Old, Hard-to-Resolve Questions in Philosophy Are Likely Often Meaningless

Philosophy has posed questions which persist literally for millennia, being re-discovered, re-asked from different angles, and with the answers seemingly producing unsatisfying paradoxes. Often, what appear to be innovations are restatements of prior arguments, often seemingly driven by the limited group of value-sets and personality types of the thinkers approaching the topics. What is especially interesting is that these sorts of arguments are either about things that seem to bear on core aspects of human experience, and/or are high-status topics of the sort pondered by high-status people.

This is not good, and where there has been a history of this, what it suggests is either

1. We haven't yet developed the means to verify it (meaning, the logical and or physical enterprise which would allow it.)
   
   
2. The question is meaningless, and this fact has been obscured by unnecessary and/or incorrect assumptions. It also follows that there is no clear consequence from a clear resolution of the question in any direction; certainly they are not testable experimentally.
   

#2 is tempting because it cuts down on the work we have to do. Many examples come to mind from theology or ancient philosophy (in the Western classical era, irresistible forces meeting immovable objects; In Christian theology, resolutions of theodicy; among Taoist logicians, the logical relationship between aspects of yin or yang, e.g. what is the relationship between hard and white.) Sweat and ink were spilled for centuries over these questions, and only with the clearing of the cultural assumptions that made them seem problematic in the first place do we stop worrying about them en masse. This implies some of our current questions may be of the same type. For any question where we assert #2 is the case, the resolution is to a) either recognize (and throw out) the errant assumptons, or clarify them; and/or b) (more interestingly and productively) explain why two apparently coherent but mutually exclusive alternatives to the question are not in fact in opposition.

In modern neuroscience and philosophy, the existence of free will is such a question.

Some Medical Hypotheses

Many people in medical fields accumulate these points of curiosity that are outside their specialization or that they otherwise never have time to follow up on. Here are several. As always, nothing here should be taken as medical advice.

1. The decline in alveolar ventilation with age as measired by DLCO (about 1% a year) results partly from the gradual accumulation of small subclinical pulmonary emboli. This predicts that people on blood thinners should show a slower decline. Also, part of the increased all-cause mortality seen in people who sit a lot relative to those who don't is the result of such emboli, in the lungs and elsewhere, suggesting people who sit less should also show a decreased rate of lung function loss. (This second part of the hypothesis is appealing because you can't undo sitting mortality by adding exercise, just like you can't undo that PE from your flight to JFK by hitting the gym after you get off the plane. Also, frequent sitting is evolutionarily recent, and in fact our ancestors most likely had more exsanguinating traumas than we do, so even without sitting the balance in our current environment is still too tilted toward clotting.) Of note, capillary microthrombi do account for some of the dysfunction in COVID hypoxemia, though I am unaware to what extent this mechanism accounts for persistent hypoxemia in recovered COVID patients (Dhont et al 2020.)
   
   
2. One of the functions of a four-chambered heart is to prevent clots from reaching end organs. In the brains of animals with less dependence on complex behavior and/or without small capillaries, this is less of a problem. True cold blooded modern reptiles do not have small capillaries and have three chambered hearts. Dinosaurs, birds and mammals are all warm blooded or poikilothermic and have four- chambered hearts. A four chambered heart provides an additional aperture that thrombi have to pass through, and for developmental reasons may make it more likely that patent foramen ovale-type defects are less likely.
   
   
3. Mammalian red blood cells are enucleate. The prevailing theory is that mammals have the tiniest capillaries of all orders (even moreso than birds, consistent with being warm blooded). The new hypothesis here is that mammals' on average more communal living makes them more susceptible to viruses. (Yes birds live communally but in terms of physical contact mammals on average spend more time directly touching.) The majority of cells in blood are RBCs. A virus adapted for infecting nucleate RBCs could do quite a bit of damage in animals that had them. But in mammals, these viruses would only enter an empty shell. Note that the next most common type of blood cell, the neutrophil, is programmed to self-destruct in 24 hours, and indeed ejects its nucleus as its main defense, frustrating any pathogen that needs time to do its work and on top of that would have to be adapted to both intra and extracellular conditions. I am not aware of any virus which infects and reproduces using the translational machinery of avian red blood cells but the existence of such viruses would support this theory. In fact RBCs in non-mammalian vertebrates do have active adaptive immunity functions (Nombela and Ortega-Villaizan 2018). That the maturation of red blood cells is directly dependent on ejection of the nucleus suggests this is an important pathway (Testa 2004), which may also be an adaptation for cancer resistance in long-lived species that thusfar only mammals have taken advantage of. Of course many viruses interact with RBCs in mammals, but do not (cannot!) use them to reproduce.

