Does awareness dilute action?

Jun 1st, 2020

Back in the mists of time (well, at least as far back as the time before google) medical students spent their time reciting patterns of letters or phrases, known as mnemonics, to help them remember medical procedures or anatomical features. For instance, who can fail to remember the sequence of carpal bones from the phrase ‘Some Lovers Try Positions That They Can’t Handle’[1] or how to manage a shoulder dystocia during birth from the word HELPER.  Apparently it stands for ‘call for Help; Episiotomy; Legs up (McRoberts maneuver); Pressure suprapubically; Enter vagina for shoulder rotation; Reach for posterior shoulder/ Return head into vagina (Zavanelli maneuver)/ Rupture clavicle or pubic symphysis’. I think most of us would probably stop at H. So, in this article, I’m going to try to make the case for the adoption of the mnemonic FREE, to guide decision making for the future, by governments, by businesses and even individuals. In asking you to consider making decisions using the heuristics captured by the phrase FREE I will also be attempting to tangentially answer the ‘Does awareness dilute action?’ So here goes.

First, let us consider the future.  To my mind, many of life’s decisions about the future are characterised by uncertainty and this uncertainty is often to the point that one can’t put a precise number on the chance of much of it happening.  Take climate change as an example. How do we know what the future climate will look like if we don’t know what future society will look like and how much greenhouse gases it will produce? For instance, has the early exposure by many of us to the 9th best sitcom in the UK during our youth (as of 2004), set us up to eschew the commercial world and become self-sufficient tree huggers or are we just stuck on a path of resource extraction? Yes, I’m talking about the UK sitcom ‘The Good Life’ which according to Wikipedia (don’t tell my students) rather prophetically, “Open[s] with the midlife crisis of Tom Good, a 40-year-old plastics designer, [and] relates the joys and miseries he and his wife Barbara experience when they attempt to escape modern commercial living by “becoming totally self-sufficient” in their home in Surbiton.” Anyway, I digress, basically, predicting atmosphere conditions in the future is deeply uncertain. Then we need to add in the uncertainty of our understanding of how the climate system works and how to model it. This is before we have even got anywhere near trying to figure out how the changes in the climate will affect us and how effective our responses to these changes will be. According to the authors, Rob Wilby and Suraje Dessai[2] this chain of incomplete knowledge of the future can be thought of as a cascade of uncertainty.  Second, I am assuming that the biggest impacts on society in the future are likely to be caused by surprise or emergent events. Here, I mean events that, arise quickly, non- linearly and whose precise time of occurrence is largely unpredictable, years in advance. For example COVID-19, or SARS, or MERS or Ebola or the Syrian Crisis.

 

Third, let us consider the current paradigm of economic efficiency.  Economic efficiency occurs where the costs and losses of action can be compared against the benefits of doing the action.  It works well for situations where costs and benefits can be quantified. Quantification of costs or even the risks using probabilities works particularly well in boundaries contexts such as the present. The future, however, is inherently unboundaried and for many situations are deeply uncertain to the point where not even probabilities can be assigned to events occurring. While a number of economic methods attempt to aid decision making under uncertainty at their heart they rely on being able to quantify uncertainty.  In many emergent situations, this is not possible.  Economic efficiency particularly struggles when the linkages between the impacts of something are indirect and separated by long causal chains.

An alternative to a paradigm of economic efficiency is economic effectiveness. The difference here is small but important. Whereas “economic efficiency relates to how successfully the inputs have been transformed into outputs. Effectiveness measures how successfully the system achieves its desired outputs”[3]. The outcome of efficiency is thus profit. The outcome of effectiveness is about moving to a new place or outcome. So how do we achieve economic effectiveness when we have deep uncertainty? Well, here I make the case for the mnemonic FREE.

According to Camilla Audia and her colleagues[4] the mnemonic FREE refers to using the principles or heuristics of: ‘Flexibility’ which involves making decisions that can be changed as new information evolves; ‘Robustness’ which involves decisions that are applicable in a range of situations; ‘Economic low-regrets’ where decisions are ones that attempt to negate the possibility of minimal or zero returns in the future at the expense of investment in other priorities in the present; and ‘Equity which involves ensuring that reducing the risk for one cohort of society or one element of the ecosystem does not result in transferring or increasing risks to another. At their basis, they support running towards uncertainty, rather than running away from it. Indeed the presence of uncertainty helps move society from efficiency to effectiveness. By being aware of the deep uncertainty of many future problems we can acknowledge that we need to move to a different way of thinking and doing. To give you a few examples of these principles in action. In 2009 the seasonal forecast of rainfall in West Africa pointed to an increased probability of heavy rainfall (but still a sizeable probability of low rainfall). The possible impact of this was localised flooding but quite where and when were impossible to exactly tell. In response to this uncertainty, the Red Cross and Red Crescent prepositioned non-perishable foodstuffs in transport hubs so they could quickly be moved to places of need as they occurred. Another example is the Thames barrier. Planners had a range of future scenarios to plan for from large storm surges to less so. The costs of building a very high Thames barrier might have been accused of wasteful given discount rates and other spending priorities. The flexible response was to build the base wide enough so the height could be added to another time as conditions changed.   It doesn’t take a huge leap of the imagination to consider how the principles in FREE could have been applied to the current COVID-19 crisis. Importantly economic effectiveness summarised by them explicitly acknowledges that redundancy in a system is a good thing helping to create resilience rather than seeing it as a barrier to profit.

Hopefully, this article has provided one rationale for embracing uncertainty and in doing so possibly changes the way we might approach future problems.  At the risk of sounding too grandiose at its heart is the idea that reframing problems through awareness and acceptance of uncertainty lead to solutions and that the mnemonic FREE allows us to plan and act in a way that leads to a more resilient and sustainable society. In ending this brief article I will leave you with what I thought was a lovely quote from the renowned sociologist Brene Brown about uncertainty:

“I spent a lot of years trying to outrun or outsmart vulnerability by making things certain and definite, black and white, good and bad. My inability to lean into the discomfort of vulnerability limited the fullness of those important experiences that are wrought with uncertainty: Love, belonging, trust, joy, and creativity to name a few.”

Professor Dominic Kniveton, Climate Science and Society. 

 

[1] Scaphoid, Lunate, Triquetrum, Pisiform, Trapezium, Trapezoid, Capitate, Hamate
[2] Wilby, R.L. and Dessai, S., 2010. Robust adaptation to climate change. Weather, 65(7), pp.180-185.
[3] https://www.oxfordreference.com/view/10.1093/oi/authority.20110803095741475
[4] Camilla Audia, C., Visman, E., Fox, G., Mwangi, E, Kivali, M., Arango, M., Ayeb-Karlsson, S., Kniveton, D., 2020 (in press). Decision-making heuristics for managing climate-related risks: The FREE framework. In Climate Risk in Africa: Adaptation and Resilience. Eds, Conway, D., and Vincent K., Palgrave Macmillan.