Medical Doctors and Priesthood Leaders
[Jesus’ cures for medical illnesses] are all miraculous, and the same power was granted to the apostles—”power against unclean spirits, to cast them out, to heal all manner of sickness and all manner of disease.” And more than this, not only the blind received their sight, the lame walked, the lepers were cleansed, the deaf heard, but even the dead were raised up. No question of the mandate. He who went about doing good was a physician of the body as well as of the soul, and could the rich promises of the Gospel have been fulfilled, there would have been no need of a new dispensation of science.
-William Osler, The Evolution of Modern Medicine
When I speak of “drawing valid inferences” or “making legal moves” in a language game, you should not automatically think that these inferences and moves could simply be made by anyone in the linguistic community. For example, in Foucault’s scenario, the patient’s submission to the psychiatrist’s authority is by no means enhanced by his ability to reason exactly as the psychiatrist would about his condition. On the contrary, such “simulations” of rational discourse would tend to underscore the depth and complexity of the patient’s mental disorder. Thus, not only must a psychiatric diagnosis be articulated according to a fixed set of rules, but it must also be articulated by someone who has been authorized to issue a diagnosis of that kind. And so, it is crucial to the patient’s having submitted to the psychiatrist’s authority that he remain silent while the psychiatrist speaks on his behalf.
-Steve Fuller, Social Epistemology
The first passage above illustrates the historical, zero-sum displacement of religious authority by science with regards to how we ought to behave and to whom we ought to look for such instruction. The second passage above illustrates the asymmetrical nature of scientific authority as it exists within society today. Before continuing I first must say that 1) I think and hope that we all treat modern medicine with the amount of respect that it has clearly earned and 2) I have no intention of pitting medical science against scriptural religion. I do, however, want to use our modern deference to the authority of medical science to illustrate the nature of priesthood authority.
For starters, I would like to emphasize the modern nature of medical science, it being a very recent product of the 19th century. While there have been moderate exceptions to the following claim, the pre-modern responsibility for healthcare has by and large been primarily – often exclusively – a religious one. Before being appropriated by the modern, secular state, medicine and healthcare within the western world revolved very much around Catholic Church and the protestant churches that grew out of it. This tradition of church taking primary responsibility for the health of its people survives in the typically religious names of hospitals (St. Judes, etc.) as well as the humanitarian approach to missionary work (that is notably absent within the 19th Century religion of Mormonism).
Even prior to the Catholic Church, however, responsibility for the general health of the community was a religious one, especially within the Hebraic tradition. While the Bible does not explicitly refer to witchdoctors or shamans, the same elements are all to be found within both the Old and New Testaments. There was no important distinction between ritual and hygienic washings; between cooking and eating Kosher, dietary guidelines, fasting and other such “words of wisdom”; between illness, insanity, possession by evil spirits and evil-doing. The prophet/priest/shaman was *the* authority regarding a communities “well-being” in the broadest sense of that term.
We can get a further feel for the authority of these priesthood leaders by taking a brief look at the medical aspects of that same authority that medical professionals wield within our own secular community today. The main point I wish to make here is that the differences between the authority of secular medical professionals and the prophets of old is much more a difference in the scope of their authoritative domains/stewardships than it is a difference in kind. Contrary to what much of our intuitions might tell us, medical professionals today are not solely, or even primarily charged with helping isolated individuals by giving them “medical advice” which we are free to head at our own discretion. Rather, the authority of a medical doctor very much revolves around what he or she says about the sanity, physical capacity, contagiosity, etc. of an individual or some course of action to others people within the community, including but not limited to employers, social services, juries, legislators, society in general, etc. Physicians are thus authorized to “represent” and speak in the place of their patients to the rest of the community in an asymmetric and unilateral sense such that, to some degree, the patient no longer has any legitimate voice of their own. If the patient says that they were in no state of mind, or were not physically capable of committing some act or performing some task, but their physician says that they were, the relevant community believes the latter rather than the former.
This is the exact authority that priesthood leaders wield over their own religious communities within the scriptures. In the same way that graduation and the bestowal of a title of “Ph.D.” sets a doctor apart from the rest of society and authorizes him or her to trump the words of his or her patient within some vaguely defined limits, the calling and ordination also sets apart a priesthood leader from the rest of their congregation as a “shepherd” and allows them to trump the words of his “sheep” within some vaguely defined limits. What is absolutely crucial within both cases is that merely following the proper rules within some relevant case is entirely insufficient to authoritative speaking on the case. No amount of searching through Web M.D. or the Bible will, in and of itself, ever authorize somebody in the relevant sense: the actual ceremony by which the authority is set apart is absolutely indispensable.
