Search the KHIT Blog

Saturday, March 30, 2019

A "Science of Deliberation"?

As regular readers know, I am firmly on the side of science--specifically the "scientific method(s)," warts and all. But, what about "political discourse," which seems more than ever overpopulated with noisy, demagogic fact-averse partisans and ad hominem rhetorical bomb-tossers? After all, the phrase "political science" is unhappily viewed by many as a contradiction in terms.

Interesting piece in Science Magazine (paywalled):

POLICY FORUM: SOCIAL SCIENCE
The crisis of democracy and the science of deliberation

That there are more opportunities than ever for citizens to express their views may be, counterintuitively, a problem facing democracy—the sheer quantitative overabundance overloads policymakers and citizens, making it difficult to detect the signal amid the noise. This overload has been accompanied by marked decline in civility and argumentative complexity. Uncivil behavior by elites and pathological mass communication reinforce each other. How do we break this vicious cycle? Asking elites to behave better is futile so long as there is a public ripe to be polarized and exploited by demagogues and media manipulators. Thus, any response has to involve ordinary citizens; but are they up to the task? Social science on “deliberative democracy” offers reasons for optimism about citizens' capacity to avoid polarization and manipulation and to make sound decisions. The real world of democratic politics is currently far from the deliberative ideal, but empirical evidence shows that the gap can be closed.

Declining civility in interactions among elected representatives decreases citizens' trust in democratic institutions. The more polarized (and uncivil) that political environments get, the less citizens listen to the content of messages and the more they follow partisan cues (1) or simply drop out of participating. Declining complexity in arguments means a growing mismatch between the simple solutions offered by political leaders and real complex problems. This decline combines with post-truth politics and the displacement of facts and evidence by the felt truth of “cultural cognition,” in which social identity conditions opinion, as seen clearly on climate change.

A long tradition of survey research in political science—going back to the 1950s—yields skeptical conclusions about citizen competence. Claims that people vote mainly guided by group identity, oblivious to reasons for or against candidates or policies (2), can fuel arguments against democracy and in favor of, for example, an “epistocracy” of government by wise elites (3). Not all survey research is so skeptical about citizen capacities; some treat cues from leaders and groups as useful cognitive shortcuts. But all survey research is “monological” in that it obtains evidence only about the capacity of the individual in isolation to reason about politics.

Psychological research shows that even if people are bad solitary reasoners, they can be good group problem-solvers (4). Individual reasoning can improve under the right social conditions (for example, ones that generate alternative viewpoints for the individual to consider), thus enabling the more positive assessment of individual reasoning found in cognitive and decision psychology (as opposed to social and political psychology) to come to the fore. Human life is indeed group life, but not in pathological form (5). Thus, research focused on individuals in isolation is not a strong match for the novel aspect of the contemporary crisis of democracy, which is a crisis of communication, not of individual reasoning, the virtues and flaws of which remain much as they have always been…

Deliberative Democracy
The science of deliberative democracy seeks evidence on the capacities of citizens as they engage democratic dialogue, not as they respond as isolated individuals to survey questions (or even as they respond in social psychological experiments that fail to capture key democratic features). In addition to focusing on individual knowledge, preference, and voting, deliberative democracy also incorporates inclusive participation that encompasses citizens and leaders, mutual justification, listening, respect, reflection, and openness to persuasion. The field of deliberative democracy could be viewed as going as far back as Aristotle (who grounded practical reason in collective political life). But what is new in the past two decades is the precision with which the tasks of deliberation—notably, the legitimation of public authority, mutual understanding, and the integration of diverse sorts of knowledge—have been specified and tested…

The citizenry is quite capable of sound deliberation. But deliberative democratization will not just happen. Much remains to be done in refining the findings of the field and translating them into political practice. That political reconstruction itself would ideally be deliberative and democratic, involving social science but also competent citizens and leaders in broad-ranging political renewal.

Highly recommended, fairly lengthy reading. Hits my sweet spot. My "Ethics & Policy Studies" Master's program was all deliberation all the time, to my great fortune.

UPDATE
 
Citation links from the Science Magazine article on "Science of Deliberation."