REFERENCES
Dhont, S., Derom, E., Van Braeckel, E. et al. The pathophysiology of ‘happy’ hypoxemia in COVID-19. Respir Res 21, 198 (2020). https://doi.org/10.1186/s12931-020-01462-5

Nombela I. and Ortega-Villaizan MdM. Nucleated red blood cells: Immune cell mediators of the antiviral response. PLoS Pathog. 2018 Apr; 14(4): e1006910. Published online 2018 Apr 26. doi: 10.1371/journal.ppat.1006910

Testa, U. Apoptotic mechanisms in the control of erythropoiesis. Leukemia 18, 1176–1199 (2004). https://doi.org/10.1038/sj.leu.2403383

Parasite Burdens and the Flynn Effect

The Flynn Effect is the real, not-test-based increase in IQ seen in first-world countries, about 3 IQ points a decade. In the last couple decades the effect has leveled off in much of developed world. There's a lot of discussion over why this should be.

One obvious candidate is parasite burden. As countries develop, public sanitation gets better, and public health improves. If it's public health (pathogens plus nutrition) and offering standardized schooling to all, you would expect to see an eventual plateau in developed countries, and the developing countries begin to follow their trend.

Any parasite which directly damages the brain is an obvious candidate as one causative agent. This is especially interesting when you read that up to one-third of people in, e.g. Peru, have radiographic evidence of neurocysticerosis - tapeworm damage in the brain. This study shows that of people with evidence of the disease, 18.2% of them in childhood have IQ < 70. Starting to connect dots, we can start making an estimate of IQ improvement from eradication of neurocysticercosis alone.

• Let's assume that (as the Peruvian study showed) 33% of people have neurocysticerosis.
  
  
• Let's assume that of the people with neurocysticercosis, 18.2% (4% of the total population) have IQ < 70, the mean IQ is 69. This is obviously simple and actually quite conservative, but the higher we make the mean number for this subgroup, the more modest the effect of eradicating neuroscysticercosis.
  
  
• Let's also assume that the 70 and above IQ folks are evenly distributed between 70 and 100. Also simplifying, but I doubt neurocysticercosis makes many people smarter.
  
  
• With those assumptions, then a 3-point IQ increase in the general pouplation could be brought about by a one-third decrease in NC cases.
  
  
• Of course the 3-point IQ trend goes on for more than 3 decades (when all three-thirds of would-be neurocysticercosis patients were prevented from getting it) so it can't just be that.

To test the hypothesis, we could look at average IQ increases going forward in developing countries currently getting de-wormed. You could also look at existing Flynn Effect curves for the developed world and compare it against the % population getting on clean public water supplies. Of course it's hardly controversial that lower parasite burden would correlate with better outcomes, and indeed the de-worming projects have already shown an improvement in school attendance in participating areas. And while parasite diseases cause massive human suffering, this is still interesting even just by purely pragmatic reasons: a country's economic well-being is linked to the average IQ.

Is a Virus Alive?

The pandemic has brought this question much more public attention than usual. It seems to be an interesting question - but on scrutiny, the problem evaporates.

Viruses are replicators. The question of whether they (or anything) is alive is not a useful one.

It boils down to this: in most of these discussions, what we're really asking, when we ask if COVID-19 is "alive", is whether it can make us sick. If it can replicate, it can make us sick, and we know that viruses can replicate. Categorizing things as "alive" turns out to be an arbitrary exercise that neither organizes our knowledge nor adds information - it's much like asking if a submarine swims. What this exposes is that we have no definition of "alive" to begin with. "Alive" is just the label in English for an intuitive category in our animal brains having to do with animacy or agency, and at the molecular level or with non-intuitive strange entities like viruses (or slime-molds, or jellyfish) these intuitions fail us.

More explanation:

1. Specific to COVID-19, most of them time people ask "Is it alive?" when we're talking about the virus "remaining alive" for certain lengths of time on surfaces. Of course what we really care about is whether it can make you sick. Poison oak oil (urushiol) can cause a Type IV allergic reaction after decades. Is it alive?
   
   
2. "Make you sick" corresponds to "reproduction". Fire, stalagmites, and black holes (if you follow Lee Smolin's argument) all grow and/or reproduce. Why aren't those alive?
   
   
3. You might have rolled your eyes when I mentioned fire, and not been wondering whether that is a living thing. We instinctively recognize there's a distinction, but it's worth spending time on. There IS something qualitatively different between a virus, and fire. Viruses are discrete entities that are alike - with elements ordered in a certain way - despite having been made from those elements when they were NOT so ordered. But fire does not carry historical information in this way. That is to say - if two coworkers get infected with COVID-19, despite being genetically different people with different cells, they will produce identical viruses. You can tell the viruses came from other coronaviruses. In contrast, if you light two identical sticks, one by sticking it in a campfire and the other from a cigarette lighter, it doesn't matter - they will burn the same way. You can't tell where that fire is "descended" from.
   