There is, however, a crucial difference between the two cases that is very much worth pointing out – other than the previously mentioned scope of their stewardship. While there is a strong connection between a rigorous and well-articulated familiarity with the rules of medicine and the graduation to the status of doctor, the same cannot be said for the ordination priesthood leaders. This is especially true within the Mormon tradition. A prophet or priest is called by God through the spirit of prophecy that is very often totally beyond articulation or rational defense. It is precisely this strong disconnect between publicly articulable reasons and authoritative stewardship that places the pre-modern faith of traditional religious values at irreconcilable odds with the modern reason modern reason of secular values.
prophet roughly equals psychiatrist in authority? I’m underwhelmed.
Comment by Howard — July 24, 2015 @ 11:24 am
As well you should be… if that were actually the argument. But it isn’t.
Comment by Jeff G — July 24, 2015 @ 11:31 am
Well that’s because a prophet or priest is…totally beyond articulation or rational defense.
Comment by Howard — July 24, 2015 @ 11:44 am
The post deals with how we interact with authority figures, not the origins of their authority. To be sure, there are vast differences between the origins and justifications for the two different types of authority, but the sociological roles that they play within their communities are very, very similar.
Comment by Jeff G — July 24, 2015 @ 12:43 pm
Well it’s easy to confuse social status with a sociological role which is a set of behaviors that are expected of someone who holds a particular status. In other words the individual playing the role is measured against the expectations of the role itself. As a result there are good and bad psychiatrists just as there are good and bad prophets.
Comment by Howard — July 24, 2015 @ 2:28 pm
I think one difference is that for those who are educated in academic they quickly learn that having a Ph.D doesn’t mean a danged thing. Only arguments and evidence does. The places where a PhD is a trump are places where people are reasoning incorrectly.
Likewise it doesn’t take much experience with doctors to know that most don’t keep up on new evidence and theories and often didn’t learn basic scientific methodology. They are often (but not always) glorified mechanics or a gate to get the drug you need. An extra step that at best provides a filter so ignorant people don’t self-medicate and hurt themselves. But when it comes to basic diagnostic skills or even a good view of contemporary medical understanding medical doctors just are poor. (Again, vastly better than the typical person – but not good enough to act as a trump)
So if this is the analogy it’s one that falls apart fairly quickly I think.
Comment by Clark — July 26, 2015 @ 7:45 pm
Or actually maybe not since I think these experts actually function as I suggest GAs do. As providing a burden of proof requirement when you say they’re wrong but not as providing a trump.
Comment by Clark — July 26, 2015 @ 7:46 pm
Well of course a PhD doesn’t mean anything to others with PhD’s. When it comes to society at all, like the cases that I mentioned, it is all that matters. It doesn’t matter what you evidence and reasoning is, if you don’t have the proper credentials, your opinion doesn’t matter.
Comment by Jeff G — July 27, 2015 @ 9:58 am
I should probably also mention that I’m not really providing an analogy at all. Rather, I am describing what actually and literally happened as secular physicians appropriated authority from the church with regards to a communities “social hygiene” as we might call it.
Comment by Jeff G — July 27, 2015 @ 10:02 am
It shouldn’t matter. That’s the point. (For the record I do not have a PhD)
Comment by Clark — July 27, 2015 @ 10:13 pm
But from whose standard can you pass such a judgement? Surely legal liabilities as well as social coordination are at least prima facie secular justification for why it does and should continue to matter. Your version of what ought to be the case seems to assume an unrealistic and unsavory individualism where people have access to disembodied information that is not pre-filtered by other people/authorities/institutions.
Comment by Jeff G — July 28, 2015 @ 11:08 am
Can I give a bayesian standard?
Comment by Clark — July 28, 2015 @ 4:20 pm
I don’t see how any equation could ever provide a moral standard from which to pass judgment on the worth of certification/ordination to legitimate authority.
Comment by Jeff G — July 28, 2015 @ 4:36 pm
How often they are right doesn’t count?
