Burning Platforms

In June 2004, I was invited to discuss two texts at the first of a series of annual meetings in the relatively new Said Business School, Oxford. The new Professor of Marketing had been a distinguished Sociologist in the field of Scientific Knowledge, and he had engineered this meeting to bring together the interesting and incisive work from the various fields of sociology of science to see if ideas could translate or transmit to the new business sector (where many sociologists end up working). 

One of the papers was written by prize winning PhD student Stephen Cole who had been honoured by the Society for the Social Studies of Science for his work on finger-print evidence in US courts of law. The other paper was credited to about 8 or so different people, but was in fact written by Marc Berg, a much published author on the way to becoming an independent health consultant in the Netherlands. The practice of including a range of multi-disciplinary stake holders as authors of the paper is a practice that has grown in popularity, alongside the rise in audit culture in some parts of academe. 

Both of the authors were successful in their field but neither had remembered the classic foundations of their chosen disciplines. My essay (on the blog side) put back some of the social staging that makes medicine and law understandable as a human activity. I anchored the action back to its base from a social science point of view and then went on to judge the value of the pieces. Both, I thought, were alarming. Both were highly ambitious. They each wanted to intervene and cause change at the heart of their chosen host field. Cole's pretension was to collapse the value of finger-prints as valid evidence in court. Berg wanted to collapse the practice of medicine in order to make managerial change. The Burning Platforms of my title were his preferred method of practice.

The challenge I faced was that of any scholar: to be true to the principles and knowledge of my discipline, so that the outcome would be an accurate analysis of the papers. If I succeeded then the benefits would accrue all round; witness to my personal worth as a scholar, witness to the knowledge base that I draw from, and an adequate exposure of the strengths, weaknesses and substance of the papers without having to set anyone on fire or collapse a whole tradition.

The meeting itself was set up as a kind of auditing, or auditioning perhaps. Where scholars at different stages in their careers, at different levels in their fields, come together to give a good listening to each other, to rectify wayward practice, argue important points, and learn from developments in adjacent fields. 

Looking back on this with hindsight I see the current regime of audit as extremely out of step with this kind of academic, scholarly, disciplined and learned tradition. One mechanism of auditing a discipline is this very meeting itself. It is one of many ways that academics organise themselves and regulate their practice. It doesn't have to be perfect, and it might not always succeed, but at least it has the virtue of being true to its knowledge, disciplined in its practice, and efficient in the exchange of ideas.

 

Unintended R D Laing

Adam Curtis' trilogy of documentaries came out in March last year. Someone has put short excerpts onto You Tube that relate to the bits about Ronnie Laing's critical American tour (the links are on the blog side).  Curtis argues that Laing's harangue had unintended consequences. In criticising the profession of psychiatry, he paved the way, Curtis says, for a more speedy medicalisation of the mind. 

The argument against the psychiatrists became such a powerful call that it rallied a potent army. Why? Did lots of people suddenly agree that leaving the important business of psychiatry in the hands of a bunch of people following a false science was not a good idea? Laing had said it was a false science propping up a failing society. One of the audience, a young medic named David Rosenhan took up the challenge and invented a radical research project which seems, at least in retrospect, to have catapulted the cause of the anti-psychiatrists into the stratosphere. 

Laing's gambit was a classic manouevre to open up a space for his own radical and interesting ideas. But his style of attack on his fellow professionals seems at least in part to have produced the conditions for a non-human intervention to take its place. How? The logic is over simple. If the men in white coats weren't to be trusted, we should turn to their non-human replacements. Why? Because it is men per se that is the problem? How does this actually happen in practice?

It can be ridiculously difficult to get a good idea into circulation (think Galileo, Copernicus, and Zero), so why is it easy to get a crackpot idea into circulation? What are the mechanisms that thrust RD Laing onto centre stage as a major player in this drama? 

Curtis's argument is an interesting one if approached in a sensible way. Because it is true that we are now in an era where criticism of professionals has become a serious argument for wheeling in non-human rationality as a replacement. But what are the conditions that have brought this strange situation into being? Why should people latch onto the argument against one idea and completely forget the other. After all, no-one was arguing for a marketing drive for medication. Certainly not R D Laing.

Taking Liberties

Last year Chris Atkins released a film and a book called Taking Liberties (Revolver, 2007). In it he documents the wave of changes in the law that Tony Blair's government have made. Not only were more laws passed than at any other time in history ever, but the particularity of the laws have obliterated the Magna Carta.

The supposition has tuned away from a presumption off innocence until proven guilty. 

When a Prime Minister's strategy of reform ends up tearing up the Magna Carta, it is a very different thing from having him harangue a crowd from a podium, and designate a particular group as The Ones who must be removed. But the lack of evil intent simply removes the consistency in the system. What we have instead is an unpredictable law of unintended consequeces - a great degree of risk and uncertainty.