   
4. Being more specific, viruses and people are both replicators. That is a useful category which encodes a qualitative difference. Fire is not a replicator. Viruses are. While fire might not be an interesting boundary case, transposons, prions and computer viruses might be. Viroids shouldn't really be considered a boundary case since they're really just naked viruses that take advantage of intercellular junctions in plants, but somehow people seem to think viroids are less alive than viruses.
   
   
5. Interestingly, we don't have to be explicitly taught what things are alive and what things are not. Speculatively, there may be a central pattern generator that has some combination of animacy, agency, reproduction, and growth. Which does usefully capture all the living things knowable in the macroscale world that our ancestors inhabited for millions of years.
   
   
6. Part of the problem with asking this question is there is no definition of "alive". Molecular biologists got bored with this question very quickly because it didn't advance any hypotheses. (Think of it as the "how many angels can dance on the head of a pin" question for this field; or if you're given to Eastern thought, "since yang is both hard and white, what is the logical relationship between these two things". That is, a problem which only seems to be a problem because of other assumptions which turned out to be wrong or unnecessary, and even if the question was meaningful, answering it turned out to be uninformative and arbitrary.) The most common definition used - again, not necessary for any experiment - is independent metabolism. You might say that an organic virus is not alive because they have no independent metabolism - this is the usual cutoff. What about chlamydia? This is an actual genus of bacteria which is obligately parasitic on host ATP. (A medically relevant genus no less, because it causes diseases humans.) Yes, it uses ATP. So do viruses once they're inside cells. So instead of "alive" why wouldn't we just say "independently ATP generating"?
   
   
7. And yet, it does seem very unsatisfying to learn that "alive" - an apparently important distinction between the types of objects I see when I look out my window - is actually arbitrary. That's because I don't see anything that the term doesn't seem to work for. I see on one hand rocks, clouds, the roof of my porch, and on the other, flowers, birds and grass. Naked-eye observers of the natural world are the Newtonians of biology. Looking out your window, you can't encounter anything where your instinct of "alive" and the better category of "replicator" don't line up...
   
   
8. ...but as soon as you see viruses or viroids or prions, your assumptions are falsified and these traits no longer overlap. Another place where the same debate happened, interestingly also outside the realm of every day experience was in the nineteenth century attack on the idea of vitalism, where a supposed distinction between living and non-living materials was shown empirically not to exist. So to stretch the analogy, Woehler was molecular biology's Planck, and instead of the ultraviolet catastrophe, he demonstrated the urea epiphany.

Number of COVID-19 Cases Correlates With Population Density

It seems fairly obvious that density should correlate with how fast a virus spreads. Comparing across countries or even states is difficult due to time of introduction as well as many other variables. This should be less of a problem (but certainly not zero problem) for a study of of cases by county within a single state. Therefore I looked at the relationship between density and cases. Keep in mind this is an ongoing pandemic so time of introduction will still make a difference, and for that matter there is no effort to control for other variables (e.g., difference in testing frequency by county.) Both axes are log 10 mostly to group points together. As you can see from the R^2 there's quite a close association.


The next and less obvious question is, if viral load (total number of viruses an infected person was exposed to) correlates with illness severity, you would expect that density would also correlate with deaths. There are even more variables that come into play with deaths - age and health of the population which definitely differs, as well as access to medical care and ICU beds. So I did the same thing for deaths; I'm not showing it since I found an R^2 of only 0.0845. I predict that a month from now that R^2 will be higher.

Why We Failed to React to the Pandemic

Given how the pandemic dominates all other news, an appropriate warning about it should have done the same. Yet in the West there was no such thing that I was aware of, including in the rationalist community.

1. We can't call it a failure to predict. I think few people in the rationalist community would have argued that a pandemic could NOT happen, before NYE 2019. It's a failure to react, even once we saw THIS non-hypothetical pandemic coming. Am I missing people who were sounding the alarm? If not, it seems rationalists are no better at spotting information important to survival than anyone else.
   
   (Side lesson: most cognitive skills are not as generalizeable as we would like to think. Because you are good at thinking critically about software does not necessarily mean you're good at thinking critically about epidemiology. I suspect this is because understanding the relevant variables is mostly about memorized instinctive system 1 associations and weightings that come from experience.)
   
   
2. Very few people saw this coming - "this" meaning "a possibility of a pandemic we must plan for". Including rationalists. Including superforecasters. People in epidemiology knew it was possible but it's hard to evaluate their claims of danger over any other profession that predicts low-probability high-consequence events in a way connected to professional success (they're always thinking about pandemics, appropriately); Bill Gates and a few other smart people outside the epidemiology world tried to raise consciousness about the possibility prior to this particular event. Was there a way to pull the signal out from them above all the other constantly-broadcasted jeremiads at the time? And it wasn't like an earthquake where one second it wasn't there, the next it was, and so far as we know there's no way to spot it early; it has been there since December and the large majority of us in the US, including rationalists, did not care much until early March. This was in no way a black swan. We knew it could happen, it had happened several times before, and we had weeks of growing warnings. It was a white swan, walking slowly toward us from the horizon, just like the last few white swans did.
   