Comment by Clark — July 28, 2015 @ 9:52 pm
Of course it matters, but who gets to measure the “rightness” of such people?
The medical community is more or less like Kuhn says it is: a self-defining community whose borders are explicitly aimed at shielding insiders from the criticism of outsiders. This was a major difference between Kuhn almost authoritarian view of science and Popper’s critical rationalism that is based upon an “open society”.
Regardless of what the arguments for or against each conception of science are, reality approximates Kuhn’s version much more than it does Popper’s. This can be seen in the fact that we do not ask medical doctors for arguments or evidence – but instead only ask for their “professional opinion” which can only legitimately be called into question by somebody who is equally qualified/certified/authorized to do so.
This just is that degree of authority that medical professionals appropriated from religious authorities.
Comment by Jeff G — July 29, 2015 @ 12:28 pm
I’m not sure I’d call Kuhn giving an authoritarian view of science. But it’s been a while since I read him last. Popper always just seemed a weird misunderstanding of positivism that thought it had critiqued positivism.
In any case among educated the point is that throwing around authority just seems ridiculous because what counts are reasons. And typically those throwing around authority do so because they are weak in the area of providing rational justification. Especially in medicine.
I think the problem you have is that you want to reject this element of modernity (which to me for all its problems seems a definite step up from what was before).
Comment by Clark — July 29, 2015 @ 10:43 pm
“I’m not sure I’d call Kuhn giving an authoritarian view of science.”
Kuhn says that science is whatever scientists say it is – this being the only demarcation between science and non-science. That’s pretty authoritarian. The only opinions and reasons that matter are those provided within a closed circle of certified authorities.
“In any case among educated the point is that throwing around authority just seems ridiculous because what counts are reasons.”
Of course that’s what they *say*. What they do, however, tells a very different story. This is exactly the distinction that Kuhn drew between idealized histories of science and the actual history of science.
“I think the problem you have is that you want to reject this element of modernity”
Well, my point is that despite the obviously good aspects of modernity (again, I never try to pit medical professionals against religious healers), it is a mixed bag with an ambiguous legacy. It pretends to be a rejection of authorities, when it is actually a transformation/substitution of authorities. It is precisely this transformation/substitution of authority that should make religious people a bit more suspicious and critical in our acceptance of it.
We can all agree that the mixing of state power with compulsory religion was something that had to go, but this isn’t all that different from mixing state power with compulsory science education or compulsory adherence to medical advice (quarantines, expert testimony, etc.) It is certainly true that the average Joe was not allowed to criticize or question his religious authorities 500 years ago, but how much is the average Joe really allowed to criticize or question the medical authorities today? Yes, we allow him to speak his mind, but this is precisely because nobody really takes him seriously due to his lack of certifications.
I wish I would have played up the Foucault example a bit more in the OP. His point was that a psychiatrist and his patient are not and never can be on an equal footing. No matter what the patient says, their words will always be treated as nothing more than merely objective data to be processed by the only “real” subjective person in the room – the doctor. The patient’s speech is data to be accounted for – regardless of how rational his speech seems – rather than reasons or suggestions to be considered and evaluated. This was the whole point of the famous Rosenhan experiment where grad students intentionally got institutionalized and thereafter acting completely normal in order to see how long it took them to get out. As Rosenhan said of his own experience: “The only way out was to point out that they’re [the psychiatrists] correct.”
The point to be taken from this is that we are trained to accept or reject some peoples’ opinions and reasons – with no regard whatsoever for how good or bad those reasons are – based entirely upon the social status of those people.
Comment by Jeff G — July 30, 2015 @ 11:21 am
But if you divorce the social aspect of science (which is very non-authoritarian and demands the questioning of authority) you really warp what Kuhn is presenting. Contra it being authoritarian it is intrinsically questioning.
Now you’re trying to raise the distinction between what goes on within the community of scientists from what goes on in the public : scientist relation. That’s fair. But even there I think things are much, much more nuanced than you suggest. And also diverse – there’s not one view but people pushing very different views including those who advocated strongly anti-authoritarian views. Not just figures like Feyerabend but also major writers at Scientific American or other such organizations. What they will all tend to say is that what counts is the evidence – the very stance you are arguing against.
