Book Review: From Oversight To Overkill
astralcodexten.substack.com
astralcodexten.substack.com
Meanwhile finding out the number of deaths caused by extra caution and delaying the experiment requires a calculation, and then a very lengthy blog post to be communicated.
Bureaucrats don't care about the second kind of deaths because they can hardly be linked to their actions. Now the first kind of deaths are directly their responsibility. And guess what, they can be avoided with a flick of a pen.
> ...the IRB demanded patients sign consent forms in pen (not pencil) but the psychiatric ward would only allow patients to have pencils (not pen)...
All individual additions are likely net positive - positive in 99% of the cases, negative in the rest. Assuming events are mostly independent, you'll sooner or later are in a world were net positive outcomes are becoming less likely than net negative ones.
You can sometimes sidestep that by combining/rewriting rules to some extent, but in the limit, you can only avoid all additional risk if you prevent any changes.
That's not a fault of IRBs. That's a fault of trying to minimize risks. I'm not sure there is a good answer here outside of "here's the maximum amount of risk we're willing to take, and here are the few clear ethical boundaries we'll never overstep".
There's a reason any place that's dealing with a lot of constraints is concerned with risk budgets, not risk elimination. And I'm not sure there's a lot of thinking on probabilistic ethics. (Or maybe I just can't find it)
This really scares me. It seems like every important facet of American life that can be touched by increased, predatory, and superfluous litigation and regulation has. If we take Scott's word for it, this 'vetocracy' costs 10 000 lives a year due to IRB over-diligence, makes Bay-area housing completely unaffordable, reduces the quality of education, and so much more.
It really seems like our first priority as a nation should be to dismantle this 'vetocracy' and let researchers perform studies, and teachers teach.
The housing is also really, really important: the Silicon Valley, San Francisco and New York etc are some of the most productive parts of your country. If more people were allowed to live there [0], your economy could grow a lot. A bigger economy directly translates to lives saved.
To give a simple example: your highway engineering people work with a value of life of something like x million USD. Any improvement to safety that costs less than x million USD per life saved gets implemented. The value of x gets set in vague relation to how rich society is.
[0] No any one individual is directly barred from moving to SF, if they pony up enough money for rent; but the NIMBY climate effectively sets a limit on the total number of people allowed to dwell there.
Also: Google (for example) has offices in lower cost locations, too. Why do they keep the offices in Silicon Valley open at all, if location is not important?
But it does exist.
Why would they keep their high rent offices in Silicon Valley open?
Are you saying they decision makers are all irrational? They still have to compete in the market. Any company that could get equal productivity out of random locations could eat their lunch with a lower cost base.
This is not currently nor should it ever be how civil engineering works.
Engineering projects select their safety features based on what funding is available for which features in a given community. I'm sure there's someone in the federal government somewhere who thinks anyone uses VSL guidance, but that doesn't make it so.
Why do you think decisions _should_not_ be made like this? How else do you want decisions to be made?
The only major-changes that actually help are stuff like work arounds ala working from home or using AirBnB to offset mortgage costs.
I've read that the meme of "middle class is dead" is mostly bullshit, incomes have stayed consistent, the only major difference is cost of living, which housing ranks #1 by far.
https://www.pewresearch.org/fact-tank/2022/04/20/how-the-ame...
Some of these can be addressed without shifting this stuff to administrative law, but it's a good baseline.
> Finally, after a year, another panel of experts ruled in favor of the investigators and gave them permission to restart the study right away. They did, but the delay was responsible for thousands of deaths, and produced a chain effect on ventilator research that made us less prepared for the surge in ventilator demand around COVID.
People who do not understand or accept the role of risk-taking in the expansion of scientific knowledge and the betterment of the human condition should not be in positions of authority over the scientific process.
I have to ask: what went wrong here? Why would such a person be in this position? Surely a judgment like this is exceptionally bad...? Or has the rot spread much farther, to the point where incompetence this severe is normal?
Meta-risk, the risk that comes from not taking any risk, needs to be drilled into everyone's head: the public, journalists, politicians, IRBs, etc. I think the concept that not taking risks is risky should have its own label, but if someone doesn't like "meta-risk", maybe they will accept "risk tradeoffs".
This comprehension on business management can lead to the conclusion that socialist visions will always have capitalist characteristics associated with their attempted executions. So it seems there's an extensive and influential capitalism that exists somewhere in the world, right now. The only way for socialist goals to prosper is to remove that wide-reaching capitalism.