   [Added later: Nassim Nicholas Taleb uses exactly the same language in this Bloomberg interview. And read more here about why it was so hard to raise the alarm.
3. Most depressingly, all this occurred after we (in the rationalist community, in parts of the psychology and media and data world) had for years pointed out the failures of predictors repeatedly and tried explicitly to improve. It's depressing because this raises the question of what else we're missing, and indeed if we ever can NOT miss things like this. Again: not even a failure to predict. A failure to react. Why? Denial, fear of social censure by others not on board? Bounded rationality, ie most of us are too stupid to extract important signals and extrapolate?
   
   
4. As a result, I am now particularly concerned about the likelihood of Carrington events and nuclear war - see here and here for near-misses (never mind their intentional use, which is also possible - indeed, that's why they were built and why they continue to be maintained.) The 1983 event is particularly chilling and came down to the career-risking, intuitive, principled judgment of ONE MAN. Petrov should be a name repeated with reverence around the world, since arguably it's because of him that there still IS a world. Our overconfidence that it can't happen occurs on a similar time scale with the Asian flu of 1957-58 which resulted in school closures and an economic downturn, though not on the scale we're seeing with COVID-19.
   
   
5. We have never seen runaway AI. We have seen nuclear weapons used in war. I wouldn't argue against the possibility of a hard AI takeoff, but you canNOT argue against the possibility of nuclear weapons used in war, because it has already happened once. Interestingly, of all the stupid denialisms out there, I have never run into Hiroshima-Nagasaki denialists.
   
   Another white swan on the horizon that rationalists should spend more time stopping.

Added later:

Here's Scott Alexander's review of the book written by Toby Ord, which besides AI lists pandemics and nuclear war. Before you're too thrilled that he gives lower numbers for nuclear war than AI, those numbers are for TOTAL EXTINCTION OF THE HUMAN RACE, not the chance of it happening. There's a lot of space between "extinct" and "a lot of the people you love will die and all of you will suffer horribly" just like there's space between "okay" and "needs intubation" with COVID-19, so don't think mild to moderate means okay.] Yet another time we survived by dumb luck:

...even when people seem to care about distant risks, it can feel like a half-hearted effort. During a Berkeley meeting of the Manhattan Project, Edward Teller brought up the basic idea behind the hydrogen bomb. You would use a nuclear bomb to ignite a self-sustaining fusion reaction in some other substance, which would produce a bigger explosion than the nuke itself. The scientists got to work figuring out what substances could support such reactions, and found that they couldn’t rule out nitrogen-14. The air is 79% nitrogen-14. If a nuclear bomb produced nitrogen-14 fusion, it would ignite the atmosphere and turn the Earth into a miniature sun, killing everyone. They hurriedly convened a task force to work on the problem, and it reported back that neither nitrogen-14 nor a second candidate isotope, lithium-7, could support a self-sustaining fusion reaction.

They seem to have been moderately confident in these calculations. But there was enough uncertainty that, when the Trinity test produced a brighter fireball than expected, Manhattan Project administrator James Conant was “overcome with dread”, believing that atmospheric ignition had happened after all and the Earth had only seconds left. And later, the US detonated a bomb whose fuel was contaminated with lithium-7, the explosion was much bigger than expected, and some bystanders were killed. It turned out atomic bombs could initiate lithium-7 fusion after all! [my emphasis] As Ord puts it, “of the two major thermonuclear calculations made that summer at Berkeley, they got one right and one wrong”. This doesn’t really seem like the kind of crazy anecdote you could tell in a civilization that was taking existential risk seriously enough.

Added still later: depressing results that cognitive biases are extremely difficult to avoid even with explicit high stakes incentives.]

The Lack of Real-World Money Pumps: How Intransitive Preferences Do and Do Not Distort Behavior

In economics and other areas of applied rationality, the problem with having intransitive preferences - where you prefer x to y, and y to z, but z to x - is that you can supposedly be made into a money pump, by taking advantage of these irrational preferences. Indeed I'd seen claims online of people who were subjects of psychology or economics experiments actually knowing that this was happening to them, but being unable to stop themselves. This seemed both intuitively far-fetched, as well as something which would be constantly exploited, especially if it was a trait that existed differentially in the population.

I had encountered this idea some years ago in the rationalist canon, but I had never been able to think of examples where it really happened. Imagine my joy when I thought I had finally run across it when, after dinner one night, my (irrational) toddler demonstrated intransitive preferences when eating M&M's and trading with me. She prefers green over orange, orange over brown, and brown over green. Here it is!, I thought. A money pump! But exactly how could I benefit from this?

