Category Archives: 1

I’m currently expanding my post on the Self Indication Assumption and the Great Filter into an honours thesis, due at the end of October. So barring bouts of procrastination or especially hard work deserving of blogging rights, I will probably remain fairly quiet till then. In the mean time, if you have any opinions on what career or the like I would be relatively good at, or anything else relevant to what I should do upon my impending graduation other than do a dance and read all those books I meant to before saving the world in some yet to be fully worked out fashion, please tell me here.

Wordpress now offers me free images of whatever I'm talking about. This is presumably an illustration of how the world doesn't necessarily become a better place if you tell everyone they urgently need to seek medical help for something you won't tell them anything more about. Image by uncultured via Flickr

I had a couple of bad looking medical test results in a row, so I was sent to a specialist, with advice along the lines of ‘well, we can’t say it’s not cancer… probably get checked out as soon as possible’. When I eventually got to the specialist he immediately told me a bunch of relevant conditional probabilities: of any problem at all given such test results, of it being a bad problem given it’s some kind of problem, the probability per year of cancer given each kind of problem. These were not scary numbers at all. Given that it can take months to extract your data from one doctor and get an appointment with a specialist, it would have been very nice to have been told these numbers by the original doctor, instead of just knowing for a few months that such results are some unknown degree of evidence in favor of cancer. Is this just an oversight by a particular useless doctor?

It seems not. I’ve noticed another two examples of the same problem in medicine recently. If you look up symptoms online, you will often be told to seek emergency medical assistance immediately. It often doesn’t even tell you what the potential problem is, and certainly not what the odds are of it occurring, so it’s pretty hard to evaluate the suggestion. If you actually go to a doctor about one of these symptoms, the doctor often tells you not to worry about it without more than knowledge of your age.  Often the website also knows your age, or at least asked it, and it would be simple for them to mention that said symptom is only a concern if you are over fifty, or even just the basic information about how common such a thing is given that symptom. Similarly my region has a free health phone line where you can ask a nurse whether symptoms are worth bothering to go to a doctor about. That seems like a decent idea, since apparently people overestimate when its worth going to the doctor. However in my small amount of experimentation it seems that anything I say prompts the suggestion that I see a doctor ‘within four hours’. I mean, I have tried telling them my bottom hurts at 2am and they tell me to get to a doctor within four hours.  I would be very surprised if an emergency room  was willing to treat sore bottoms in the middle of the night, so why not just tell the caller that at the start? Sending someone to a doctor can’t possibly help if the doctor is guaranteed to send them home.

In all these cases medical advice errs so much in the direction of caution that the doctor finally responsible for treating you will often hardly have to look at you before sending you home. The advice givers also refuse to offer relevant information such as conditional probabilities, so you can’t judge for yourself how far you want to cycle in freezing night to avoid a one in a million chance of arthritis or whatever. The costs of these behaviors in the short term are needless anxiety for patients, and doctors’ visits that informed patients would not want. In the long term patients will learn to distrust such advice givers and will miss out on useful advice when they really should go to an emergency room, while probably still harboring a slight fear that they have done wrong and will prematurely die for their sins. Is this medical advice format as common as it seems to me? Why is it done? I can understand an uninformed relative who is super-concerned about your wellbeing and believes you to be biased telling you you must seek medical advice for everything and refusing you any information. Or a doctor being in favor of it. But why do these presumably informed third parties and other doctors do it?

Added 1 Sept 10: I’m fine, sorry I wasn’t clear enough about that.

I wonder if part of the reason for persistent disagreement on political positions is that people mean quite different things by ‘We’ in sentences like ‘We should do x’. Here are three:

We = ‘the government’

As in, ‘we should control markets to avoid the dangers of their extremes’, ‘we should have discretion in the treatment of prisoners to allow for the complexities of the situation’,  ‘we should ban smoking even though people want to smoke, because they won’t when they stop being addicted’,  and ‘we should censor especially harmful writing’.

This is interesting because if ‘we’ should do these things, naturally ‘we’ should be given the power to do them. However in practice since you aren’t actually in the government, what you think ‘we’ should do is not very relevant once you have allowed such power. This is especially the case with issues where you can’t easily check that ‘we’ are doing what ‘we’ should, or do anything about it.  For instance issues which prohibit your knowing what’s going on (e.g. censorship), or where good and bad actions would be hard to tell apart from the outside (for instance well justified paternalism and interest-driven paternalism), issues which involve no simple standards to check behavior against (where much discretion is allowed it is hard to claim particular decisions were wrong, or to show this to others), and issues where you are expected to disagree (for instance paternalistic laws). By calling the government ‘we’ it’s easy to forget the difference in effort required to do something and to check a large powerful organization elsewhere is doing something.

We = ‘everyone’

As in, ‘if we just cut our meat consumption in half we would cut carbon emissions by –%’

This one is interesting for similar reasons to the above; it makes it extremely easy to overlook the fact that you don’t make decisions for everyone else, and don’t know what they are doing mostly. ‘Just cutting our meat consumption in half’ requires somehow persuading perhaps billions of others to reduce their meat consumption, despite their other priorities, disagreement with the claim, lack of sympathy to the cause, inability to hear you or know that you are suggesting such a thing even if you can afford a very expensive advertising campaign, lack of reason to trust you, lack of evidence that others will take part, and ability to just free ride if most people were to do what you say.  Despite these problems, when I was a teenager it took me a while to work out why ‘we’ don’t ‘just’ make electric cars powered by solar energy instead of petrol driven ones if we know carbon emissions are such a problem.

We = ‘you and I’

As in, ‘we shouldn’t have to pay for a corrupt bureaucracy to oppress us in the name of the majority’s interests’

This seems the least delusional meaning of ‘we’, but the others must exist for a reason. I suspect that if everyone thinks of themselves as part of ‘we’ and talks and acts as if their decisions are the ones everyone will make, they do avoid some of the coordination problems that their word usage overlooks. For instance if a bunch of people avoid polluting their local river because ‘if we just keep it clean will be much nicer’, they do actually get what they want, at least until someone has enough at stake to think about it more.

I think these meanings of ‘we’ are more popular amongst those with different political leanings.  In general, whoever ‘we’ are to you, you will tend to ignore the coordination problems within that group, or between that group and the real you. This helps policies that sound good to one group sound absurd to another.