1

How elite partisan polarization affects public opinion formation

JN Druckman, E Peterson, R Slothuus - American Political Science …, 2013 - cambridge.org
Competition is a defining element of democracy. One of the most noteworthy events over the 
last quarter-century in US politics is the change in the nature of elite party competition: The 
parties have become increasingly polarized. Scholars and pundits actively debate how 
these elite patterns influence polarization among the public (eg, have citizens also become 
more ideologically polarized?). Yet, few have addressed what we see as perhaps more 
fundamental questions: Has elite polarization altered the way citizens arrive at their policy

2

[HTML] Democracy for realists

CH Achen, LM Bartels - Democracy for Realists, 2017 - degruyter.com
Democracy for Realists assails the romantic folk-theory at the heart of contemporary thinking 
about democratic politics and government, and offers a provocative alternative view 
grounded in the actual human nature of democratic citizens.Christopher Achen and Larry 
Bartels deploy a wealth of social-scientific evidence, including ingenious original analyses 
of topics ranging from abortion politics and budget deficits to the Great Depression and 
shark attacks, to show that the familiar ideal of thoughtful citizens steering the ship of state

3

[HTML] Against democracy

J Brennan - Against Democracy, 2017 - degruyter.com
• I wrote about nineteen invited op-eds and magazine articles pointing out the flaws in 
democracy. There wasn't the same kind of interest in 2014 or 2012 when I was writing about 
this.• Similarly, I went on public radio to discuss my thesis that some voters should not vote. 
Listeners called in to say,“I know! What do we do?” I had done the same program on same 
topic a year before; then, listeners called in to demand,“How dare you?”• I had multiple 
media inquiries per day from October through December.

4

Democratic reason

H Landemore - Democratic Reason, 2012 - degruyter.com
Individual decision making can often be wrong due to misinformation, impulses, or biases. 
Collective decision making, on the other hand, can be surprisingly accurate. In Democratic 
Reason, Hélène Landemore demonstrates that the very factors behind the superiority of 
collective decision making add up to a strong case for democracy. She shows that the 
processes and procedures of democratic decision making form a cognitive system that 
ensures that decisions taken by the many are more likely to be right than decisions taken by

5

Human life is group life: deliberative democracy for realists

S Chambers - Critical Review, 2018 - Taylor & Francis
Skepticism about citizen competence is a core component of Christopher H. Achen and 
Larry M. Bartels's call, in Democracy for Realists, for rethinking our model of democracy. In 
this paper I suggest that the evidence for citizen incompetence is not as clear as we might 
think; important research shows that we are good group problem solvers even if we are poor 
solitary truth seekers. I argue that deliberative democracy theory has a better handle on this 
fundamental fact of human cognition and therefore has a more realistic view of the

6

[BOOK] The Oxford handbook of deliberative democracy

A Bächtiger, JS Dryzek, J Mansbridge, ME Warren - 2018 - books.google.com
Deliberative democracy has been one of the main games in contemporary political theory for 
two decades, growing enormously in size and importance in political science and many 
other disciplines. The Oxford Handbook of Deliberative Democracy takes stock of 
deliberative democracy as a research field, in philosophy, in various research programmes 
in the social sciences and law, and in political practice around the globe. It provides a 
concise history of deliberative ideals in political thought and discusses their philosophical …

7

[BOOK] Politics with the people: Building a directly representative democracy

MA Neblo, KM Esterling, DMJ Lazer - 2018 - books.google.com
Many citizens in the US and abroad fear that democratic institutions have become weak, and 
continue to weaken. Politics with the People develops the principles and practice of'directly 
representative democracy'-a new way of connecting citizens and elected officials to improve 
representative government. Sitting members of Congress agreed to meet with groups of their 
constituents via online, deliberative town hall meetings to discuss some of the most 
important and controversial issues of the day. The results from these experiments reveal a …

8

Deliberative abilities and influence in a transnational deliberative poll (EuroPolis)

M Gerber, A Bächtiger, S Shikano, S Reber… - British Journal of …, 2018 - cambridge.org
This article investigates the deliberative abilities of ordinary citizens in the context of 
'EuroPolis', a transnational deliberative poll. Drawing upon a philosophically grounded 
instrument, an updated version of the Discourse Quality Index (DQI), it explores how capable 
European citizens are of meeting deliberative ideals; whether socio-economic, cultural and 
psychological biases affect the ability to deliberate; and whether opinion change results from 
the exchange of arguments. On the positive side, EuroPolis shows that the ideal deliberator

9

The emancipatory effect of deliberation: Empirical lessons from mini-publics

S Niemeyer - Politics & Society, 2011 - journals.sagepub.com
This article investigates the prospects of deliberative democracy through the analysis of 
small-scale deliberative events, or mini-publics, using empirical methods to understand the 
process of preference transformation. Evidence from two case studies suggests that 
deliberation corrects preexisting distortions of public will caused by either active 
manipulation or passive overemphasis on symbolically potent issues. Deliberation corrected 
these distortions by reconnecting participants' expressed preferences to their underlying