As it turned out, there was no way to money-pump her, and might not be a way to ever meaningfully money-pump anybody. But to illustrate the point I'll give you a hypothetical example of how it could work. This hypothetical example alters her real behavior considerably - to see what I changed and why it could not work in the real world, skip ahead to "Where Are the Real Money Pumps?" in bold below.

Say we both start out with 12 green, 12 orange, and 12 brown, and assume the following preference rules (individual exchange rates):

I have transitive preferences: I like green twice as much as orange, which I like twice as much as brown. (1 green = 2 orange = 4 brown)

She has intransitive preferences: she likes green twice as much as orange, which she likes twice as much as brown, which she likes twice as much as green, etc.) In fact, I would argue that she has a subtype of intransitive preferences, cyclic preferences: with intransitive preferences you can also just say that there is no value on something and it can't be used in trade. (Though irrational by Von Neumann-Morgenstern and other standards, this is in fact how normal human beings behave; in contrast, when someone will put a price on anything, that person is called a psychopath.)

It helps to see the specifics of how you can take advantage of someone with cyclic preferences, but it's dry and boring, so I'll include it in a "supplement" at the end if you're interested and don't just want to take my word for it. Suffice it to say after at most 7 trades, I would have all the M&M's except for two brown ones.


THEN WHERE ARE THESE MONEY PUMPS? I.E., WHERE ARE THE SYSTEMS OF CYCLIC PREFERENCES THAT ARE ECONOMICALLY TAKEN ADVANTAGE OF?

I went looking for cases in the real world where people get money-pumped, and found:
a) none, and
b) I'm not the only one who has noticed this gap.

In fact money-pumping seems to be an entirely theoretical risk, predicted deductively from rationality models. So what's going on? Likely some combination of:

1. People are irrational and their preferences are a mess, but they aren't neatly cyclical like this. In fact we should expect that most intransitive preferences are just that - they have no relation to any other preferences - therefore precluding a cyclic system of intransitive preferences. That is, sets of cyclic preferences are a subset of intransitive preferences, but because of the nature of intransitive preferences (basically they're a mess with little relation to each other or even consistency on short time scales), cyclic preferences are very rare or nonexistent in the real world.
   
   
2. Humans have many heuristics that can cause reasoning errors, but that also must have been on net beneficial to our ancestors, and (sometimes) they only make sense in the context of their environment. For example, we like to punish wrongdoers, to the point where we will spend more resources to do it, even when the damage has already been done. This seems irrational, unless you realize that there are not many limited-round-games in life, and if there was someone doing bad things in your tribe fifty thousand years ago, it made sense to invest those punishment-resources now to deter further wrongdoing later. A more germane example is the endowment effect, which is a heuristic that clearly has the effect of keeping people from getting taken advantage of in markets with asymmetric information. I expect that with cyclic preferences, there is a meta-preference that usually acts like a circuit-breaker for this sort of thing, for example just thinking about the goods in dollar figures. Of course, you could rightly object, if someone can do that, they don't really have cyclic preferences, since the dollar is like a color of M&M that doesn't admit of intransitive valuation - and you're right! Which is why people don't actually get money-pumped! In this same way, I expect that even my toddler would notice her overall number of M&M's is shrinking and mine is growing and at some point say she's not playing this stupid game anymore.
   
   
3. There actually are some cyclic preference-sets revealed by people engaging in repetitive behavior that makes their life consistently worse. This includes compulsive gambling, junk food, substance abuse, and staying in abusive relationships (or seeking out new ones.) It's interesting that these aren't about trading with currency, or at least don't centrally involve explicit trade or currency exchange, which are relatively new things in terms of evolutionary psychology, and something where along with learning them explicitly, we have developed learned defenses against being taken advantage of (as noted above.) Even in those cases where there appear to be cyclic preferences, these are better understood as predictably shifting preferences (due to things like future discounting), but this is a semantic distinction since they have the same outcome.

SO WHERE DO WE SEE IRRATIONAL BEHAVIOR DUE TO INTRANSITIVE PREFERENCES?

Clashes between the system of transitive preference systems - speaking broadly, the economy - and intransitive preferences are somewhat rare, but they occur, even when they are not cyclic. You don't think of people repeating abusive relationships as part of the economy, but that's a great example of intransitive preferences. Gambling and substance use are part of the economy, but at the fringes (it's interesting that societies usually have prohibitions or regulations about trading the same sorts of things, things which involve strongly affective parts of our cognition and behavior like gambling, sex, drugs, and firearms.)

Some psychopaths recognize the intransitive nature of most humans' valuation of other human life (it's "priceless"), and take hostages who they will kill unless they are given money or some other objective. In those cases, many humans magically overcome our intransitiveness and kill the hostage-takers, or allow the hostage-takers to kill their victims in order to avoid negotiating in the future.