I’m not sure using a person committed to a asylum is a good example or analogy for what’s going on. Indeed the problem of psychiatry is precisely that it can’t usually point to evidence so in it’s place there is usually an appeal to authority. But that’s why so many scientists don’t consider it a science and why the whole approach to psychiatry loosely ushered in by Freud largely fell apart in the 1980’s. (I have a great history book on this if you are interested. I’m at work so I can’t recall the name off the top of my head)
Now I don’t want to say scientists don’t make appeals to authority. They often do. But typically upon closer examination the appeal is really to a well tested theory like the laws of thermodynamics. (Telling people their pet project violates the 2cd law is a great way to get them angry and have them tell you you’re being authoritarian but really what you are doing is comparing a well tested theory to a theory typically with extremely ambiguous evidence)
Comment by Clark — July 31, 2015 @ 11:33 am
Just to be clear. The issue to me is ultimately the role of authority vs. the role of evidence. I just can’t buy on any level the devalued place of evidence you have.
Comment by Clark — July 31, 2015 @ 11:59 am
The whole point, however, is that in practice evidence and authority are never placed on equal grounds. Instead, we simply dismiss evidence presented by those who are unqualified/uncertified/unauthorized to interpret evidence within any given field. My point isn’t that evidence never comes into play. Rather, it is that evidence is never allowed to speak for itself independent of authority.
“the social aspect of science (which is very non-authoritarian and demands the questioning of authority)”
But this is only true – just like Kuhn says – *within* the circle of authorities – something which I already claimed within the OP. Of course other authorized scientists are allowed to question the evidence and reasons of another (aka a second opinion), but this is something totally different from what both Kuhn and I claim. (Popper’s main point was that demarcation must be grounded in something non-social, otherwise it necessary becomes authoritarian. Kuhn’s point is that there is no such non-social grounding for demarcation and we thus must fall back upon what certain people – practicing scientists – say. But this is exactly what Popper was afraid of.)
“major writers at Scientific American or other such organizations… all tend to say is that what counts is the evidence”
Of course they say that! They have every motivation in the world to say it. But that claim is exactly what the science of science (aka the sociology of science) totally falsifies. Those claims, in short, are largely an ideology by which intellectuals further their own interests within society. To a large extent, I completely agree with these writers in that this is how it ought to be – being largely aligned with Feyerabend myself, I wish Popper’s democratic vision of science were true. When it comes to how things really are, however, I sadly agree with Kuhn in that the idea that evidence is all that matters is simply the way in which orthodox science dresses up and largely falsifies its own history.
“Indeed the problem of psychiatry is precisely that it can’t usually point to evidence so in it’s place there is usually an appeal to authority.”
Foucault’s point, however, is that this generalizes to all medical practice. As a personal example, I have been dealing with leg issues for almost 10 years now. In the past I have met with and derived a great deal of relief from a sports chiropractor. Once I moved to a different area, I switched to OD and PT doctors since my insurance made their visits less expensive. What blew me away was how neither of these doctors had any interest whatsoever in my past chiropractor’s diagnosis on my own opinion on the matter. They both treated our opinions as symptoms rather than potential diagnoses. Eventually, I was able to get them to acknowledge the source of my pain, but only by making them think that it was their idea rather than that of a chiropractor.
Importantly, this somewhat mutual antagonism and contempt between medical doctors and chiropractors generalizes to an enormous degree. I used to married to a family of doctors and they and their doctor friend frequently and often spoke of chiropractors as “not real” doctors. If medical doctors aren’t even willing to listen to the evidence and reasoning of chiropractors, how could we ever expect them to listen to that of a normal patient.
The whole point is that if you are not a certified peer, then we are in no position whatsoever to “review” the findings of medical professionals and other scientists. (I actually think that evidence and reason did matter quite a lot before science was professionalized at the end of the 19th century. In the pre-certification days of the Royal Society, evidence was *almost* all that counted, although the social distinctions between Hooke and Boyle show that such things still mattered. With the professionalization of science unto Whewell, scientists came to be “set apart” from society by way of degrees and certifications. This setting apart was, quite expectedly, a major catalyst for the intrusion of authority and social distinction in sciences.)
Comment by Jeff G — July 31, 2015 @ 1:09 pm
Perhaps it is worth pointing out that my post is primarily about medical scientists. (I do think that the points generalize to some extent to other scientists, but I’m not really prepare to say how much.)
