Tuesday 18 June 2019

For The Sake Of Science - Let The Anti-Vaxxers Have Their Way

The authority of scientific experts is in decline. More and more people think they can figure things out just fine by themselves and reject the intellectual division of labour laboriously built up over the last few hundred years. This is foolish since expertise is a civilisational super power on which our modern prosperity is founded. It is also dangerous since expert advice is essential to addressing existential threats like epidemics and climate change. The fewer people believe scientists’ pronouncements, the more danger we are all in.

Fortunately I think there is a solution for this problem. Unfortunately, it looks like some people are going to have to die.


How did we get to this place? I see two interacting mechanisms: the paradox of expertise and the rise of consumocracy.

By definition, experts are the best source of knowledge and policy advice. (If someone knows better than the official experts, that just means they are the real expert.) So expertise should be a highly valuable, respected resource. But it isn’t because of the paradox of expertise: experts lose credibility for getting things right as well as for getting things wrong.

First, consider what happens when experts give correct advice and we believe it and act on it in time. In that case the problem they warned us about will be prevented or much reduced. But then, because nothing really bad happened, the casual observer will conclude that yet again the experts were wrong or exaggerating, and determine not to believe their claims in future. The problem is that the better experts are at identifying and fixing problems before they appear, the harder it is for them to show the value of their contribution: the terrible things that would have happened without their intervention. 

Second, consider what happens when we follow experts’ advice that turns out to be mistaken. This is bound to happen sometimes. The fact that experts represent the best understanding anyone in the world has about some topic doesn’t mean that that understanding can’t be wrong (as medical science got ulcers wrong for decades). It just means that we don’t have any good reason to believe that anyone else knows better. It can also be that scientific knowledge is correct in general, but doesn’t have the resolution to give accurate predictions about every case (such as who the economic losers will be from the free trade policies that makes the world much richer on average). In either case, the fact that even when wrong the experts are a better guide than anyone else is not counted. Wrong is wrong: the experts are blamed for the problems they failed to prevent and the credibility of their future claims is reduced.


Besides the built in self-undermining character of expertise there is also the phenomenon of consumocracy: the increasingly popular notion that we have the right to believe whatever it pleases us to believe and anyone who tries to tell us we’re wrong can go to hell.

This is driven partly by our human psychology directing us towards the things that promise to make us feel good. What the people who have dedicated their lives to scientific research have to say is difficult to comprehend and often bone-achingly dull compared to a Youtube video by a Flat Earther that makes you feel like you can do science from your couch. There are various kinds of psychic reward available here. There may be a pleasure in believing outrageous things and arguing with other people about them on the internet; or in believing you know something that other people don’t; or in membership of a community of fellow believers. Conspiracy theories are particularly fun to believe in because they make complicated and unpleasant events immediately comprehensible by making them actually all about you, the consumer of news events. The world isn’t so big and scary and difficult after all! It’s just a conspiracy by an all powerful government agency (or aliens, or God) that cares deeply about your opinion! 

Although the pursuit of purely psychic rewards has always been a vulnerability of human reasoners, it has only become full blown consumocracy thanks to a cultural shift. As Kurt Andersen explains very eloquently in Fantasyland, we are dealing with an outgrowth of the same individualism that fueled the rational enlightenment against unjustified authority and gave us modern science (the motto of Britain’s Royal Society was ‘On no-one’s authority’.) The flip side of establishing the right of individuals like Galileo and Darwin to follow the evidence wherever it leads them is the right of individuals to believe whatever they want for whatever half-assed reasons they find compelling. Of course this is ridiculous. Facts are not matters of personal preference, like pizza toppings. They are or they aren’t. And whether they are has nothing to do with what we would like.

When consumocracy combines with the paradox of expertise, we get the current anti-civilisational phenomenon of mass idiocy: vast numbers of people turning their backs on what humanity actually knows in favour of homespun stories that they enjoy more. That includes such dangerous stories as the idea that vaccines cause autism, that climate change is a conspiracy of grant hungry scientists, or that genetically modified food is poisonous. In these cases, people's right to believe what they want and to act on their beliefs directly imposes risks on the rest of us. In other cases - like flat earth theory - the beliefs themselves may be harmless, but their spread makes it harder for the intellectual division of labour to function. This is especially because of the intimate role that conspiracy theorising plays in justifying the idiots' rejection of mainstream knowledge.


How should we - the believers in science - respond to the rise of mass idiocy? Two response are common, but neither seems likely to succeed. 