A fortunately more common but unfortunately probably more intractable problem is healthcare: about 70% of healthcare dollars in the U.S. spent by someone are spent in the last 6 months of that person's life. We could spend more and more getting additional minutes at the end of life. Unless we're going to ruin ourselves in this way, there has to be a rule, regardless of whether we're in a public or private healthcare system. This is something we don't like thinking about.

Finally, whenever people try to create a system of transitive preferences outside of the mother-system (the economy), the gravity of the currency economy inevitably connects to it and sucks it in, whether we're talking about Ithaca-dollars, or the charade of "no currency" at Burning Man.


SUPPLEMENT - AN EXAMPLE OF HOW CYCLICAL PREFERENCE MONEY-PUMP WOULD WORK, IF IT EVER ACTUALLY HAPPENED

Starting out we have:

Me: 12 green, 12 orange, 12 brown
Her: 12 green, 12 orange, 12 brown


Round 1. I offer her 6 of my orange for all 12 of her brown. Now we have:

Me: 12 green, 6 orange, 24 brown
Her: 12 green, 18 orange, 0 brown


Round 2. I offer her 6 of my brown for all 12 of her green. Now we have:

Me: 24 green, 6 orange, 18 brown
Her: 0 green, 18 orange, 6 brown


Round 3. I offer her 3 of my orange for all of her brown. Now we have:

Me: 24 green, 3 orange, 24 brown
Her: 0 green, 21 orange, 0 brown


Round 4. I offer her 11 of my green for all 21 of her orange. (Give her a good exchange rate and round up. She's irrational, I'll get it back!) Now we have:

Me: 13 green, 24 orange, 24 brown
Her: 11 green, 0 orange, 0 brown


Round 5. I offer her 6 of my brown for all 11 of her green (rounding up again.) Now we have:

Me: 24 green, 24 orange, 18 brown
Her: 0 green, 0 orange, 6 brown


Round 6. I offer her 3 of my green for all 6 of her brown. Now we have:

Me: 21 green, 24 orange, 24 brown
Her: 3 green, 0 orange, 0 brown


Round 7. I offer her 2 of my brown for all 3 of her green (rounding up.) Now we have:

Me: 24 green, 24 orange, 22 brown
Her: 0 green, 0 orange, 2 brown

...you get the picture.

As I was calculating this out I actually found it quite hard to think about the irrational player's decisions. There is value exchange symmetry in rational trading, which is to say, it doesn't matter if I am getting higher-value units or lower-value units. Whereas I would be tempted to say to the irrational player in round 7 above, "Look, why are we going through all this? Why don't you just give me those last 2 brown because they're worth less than themselves!" (Also more than themselves. But I want them, so I wouldn't say that.)

Originally I couldn't see how to benefit from this, even hypothetically - I thought "I could keep the trade going indefinitely but not accumulate anything". The errors were a) I actually had no preference for one color over another, and b) her preference for the "better" one in any pair was arbitrarily small (e.g., she just barely liked orange better than brown), and you can't subdivide M&M's (so with rounding either you could never arrive at having almost entirely fleeced the other party, or it would take too long. On the other hand, if you benefit from the trade itself and have no preferences, and you CAN usefully subdivide, you could still benefit. But I wasn't charging M&M commissions.

There is a total wealth (by my measurement, in units of "browns") of 168 in the game, with each side (by my measurement) starting with 84 brown-units. At the end of each round, with my trades, the value I hold is 84, 126, 126, 124, 162, 156, 166. You actually can't even talk about the other player's total value because what unit do you use to measure it? If we held differing, but rational, valuations - as people do in the real world - then say my daughter values browns twice as much as orange, orange twice as much as green - we'd quickly both wind up with her holding all the brown and me holding all the green. And that would be fine. In fact there have been cases in history where people became worried about the problems that could arise when preferences were different - Isaac Newton noted that because the English and Chinese relative valuations for gold and silver were different, that in a simple system eventually one would end up with all the silver and the other with all the gold, and trade would grind to a halt. But of course the system isn't that simple, and in any event as long as preferences are rational - not circular - it wouldn't matter.

Editorial Clickbait about Psychiatry in the New England Journal of Medicine

I'm really disappointed in NEJM for publishing this piece by Gardner and Kleinman (G&K.) Overall this article is not helpful or useful. There is a cottage industry of psychiatrists writing hit pieces on our own specialty, and often they make coherent and actionable points that improve the specialty and ultimately patient outcomes. But of many valid criticisms of psychiatry, this article bizarrely focuses on two problems that pervade most of medicine, and implies that they are uniquely problems for psychiatry. The thesis seems to be that psychiatry has been damaged by reliance on a biological approach, which has stunted its ability to treat patients, and damaged our interactions with them by decreasing the quantity and quality of our interaction.