In Chris Atkins film he re-presents the moment when Walter Wolfgang was slung out of Jack Straw's talk at the Brighon Labour Conference (2005). Wolgang, a very slightly built man in his 80s, had been unable to stop himself shouting Nonsense when Straw was talking of the war. Watching this footage is chilling. Not only is it horrible to watch big beefy bouncers manhandling a little old man, but it is also very upsetting to see most other people stunned into inaction. One brave bloke who attempted Wolfgang's rescue was himself seized, dragged off into a room where the camera couldn't follow and was physically abused. Atkins' film then cuts to a smiling shot of a bemused Blair who says: "I wasn't there".

Desire, life, death, and drive

Socrates, Cicero, and Montaigne have all said that to philosophize is to learn how to die.

This line is from a review in the Times Literary Supplement (21 May, 2008) by Daniel Pick of a new book by Mark Edmundson
THE DEATH OF SIGMUND FREUD
Fascism, psychoanalysis and the rise of fundamentalism
282pp. Bloomsbury. £18.99.
978 0 74758607 4

My thanks to Penny Geogiou for bringing this to my attention moments after I received an email from from a sociologist who had told me the rather pitiful tale of one of his colleagues. They are suffering an excess of audit in their department and being asked to spend lots of time on form filling that has no value for the work that they do, in fact it is detrimental. The colleague was very vocal in her refusal to indulge in such nonsense. Her outburst was sufficient to call a senior administrator in to defend his labyrinthine predilections. Perhaps it is the shift in power relations that led the academic to immediately capitulate. She found herself praising the virtues of the red tape equally loudly, much to the surprise of her colleagues. The administrator withdrew, satisfied.

I wondered what happened to this woman. It is not unusual to find someone beating themselves up after such an unpleasant encounter. When a bully succeeds in pressing home his power, the bullied has three options to deal with the residue that results. Self punishment. Passing the indignity onto someone else. Sublimation, or turning it into something more creative. 

Figuring out how to live with the excesses of our drives is one of life's more important questions. Antiquity and classical literature is full of it, and Freud and Lacan champion it. But in modern British life, it appears to have fallen out of fashion. 

English Professors against QAA

Thomas Docherty, professor of English at Warwick University published a new book this year: The English Question or Academic Freedoms (Sussex Academic Press, 2008). The Guardian's Chris Arnot wrote a column that pit Docherty against some QAA advocates. 

Here's a quote from Docherty: "The QAA, for those of us who have suffered under its tawdry posturing, is a cancer that gnaws at the core of knowledge, value and freedom in education; its carcinogenic growth is now perhaps the greatest pervasive danger to the function of a university as a surviving institution," he writes. "It has presided over the valorisation and celebration of mediocrity, paradoxically at the very moment when it is allegedly assuring the public of the quality of education and universities ..."

and here's part of the riposte: "Hefce has defended its creation. "We strongly refute Professor Docherty's comments," says its director of learning and teaching, Dr Liz Beaty, "and have complete confidence in the way the QAA is carrying out its role." [my emphasis - JL] She points out that, in response to concerns about the administrative burden, the agency adopted a "light-touch" approach after 2001."

One of the features of the ripostes is that they call on a tawdry notion of evidence to refute Docherty's argument - look closely and you find that the way they comport themselves is the question, not the reason or logic of their act.  This is part of an attack on the real value of academic work, and the beginning of a slide into fakery (ie pretending to do something by going through the motions).   Arnot frames a clash of paradigms here.

http://education.guardian.co.uk/higher/news/story/0,,2240583,00.html


The book's title resonates with the important work of Conrad Russell: Academic Freedom (Routledge, 1993). http://www.atm.damtp.cam.ac.uk/people/mem/papers/LHCE/uk-higher-education.html

If EBM is the answer, what was the question

If EBM is the answer, what was the question? Who asked it? When?

Although Archie Cochrane is implicated in this process, he didn't spearhead the current rise of RCT in the NHS, and amongst those that did, few mention the man. It was as if it emerged out of nowhere, attached to no-one.

For some bizarre reason, EBM has not become a new science. Instead it has become entangled in politics and is best understood as a rhetorical phrase.  

The phrase has power to hypnotize people. In the particular arrangement of the NHS, the Government and the University sector, it has become a key phrase which is shaping people's livelihoods, money, and jobs. 

Whatever Evidence Based Medicine might have been, it has become the rallying cry in a strange kind of paradigm war. Intended or otherwise, under the banner of EBM a backward step is being taken.

The war is odd tho. Instead of finding pioneering scientists championing new ideas and new ways of doing things, we find bureaucratic systems, and an apparent army of nameless automatons. 

Evidence Based Medicine

Archie Cochrane died in 1988 but in 1972 he published a little book in which he championed the EBM cause in the name of the Randomised Controlled Trial. He said that the first couple of chapters were an easy write, but the rest of the book was a depressing grind. He had said all he wanted to say in the first few pages, but was obliged by the sponsor to pad out the pages to make it into a book. The book sets off saying how little of what doctors do is based on evidence. 

But what kind of evidence is needed in medicine, and who is to be the judge? 

Archie Cochrane points out in his book that if you take a map of the world and place a black dot everywhere you find an RCT you will notice that all the countries concerned are those of a protestant persuasion. Communists and catholics are bereft of the thing. At least that was true in 1972.

This is a very interesting observation. Archie Cochrane, however, joked that it simply showed the natural superiority of the protestant.