witches floods and wonder drugs

Im worried about intrergrating my analysis in with my descriptions of the article.
do I need to specify what the key concepts, lessons and implications are?
can I mix in my public choice theory? Where politicians not economists are decision makers I think it helps explain outcomes.
iv only written on the main part of the witches article, should I wrote on the rest of it/ it seams to be generally the same conclusions repeated.


writing task for this week: Based on the discussions and analyses we do here, you can begin to develop an answer to one exam question in your blog , as we did in week 1: Clark uses 3 images - witches, floods , and wonder drugs - in his paper on risk and risk management. Write a critical essay summarising and explaining the key concepts, lessons and implications for “Risk as a people problem” he draws from each of these images, taking each one separately, and overall. and as a whole. What additional ideas does Tufte contribute to Clake's analysis of risk and risk management? (A good answer will contain not only a thorough critical exposition, but your thinking about connections with other material in the course or discussions in class or in blogs ).

Introduction to witches floods and wonder drugs.
Witches, Floods and Wonder Drugs: Historical Perspectives on Risk Management by William Clark seeks to demonstrate that risk is a people problem, through the application of historic examples to modern scenarios. Clark argues that socially relevant risk is not physical harm from an event, but rather the perceived inability to cope with such an event. Improved ability to cope with events is a management problem involving identifying risks, understanding their nature and how they are created and taking actions which will ensure the ability to cope with events in a favorable way, although Clark warns that to believe understanding is complete would be unwise.
Risk management is a ‘trans-science’ in which risks cannot be completely identified or result in certain outcomes, events must therefore be evaluated ordered categorized and structured to the highest possible level with incomplete information and the best possible strategies within such limitations chosen.
In managing risks policy analysis is more useful than science. This is because it offers a better understanding of feasibility (though not necessarily desirability). It also offers a better understanding of ‘soft fall’ coping strategies which are not essentially efficient or optimal but do have some ability to deal with unknowns.
The most important lesson that historical risk management can offer us seams to the importance of flexibility, unlike what we have seen the hysterical witches example and the rigid modern examples.

Risk is defined by the fears of individuals and society, and how we cope with such fears has a large effect on both individuals and society in material and mental terms. If the individuals dealing with risk management either share these fears or distance themselves from them. As such they have a tendency to be unable to see outside the problem and become part of it or become unable to see inside the problem and trivialize it. These conflicts are likely to continue to plague decision makers. Clark suggests looking at our history to gain a better perspective.
Clarks essay is a first attempt at a historical essay of risk management, the aim of which is not to be a definitive article on the subject but rather to provoke higher quality debate on the topic.

Throughout the renaissance and reformation society was plagued my severe weather, disease in people anminals and crop failure, ailments persistent throughout history.
authourity institutions, residing within the church were the sole source for ‘truth’ and were responsible for educating accordingly along with spiritually guiding and protecting the population. As ‘experts’ and ‘authourities’on all subjects the church was called on to explain these negative events. In at attempt at explination and remedy of the unknown the church assigned the tag of witchcraft, (the witch narriative had been blamed for fears for centuries howvere until this point the church had taking a skeptical approach, calling witchcraft fantasy and proposing that witches only posed harm to their own souls) and in doing so created a new profession of witch hunting.
the result was that risk assessment and management during this period was dealt with entirely through witch hunting.

in order to calm upset and social social concerns caused by seemingly inexplicable disasters the authority of the time enlisted the inquisition. the inquisition became a popular growth industry, providing jobs and a method of advancement up until the enlightenment. However it also caused great harm to the people it sought to protect.

Authourity for the inquisition came from Malleus Maleficarum (the Hammer of the Witches 1486) and Pope Innocent VIII’s bull Summis desiderantes affectibus which gave credit to the theory of witches as a public risk. This lead to the reasoning that action that harmed individuals was justified if it helped protect society from risk.

Key concept- trying a witch has no end, likewise nothing is competley risk free.

Key concept- you might me trying to peotect the people, but unwittingly you might be harming them

Key concept- Risks are fear inducing
the promotion of the concept of witchcraft created fear in many individuals, previously unconcearned, creating more fear and eventually hysteria. Discovery of ‘witches’ lead to greater fear, requiring more witchhunters to deal with the problem.
There is a strong argument for a causual relationship between assemement and risk, this becomes self fufulling.

key concept- because the relationship between increased searching leads to increased results, which justifies further increased searching there is no end point or limitation to the search.

Lessons from the witches example

if assused of being a witch there are two options, profess innocence, and be killed for being a lying witch, or confess and be killed for being a witch.
similarly, if accused of being a risk there is no definitive ‘no’ answer, or stopping point at which the search is ended. ‘accusation is tantramount to conviction’ and the only end point is to admit defeat.