The argument I would like readers to take from the post if basically as follows:
1. Part of practicing medicine involves a refusal to treat one’s patients (be it individuals or some collective group) as peers in that the patients’ words are merely symptoms in need of diagnosis rather than potential diagnoses as such that are worthy of serious consideration.
2. This doctor/patient relationship is a direct descendant of the priest/parishioner relationship – both of which have to do with social hygiene and general well-being – spiritual or biological.
3. We are our priesthood leaders’ patients.
4. Thus, our priesthood leaders’ should not treat us as peers – our reasoned objections, suggestions and criticisms are symptoms of our spiritual health that are in need of diagnosis rather than potential diagnoses as such worthy of serious consideration.
Comment by Jeff G — July 31, 2015 @ 2:20 pm
Jeff G,
Medicine also follows the practice of informed consent where the patient is required to direct the medical care and is the ultimate decision maker. Typically included in the informed consent process are alternatives to consider and the risk, benefits and uncertainties of the process.
I think LDS authority passes the ultimate authority test where the individual is the ultimate decision maker. What do you think about the other aspects of informed consent for religious authorities?
Comment by Martin James — July 31, 2015 @ 2:36 pm
The problem Jeff is that you assume this social grounding is authority. But that’s what I dispute. I fully acknowledge there’s a social trust element at play. I just dispute it’s really authority in a straightforward way.
Now of course if someone just claims to have a lab with results people aren’t going to trust them if it’s not associated with a trustworthy organization. However that element of trust while it has similarities with authority can’t be seen as purely authoritative. Further there are ways those not-formally scientists can undermine this via experiment. i.e. conduct an experiment, video tape it, and make an appeal.
Now as a matter of practice this doesn’t happen that much simply because the amount of knowledge necessary to contribute usually requires going to college which I suspect you would then argue is a kind of authoritative stamp. I’d disagree and I think the questions of authority simply are deeply problematic here. Consider someone like Freeman Dyson without a PhD or significant contributions made in science by undergraduates.
Again, I suspect you’ll argue that these are only counted when someone with authority counts them. But at a certain point we reach the “when you’re a hammer everything is a nail.” The question then becomes what counts as falsification since to contribute to science means being in social contact with scientists. Now I’d say it’s that convincing on an individual level with persuasive arguments that is what counts rather than authority. You say it’s authority that matters. But how do we adjudicate between the two? Any example I could give, since inherently being a social interaction with scientists you could always argue is authoritative trump.
But if you can’t provide a way to find a difference it seems to me it is a difference without a difference. i.e. what you call authority can’t be distinguished from non-authority.
Comment by Clark — July 31, 2015 @ 3:38 pm
As I said I don’t think most doctors are good diagnosticians. They really aren’t well trained on this despite appearances. They certainly aren’t trained in basic scientific methodology unless they pick classes on their own to do so as an undergraduate. So I agree with your criticisms but this to me simply shows the inherent problems of doctors. Yes doctors appeal to authority but this is bad and typically is the cause of most of the problems in medicine.
There’s all sorts of very bad practices that persist in medicine simply because doctors prefer authority to science. The mere fact we have to talk about evidence based medicine is itself a symptom of the problem. Of course all medicine should be evidence based – that it is not and that’s status quo should be shocking.
Regarding chiropractors, I’d say they are even worse than doctors in that they appeal to far, far less evidence. That said, it’s also true that doctors will discount chiropractors despite evidence due more to thinking of completing authority rather than science. However the entire paradigm chiropractors typically (although not universally) base their thinking on seems deeply dubious and certainly not tied to empirics. (At least medicine *claims* to reduce down to traditional science of biochemistry)
Comment by Clark — July 31, 2015 @ 3:44 pm
Just to add, if we try to analogize priesthood to medical doctor to me it is just plain bad precisely because how medicine developed to my eyes seems horrible. It was the privileging of authority over reason that made so many developments take so long and still is why medicine isn’t where it should be.
Comment by Clark — July 31, 2015 @ 3:47 pm
Martin,
I disagree with your attempt to make one on one consultation the paradigm of medical authority. I am much more concerned about expert testimony, quarantines, health inspectors, social services, incarceration and other such compulsory expressions of authority within society at large. In these cases, informed consent is specifically sidelined in the name of a very exclusive authority which does not acknowledge or tolerate “outside” differences of opinion nor does it hold the informed consent of such outsiders in much regard.