10

Framing and deliberation: How citizens' conversations limit elite influence

JN Druckman, KR Nelson - American journal of political …, 2003 - Wiley Online Library
Public opinion research demonstrates that citizens' opinions depend on elite rhetoric and 
interpersonal conversations. Yet, we continue to have little idea about how these two forces 
interact with one another. In this article, we address this issue by experimentally examining 
how interpersonal conversations affect (prior) elite framing effects. We find that 
conversations that include only common perspectives have no effect on elite framing, but 
conversations that include conflicting perspectives eliminate elite framing effects. We also

11

[HTML] Does enclave deliberation polarize opinions?

K Grönlund, K Herne, M Setälä - Political Behavior, 2015 - Springer
When like-minded people discuss with each other, ie engage in 'enclave deliberation', their 
opinions tend to become more extreme. This is called group polarization. A population-
based experiment with a pre-test post-test design was conducted to analyze whether the 
norms and procedures of deliberation interfere with the mechanisms of group polarization. 
Based on a survey, people with either permissive or restrictive attitudes toward immigration 
were first identified and then invited to the experiment. The participants were randomly

12

[BOOK] Democratic Deliberation in Deeply Divided Societies:: From Conflict to Common Ground

E Ugarriza, D Caluwaerts - 2014 - books.google.com
Through case-analysis and cross-sectional assessment of eleven countries this collection 
explores the most deeply divided societies in the world in order to highlight what deliberative 
democracy looks like in a deeply divided society and to understand the conditions that 
deliberative democracies could realistically emerge in difficult circumstances

13

[BOOK] Democracy when the people are thinking: Revitalizing our politics through public deliberation

JS Fishkin - 2018 - books.google.com
Democracy requires a connection to the'will of the people'. What does that mean in a world 
of'fake news', relentless advocacy, dialogue mostly among the like-minded, and massive 
spending to manipulate public opinion? What kind of opinion can the public have under 
such conditions? What would democracy be like if the people were really thinking in depth 
about the policies they must live with? If they really'deliberated'with good information about 
their political choices? This book argues that'deliberative democracy'is not utopian. It is a

14

Public deliberation in an era of communicative plenty

SA Ercan, CM Hendriks, JS Dryzek - Policy & politics, 2019 - ingentaconnect.com
This article introduces and develops the concept of'communicative plenty'to capture the 
implications of the increasing volume of communication, both online and face-to-face, in 
contemporary democracies. Drawing on recent systems thinking in deliberative democracy, 
the article argues that communicative plenty can offer a viable context for large-scale public 
deliberation provided that: i) the spaces for voice and expression are accompanied by 
sufficient spaces of reflection and listening; and that ii) collective decisions involve

15

Fighting misinformation on social media using crowdsourced judgments of news source quality

G Pennycook, DG Rand - Proceedings of the National …, 2019 - National Acad Sciences
Reducing the spread of misinformation, especially on social media, is a major challenge. We 
investigate one potential approach: having social media platform algorithms preferentially 
display content from news sources that users rate as trustworthy. To do so, we ask whether 
crowdsourced trust ratings can effectively differentiate more versus less reliable sources. We 
ran two preregistered experiments (n= 1,010 from Mechanical Turk and n= 970 from Lucid) 
where individuals rated familiarity with, and trust in, 60 news sources from three

More on this ASAP. We're flying home today from closing on our new digs in Baltimore. Moving truck comes to CA next Friday. About to leave for BWI. Hotspotting off my iPhone at my new kitchen nook.

MONDAY UPDATE

Finished this book. Quick cite:

…[E]ven as networks of interactions between humans change, much about them is enduring and predictable. Understanding human networks, as well as how they are changing, can help us to answer many questions about our world, such as: How does a person’s position in a network determine their influence and power? What systematic errors do we make when forming opinions based on what we learn from our friends? How do financial contagions work and why are they different from the spread of a flu? How do splits in our social networks feed inequality, immobility, and polarization. How is globalization changing international conflict and wars?
   
Despite their prominent role in the answers to these questions, human networks are often overlooked when people analyze important political and economic behaviors and trends. This is not to say that we have not been studying networks, but instead that there is a chasm between our scientific knowledge of networks as drivers of human behavior and what the general public and policymakers know. This book is meant to help close that gap.

Each chapter shows how accounting for networks of human relationships changes our thinking about an issue. Thus, the theme of this book is how networks enhance our understanding of many of our social and economic behaviors.