Alonso Salazar Frias did some alalysis which showed the influence of torture on confessions and order that people no longer br tried as wiches without indepentend evidence first. Accusations wrent enough. Ie he introduced rules of evidence .
rules of evidence have yet to be introduced to modern risk management, and it may be a logn time befoe they are. Itwill take the course of history for us to be able to look back and see wheather our attemots at risk management were helping manage risk or is like the witch hunts they were chasing myth.

after the church was prevent from confinscating property from those accused the number of accused fell. This is consistent with basic economic policy, when the price of a good falls, the supply will also fall.

politically the witch hunt shifted accountability for any number of issues from the governing institutions to the ‘witches’ and removed responsibility.

Implications for risks as a people problem from the witches example

Like the witch hunt from which no one can be proven innocent scientific approaches to evaluating risks are always capable of gathering evidence of some form of risk.

Hindsight shows us that the inquisition designed by the church to peotect the people in fact hurt many and saved none. Likewise hindsight may demonstrate that zealous scientific searching for risks may in fact have either harmfull effects, or more likely simply fail to protect those it was desined to.

The only end point is to admit defeat- in modern terms this means that either risk is found, or the investigatior has reached the limit of their ability to investigate. This absence of a stopping point diminishes the areas credibility as a science and leads it more to propaganda according to clark.

Although modern science claims to maintain its rationality though open and and critical inquiry it rarely faces critics. Those who do criticize face harsh criticism themselves, for example those who defended witches were accused of witchcract themselves. Those who criticize risk assessors are accused of willingness to expose others to harm.

Floods
lessons in risk analysis can be taken from our attempts to manage the enviorment. As with the drugs example rivers provide both good, irrigation etc and bad floods. Unlike the witch example the risks here are not imagined and have noth short and long term consequences.
historically risk management of the environment was done through modifying human behavior to avoid risk. Populations were flexiable in living arrangements and smaller population groups enabled less impact to be placed on the environment.
currently the opposite tends to be true, industralisation and population growth hav lead to decreased flexibility in location and greater reliance on stability of environment. This prevents the ability to avoid risk, instead trying to control or reduce the variability of nature through engeneering.
while this has some success in mitigating short term risks it tends to be accompanied by ‘expensive and unanticipated long term consequences’. Controlling small risks leaves us more vunderable to large risks. This has been ashown in the US during the 1960s when it could be seen that increased flood control was met by increased damage from flooding.
it took some period of time before this was accepted and it was understood that the practicing theory behind flood risk management was insufficient. It had not included behavioural responses which consisted of populations moving to areas which were now considered safe due to the attempts at risk management. This combined with a sense of safety lead to more damange when construction failed.
risk strategies involving the human aspect are now being developed, largely involving migration and flexiable responses.
an example of the cost of changing riskcontrol paths is that of forrest fire management in amercians national parks. ‘withdrawal from an initially suffessfull risk reduction poicly has been delecate and expensive in the extreeme’
pest control- in the case of pest control we have become reliant on partly successful risk management because to change to a better (or prior) system would involve a period of likely extreme deveastation. This is an example of path reliance?
parallels can be drawn to the human drug industry, where we see an example of public choice theory… name of game? Where in minor infections which helped guard against severe illness by building immunity , avoiding these minor infections leaves populations more succeptable to contracting severe illness with more darastic outcomes. This happenend in the case of polio, as conditions improved less minor polo cases were seen but severe cases became more common. This example implies that the control of the disease through sanitation etc has lead to increased vunerability of large scale risk, as what happened with flood control.
this alternative risk needs to be examined as an aspect of risk management.
the common theme from these examples is that uncertainty and variability have been viewed as risks and attempts have been made to remove variabily and create certainty in order to manage risk. Initiial success in ‘decreased frequency of variation in the system was accompanied by increased vunerability to and cost of variation when it finally broke lose from managerial controls’.
risk management resulted in risks being faced by those who were inexpierenced with copign with the risks instead of those who were prepared to cope with such risks.
our unknowns are greater than our jknown, we cannot reduce risk through curerent controls, rather we simply transform the nature of the risk.
clark suggests we learn to design risk management schemes to be able to adapt and cope with failure. He proposes uncertainty tolerant management policies and increased institutional flexiability.
the implications for adaptice management of social assmeent are best suited to risk situations in which information is incolplete.

-avoid instead of manage risk?