Clark,
“I just dispute it’s really authority in a straightforward way.”
If these aren’t cases of authority, then I don’t know what is. To be sure, scientific authorities legitimize their authority very differently than priesthood leaders do, but this doesn’t make it less authoritative all the same. The explicitly guild-like and thus exclusionary and authoritative nature of academia and the Medieval priesthood is no accident.
“Further there are ways those not-formally scientists can undermine this via experiment.”
So they say. How often, however, does this actually happen, especially when the strong majority of experiment are never duplicated? How are such claims that authoritative statements could, hypothetically and ideally be checked by evidence, even though they never actually were (and even if they were, they were checked by people whose interests are VERY similar to the original authority) any different from other claims to authority?
“Now I’d say it’s that convincing on an individual level with persuasive arguments that is what counts rather than authority.”
Like Martin, you seem to want to construe science in non-institutional terms, thus making it seem that authority plays no major role. This, however, ignores the numerous ways in which science is institutionally integrated with state-sponsored powers of compulsion. There are also less-formal ways in which academic credentials function as authority. I work as a research analyst and it is common knowledge that if I write up a report for a client and somebody with a PhD writes up another report that is less well-argued, the client will not only choose the latter, but they would be willing to pay much, much more for the latter. I see this happen on a regular basis and for obvious reasons: the client isn’t looking for help on how run their business. What they are looking for is the PhD stamp of approval for a decision that they already made prior to any outside consultation. In other words, they want to shut up any and all critics who are not authorized to peer-review such conclusions.
“Any example I could give, since inherently being a social interaction with scientists you could always argue is authoritative trump.”
Okay, so then why is my version not allowed if it too covers all the appearances? Isn’t this just a confession that such choices are ideologically motivated?
“Yes doctors appeal to authority but this is bad and typically is the cause of most of the problems in medicine.”
It looks like we are closer than I thought then. I too am suspicious of such appeals to authority, but I am unwilling to write them off being fully bad or as outlying deviations from some much better norm. Yes, we can preach ideals until the cows come home, but the fact of the matter is that I am in no place to confidently prescribe a better way to medical professionals.
“Of course all medicine should be evidence based”
I’m not so sure. Most medical treatment throughout history has not been evidence based in “know-that”, but rather traditional and many holistic remedies that are results based “know-how”. It is nowhere clear to me that the latter ought to reduce to the former.
“There’s all sorts of very bad practices that persist in medicine simply because doctors prefer authority to science…Regarding chiropractors, I’d say they are even worse than doctors in that they appeal to far, far less evidence.”
Again, this sounds pretty ideological. Yes, science has definitely helped further medicine since they joined hand 150 years ago, but the idea that a doctor is only good to the extent that he acts “scientific” seems undermotivated and pretty extreme to me.
Comment by Jeff G — July 31, 2015 @ 4:36 pm
Clark,
Your idea of science seems to rely upon the same historical misreading by which Kuhn was able to hide the authoritarian nature of his own model. Namely, you both seem to assume that science is something that is a low-cost project which is open to pretty much anybody with the time and interest – similar to the Royal Society. Once, we acknowledge that a great deal of modern science and medicine requires huge amounts of funding and apparatuses that can only be afforded by states, large corporations and especially research institutions, the potential for review to come from outside of the very small circles of designated elites become increasingly small. This practical separation of a small, well-insulated group of experts just is a kind of authority.
Here’s a good overview of where I’m coming from:
https://books.google.com/books?id=c6mP5H0l_XUC&pg=PA342&lpg=#v=onepage&q&f=false
Comment by Jeff G — July 31, 2015 @ 4:57 pm
“I am much more concerned about expert testimony, quarantines, health inspectors, social services, incarceration and other such compulsory expressions of authority within society at large.”
Ok, but almost none of those are the primary purview of medical doctors as medical doctors.
Comment by Martin James — July 31, 2015 @ 10:52 pm
Don’t kid yourself, Martin. Just because doctors don’t usually exercise these forms of authority in their typical check up, doesn’t mean that they aren’t there in every single check up all the same. The doctor is not merely there to help you child get better. They are also there to make sure that you are raising your child within the standards that they have set for you.
The authority exercised within the standard check-up goes even further than this though. The status of doctor includes the tacit claim that they know more about your body than you do…. and this just is authority which society takes away from you and gives it to the doctor. You are no long able to speak for you own body when the proper expert has already done so.
