Mike Spagat writes:
Do you think that this book review by Richard Horton might help to explain his fondness for publishing stuff that turns out to be wrong?
Richard Horton is the editor of the medical journal Lancet; he’s come up in this space before. Here’s his key quote in his review of Eugene Richardson’s recent book, Epidemic Illusions:
A first target in this project to loosen the ties around sanctioned truths is, he argues, to confront the privileged influence of global health data—“an ideological apparatus of protected affluence disguised as objective inquiry”. Instead, we should recognise the political nature of health and its determinants and “begin to parametrize historical and structural forces in shaping populations’ dispositions toward medicine and healthcare”. “Global social injustice is”, he writes, “by and large epistemological injustice”. Enter scientific journals, such as The Lancet, that validate “the types of discourse that society accepts and makes function as true”.
I have three reactions here:
1. Most importantly, yeah, inequalities in power and resources are hugely important. As a person who lives a comfortable life and benefits from these inequalities, the least I can do is to recognize that they exist and appreciate the efforts of people who are trying to do something about it.
2. John Kenneth Galbraith wrote about countervailing power, and I think this is an important idea. To fight power you need the support of other sources of power. No way around it. I thought about this because, in his efforts to imagine alternatives to coloniality etc., Horton gets support from the Guy Fieris, of the Bill Gates / University of Washington Institute for Health Metrics and Evaluation. In pointing out this connection, I’m not trying to slam Horton as a “hypocrite” who decries colonial power in one setting but takes its money in another form. Not at all. The existing power structures are what we have to deal with, and props to someone who makes use of what’s there in order to effect changes.
3. I’m kind of annoyed when Horton disses “the privileged influence of global health data.” I mean, sure, I kinda know what he means, but, as Spagat notes, Horton in his journal has published some wrong things. That’s the way things go—edit a journal, it will make some mistakes, it’s unavoidable—but there has been a problem with Horton not seeming to want to admit these failures. Some amount of the journal seems to be allocated to pushing a political agenda.
I see a bit of horseshoe going on, with people on the left and right being anti-science when their ideologies are threatened. This is not to say that political concerns are unimportant; I’d just like to see the politics decoupled from evaluation of scientific claims.
I am having some trouble understanding Dr. Horton’s comments that you quote. For example, what is “epistemological injustice?” I know what epistemic injustice is. I know what epistemology is. I know what injustice is. However the term he uses is unfamiliar to me. The short paragraph you cite has other examples. How does one parametrize historical forces? Am I losing my ability to comprehend, or is there some term of art jargon that I am simply unfamiliar with? I worry that my understanding is beginning to unravel.
I have the same reaction. “Parametrize historical forces” What a load of . . . I find this lack of clear writing suspicious. Is Horton saying, “There is no such thing as true or false. Just one’s particular point of view, and the point of view that dominates is the one with the political power. We should balance that.” I could respect and argue with that relativism, but I bet he would deny being a total relativist. So, is he saying, “Institutions and leaders involved in scientific inquiry have biases, which impact which conclusions those institutions make under uncertainty. We should provide a balance against those in power to reduce bias.” I could agree with that, and suspect that most people would. Why the ambiguity? I suspect that the second version does not support the ideological agenda he wants, but I don’t really know. Maybe he just wants to sound sophisticated.
Oncodoc, Steve:
I think that people often say things that vaguely sound reasonable without thinking them through. As a journal editor, Horton is used to being the boss and not having his statements questions. And in this case he’s writing a book review in his own journal so maybe nobody looked at it very carefully.
Both “epistemological injustice” and “parametrize historical forces” are statements by Eugene Richardson, only quoted by Richard Horton. I suppose one could argue that by quoting them Horton’s indicating he’s on board with the jargon. But an alternative explanation is that he’s just following the rule my students sometimes follow: quote it verbatim when you don’t understand it well enough to paraphrase it.
So, my complaint should really be directed at Richardson not Horton. But, I still think the complaint is valid. It is either terrible writing or intentionally obscure language for the sake of eliding some serious issue.
I’ve dug out one of Richardson’s articles and er yeah. It’s pretty jargony and buzzwordy.
I think I’d summarise it (based on what I’ve read) as injustice in terms of what researchers are interested in, what is defined as in and outside of the context of a study, what interventions are and are not considered, and who research outputs are written for.
Frankly, having read his article, my overall read is that well, Richardson has a point, though he’s probably overly strident, but he’s way too in love of using big complicated words, in ways that really do not help the persuasiveness of what is quite a simple message in places.
Like he’s got a whole article on Ebola vaccination whose basic point is that “discussions of reluctance to take the vaccine should consider that these people have very reasonable distrust towards the people offering the vaccines and what can be done to earn that trust, also the medical lingo being used is considered insulting by the locals”, but it’s all “hermeneutic injustice”, “symbolic violence”, “truth claims”…
It’s part of what Scott Alexander calls “justice creep”:
https://astralcodexten.substack.com/p/justice-creep
I found the conclusion of Horton’s review odd:
So the Battle of Seattle has now resulted in an empire? I think overthrowing the British/French empires would have been more practical based on them existing. Although I suppose you could just declare victory against an imagined empire.
When I saw this blog post title I thought this was going to be about a case of misuse of a horseshoe prior in a Lancet article. I guess you never know on this blog.
I had a similar thought! Glad to hear I’m not alone.
To your first reaction, are you familiar with “critical systems heuristics”? It’s a simple approach to help one think through issues of power. See, for example,https://oro.open.ac.uk/21299/1/systems-approaches_ch6.pdf or perhaps the shorter https://www.betterevaluation.org/en/plan/approach/critical_system_heuristics .
Bill:
Interesting. I’ll have to look at this more carefully. It seems like an advance on what I say in my Communicating Data and Statistics course, which is to alway remember GOALS and AUDIENCE.
Throwing terms like “epistemological injustice” around seems extremely lazy to me because it implies that a) ideas/knowledge are a “resource” and people exist as independent “owners” of that resource, rather than the ideas being something that directly informs who the people are, and b) there has to be some moral actor that perpetrates the injustice. Are QAnon conspiracy theorists victims of injustice because of the crackpot theories they hold to be true? Sure, you can say, those people might have access to better information, but what does “access” really mean? If you can physically access (read, watch) sources XYZ but the software you are running in your brain is telling you “don’t believe anything from XYZ”, is it really “access”?
It goes back to the age-old Buddhist question “who is the thinker behind the thoughts?” and to me the answer is clear, there is no thinker. From that perspective, the term “epistemological injustice” is meaningless – we’re all just running the most recent version of the brain software that was extracted from our environment & internally refined. It still makes sense to want to propagate the “good” software, that is, to disseminate ideas that make people live better, happier, and longer lives, and make them accessible to people who weren’t able to reach them in the past. But I think it’s entirely meaningless to talk about the presence/absence of the ideas themselves in moral terms.
Thank you for your second paragraph
I don’t have any well formulated thoughts about it at the moment but I find it an interesting perspective worth pondering
Hello and thanks for posting Andrew.
My take is that if the editor of the Lancet can’t spot intellectual gobbledygook when he sees it then it can’t be surprising that the journal he edits publishes a lot of gobbledygook and doesn’t correct the record when it’s exposed as such.