planet are the main things we have, and divine intervention in the physical world is not part of your realm of possibility. For someone who doesn’t share that worldview, it may never make sense why these behaviors represent wrong thinking. Put another way, “Type 4” behavior can be seen as a contradiction in terms. No one intentionally solves a problem they believe is the “wrong” problem. The address that problem because they believe it’s the “right” one.
Sorry if this comment is not particularly constructive, but I do think that for those building a movement for sustainability (or equality, to throw another wrench in), the question needs to be asked: To what extent is our culture not sustainable because citizens don’t know HOW to be sustainable, and to want extent is it because citizens don’t WANT to be sustainable? (And can the latter be changed, and how?) I hope that in the book Mitroff and Abrams address this question somehow.
February 19, 2010 at 6:03 am
Interviews, Reviews, and More of “Dirty Rotten Strategies” « Ian Mitroff
[…] I enjoyed this thorough and incisive review of our book by Dan Bednarz on his blog, Health After Oil: The Impact of Energy Decline on Public Health & Medicine. […]
March 13, 2010 at 7:09 pm
wildwood
This author is correct in that a systems view is rare and necessary. It is possible. I work in psychiatry using a systems view. And I have extensive experience is how a systems view is not understood by 90+% of those in this field. And then if you do have an idea of what systems is, implementing it in this culture takes courage as there is a huge resistance. The systems view is not linear, manualized, you won’t become famous and important among your colleagues, make alot of money and you will have to learn to enjoy and work with and hold patiently the uncertainty innate in systems. Psychiatry tries to base itself after the medical model and systems in very different. However the rewards are high and the possiblities are endless, but don’t expect a pat on the back or to get your ego inflated with alot of recognition or accolades. You have to do it because you see it, believe in it, see it’s power and sense and love it.
March 24, 2010 at 2:29 pm
thegatekeeper
A future nurse, I lament the health care bill, even though I fantasize about environmentally sustainable, evidence-based health care for all. The author addresses “supply-side sustainability,” and a systems approach. As far as medical errors go, the paradigm is to “blame the system” rather than the individual and instate a root cause analysis investigation. This is lacking in health care reform, especially for those bleeding-hearts who wish to see truly universal health care. Where are we going to obtain the resources to accomplish this bill, much less universal health care? Peak oil is knocking at the door. The nursing and primary care provider shortage is approaching crisis level; if we do not have enough now, what is going to happen in a few years when the baby boomer cohort becomes a bell-curve of chronic illness? When health care increases to 20…25% of the GDP? Will the government start pouring money into training nurses for free and providing incentives for medical students to elect primary care? I’m fortunate that I recieved a full-tuition scholarship that adjusts with inflation and rising education costs; most new nurses will be in debt for a long time. The ICUs, with costs around $10,000 a day for a MINIMAL care stay, will be overflowing with obese, elderly patients who have a sense of entitlement to expensive tertiary palliation. This is the legacy I am inheriting as a 22 year old, soon to be nurse
July 4, 2010 at 4:42 am
jony
The systems view is not linear, manualized, you won’t become famous and important among your colleagues, make alot of money and you will have to learn to enjoy and work with and hold patiently the uncertainty innate in systems.