Sahana: Hi everyone! Welcome to In Limbo Conversations. Today, we have with us Matt Bennett. He is the Senior Research Officer on a project titled 'Competition and Competitiveness' at the University of Essex. His areas of research include both continental and European philosophy, ethics and political philosophy, especially trust and responsibility and bioethics and philosophy of health care, especially end of life and palliative care. For more details about his work, click here. Thank you for joining me today Matt!
Matthew: Thank you!
Sahana: So in a very recent piece in the Kennedy Institute of Ethics journal titled "Should I Do as I’m Told? Trust, Experts, and COVID-19", you highlighted that when public policy claims to follow the science, claims to follow the science are made- citizens are asked not simply to believe what experts say but also to follow the expert recommendations. You suggested that this requires a more demanding form of trust which is called 'recommendation-trust'- so, I thought we could start by talking about the motivation for a trust based relation with the public than a fear-based relation. So, in the current situation, could you share, during the pandemic, what it means to attempt to enforce a policy based on fear and what could be the downsides to this approach?
Matthew: Good. Thanks! So, I think it's worth starting by thinking about what kind of relation between public and government we want- more generally, as well as, within the context of the pandemic and so really the contrast I'm interested in here is between something of a liberal approach to thinking about government which would be citizens voluntarily comply with mandates or policy that are introduced by a government- this is a completely idealized form of what such a government is going to be like and it's worth returning to what a non-idealized form would look like, but for the purposes of the contrast- on the one hand, we have voluntary compliance and on the other hand, we have a sort of wholesale comprehensive policing of a population to make sure that when a policy is introduced, whether a citizen wants to adhere to it or not, they are going to and this can of course take various forms. It could be straightforward military patrolling in the streets, it could be a heightened police presence, it could be less direct forms of state coercion. So this could be threats of fines for breaking social distancing measures and things like that, so this is the contrast I have in mind between coercive measures from the state and voluntary compliance and so the reason I think that a lot of the time, when we talk about trust in government as a very important cornerstone of a democratic society is that again, although it's an idealized form of this, what we're usually hoping we'll get of these two different models is the voluntary compliance model as opposed to the comprehensive direct state coercive model and one of the ways in which we can do that and probably, a necessary feature of that form of government is going to be public trust in government and that's going to underpin their voluntary compliance with what the government wants them to do and so, where fear comes in is a little bit more complicated. But I would think that fear falls on this direct coercive side of the contrast- of course, coercion from the state needn't always involve threats that make people fearful of what would happen if they don't adhere. The emotional side of this is not always necessary but I think the important point is whether or not we're asking people to voluntarily go along with pandemic policy or not.
..a lot of the time, when we talk about trust in government as a very important cornerstone of a democratic society, what we're usually hoping..is the voluntary compliance model as opposed to the comprehensive direct state coercive model and one of the ways in which we can do that and probably, a necessary feature of that form of government is going to be public trust in government and that's going to underpin their voluntary compliance with what the government wants them to do..
Sahana: Okay. So, there is the fear-based approach and then we have the trust based approach. In the case of trust-based approach, you have talked about the three kinds of trust- which are practical trust, epistemic-trust and recommendation-trust. I thought we could focus on epistemic and recommendation-trust to introduce the idea of a recommendation-trust if we take for instance, the claim that coronavirus is transmitted by droplets. So this is a claim which is backed by evidence and based on this empirical claim, certain recommendations have been made by the experts like social distancing, that we should maintain six feet or two meters of distance from each other. Now this is, of course, an oversimplification of all the factors which go into making a recommendation. So I'm of course for the sake of convenience- if we go with the idea that there is an empirical claim and a policy recommendation made on this basis- could you sort of tell us, in this case, what would it mean for an audience for epistemic-trust the experts and what would it mean for the audience to recommendation-trust the expert?
Matthew: Okay. So, what I understand by epistemic-trust is an attitude that a person extends to another person when they believe what that person tells them simply because that's what they've said is true and so this can happen in various different contexts- we can do this with friends or family or other personal relationships and of course, we can do this and do it all the time with regards to experts of various different kinds including scientific experts and including of course the kinds of experts that have become particularly important this year in the context of the pandemic. So, epistemic-trust is when I epistemic-trust a scientist if they tell me that coronavirus is spreading in a certain way, I epistemic-trust them when I believe that on the basis of the fact that they're an expert, this is what they've told me. recommendation-trust is my term for a similar response to another person telling me that there is something I should do rather than something that is true and on that basis, I should believe but of course, this is also an important kind of trusting relationship that the public are asked to adopt towards scientific experts and towards politicians but when it comes to trusting experts, it becomes particularly important- recommendation-trust when scientists are involved in policy because once you're involved in policy, they aren't simply providing us with inert facts as it were, but they're also very often involved in either deliberative processes that result in policy and those policies can either be in the form of a recommendation or a government mandate and in some cases, such as in Sweden at the moment, in various other parts of the world, scientific experts are very much at the forefront and not just deliberating with government but actually proposing the policy themselves and so, in this context, we're asked not just to believe what another person has told us, scientific expert but we're asked to follow a line of action that a scientific expert has told us- "Well this is what you should be doing."