First, we can use our control of the political system to enforce obedience to the advice of the experts. For example, in 2017 Italy made various childhood vaccinations compulsory in response to the spread of anti-science theories that had reduced vaccination rates and led to dramatic increases in measles cases. This kind of intervention aims to stop the idiots from acting on their beliefs by backing up the epistemic authority of expertise with legal force. It follows the reasonable ethical principle that while idiots may have a right to believe what they like, they do not have a right to endanger their children or others because they are too lazy to bother to think properly.

The problem with this coercive approach is that it does nothing to counter the underlying problem: the core mechanisms (the paradox of expertise and consumocracy) that are driving down faith in science. It is furthermore politically unsustainable since it requires a majority of voters to vote science and that majority cannot be counted on to persist indefinitely. Idiots can also vote in a democracy. Once there are enough idiots politicians will start courting them and their delusions. This has just happened in Italy, where two anti-system populist parties fulfilled a campaign promise to rescind the mandatory vaccination law.

The second approach attempts to counter the mechanisms of doubt by providing a robust positive defence of the intellectual division of labour. Here we try to explain why it is rational to set aside your right to think for yourself about everything and trust the people who know more about it than you. That effort includes educating people on how to distinguish charlatans like Dr Oz from real experts, i.e. those recognised as experts by other experts. (I have made my own contribution to that effort previously.) 

The trouble with the educational approach is that it assumes that everyone cares about truth and the problem is just that many of us are bad at working out how to find it. But vaccine ignorance is higher in richer countries than poorer ones - just 33% of French people strongly believe that vaccines are safe. Is it really plausible that all these people with more years of education than any previous generation and free access to the world's knowledge on their phones just can't figure this out?

It seems more likely that this is a values problem than a knowledge problem. A consumocracy trains its citizens to look at the world through the lens of self-interested pragmatism, to focus always on the costs and pay-offs for ourselves. In this light, truth per se doesn't matter unless it is connected to a psychic or material pay off. Many consumocrats do gain a psychic pay off from using the idea of truth to describe their beliefs, but only because they like to pretend to themselves that their beliefs are justified and they like having a reason to reject criticism. They don't care about truth itself - certainly they don't get any pleasure out of having their beliefs corrected by objective reality, as scientists do. Unfortunately, if the problem we are facing is about values, then trying to educate people in how to find reliable truth is not going to achieve much.

I have a different solution. We should allow the idiots to act on some significant but not calamitous mistakes even if - actually because - there will be a cost in human lives. Only in this way would we give people a reason to care about truth and hence a reason to seek out genuine expertise. If done correctly it would have benefits beyond the specific case, by bringing home to people why scientific experts are worth believing and by closing down the safe spaces in which fantasists thrive.


Do vaccinations endanger my child's health?

When we are deciding who or what to believe on this question we are making an epistemic gamble. The most obvious thing to figure out is what the possible consequences of vaccinating/not vaccinating are and which are most likely (i.e. what are the facts of the matter). Scientific experts are objectively the most likely of anyone to be correct, and so it might seem that the rational person should always bet with the scientific experts rather than against them.

However, the most important feature of a gamble is not the probabilities of the different outcomes but the stakes: how much might I win or lose? Here, the paradox of expertise bites again. Because governments have institutionalised the advice of experts, no one anymore remembers how horrible measles outbreaks are. The cost of not believing in measles has been forgotten. The experience has been lost from social memory and only exists in abstract form as graphs and hypothetical projections put together by experts. Thus, the only thing at stake in this epistemic wager is the parent’s own internal psychic rewards, for example the pride and sense of achievement the anti-vaxxer may feel watching their child grow up normally and thinking 'I did that!' This is a bet the anti-vaxxer can’t lose.

This case also demonstrates the unsustainabilty of attempts to enforce the advice of experts. Many governments are contemplating mandatory vaccination laws out of a humanitarian concern to save innocent children from dying due to mistakes by idiots. To the extent that they succeed, the worst possible outcomes will continue to be forestalled: vaccination rates will stay high and measles outbreaks will remain easily contained. Yet the vaccination crisis will continue. By reducing the life and death stakes – by protecting parents from reality – the government also reduces parents’ interest in finding out who really has the best knowledge of how vaccines or measles actually work.

It may not be irrational for an individual to select their beliefs in this way. Nevertheless, once large numbers of people become accustomed to making choices based on what they would prefer to believe is true, protecting them from the real world consequences of being an idiot quickly becomes politically unsustainable. This is because their behaviour undermines the authority of the scientific expertise that holds together the system in which their dissent from reality is made possible. At some point the system will collapse dramatically, like a political constitution overwhelmed by the careless opportunism of politicians who took stability for granted (e.g. Brexit). 