Comment by Jeff G — August 1, 2015 @ 7:23 am
Jeff,
You are blending things again. Doctors don’t have any independent power of jurisdiction, there are political forces involved also. Furthermore, the political authorities have been encroaching more and more on the “expert space” of doctors. Two simple cases in point are abortion and assisted suicide. Doctors do not get to say what the rules are in these cases. The same with prescriptions. The schedules of what drugs are classified as available to use is under the control of the government and not the physicians.
I think it is much more the case that the state uses the authority of the physicians and other experts for its own ends than it is the case that the experts use the state to father their own nest although it is certainly the case that both occur.
Take the case of the Ebola quarantines and non-quarantines. There is considerable executive flexibility outside of the role of expertise in all of the areas you describe.
This is why experts are so threatened by political forces that do not recognize the power of experts: because they have very little independent power. If the state outlaws a therapy or a practice that is the end of it. Period.
Comment by Martin James — August 1, 2015 @ 2:27 pm
“This is why experts are so threatened by political forces that do not recognize the power of experts: because they have very little independent power.”
Isn’t this exactly the case for every form of authority that has ever existed? No prophet, priest, pope or king has ever had any “independent power.” Instead, their power consists precisely in their connection to political forces… just like I have been claiming.
Comment by Jeff G — August 1, 2015 @ 3:28 pm
Jeff, there’s no doubt types of science are expensive and thus people will tend to require experience before funding. But is experience the same as authority? Again, how do we distinguish between the two?
In any case while some science is very expensive not all is and there have been important discoveries made by non-PhDs. However all this is moot since you’ve avoided the central question of how to distinguish authority from these other issues.
Perhaps this would be easier if you could clarify what you mean by authority since your use seems to shift quite a bit.
Fundamentally it just seems like you expand authority such that anything that’s a short hand to decide where to allocate resources is authority.
Again I’m not saying authority within science doesn’t matter. Just that it is but one example of a type of evidence with which people calculate. To keep our long standing dispute clear – fundamentally the issue is just when authority is a trump versus when it is one part in a calculation.
Comment by Clark — August 1, 2015 @ 5:51 pm
I don’t think I’m saying a doctor (or any “engineering” profession) is only as good as they do science. However I think to the degree that they don’t question their assumptions to empirically test if they work then they undeniably tend to fail. I don’t think the individual doctor need do this (although I think it better if they do) however the community most definitely should be doing this rather than relying on authority.
Comment by Clark — August 1, 2015 @ 5:53 pm
“Isn’t this exactly the case for every form of authority that has ever existed? No prophet, priest, pope or king has ever had any “independent power.” Instead, their power consists precisely in their connection to political forces… just like I have been claiming.”
My point is that we should only care about their political power to the extent that they are “correct”. If the “correctness” only occurs in the context of their power then there is no need to worry about the loss of their power.
Comment by Martin James — August 3, 2015 @ 8:34 am
“No prophet, priest, pope or king has ever had any “independent power.”
The power of prophets doesn’t depend on assent. They control all the power of the universe, correct?
Comment by Martin James — August 3, 2015 @ 8:37 am
I wonder if the distinction we’re looking for isn’t formal vs. informal power. Take a scientist. There are two aspects to their authority. The informal one of how many people respect them, how well they can present their case, etc. Then there’s the formal one based upon credentials (where they went to school, do they have a PhD, what was the degree in, what chairs do they have etc.) This is blurry since of course some schools are judged better than others, especially in particular fields. Likewise ones publication matters but that’s again a function of what the papers are about, where they were published, etc.
Comment by Clark — August 3, 2015 @ 11:52 am
Martin,
“My point is that we should only care about their political power to the extent that they are “correct”.”
It’s so easy to simply throw around ideologies like this, but what in the world does it mean in practice? After all, I agree with what you’ve said. The point that I bring up, however, is in asking “who gets to correct such people?” By objectifying “correctness” we completely sideline the very important fact that only people are have been trained and certified to think and speak exactly like the doctors that are on trial, so to speak, are allowed to call them into question regarding their correctness. This is hugely important since this is exactly how any and all social strata that find themselves in power maintain their authority.
“The power of prophets doesn’t depend on assent. They control all the power of the universe, correct?”