I epistemic-trust a scientist if they tell me that coronavirus is spreading in a certain way- I epistemic-trust them, when I believe that, on the basis of the fact that they're an expert... recommendation-trust is my term for a similar response to another person telling me that there is something I should do rather than that something is true..
Sahana: What do you feel is added in the case of recommendation-trust? In the sense that when I have to believe someone and when I have to follow what they ask me to do, what do you think is added in the case of action which is not necessarily required or is present in case of mere belief?
Matthew: So one of the things I'm interested in with this contrast of these two different kinds of trust is what makes trust reasonable or rational- so, what conditions have to be in place in order for us to think that a person is given enough reason to trust another and I think the conditions that need to be in place are different in epistemic and recommendation-trust. I think more needs to be provided, the conditions are more demanding for recommendation-trust and so maybe, it's worth thinking about what those conditions are. Of course, there are debates among epistemologists and philosophers about exactly what conditions need to be in place in order for it to be reasonable to epistemic-trust another person, but roughly speaking there's a consensus around at least two conditions: one is going to be that the person is competent with regards to the thing they're telling me about and so, with regards to the current situation, we might think the relevant competency is going to be epidemiology. You know we need state epidemiologists to be sufficiently competent in their field for us to think we can believe what they tell us but, we're also going to need for me to trust the state epidemiologists. I'm also going to have to judge whether or not I take this person to be honest or sincere with regards to what they're saying, so I need to both be confident that they know what they're talking about but also, that what they tell me is not going to be in some way insincere, that what they believe about the spread of the virus, what we should do about this is both something that they know about well and that they're going to tell me sincerely.
Now, in the case of recommendation-trust, I take these conditions not to be sufficient for us, for me to think I should also do what the state epidemiologist tells me I should do. I think it's a somewhat stylized example but the example I use in the paper, I think, it helps to make the argument somewhat clear as to why it's not enough- so,if we think about this contrast in the context of an individual patient going to see a medical doctor, the medical doctor could for example have a conversation with me about some of the facts of the matter about the success of a CPR outside of a hospital environment and we might have this conversation because I'm considering whether or not to sign some kind of "Do not attempt CPR" or "Do not resuscitate" order and the doctor tells me for example about the success rate of CPR and okay, so, if I believe what the doctor tells me, I trust them and if I'm going to reasonably trust them, I'm going to at least need to think that the doctor knows what they're talking about, they're competent about this and also, I have no reason to think they're being insincere. Okay, great, if then, as part of this conversation, the doctor then says to me on the basis of these facts, you should sign the "Do not resuscitate" order. Now first of all, there's a massive ethics breach here- and I can't imagine most doctors would ever do this- but if you set that to one side and then think about whether, given the context, it's reasonable for the same patient to not just epistemic-trust but also recommendation-trust also think "Well, I should do what the doctor tells me to do." Even if the patient thinks the doctor is competent and sincere, they still haven't been given enough reason to think that they should sign the order and the reason for that, I take, it is that the patient could be reasonably sceptical that the doctor properly understands what is in the interest of the patient and what the patient values, what the patient really wants out of all this, what ends that they're pursuing. The doctor can be competent medically, they can be sincere and yet, still not understand that and still be a good doctor of course. And so, that's why the conditions for epistemic-trust are not necessarily going to be enough for recommendation-trust.
..the patient could be reasonably sceptical that the doctor properly understands what is in the interest of the patient and what the patient values, what the patient really wants out of all this, what ends that they're pursuing...The doctor can be competent medically, they can be sincere and yet, still not understand that and still be a good doctor, of course. And so, that's why the conditions for epistemic-trust are not necessarily going to be enough for recommendation-trust...