Medications provide both benefits and risks. These risks are limited to those taking the drugs, are taken with full information about both risk and reward and limited in the risk they pose. This is what makes social risk in the case of wonder drugs different to that of witches and floods.
the extensive research, testing, and evaluating of drugs is accompanied by information especially desgined to be easily understood by the population and presented by professionals trained at informing and aiding informed medical decision making. risk assement in the case of drugs is therefore highly developed as a field. Clark seeks to discover if this successful risk management can be applied to other fields.
the opposing side to this lengthy process is of course less information provided to risk takers, but quicker access to drugs which may hold great benefits. The new drug testing process is costly, lengthy and may prevent marginal drugs being developed. The potentiopnal benefit vs potention risk is a common risk management issue.
in the usa there is extensive pre market testing to mitigate risks of unanticipated side effects where as in the uk dugs are released sooner and side effects monotered post marketing. Comparasiions between the two generally conclude that the uk approach is more beneficial to the public as the amercians sytem is costly, discourages new developments and has not been able to provide an assurance of safer drugs. Regulation review is suggested in the usa to streamline the process. There are however calls fro the process to be toughened up. The FDA has been frequently reorganized by congress and despite its calls for clear unambiguous regulations from congress on risk management for the public good it has failed to obtain these.
public safety remains a political issue despite sufficient economic and scientific data to make informed decisions about public risk.

Joshua Lederberg argues that safety testing is based on a complicated set of obsticles rather than specific challenges which are superior in catching likely potentional hazards.
-the current obstacle course requires testing to see if those who win are truly the best performers.
Lederberg calls for ‘an expiermental design approach in drug safety regulation’
analyzing regulation through economics tends to lead to the conclusion that the regulation is inefficient in some way. It would be incorrect however to interperate this as a choice between regulation and deregulation. Rather regulation needs to be made more efficient. This can be done through research into the ability of testing procedures to catch risks. Should certain testing procedures be found to be nto of great worth then they must be replaced by new testing procedures more efficient in catching risks in that area. This is a process that will require continous evaluation and adjustment. Greater efficiency could be seen through applying intensive pre arket screening where necessary and post market screanign where possible.
“we will have to learn to make efficient diagnostic use of the different empirical expierences emerging in different countries under different regulatoary approaches.” The argument for “adapative risk mamangement” as suggested by the historical example of resource management is therefore strengthened by the above analysis of the drug market.

The more drastic alternative is to address the NASA manned space program’s current lack of specific, highly targeted goals, even if it ultimately means scrapping today’s shuttles and half-built space station. In the absence of such goals (and funding appropriate for them), it is almost impossible to evaluate the current program and its trade-offs. New goals for NASA might be as ambitious as landing someone on Mars or as relatively simple as encouraging space tourism. Whatever the case, let the agency concentrate on building the right vehicles for the job.

Even a new space program will carry a risk of dangerous failure. One could hope that it would be far lower than that of the shuttles, but there are no guarantees. Even so, the scale of the catastrophes might be smaller; the numbers of flights involving people might be lower; we would have the cold comfort of knowing that when vehicles failed, it was not because they had been burdened with design requirements that raised the inherent risk.

Such a plan would be expensive and probably yield little scientific knowledge at first (the Apollo program did not provide much good science in its early phases, either). But it would be a program that more intelligently balanced respect for human life against the value, both scientific and spiritual, of venturing into space. Let’s salute the bravery of the astronauts, not insult it by asking them to risk their lives in a poorly considered cause.

John Rennie, editor in chief, Scientific American

Overall conclusions from witches floods and wonder drugs

Additional insights from tufte on clarks analysis of risk and risk management

Relate it to the earthquake

He tested the water, and the test was clear, but he didn’t take this to mean that was water was safe,
Policy thinking is and must be causality thinking
previsouly ppl had tough cholrea speard through the air or something. The reason snow was able to figure out how it spread was because he used causal thinking, this theory came out of medical thinking and observation.
it is nto enough to complie data, it hass to be done in a way that demonstrates all possible links.
quantitive comparisions must be made, why did others not gfet sick in addition to why did people get sick?
alternative explinationsand contrary cases must be considered. You cannot only include evidence that supports your conclusion, all factors must be considered. Like the bond st well case further investigation may be able to explain statistical abnomilities.
potentional errors in data must be investigated.

the evidence that linked cool weqather launches with o ring fasilure was inconclusive, although history, theory and expiermental data did suggest it.
this brings into question the use of group think, technocial decision making, political influence.
should engeneers have to argue with administraters?
although damage to the o rings was graphed the graphing failed to relate it to a cause (cold weather). Graphing of damage should of focused on possible causes of damage not varing degrees of damage.
temperature had in fact been a part of the chart analysis but was not shown on the chart.
analaysis was also based ontwo past cases rather than erosion, the focus on only two cases weakened the argument and was a poor choice of suportingmaterial.
thinking causality but not demonstrating their work in a causality way
the analytic grapgics failed to show what what known to those that made them, that there was a risk.
perhaps the scientists presentin the evidence should have been better trained in communication. ?
things to be avoided; the disappearing legend, chart junk, lack of clarity in depicting cause and effect, wrong ordering of data,
officials had clouded what engeneers saw as clear data,,
“for successful technology reality must take a precedence over public relations, for nature cannot be fooled”.
the quality of these two presentations have affeacted the consequences.
visual representations of evidence needs rules governing the reasoning of quantative evidence. Information displayed needs to correspond directly to scientific conclusions, and clear evidence needs clear presentation.