There are a few key patterns of networks that matter, and so the story here involves more than just one idea hammered home. By the end of this book, you should be more keenly aware of the importance of several aspects of the networks in which you live. Our discussion will also involve two different perspectives: one is how networks form and why they exhibit certain key patterns, and the other is how those patterns determine our power, opinions, opportunities, behaviors, and accomplishments…
[pp 4-5]
Awesome read. Much triangulation to come, ASAP.

Dr. Jackson in closing:
The more things change
Technology will continue to advance and reshape our networks. Humans have been rewired many times: by the printing press, letter writing, trains, the telegraph, overseas travel, the telephone, the Internet, and the advent of social media. Perhaps it is our arrogance that leads us to assume that the current changes in our lives are truly revolutionary and unique.

Nonetheless, the changes are real— as we saw with networks of trade and military alliances. Still, humans are predictable. Human networks are easily recognizable and have exhibited regularities for some time. In our social transformations we see “more” of many things: denser networks, more homophily, more polarization, faster movement of information and contagion. And, as we have learned, even small changes in connectedness can have big consequences. Even changes in the extent, rather than the shape, of our networks can have profound implications— for contagion, immobility, and polarization.

There is much to be optimistic about. Economic productivity is at a historic high, large parts of the world are emerging from extreme poverty, and wars are down. People are living longer and enjoying themselves more. But there are challenges ahead. Divisions in our networks of interaction and communication remain, and some are even growing despite our advances in the ability to connect at a distance. The resulting frustration with increased immobility and inequality, when combined with growing polarization, can be volatile.

We need to better understand the benefits and risks from ever increasing financial entanglements and address those risks rather than ignoring them. We need to recognize that our network is highly connected when it comes to the transmission of diseases, including some that we have yet to encounter and that may spread more rapidlyand widely than in our worst nightmares. We need to recognize the numerous externalities in our lives, as well as how networks shape our social norms and behaviors, including corruption and crime.

We need to combat the damaging side- effects of homophily, as well as improve the incentives to collect and spread accurate and deep information, while learning to better filter the noise. Understanding the human network can ensure that our increased connectivity will improve our collective intelligence and productivity, instead of dividing society even more.
[pp 239-40]
Could not be more timely.

Topical downstream links: "Define 'science'."Also, what about "Democracy?" Also, is there a "Science of Science Communication"?

UPDATE: FROM THE "IMAGINE MY SURPRISE" DEPT.

_____________

More to come...

Monday, March 25, 2019

March Madness


OK, what a weekend. The President and his crew do Mueller wrap-up post-Barr announcement victory laps and end-zone spikings touting his "total exoneration," while his (for now punked) political adversaries (including the "liberal fake news media") bravely vow to ramp things up yet another notch.

Trump Press Secretary Sarah Huckabee Sanders tweeted this (click to enlarge):


Gotta admit, that's pretty funny.

Is actual governance at the federal level now beyond passe? Health care, infrastructure, climate change, international trade policy, North Korea, etc?

But her emails!

FROM THE BE-CAREFUL-WHAT-YOU-ASK-FOR DEPT. "GOVERNANCE" UPDATE. "HEALTH CARE?"
The Trump Administration Now Thinks the Entire ACA Should Fall
In a stunning, two-sentence letter submitted to the Fifth Circuit today, the Justice Department announced that it now thinks the entire Affordable Care Act should be enjoined. That’s an even more extreme position than the one it advanced at the district court in Texas v. Azar, when it argued that the court should “only” zero out the protections for people with preexisting conditions.

The bad faith on display here is jaw-dropping. Does the administration really think that the very position it advanced just month ago is so untenable that it must now adopt an even crazier view?

Much as it may dislike the fact, the Trump administration has an obligation to defend acts of Congress. Absent that obligation, the sitting administration could pick and choose which laws it wants to defend, and which it wants to throw under the bus. Indeed, the decision not to defend is close cousin to a decision not to enforce the law. If the ACA really is unconstitutional, wouldn’t continuing to apply the law would violate the very Constitution that empowers the President to act?

Even apart from that, the sheer reckless irresponsibility is hard to overstate. The notion that you could gut the entire ACA and not wreak havoc on the lives of millions of people is insane. The Act  is now part of the plumbing of the health-care system. Which means the Trump administration has now committed itself to a legal position that would inflict untold damage on the American public…
 From The Incidental Economist. Read all of it.

