Tuesday, 6 October 2015

Complexity and Vaccines.

Complexity is hard. It is hard because each and every one of us develop in a cultural system, with the same pattern-finding brains, conditioning us to identify cause and effect. Yet in sufficiently complex systems, without computers to aid us, identifying causality is simply impossible without the creation of, and attachment to, a subjective narrative drawn from our own personal experience and mental schemas.

A consequence of this is the sustained phenomena of ideology, where particular narratives are continually reinforced within a powerful, sub-cultural sphere, pontificating on highly complex social issues with an authority and certainty that complexity theory objectively denies them. This holds true at multiple scales, whether its a village council, an online forum, or Westminster.

And so here we complexity theorists sit, witness to opposing forces shouting at each other with stunning conviction, often needing nothing more than a few cherry-picked quotes from a single, possibly self-interested, source. Every time we hear an economic forecast stretching two, three years into the future, every time we hear a prediction on how much a 20 year infrastructure project will cost, what do we propose? Are we to just sigh wearily while the opposing groups have their turn reading the tea-leaves and proclaiming Truth? It’s seriously getting boring shouting at the Today programme on BBC Radio4, “but complexity!”.

Now, I’m not saying that beliefs and values should have no part in our collective self-organisation. By all means have idealism, I encourage it highly, but it has to be recognised as a goal to aim for, the objective of the strategy, and not the strategy itself. Almost by definition, blanket, immediate reform shaped from an ideal tends to emerge from initial conditions that were so crap that they inspired the mandate for idealistic, radical change to begin with. Initial conditions are important, really important, and history has shown what happens when they are disregarded. It aint pretty.

It doesn’t have to be this way. Once you get past the conditioning, complexity is by definition intuitive. But damn, that conditioning..

Case in point: the vaccination debate.

Take vaccinations. Recently, vaccination rates in the U.S. have declined to dangerous levels in some areas, resulting in outbreaks of measles such as that which occurred recently at Disneyland. Some parents are choosing not to vaccinate their children, with many citing the low but real chance of side-effects, and others going so far as to claim the whole thing is a Big Pharma based conspiracy. More people still are hung-up on the issue from a question of personal freedom, the immorality of being compelled to do something, and think that there should be a choice, perhaps together with education.

These people do not understand complexity theory, on a number of levels. Primarily, I think the major problem is an inability to switch between scales of reference, due to the cognitive dissonance that it might entail. In this case, personal freedom is enshrined at the scale of the individual only, with the systemic scale ignored, or else presumed to emerge according to a bottom-up process only. It’s easier to discern cause and effect at the scale of yourself, and more tempting to elevate the risk factor, when viewed selfishly. It also signals a lack of understanding regarding the potential for bottom-down emergent forces; the way in which systems influence people. Conversely, the more extreme anti-vax crowd impart the kind of cause and effect seen at the scale of the individual – intent, control, homogeneity – onto the system, personified as an evil there to fight, a powerful and well-established narrative to cling on to.

Where cause and effect is relatively simple to confabulate narratives for at the scale of the yourself (it’s actually just as hard, objectively, hence relying on epidemiology in pharmacology), resulting in numerous anecdotes spread with personal belief, the systemic scale is something of an abstraction. Time and distance conspire to hide cause and effect from us, leading us to rely on those actively looking and reporting back. Most do a good job, but it only takes one for enough people to latch onto, with their worries and confirmation bias, to suddenly create doubt in the public’s mind; a mind manipulated with fear for the sake of click-bait headlines and newspaper sales. Whether doubt is good or bad is not an inherent trait, it requires contextualisation, and with vaccinations, doubt has a death toll.

This is why it is particularly emotive for me – I can think of no other area of research where so much effort has gone into satisfying people that have made names for themselves through constant criticism of proven work. I feel for the parents whose fear has been manipulated, but I am also angry that so many can disregard the majority of people in their community, and demand the right to bring back diseases that should have been eliminated by now.

I cannot imagine that their choice really is to usher in another age plagued by avoidable, devastating illnesses, killing thousands of children. But if you do understand that risk, and you still want both sides given attention and respect, even for idealistic reasons, then sorry, you’ll get no respect from me. And if you don’t care and actively profit from this fear, than shame on you.

You aren’t allowed to drive on the other side of the road, but no one whines about losing their freedom because of it. I know vaccines feel more invasive, but its the same deal. We all have to do it; we all have to make sacrifices for the good of the whole. Order doesn’t just magically spring from the rational self-interest of one scale of emergence, whatever Ayn Rand might have you believe. So vaccinate your kids, please. We collectively earned this opportunity, and no individuals can claim the right to impose themselves, and take that away.

Its the best that we have, but it can be better

Any form of governance, whether it’s politics, health systems, education, etc, has no choice but to manage the complexity by applying the same rules to everybody. That is how how the nation state and it’s laws (should) operate, and that is how we practice medicine (to a degree). It is far from perfect; having to rely on the use of averages, probabilities, catering for the lowest denominators, and not having the capacity to tailor rules to the scale of the individual, governing a whole system will inevitably, unintentionally, screw individuals occasionally.

We just have to accept that, for now. We have no other choice. With any controversial area, the alternative is to introduce chaos into terrible initial conditions. As I said, argue for your ideal, but before that ideal can touch decision making that affects all of us, first it must be granted space to influence the scientific consensus. Not until individualised decision-making is actually plausible will it start to become immoral not to utilise it, but until then, we have to accept this is the best we can do. You don’t have to like it, and you wont always get what you want. Personally, I’m happy to listen to thousands of passionate experts that have spent their lives trying to understand that which I accept I am, objectively, personally blind to.

Incidentally, if we do want individualised governance within self-organisation – making each individual as free as possible, removing the one-size-fits-all approach of age restrictions, drug prohibitions and the like – we would need so much data available that it is hard to imagine it not going terribly awry without a radically different political economic structure than today. As I said, initial conditions are vital to consider.

My/A conclusion

It’s imperative that the limits of knowledge, and the absurdity of conviction, revealed by complexity theory is pummeled into all levels of culture and governance. Shift the focus from ideology to methodology, learn what constitutes good evidence so you can hold authority to account without succumbing to frauds like Andrew Wakefield, and stop being so selfish when it comes to accepting consensus, especially in cases where the stakes are so high (climate change is another one).  Recognise the importance of the systemic scale, and learn to love synthesising the dissonance that comes from incorporating the two scales together.

And yes, I do feel conviction in speaking of the absurdity of conviction, and no, that isn’t hypocrisy. Belief and conviction is not inherently bad, it’s the imposition of said conviction on others that is bad. And when complexity applies as it always does in heated debates, showing that conviction to be inherently unknowable, be it in anti-vaxers, economists, politicians, whoever, that’s when I have to clench my fist, sigh, and try not to feel too downhearted. Its a necessarily slow process, this alternative to imposition – the gradual accumulation of wisdom and knowledge – and I for one have no problem using conviction to protect those gains. Join me in continuing to speak out about these many abuses of authority, fellow complexity theorists, so that we might get to a better place sooner rather than later.

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