Thursday 6 September 2018

My experience of trying to 'reform' science, medicine, psychiatry, and higher education

I spent quite a long time (from - say - 1985 to 2010) trying in all possible ways to reform (or at least prevent the rapid decline and corruption of) the areas in which I was employed and worked without the slightest degree of success.

The reason was simple, and I expressed it most fully in relation to science; and it was that the rot was already too extensive, and there were insufficient people who wanted to reform the subjects.

There are, indeed, (here and now) extremely few people who work in any area, that have any kind of vocation for work - almost everybody has a careerist attitude; and is therefore obedient primarily. So when it comes to stopping the rot; the rot itself isn't usually very keen to make an effort, or even to be associated with an effort. Typically, people just melt-away...

So - despite writing about things, speaking about things in lectures, seminars etc, making-waves as and when - I just watched the whole horror story unfold.

This has had a permanent effect on my attitude; because I realise that when the mass of people in an organisation, an institution, a profession, a nation... are complicit in corruption, when they are careerist, when they are motivated by short-termism, by the attempt to maximise pleasure and status or minimise suffering or risk... then there is no realistic prospect of overall and positive reform.

(This fact of what people were like was one of the great disappointments of my life - and I found it dominant everywhere and everwhere worsening, although not everywhere equally bad.)

Minor specific victories, or delays; when all around is collapsing and stampeding in the wrong direction, are really not worthwhile - and, indeed, I have experienced a success being twisted round and used in exactly the opposite way from that intended.

This happened from about 1990 when I initiated an idea of a 'core and options' medical curriculum, which was taken up by the General Medical Council and adopted widely - but not to enhance the depth of understanding of a specific subject, but instead to destroy the vital educational aspects of traditional medicine, such as gross anatomy. 'Core and options' therefore overall did more harm than good; or else was merely used to do something bad that would have been done anyway, but perhaps with a different excuse.

Anyway, my lesson was that all systems depend on people; and goodness depends on good people - which means people motivated by good. And this in turn depends on the definition of good.

If/ when good is defined in a broadly utilitarian fashion, as in all modern societies through the West, then goodness is equated with happiness, pleasure, absence of suffering - and all systems (science, medicine, psychiatry, universities, nations etc) are always and necessarily corrupted. How could they not be?

With the prevalent utilitarian morality as bottom line - there will be generalised corruption, and there will not be any traction to deal with it - so corruption will continue. Modern institutions cannot ever be reformed because they do not want to be reformed.

Only if, or when, people adopt a transcendental, religious, god-centred morality can there be any reform of institutions. In the meantime, we can only reform our-selves (and perhaps a few loved ones). 


Seijio Arakawa said...

I had noted that a lot of the more reasonable academics I've interacted with display an undercurrent of frustration that the next generation is even more careerist than they were, and the way that system is set up, they have no real power to pick better successors. More cynical people 'win' the game while more idealistic people (the kind who would do well at in-depth 'basic' research i.e. real research) depart in disillusion or disgust.

Since that is the feeling of the people who are held up as having survived the arduous selection process to 'win' their 'academic freedom', it is obvious that the only 'solution' to this problem is to de-invest one's ego from continued success within the institution, let alone continued success of the institution.

Theramster said...

The world is a saner place because of your witness. There is something stimulating about your writings that is simply lacking elsewhere. This makes me return to them for consolation and intellectual stimulation. You're definitely on to something and this I believe what is so exciting. You're a lonely voice for sure, unique in the kind of songs you're humming, which is truly refreshing. You will sound true, regardless of the clarity of the lyrics which are constantly being enriched and transformed, to everyone ready to hear you because you strike a familiar chord with them.

I think many people are being influenced by you without giving you credit. They reap rewards because they choose to play within the existing system for personal gains. Half truths though are potent lies.

Long term your deeper intuitions will be vindicated.

Christ bless you, Bruce!

Tobias said...

The box ticking mentality of bureaucracy is where I have seen careerism at its worst. Regulations, inspections, monitoring, etc., where everything is done to a standard formula, and where the stupid believe they are doing a good job, and where the intelligent realise they are not, but don’t care a jot. The intelligent ones never challenge because they know that if they do make a stand, they will be ignored for promotion, and lies will be told about them. They are ‘crazy’, ‘eccentric’, ‘confused’. These people are the worst sort of human being - content to let things go to blazes, so long as they are OK. A safe pair of hands is always preferred to the maverick with revolutionary ideas; heaven forbid, the ideas might work, and that would be too much of a challenge to the comfort of organisational pointlessness. So, sit hard on the honest, intelligent man, crush his spirit until he complies with the lies, or goes away.


Bruce Charlton said...

@Tobias - Cynics make the best bureaucrats - the most cynical people I knew as teenagers or young adults, are now the most docile, craven, Establishment careerists - but still regard themselves as rebels!

Unknown said...

Given how messed up things are, what advice would you have for people setting up a new medical research foundation? Assume that the small group of people involved are not beholden to the System and can make funding decisions largely free of bureaucratic interference. (I'm not certain that the foundation could get away with funding Duesberg, but its likely.)

I've read your book on the corruption of science as well as observed the corruption directly from a neuroscience PhD program (thanks to you I was mentally and spiritually prepared when things went bad, so I was able to get two others out of an ugly situation.)

-- Robert Brockman II

Chiu ChunLing said...

The essential problem is that people in the modern world don't think about death very often, at least not in any realistic way.

For most people in previous ages, encountering reminders of the certainty of eventual death and the possibility of death at any time was a fairly frequent occurrence. To moderns, what is encountered is fiction, or indistinguishable from it. There are statistics about how many homicides or whatever a child will 'witness' growing up through exposure to the modern media, but the problem is precisely that the child knows that these deaths are not real and yet are perceptually indistinguishable from the occasional 'real' deaths that make the news.

Our modern society labels the encounter with death, real and personal and undeniable, as "PTSD" and pathologizes the state of mind of being genuinely aware that death is something that can happen outside of a movie or whatever.

Bruce Charlton said...

@Robert - Well I wouldn't! If you want to fund good research, you could only do it from direct personal knowledge of the people involved, without 'competition' (and preferably a strong personal interest in the problems being addressed) - and not by any kind of advertising/ application/ selection process kind of thing.

In other words, you should be a patron, not a foundation.

Theramster said...

@bruce @robert
Going back to non-institutionalized discoveries, of intelligence, vocation, passion and patronage. Unfortunately this requires a social setting that values, recognizes and promotes in a personal manner such behaviors. A bureaucracy can't promote anything beyond its own vision, much like a molding machine can't produce a more useful shape. The best it can do is to produce the same shape. In contrast to an awakened person who is personally involved with the work he promotes and its potentialities.In this case the work is a gifted human potential.

So much resources are wasted in higher education and research to simply maintain an overall power structure rather than to promote the production of actual accomplishments by promoting those who can accomplish them.