"You're going to have such great health care, at a tiny fraction of the cost, and it's going to be so easy." - Donald Trump, October 2016 Florida campaign rally.
OTHER HEALTH CARE INFOTECH NEWS
23andMe Thinks Polygenic Risk Scores Are Ready for the Masses, But Experts Aren’t So Sure
A new genetic test that estimates your risk for diabetes is probably less useful than standing on a scale.
Don't get the risk modeling analyst in me started on this kind of stuff. Yeah, let's waste more money. I am reminded of my January 2018 coverage the the Health 2.0 WinterTech conference:

"Also on the agenda, the "FICO Score for Health" was back.
Dacadoo is the "Health Score" company - providing a mobile-first digital health platform that helps people live healthier, more active lives. The dacadoo platform allows organizations to offer a fun, engaging experience that measures, coaches and improves people's health across three key dimensions: lifestyle, biometric and emotional wellbeing. Dacadoo takes inputs from a variety of tracking devices, as well as its own app and applies a research-backed, patented process to calculate a single, composite health score for each individual. Dacadoo's customers include large and mid-sized companies, health and life insurance companies, and health & wellbeing service organizations.
I used to work in credit risk modeling and management (large pdf). Would love to see this algorithm."

What could possibly go wrong?

WAPO UPDATE
House Democratic leaders urge focus on health care in wake of Mueller findings
_____________

More to come...

Thursday, March 21, 2019

Among the hazards of becoming an MD

"In America, becoming a doctor can prove fatal. Suicide is estimated to be the second leading cause of death among medical residents, after cancer. (In contrast, the leading cause of death in the general population for that age group — 25 to 40 — is trauma.) Suicide statistics for young doctors are difficult to track because many deaths go unreported as such. But we know that 300 to 400 American doctors complete suicide each year, twice the rate of the general population..."
From The Boston Globe. Think about that. Read the entire piece closely.

From "Can medicine be cured?"
"You might argue that the happiness and morale of doctors is of no concern to anyone outside the profession and their families: this has been the view of politicians, managers and the media. A functioning health-care system, however, cannot exist without a strong and well-supported medical profession..."

O'Mahony, Seamus. Can Medicine Be Cured? Head of Zeus. Kindle Edition, location 2104.
_____________

More to come...

Monday, March 18, 2019

Clinical venture capital catnip


Yep. I have certainly covered the stew outa this story.

UPDATE

I have a new book to review. Generously been accorded a review comp by Dr. Jackson's publisher. Stay tuned.

"Inequality, social immobility, and political polarization are only a few crucial phenomena driven by the inevitability of social structures. Social structures determine who has power and influence, account for why people fail to assimilate basic facts, and enlarge our understanding of patterns of contagion—from the spread of disease to financial crises. Despite their primary role in shaping our lives, human networks are often overlooked when we try to account for our most important political and economic practices. Matthew O. Jackson brilliantly illuminates the complexity of the social networks in which we are—often unwittingly—positioned and aims to facilitate a deeper appreciation of why we are who we are..."
Sound familiar?

UPDATE: Just in from STATnews:
Medical schools must prepare students to work in a world altered by climate change
As a medical student fumbling with the fundamentals of interviewing patients and taking medical histories, the realities of being a doctor seem like a far-off dream. My colleagues and I work hard to prepare ourselves to be equipped to address the increasingly complex health care issues that will affect the lives of our future patients, from inequities in access to quality care to multidrug resistance.

The most pressing of these issues is climate change, a growing environmental emergency that will have devastating health impacts. Food shortages induced by climate change are alone expected to account for more than 500,000 additional deaths globally by 2050. Regardless of their personal interest in climate change or their belief that advocacy about it is within the scope of medical practice, physicians will be on the front lines of confronting its effects.

Action on climate change has been paralyzed by denial, misunderstanding of its urgency, and a sense of powerlessness in the face of an existential threat. This is why it is especially important for medical schools to integrate climate change into their curricula so future physicians understand the challenges and are prepared to use their positions as care providers, educators, and advocates to tackle this threat… 
Yeah. Recall my series of "Anthropocene Denial" posts. Incrementally improving Health IT workflow UX is not gonna matter materially should we continue to fail to address climate change.

UPDATE

As noted in my recent "Health care for the homeless" post, Cheryl and I are moving to Baltimore shortly. Consequently, KHIT will likely be mostly "dark" for a couple of transition / cross-country travel weeks early-mid April. I-40, two cars, two dogs, two cats--yeah, ought be great fun.

THERANOS HBO REFLECTION

Naked Capitalism's Uber takedown
_____________

More to come...