Sahana: Okay so in a certain sense, I have to not only believe in the facts that are presented, but also that when the recommendation to act a certain way is made, it is in my best interest. Since the non-expert does not have the prerequisite knowledge to evaluate the evidence, they have to in some way build a trust with the expert and believe that this person will have my interest in mind- so for this, I want to ask here- there was an option of deliberative polling that you had looked at and which at the level helps people to see that there is a representative involved in the policy making process who is in touch with the reality of my situation. You pointed out that this isn't really viable in emergency situations like the current pandemic situation and I thought- could you tell me why do you feel that? It's really a naïve question but why do you feel that it might not be possible in the current situation?
Matthew: Okay, perhaps it helps to explain a little bit more what deliberative polling sometimes looks like. I take it that there are a few different ways of doing deliberative polling but the format that I have in mind is something proposed by James Fishkin and the idea is to take an appropriate representative sample of the public and have them discuss a policy issue with the goal of being able to converge on a policy proposal that they will agree with, to give them enough time and space to be able to deliberate through this with one another from their various political perspectives but to also to make sure that this is informed by whatever science is relevant and so, part of the process would be to have relevant experts present enough detail about relevant scientific findings in an accessible way to the novices that are part of the deliberative polling process and also to talk through some of the doubts or the reasons, to think that the science may not be entirely accurate and give arguments for thinking that whatever doubts the members of the polling process might have, they should be allayed, so basically addressing potential counter-arguments to what the facts really are and then it's been shown by various studies that this kind of thing can help to mitigate problems with, for example, cultural cognition. Cultural cognition being a phenomenon by which a person who is presented with evidence or facts that are not necessarily compatible with their political perspective are less inclined to accept those facts and it has been shown, through various studies, that deliberate polling processes can break down cultural cognition. So, people become more receptive to what the evidence actually shows them and then, can incorporate that into their deliberation about what the policy should be. That's deliberative polling, the kind of thing I have in mind here. Now, this might be one way of thinking, as you say, if we were to produce policy in this way and also, if we can communicate to other members of the public who have not been involved in the deliberative polling that this is what has happened and that the sample is sufficiently representative and what have you- then, it could be a way of being able to show to the public that we have taken measures to make sure that the public interest has been incorporated into the policy process, that we are actually paying attention to members of the public and they're involved in this in a big way.
Now, the reason why I think in the context of the pandemic and certainly, this seemed to be the case at the beginning of the pandemic when time was very short and quick responses were needed. So, one of the reasons I think this is not so appropriate here, is simply time pressure. Another reason to think that perhaps this is not going to work for something like pandemic responses that need to be taken at least at a national level, is that the scale and the size of the population that is covered by the relevant policy doesn't obviously match well with the deliberative polling process. So, I take it that one of the virtues of the deliberative polling process is that it can work well for very local matters, where there is much more proximity between or, you have a much better chance of being able to say to the members of the public who are affected by the policy, "You're properly represented within the deliberate polling sample." You have that for, you know, a whole nation. Depending on the size of the nation, I think it's going to be a hard sell to then say to other members of the public, "Well, we've taken your interest into account because someone - who's kind of like you - was in a room with some scientists and that's what they came up with."
Cultural cognition being a phenomenon by which a person who is presented with evidence or facts that are not necessarily compatible with their political perspective are less inclined to accept those facts and it has been shown, through various studies, that deliberate polling processes can break down cultural cognition. So, people become more receptive to what the evidence actually shows them and then, can incorporate that into their deliberation about what the policy should be.
Sahana: Okay, okay. So, in the paper you also looked at the way in which science-led policy is communicated to the public. So, this could be one of the ways to develop recommendation, trust you had said. But there was expressive overdetermination and identity vouching - so could you please tell us what “expressive overdetermination” and “identity vouching” is?
Matthew: Sure. Expressive overdetermination - this is a phrase I've taken from Elizabeth Anderson; although she takes it from elsewhere. If the idea is to, rather than arrive at policy with the aspiration for some kind of neutrality that can be accepted - a neutral public policy - that is, not something that we would only accept if we had a certain cultural background or we were committed to certain values or what have you. But instead, is something that anyone can accept so long as they abstract themselves from their cultural background and accept a sort of level of mutual public reason. Instead of doing that, the idea is to imbue policy with multiple meanings, multiple signification and multiple values, with the hope that if we do this, then people who would otherwise be conflicted about what we should do with a certain policy matter can all get behind the same policy without having been asked to abstract themselves from their political perspective. And so, the example that is used in some of the literature in expressive overdetermination. One of the examples comes from the French abortion law reform, and the idea is that after decades of what seemed to be intractable dispute about this - largely between, as you would expect, liberal, progressive approaches to the reform and religious conservatism. The solution came in coming up with a policy that could be accepted by all parties involved as something that was sufficiently in accordance with their values. The particular policy that is said by some to have achieved this, was to make it the case that abortion would be available to persons, provided that they had an irreversible or unreviewable, "Certificate of Personal Emergency" - was the term. And for religious conservatives, the idea was that they could get behind this, because certification would be needed, it would be regulated in that way. But liberal progressives could get behind because that certificate was unreviewable - once the right is granted it can't be taken back. I have to say, I don't know a great deal about the policy process in this particular example, but this is just a way to illustrate how expressive overdetermination is thought to work.
