I wrote the previous post about a week ago, but didn’t feel like publishing it before anyone commented on the previous four published in rapid succession. It was only while telling H.A about Ashwin Parameswaran that I was inspired by the latter to re-check chapter nine of “Seeing Like a State”. That chapter is a celebration of “metis” or local, practical, or personal knowledge over “techne”, what we would consider more scientific knowledge. It included not only the folk-wisdom of agriculturalists, but the medical knowledge of doctors. I was particularly struck by the passage in which a doctor claims he can just by looking identify to a great degree of accuracy whether an infant was seriously ill and needed medical attention, but couldn’t fully explain what visual cue alerted his judgment. It brought back to me memories of Robyn Dawes’ “House of Cards” in which he gives numerous examples of psychiatrists claims to experience derived insight & intuition completely unsupported by performance data. In another of his books “Rational Choice in an Uncertain World” he explains (with some of the figures providing examples of Goofus behavior) how our minds are prone to that kind of error due to our inability to understand how randomness works and our susceptibility to confirmation bias. Dawes’ experience was with the notably flaky field of mental health, surely physical doctors are much better. Robin Hanson has been on a one-man crusade to take them down a notch and insist on the use randomized studies on health outcomes rather than relying on their expertise. Has anyone tried reconciling the clash of metis and techne? Malcolm Gladwell may have fumbled in that direction with “Blink”, but I don’t feel like reading it.
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