You’re trying to equate political power – which priests and prophets certainly do have – with power to perform miracles, etc. The political power of priests and prophets explicitly depends upon their having followers that believe them…. Just like any other authority figure.
Comment by Jeff G — August 3, 2015 @ 12:33 pm
But Jeff doesn’t your framework demand that equation? Look at the response to me earlier. Who decides what success is? Or, in the case of priests, who decides when a successful miracle has happened? If you cut yourself off from realism then that would seem to be a problem. If you say, well some priests have real priesthood and some don’t, then we have to ask how that is adjudicated. As soon as you make that move though then it seems like you’ve undercut your whole approach. (I recognize that you want to ground it on personal revelation – but again who decides when that’s happened?)
Comment by Clark — August 3, 2015 @ 12:50 pm
I am trying to unequate Mormon authority, which claims objective world power through miracles and knowledge, with the ordinary authority of your historical examples. You are de-mythologizing the technical capacities of the priesthood and that is a primary reason I am unpersuaded by your approach.
My other main concern is that your approach is that I think your approach opposing mormon authority to trends in the world, makes it less and less likely people will stay mormon. We agree the most about the situation of the ordinary person, but I think it is more difficult than you for people to have multiple status hierarchies and that is why so many LDS leaders are or were leaders in their secular positions. I think your approach makes LDS authority seem more and more distant from the ordinary status psychology of people and thus less and less viable. I maintain that the link to authority is tied with the ability to “deliver the goods” and that the righteous will follow the power that corresponds to righteousness.
Comment by Martin James — August 3, 2015 @ 12:54 pm
Clark,
I don’t see that important of a difference between formal and informal authority. My point is that there is a very small group of people who speak to what the “correct” way to live is and the only people who are allowed to correct that group are people who are themselves a part of that very same group! Insiders within this group are also somewhat stratified, but this stratification is very small and inconsequential in comparison to that between the insiders and outsiders – between the certified and the certified.
No matter how much a read and study up on a subject, I will never ever be called as an expert witness on the subject. This is because expertise is not gauged by how much I actually know, but by how much I am perceived by other people to know – and not just any other people, but people who have already been authorized to authorize other such people according to how well they are able to speak exactly like they do. There is very, very little difference between this boundary maintenance and reinforcement of the authority of insiders over outsiders with regards to medicine and that in which a quorum of apostles call another apostle that is – unsurprisingly – very righteous and faithful as defined and measured by – in other words they behave and speak exactly like – the former apostles.
In other words, peer-review comes at an extraordinarily cheap price when we get to define who does and does not count as a “peer”.
Comment by Jeff G — August 3, 2015 @ 12:55 pm
The reason the distinction between formal and informal is important is one tends to be analyzable in terms of formal permissions. So a police officer has authority because the bureaucracy granted them that authority which is in turn dependent upon the formal structure of local government (laws) which is in turn dependent upon elected officials whose authority comes from the elections.
The reason for maintaining the distinction is that often people with formal authority can do things those with informal can not. (Think of arresting and jailing someone) Likewise informal authority usually comes via persuasion or fear in a fashion that simply grounds things quite differently.
As to “experts” I think that this is largely an effect of informal power rather than formal. Likewise the more one knows about an area, the very different that the lines of informal power develop. Someone completely ignorant of law will apt to grant any attorney far more authority than they deserve, for instance. They may even be ignorant of formal authority such as where an attorney is legally allowed to practice law (accreditation) and they’ll likely be ignorant to the skills of the attorney. (Someone skilled in patent law is less likely to be an authority on criminal justice for instance)
This suggests that the authority granted to someone is different from what authority they might have in general and certainly different from formal authority. This matters because when the agent acts on you what counts isn’t your perception of authority but the perception of authority in the wider context. I may judge a police officer to have no authority to do something but this matters less than how others around them judge them. (For example it’s completely legal to photograph or police officer yet that won’t keep them from doing things to you)
Authority in practice is thus more complex than it appears at first glance. Since abuse of authority takes time to adjudicate and may never be adjudicated depending upon circumstance.
Comment by Clark — August 3, 2015 @ 1:34 pm
I just wanted to let you know I thought this was fascinating and enlightening look at the meaning and role of priestly authority. Nice job.
Comment by Doug — August 30, 2015 @ 5:07 pm