Expressive overdetermination...the idea is to imbue policy with multiple meanings, multiple signification and multiple values, with the hope that if we do this, then people who would otherwise be conflicted about what we should do with a certain policy matter can all get behind the same policy without having been asked to abstract themselves from their political perspective...
And then, on the other hand, we have identity vouching. So, identity vouching is a pretty straightforward thing I think. So, it's really to just make sure that in the communication of policy to the public, we recruit members of different socially salient groups, in order to make sure that people in the relevant socially salient group, or, who share the demographic with the spokespeople for the policy are more inclined to think "Well.. if this person is from a similar background to me.." - and we'd have to be careful about which kind of background we're talking about. But, if for example, a person from a religious conservative perspective were to see that another high-profile religious conservative was behind a policy, then the idea is that they're more likely to think that this policy is in accordance with the things that I value. And so, that indeed is an example that is used by Elizabeth Anderson again. Her example is Obama recruiting Religious Conservatives in favor of his climate change policy. In order to court the favor of members of the public who would traditionally be wholly against progressive climate change policy.
In the context of the pandemic, if we were to think about examples of this now, I have to say, I think it's at the moment easier to find perhaps identity vouching than expressive over determination. But, let me give a kind of an attempt at an example of each. So, expressive overdetermination again, using a policy that is sufficiently polyvalent - so that people from different political perspectives feel they can get behind it. I know the case of - it's not so much of a policy as it is a public awareness campaign - in Mexico City, that involves posters that are put up in various places, on the side of bus stops and things like that. And these posters all have a picture of a person wearing a mask. And the message on these posters, each of the posters say "Wear it for 'something' ". But something changes depending on the poster. So some of these posters will have a picture of a person wearing a mask and the poster slogan will be "Wear it for love." Other posters will say "Wear it for respect" and there are some other posters that say "Wear it for courage."
And I think this is similar to expressive overdetermination, insofar as it seems that part of the idea behind it, is that it can appeal to people who have different things that are important to them, different virtues in mind when they think about, you know, how they want to conduct themselves in public life. Perhaps the person who thinks.. who's receptive to a call to implementing the right kind of social distancing for courage, is not going to be so receptive to doing it for love. But perhaps the person who will be receptive to doing it for love is not all that bothered about doing things for courage. So you see how this is a kind of expressive overdetermination. Identity Vouching, then finally. I know of a case, a recent one in the States. The National Medical Association in the States - which is a an association of African-American doctors - has recently announced a CoVid-19 task force and their explicit intention behind creating this task force is to make sure that when a vaccine is available to [unintelligible] that African-Americans would be more likely to or less hesitant to accept the vaccine - provided that the National Medical Association has approved of the vaccine and said, you know, "We're confident in this. We don't need to worry. This is something that everyone should be taking." So what they will be doing is scrutinizing the FDA and other governmental.. federal governmental institutions in the United States and proposals they're making for vaccine rollout. And provided that the NMA think that this is all okay, they will then be asking African-American doctors to tell their patients. This is something that we can accept.
...identity vouching..is to make sure that in the communication of policy to the public, we recruit members of different socially salient groups, in order to make sure that people in the relevant socially salient group, or, who share the demographic with the spokespeople for the policy are more inclined to think "Well.. if this person is from a similar background to me.." - and we'd have to be careful about which kind of background we're talking about..
Sahana: Okay, okay. So, related to that - while I was reading your paper I felt like there was a certain kind of tension about the role of Cultural Cognition. Because what I feel is in my interest is very intimately related to the kind of culture I come from. So, it seems that on one hand we want to combat cultural cognition so that the public would be more disposed to trusting the experts, but at the same time we also realize that each of us is sort of embedded in a certain culture - which is very intertwined with the social political and economic backdrop. So what do you feel about the role of culture in policy building exercises? How can a balance be struck which is - where it is not dismissed, but it is also not the determining factor? How does that feature for your, you know, idea about recommendation-trust?