So just educating people about risk might actually, ironically and funnily, be an unproductive decision and indicative of a much more interesting problem.
That's not true in general. It all comes down to incentives on both the institution and individual actors.
To give a counter-example to your claim, there are plenty of companies who see the writing on the wall, and desperately try to do something to avoid the risk of inaction.
Facebook might be an interesting example: it's slowly sliding into less and less relevance, and the 'metaverse' is a big and bold bet to actively change that. (To make that example even better, as far as I can tell, it's not working out. So we can guess that there was considerable risk in taking that bet.)
I think Facebook and the metaverse is a great counter-example, but it also seems to highlight the general trend. I would be very surprised by any institution where power is diffuse understanding the value of avoiding meta-risk. Business can concentrate immense power in the CEO, particularly when they are also the largest shareholder, which enables them to act decisively.
I would love to see examples of where groups or co-operative without powerful individuals collectively chose to embrace risk to avoid meta-risk, since they could provide incredibly valuable lessons.
Such a person will always be in this position, it is the type of personality that thrives in a bureaucratic institution. No amount of fiddling with the process will fix it, you need an alternative form of decision making
Associated with that is that many people don't consider the level of risk when they are considering whether something is or is not a problem.
And both things don't just apply to IRBs. A friend told me about when his workplace had a security assessment (for Reasons). the assessor's only finding: that a houseplant by the door had sharp leaves and could be used by a malicious intruder as a weapon. Yes, I suppose so. Job done by security assesso. But, just perhaps, a malicious intruder might not choose to rely on being able to slash someone with the houseplant, in which case worse things might possibly happen.
This is the same reason a home inspection report during a real estate sale ALWAYS finds problems with the property for sale
> pull the culture towards celebrating harm-avoidance as the greatest good, and cast suspicion on anyone who tries to add benefit-getting to the calculation
Minor nitpick, but it is more accurate to say that they prefer prevention of new harms over the prevention of old harms.
The current wording (plus the commentary over Gnosticism) kinda makes it sound like negative utilitarianism, or harm aversion (preferring the reduction of suffering over the addition of "positive pleasures") which would be a legitimate position. But the post is something more like "new risks aversion", i.e. preferring current harms over possible new harms regardless of the lower intensity of the "possible new harms", which sounds pretty irrational.
Somebody, let’s call them Dr. X, invents a computer algorithm that cures cancer. It works by running simulations of the patient’s cells. Its output is a list of diverse interventions, for example, pairs of RNA fragments and custom delivery mechanisms for each fragment. For a given patient, the algorithm outputs between 100 and 10000 interventions, all of them different and tailored to the patient. The simulation also takes into account possible adverse effects, it’s really a cure.
With the current regulatory framework, does Dr. X has any hope of his invention being used at hospitals in less than a decade, or all he can do is to use it on himself and/or make the algorithm available in the dark web?
Add another tally mark to "bureaucracies can only kill, never create".
Try saying "accept what we cannot avoid" to my skewed feet, OHRP. I WISH I had the finances to fix them, but because of people like you, any advancements on cheap treatments for this issue will be met with hundreds of miles of red tape just to form a simple test.
This quote sums up how I feel about the OHRP, and all bureaucracies similar to it:
> A survey of how researchers feel about IRBs did include one person who said “I hope all those at OHRP [the bureaucracy in charge of IRBs] and the ethicists die of diseases that we could have made significant progress on if we had [the research materials IRBs are banning us from using]”.
"Whitney can find five people who unexpectedly died from research in the past twenty-five years. ...
"What are the costs? ...the monetary costs are around the order of $1.6 billion.
"What about non-monetary costs? ... Low confidence estimate, but somewhere between 10,000 and 100,000 Americans probably die each year from IRB-related research delays.
"So the cost-benefit calculation looks like - save a tiny handful of people per year, while killing 10,000 to 100,000 more, for a price tag of $1.6 billion. If this were a medication, I would not prescribe it."
That Hans Jonas quote is insane. I hate insane americans, why do they have such outsize influence on culture there (and through cultural imperialism everywhere else)?
One you regularly see here is the complaint about Wikipedia: "I tried to edit the page about me/my work/my family and they wouldn't let me. But I'm the expert on me/my work/my family and it's currently wrong".
Which sounds outrageous!. But at the same time "people can freely edit their own pages" has obvious failure modes too.
Similarly, getting mental patients to sign in pen can be presented as pointless nonsense. Or it can be seen as part of a strategy to stop defenceless patients being taken advantage of by malicious doctors and stop vulnerable doctors being sued by malicious patients.