How can we break this cycle of increasing consumocracy and declining credibility of experts? Forcing people to go along with what the experts say just makes them more complacent in their idiocy. Trying to persuade them that scientists really do know more than they do won't work unless they have a reason to care about objective rather than subjective truth. The failures of those two imply a possible solution. We should allow the stakes to rise again so that people have a reason to care about finding out the truth, and hence a reason to care what the real experts have to say.

Many people disbelieve climate scientists but almost everyone believes weather forecasters - in spite of the fact that weather forecasters get things wrong with some frequency. The reason is that we have all have had many opportunities to experience the bad effects of relying on our own intuitions rather than the advice of expert weather forecasters. We have learned from experience that the science of weather forecasting is not perfect, but is still much much better than what we can do. In a modern individualistic society it seems that experience is key to belief, the more dramatic the better. Hence, witnessing extreme weather events battering the Midwest, if only on the news, seems to be moving views about climate change where decades of pronouncements and explanations by climate scientists had failed. The problem is that waiting for the evidence of experience to appear exposes society to unnecessary risks and costs. The price of mitigating climate change is massively greater now than when the Intergovernmental Panel on Climate Change was first convened in 1988 to assess the scientific evidence. By waiting until the climate had already started dramatically changing in front of our eyes, we wasted a lot of time and put ecosystems, economies, and billions of lives in danger. What's the point of experts if you won't believe them in time to act?

If experience is central to remembering the value of expertise, then we may need to create more vivid (and hence recent) societal memories of what happens when we don’t follow experts' correct advice. The best way to achieve this - both practically and ethically - is to allow people to play out some of their epistemic gambles for real rather than imaginary stakes. Childhood vaccinations are a good case to trial this approach for several reasons. First, vaccines are a medical intervention which nearly everyone experiences, so they are an important proxy for faith in evidence-based medicine and science in general. Second, because unnecessary child deaths are especially tragic and hence very powerful learning experiences for the whole of society (not merely the parents). Third, because the evidence of experience should appear early enough  to learn from (unlike in cases like climate change). Fourth, because the costs would be high but manageable. Even when no one in America was vaccinated against measles 3-4 million cases translated into 50,000 hospitalisations, but just 500 deaths per year (CDC).

It would already be worth doing this just to reestablish faith in vaccination science, which we may need for diseases much more deadly than measles. However, the benefits should go beyond that to a greater general respect for scientific expertise. The basic idea is that by refusing to protect people from objective reality in this particular case, we will innoculate them against becoming full-fledged fantasists who eventually endanger us all. Another way of putting it is that, by  letting more of the smaller dangers get through, idiocy won't have the chance to build up to really dangerous levels. This is the same principle as modern wildfire management: by leaving smaller fires to burn themselves out you let some people suffer the loss of their houses and business, but by doing so you prevent the build up of combustible material to levels that would fuel a much more dangerous less controllable inferno.

Sometimes a tragedy can do more good than harm. From time to time, we should step aside and let the idiots have their way. So if parents don’t want to vaccinate their children because of what they think they found out in their Facebook research, let them experience the full consequences of that decision. Some of their children will die, and this is sad because those children will be paying the price for their parents’ fantasies. Some other children will die despite their parents’ faith in vaccines (because they were too young to be fully protected, or had immune-system problems) and this is also sad. But it is that sadness which would provide the reality check that nothing else seems capable of providing. 

It may seem callous to think of children’s lives in this calculating way. But we trade off innocent lives for other values all the time. We could set the speed limit at 20 mph, but we don't because we think it is more important to get to work a bit faster even if thousands of children die as a result. Let's not start pretending now that every life is beyond price. Moreover, we should think not only about the few lives we can save by enforcing vaccination on foolish parents now, but also of the need to maintain popular trust in the science of vaccination - and science in general - so that we can continue to save hundreds of millions of lives in future. For if our societies cannot recover our ability to trust the experts then much worse things than a few measles outbreaks will follow.


Scientific expertise is a civilisational resource - but only so long as people believe in it. The measles vaccination case is only one example of this among many others (climate change denial, GM 'monster' food, big pharma conspiracies, etc). But the measles case also suggests an obvious solution. Once measles outbreaks were no longer remembered people had the space to develop their own wingding theories that give them imaginary (psychic) benefits. If we want to maintain the credibility of science we need to eliminate the safe spaces in which such dangerous fantasies can grow and spread. In the long term, allowing people to witness the real world consequences of betting against experts may be the most effective means of defending science and thus protecting our children not only from measles but also from the other great challenges they will have to face in a dangerous and complicated world.

A previous version of this essay was published on 3 Quarks Daily