First: these two have apparently not been talking to many of their colleagues, inside and outside of psychiatry. How many physicians do you know, especially in cognitive specialties with lots of patient contact, who say "No, I don't have inappropriate time pressures on my patient interactions, and what pressures there are, are not worse than they were thirty years ago"? Most psychiatrists would love to spend more time with patients. When we don't, it's not because we've already gone through the checklist so we don't want to waste time forming rapport - it's due to the moral hazard introduced by the financial and administrative structure of modern medicine. The same argument obviously applies to many specialties outside of psychiatry.

The second part of their argument is that over-reliance on a biological approach is what has distorted psychiatry and prevented us from adequately treating patients. In case they haven't noticed, we do have psychiatric medications which work, that we didn't have a few decades ago. (They somehow fail to comment on the existence of SSRIs and second-generation antipsychotics, for example.) How is this the failure of a biological approach? It is trivially true that biological approaches to psychiatry have not yet been as fruitful as we would all like. The genomics revolution (for example) has also not benefited most branches of medicine to the degree hyped - yet. It's a bit premature to say that therefore, biological approaches like genomics have not yet benefited psychiatry and therefore will never benefit psychiatry. They have essentially not benefited any other branch of clinical medicine besides hem/onc - because it's easier to kill or poison certain cells (especially ones that are suspended structurelessly in fluid, rather than connected in a specific network, neural or otherwise) than it is to make them work better. We should expect that oncology would have been the first to benefit. In this G&K are rather like engineers in 1900 saying "we haven't achieved powered flight yet, therefore it can't be achieved ever." (Which, by the way, some engineers at the time did.)

It's unclear what G&K's solution is. Perhaps most tellingly, the voices I've seen online defending this article seem to have great difficulty understanding the definition of "syndrome", or the idea of treating empirically before the biology of a specific case or even the disease itself is clear is quite often the best approach (and again, this is not specific to psychiatry.) For instance, many psychotherapies have an impressive evidence base at this point, and if we don't understand psychopharmacology as well as we would like at the biological level, we certainly don't have anything like a fully articulated biological theory of psychotherapy either. If you have a treatments that can help - pharmacologically or otherwise - it's immoral to withhold it just because the science behind the treatment mechanism or pathophysiology is not settled. And as near as I can tell, that's exactly what G&K are proposing.

All Perching Birds Descend From an Australian Ancestor

When I visited Australia, I remember walking around my first day seeing lorikeets and other very tropical-looking birds and thinking "Huh, I guess I'm in Gondwanaland now." Little did I did I know, all perching birds even including my own North American ones are actually Australian! This, from a new PNAS study showing that the last common ancestor was 47 MA ago in Australia. Immediate evolutionary just-so thoughts: Australia has a strange and (relative to other continents) low mammal population, which may have allowed for such a radiation within Australia. Neighboring New Zealand had no mammals at all until seven centuries ago, and is famous for its (sadly threatened) bird diversity, as well as its birds filling many roles usually taken by mammals (hence, now being threatened.) As the Earth went through pulses of cooling and drying and Australia moved north and became drier, less forested, and less hospitable for perching birds, this may have given an opportunity and incentive for a diverse bird population to spread to other continents where they hadn't had similar opportunities to get a head-start on mammals. The paper focuses more on known global climactic shifts, such as the cooling in the Oligocene-Miocene transition: "Three rate shifts [i.e. in rate of diversification] appear to have occurred almost simultaneously during the Oligocene-Miocene transition in three different oscine clades on three different continents...[obviously, after the most recent common ancestor had left Australia.]"

Oliveros CH, Field DJ, Ksepka DT, Barker K, Aleixo A, Andersen MJ, Alström P, Benz BW, Braun EL, Braun MJ, Bravo GA, Brumfield RT, Chesser RT, Claramunt S, Cracraft J, Cuervo AM, Derryberry EP, Glenn TC, Harvey MG, Hosner PA, Joseph L, Kimball RT, Mack AL, Miskelly CM, Peterson AT, Robbins MB, Sheldon FH, Silveira LF, Smith BT, White ND, Moyle RG, Faircloth BC. Earth history and the passerine superradiation. PNAS April 16, 2019 116 (16) 7916-7925

How Delusions in the Real World Disappointed My Expectations

Delusions have long been of interest to me and they're fascinating for many people. Why do people see the same thing as everyone else, but arrive a very different conclusion, and become unable to change their mind about it? I've been fortunate to be able to do basic research into this phenomenon, and in my daily practice I see and treat them frequently.

(You should note that delusions represent a small, pathologic subset of false beliefs, really a disturbed belief process distorted by different anatomy. We all have false beliefs, but hopefully we can update them when we get new information. Even when people don't update their beliefs based on relevant information - they're usually identity-forming or socially important beliefs - and frustrating though that is, that is still different than a delusion. So, no, your most un-favorite religion or political party adherents are not delusional, even if they're wrong.)