Matthew: Yeah, okay. I think this is a really good question and a really big question as well. So I'm not entirely confident in what I can say in response to it. I certainly don't think I can answer the question, How do we, you know, strike the right balance? But one thing I think I can say is the.. part of my motivation for writing the paper in this way and approaching this question of what happens when we're asking people to trust not just scientific fact but science involved in policy, is that it's not so obvious that cultural cognition - in the case of policy recommendations - is irrational or objectionable. Particularly if we think that there should be some level of democratic legitimacy to policy recommendations and certainly to policy mandates. I keep talking about this in terms of recommendation. Of course, it's the case that much of what is happening around the world in terms of public health responses to the pandemic - these are not just recommendations. These are things that are enforced. I said earlier that I have this idealized contrast between state coercion - voluntary compliance, but of course, in practice, it's neither fully one or the other. Or almost never fully state coercion. But it's certainly never fully voluntary compliance. So anyway, this isn't always just a recommendation.
But even if it were just policy recommendations led by science, it's still the case that there are questions of democratic legitimacy here. We're asking people not just to accept facts and to be responsive to them but to change the way they live their lives in really quite radical ways for many people. And this requires an attention to what people value. In a way that I think is much more legitimate than it is when we're asking people to set aside what they value in order to believe what scientists have discovered. So, another thing that I think is relevant here is that, is just a very basic distinction between the rationality of believing something because we want to or don't want to believe something and the rationality of doing something because we want to do it. Usually we think that it's the rational approach to epistemology- forming correct beliefs should be resistant to what we want to believe. Something is not true just because we want it to be true. But then when we're talking about asking people to change their behavior and to act in certain ways, well it's not obviously the case - and in fact most of the time it's definitely not the case - that it would be irrational for a person to say "I'm not going to do that because I don't want to do it" and it's that very kind of fundamental but somewhat basic distinction that I think is relevant here to discussions of trust in scientists, when they're involved in policy.
Something is not true just because we want it to be true. But then when we're talking about asking people to change their behavior and to act in certain ways, well it's not obviously the case - and in fact most of the time it's definitely not the case - that it would be irrational for a person to say "I'm not going to do that because I don't want to do it" and it's that very kind of fundamental but somewhat basic distinction that I think is relevant here to discussions of trust in scientists, when they're involved in policy.
Sahana: Okay. Okay. So to wrap up, I sort of wanted to ask about.. during the pandemic there has been continuous change in information we have at hand about the coronavirus. So, how long do they stay on surfaces? Antibodies and immunity vaccines. And people tend to have this idea, that science is just something that should not change. What do you think is the effect of this continuously evolving stream of information on recommendation-trust?
Matthew: I think it's probably going to be very similar to the effect on epistemic-trust. So the significant effects of the science changing, as it were, I mean, for one thing, look - it's just very confusing isn't it? So, it's.. even for someone like myself who is somewhat obsessed with following the latest news about recommendations and, you know, some public reporting on science about the spread of the virus and what have you.. I still find it very confusing and very difficult to know and make decisions about what I should do and to feel that I have any kind of certainty whatsoever about all kinds of questions related to the pandemic and the virus. So it's confusing both with regards to the beliefs that I form about what's happening right now and also with regards to what I should be doing about the pandemic, about the virus. And that goes back to the condition, some of the conditions that I think need to be in place for reasonable or well-placed epidemic trust, and those that need to be in place for recommendation-trust.
And the thing is that because - the way I put it is that we need more for recommendation-trust than for epistemic-trust - that of course still means that whatever conditions need to be in place for epistemic-trust most of the time if not all the time need to be there for recommendation-trust too. So, in order for me to follow scientific recommendations, I'm going to want to know that the relevant science is competent on the matters of fact, as well as understanding my interests and what have you. But I still need to know that the competence is there by the matters of fact. And when, as we are being told very often now, and it is absolutely the case when we hear that the science is at a very early stage on this virus, and that there is certain amounts and significant amount of disagreement on the epidemiology and public health responses - what we should do in response to those changing matters-of-fact on the virus. This is an indication that the level of competence is perhaps not what we want it to be, in order for us to fully trust. And that goes both, I think, for epistemic-trust and for recommendation-trust. There's no obvious way around this with sciences in an early stage for very good reason. It couldn't really, as far as I can see, be otherwise. But then, that does raise significant challenges for building trust.
Sahana: Okay, so that's that's all the questions I wanted to ask you Matt! Thank you so much for doing this with me.
Matthew: Thank you! I really enjoyed it. Thank you very much.