Posts by Grant Taylor
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This is bloody tragic. I was very lucky to have been part of the public mental health system as a Clinical Psychologist back in the 1980s when there was adequately provisioned inpatient care (not always very skillful or enlightened, eg the findings of the Mason Report, but adequately provisioned) and a visionary, idealistic and evidence-based implementation of the Community Mental Health model. My colleagues and I were often frustrated by the limited resources even then (mental health care has NEVER been funded in proportion to its prevalence or morbidity; don't get me started about heart disease and cancer) but we were proud of being part of a system that was by-and-large accessible and able to apply some secondary preventive interventions. Those now seem like Halcyon Days indeed - and not just because of the common use of benzodiazapines back then. There are many things that manifest the inhumane heartlessness of neoliberal political/economic philosophies but the neglect of mental health care, consumers of which are among the most vulnerable people in society, is foremost among them.
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Hard News: An interview with Ben Goldacre, in reply to Rich of Observationz,
I'm all for everyone learning as much as they can about anything they wish to - but that is not the same thing as developing a level of understanding equivalent to that of someone who has made it their life's work to know as much as possible about a particular topic. In my own fields of understanding I have frequently come across people who have 'done their research' but are so far off beam with the self-tutored conclusions they have come to that it is difficult to know where to start in having a constructive conversation with them. Interestingly, I have usually found them to have an attitude of far greater 'faith' in their knowledge than the experts usually have in their own.
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Hard News: An interview with Ben Goldacre, in reply to Bart Janssen,
These are standard things that indicate bullshit
Yes and no. Bullshit comes in shades of grey. Most current knowledge is more or less bullshit and, importantly, there is a difference between bullshit and bullshitters. I am always on the look out for bullshitters (and as Russell has indicated, this is a social judgement not an intellectual one; the “truthiness” concept of a few years ago comes to mind) but I am prepared to believe the word of an expert non-bullshitter as the best access to the truth I am likely to have, even if that word is almost certainly to some extent bullshit*.
The challenge is to figure out who we believe when our ability may be limited to even properly parse and understand the answers to the questions you suggest, Bart. You are right that it is reasonable to ask such questions but it may be foolish to believe that (a) we actually know what are right questions to ask in the first place (incidentally, asking the wrong questions is one of the things that creates a tremendous amount of bad science), (b) we are able to comprehend the answers we are given, and (c) we can accurately judge to what extent these answers are incorrect.
There ain’t no getting past trust, IMO. Trust is what the world runs on.
*PS: One of the Deans of Auckland Medical School many years ago (I think it was Cole) addressed a year 1 class saying that 50% of what they were about to learn in the next five years will be wrong - but we wouldn't know which 50% for another ten years).
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Hard News: An interview with Ben Goldacre, in reply to Russell Brown,
The reality of course is that as I wrote at the time it’s a bit more complicated than that.
Yes. Actually, that applies to nearly everything covered in the interview.
Ben’s right, I think, in most of the points he makes but reality is simply way more complicated than the evidence-based medicine/healthcare database (even if were full utilised), research methodologies and budgets can get around currently – possibly ever, but who knows what might be possible as AI develops.
His views of how things ought to be are actually pretty simplistic; conversely, things are not really as bad as they might seem in light of his valid criticisms. For example, the researched medicines industry is not without self-serving bias and frank corruption – but I am very grateful for researched medicines and for the billions that Big Pharma has invested in developing treatments, which although not perfect and probably not as effective as they are ‘sold’ to be, are a damned sight more efficacious and safe than so-called “alternative” medicines. Cognitive-behaviour therapy may have been shown to be as effective as SSRIs in a range of studies of questionable ecological validity – but SSRIs are a great deal cheaper, more accessible and socially acceptable than CBT, which is why they are more often prescribed.
Also: we have no option but to “trust the experts” – in most aspects of an increasingly technology-driven world. Life would be untenable otherwise.
I have written a little myself on these questions elsewhere, if anyone is interested.
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OnPoint: Beyond 'a bad look', in reply to Sacha,
Are you saying that’s not the case here?
Well, as I have said, I don't think they did/are doing a particularly good job but I think they are doing a good enough job (a la Pareto Principle), such that a better job would not have made a huge difference to the outcomes that Keith stated at the beginning of his post.
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OnPoint: Beyond 'a bad look', in reply to Lilith __,
You might be right, Lilith. I really don't know what is behind the falling voting rate, here or elsewhere. Perhaps the news media have a big role to play in this - but I also get the impression that fewer and fewer people are consuming conventional news media and I wouldn't be surprised if the people who don't vote are also the people who don't pay attention to political journalism. The shallowness of analysis, and perhaps bias, that we are bemoaning here is perhaps a response to this loss of audience. Even if we had the Guardian or the New York Times in NZ, I doubt that the level of political engagement or dissatisfaction with the current government would be any higher.
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OnPoint: Beyond 'a bad look', in reply to Bart Janssen,
Let me clear that I agree that journalists have not served us well. I cancelled my Herald subscription during the last election campaigning (and haven't reinstated it) precisely because of this.
But we can't, perhaps even musn't, take responsibility away from the electorate for the government we get. You don't like them, I don't like them, I didn't vote for them - but a decisive segment of the population did. And I don't see how the journalism we got, flawed though it was, could have been the decisive factor in either the election result or the behaviour patterns of the current government.
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After the election last year, I wrote this post on why the media failed over Dirty Politics. Not just because Key won the election, but also because Katherine Rich is still sitting on the Health Promotion Authority, because Jason Ede got swept under the carpet, and because Judith Collins didn’t actually face any consequences
While I agree with your take (and those of the commenters) on the shortcomings of NZ journalism, I think that judging the value of journalism by its political consequences is rather undemocratic. Ultimately, politicians can only do what the people let them do, provided the democratic process is more-or-less intact. Journalists can only be held accountable for the outcomes you describe if they have failed to inform the public of the facts, their meaning, implications and context - after that, it is between the public and the politicians.
Our journalists don't always do a good job of informing the public but I think it is a bit of a reach to ascribe the behavior of the current government to journalistic ineptitude.
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Nicely written, Dave. My heart is with you and a fair slice of my mind as well.
But NZ's economy has always existed in an international context. Much of the prosperity of my youth (mostly the 60s and 70s) was due to patronage from a country that my grandparents (all born in NZ) called 'Home'; when that stopped, everything changed, even if Muldoon et al tried to hide the reality.
NZ is a sparsely populated island nation with a small population, geographically isolated in the South Pacific ocean. It is extraordinary that we have the standard of living that we do - and we only do so by the grace and favour of our 'trading partners' ('partner' is a euphemism here, as it is in business generally). I.e., to the extent that it suits them to buy from us whatever we have to sell them. Happens to be dairy at the moment. I remember when it was wool and vaguely recall the lamb economy. As a part of the technology sector, I am looking forward to the 'knowledge economy' taking flight - but I am not holding my breath.
I loathe and detest neoliberalism on many levels but it is the tune to which the wealth in the world is currently dancing and we won't change that with a local revolution.
But why the hell can't we have a government that does a better job of buffering its worst ills? We elected them to take care of our interests, not pimp us out.