There are a number of misconceptions, or more accurately, misexpectations, that I had about delusions when I went into this business, which will be glaringly basic and obvious to any psychiatrist, but will probably not be so obvious to other people. In no particular order:

• If and when delusions resolve, there is only rarely a "eureka" moment where the patient realizes the belief is false, or has even a significant enough increase in insight to gradually look back and sheepishly say "Yeah, I guess that wasn't true." Rather than updating the belief, people just stop being so motivated by it. That is to say, in the large majority of people, rather than the belief changing, the centrality of the belief changes. I find this very unsatisfying. "Yeah, I still think drones are probably following me everywhere but I don't worry about it that much." This isn't all that much different from belief in health - confirmation bias is all-pervasive, and recall that science advances one funeral at a time.
• Related: you can't talk someone out of a delusion. Ever. (As the rationalist proverb goes, you can't reason someone out of a position that they didn't reason themselves into.) At best, you will waste your and their time, and at worst, you will anger them and damage your therapeutic alliance. And if the psychiatrist who gives into this urge is completely honest, it's partly informed by a need to "win" the discussion. Even if you know this intellectually, early in your career it's very difficult to avoid engaging a delusional patient in this way (partly because the patient will not infrequently challenge you to do exactly that.) At this point I'm proud to say I can mostly resist the temptation.
• Though delusions sometimes do appear in isolation, they rarely occur without other neuropsychiatric symptoms. Even delusional disorder (where the patient has ONLY delusions) is often a misdiagnosis that evolves to something else - like dementia, especially when appearing in middle age or later, with the delusion merely as the earliest symptom. So very often, the person with a delusion is quite psychiatrically ill in many ways that make having a coherent discussion about the delusion (to hear a coherent set of delusional beliefs) very unlikely; e.g., severe paranoia that keeps them from talking to you about the details of the delusion, and/or constant hallucinations which distract them and to which they respond, or merely an inability to speak in a way that makes sense at all.
• This one was most disappointing to me: delusions are rarely coherent, in contrast to how they are often presented in the lay media - for example, K-PAX, or the analysand in the essay The Jet-Propelled Couch (who supposedly was in reality the science fiction writer Cordwainer Smith.) They are sometimes completely bizarre and incomprehensible, and even after giving the patient a chance to explain, you still have no idea what they mean. (This is one subtle feature of thought and speech in psychosis: though the sentences might be grammatical and seem to be meaningful, strung together, you can't make sense of what they're saying or even clearly remember it ten minutes later - much like, I think not coincidentally, we struggle to remember an early morning dream even until lunchtime.) Even when delusions are "about" something comprehensive, they are only peripherally about discrete objective facts, delusions are based on affect and "primitive" themes of the sort that color nightmares[1] - pursuit, certain people being morally bad, looming organizations with sinister intent, an overwhelming sense of contamination, etc.
• It is often striking how incurious delusional people are about their predicament - after years of, say, harassment by a sinister government agency, when one asks "Do you know why they're doing this? And where they get all these resources? And how their technology operates?" people often do little more than shrug.[2] They are also usually obviously and badly internally inconsistent, again unlike the cleverly constructed delusions in fiction. If the psychiatrist in the Terminator thought the future-warrior's tale was a delusion, he was right to be impressed by it. People will tell you (for example) that they were victimized for many years by their persecutors, until they developed their special powers at age 23 that made them immune; then in the next sentence, tell you how they were victimized at 26. Rather than becoming upset when such continuity problems are pointed out, they generally just wave it off as irrelevant and keep going.

Delusions are hard to treat; even so, medications can and do help people. But if you get into this business to hear fully elaborated, articulate, consistent delusions about time travel, space empires, or sinister (but interesting) experiments that shadowy government agencies are doing on us - you're going to be disappointed.


[1] Even in delusional "shadow syndromes" like physics crackpots or various denialists that do seem to be focused on external objective cold facts, invariably there is ranting against the Establishment and paranoia about people stealing their work, and this takes up much of the time that might otherwise in a more rational person be devoted to research or making their case.

[2] Regarding this incuriosity: delusions are not the only neuropsychiatric symptom where this feature appears. I'm agnostic as to whether this incuriosity is actually part of these diseases, or is just (unfortunately) the natural state of most humans. For example, hemi-neglect is a symptom usually seen after strokes, where the patient loses one half of space. I don't mean that they can't sense what's going on one side of them; they literally can't understand that that side of the universe exists, exactly like you or I can't perceive the fourth dimension.

To illustrate: these people lose not only the use of one half of their bodies, but the awareness that they exist. So they will deny that they have a left arm. And if you hold their (genuinely paralyzed) left arm up in front of them, they often confabulate ridiculously: "That's my sister's arm. She's hiding under the table." Now, if my doctor told me I had four arms, I would tell her she was a goof. But if she could consistently could keep holding two extra arms up in front of me that had roughly the shape and skin tone of my other arms and in the middle of a room where there was no chance of a trick, I would eventually have to concede that I was having perceptual difficulties and that I indeed had four arms, even if I couldn't tell how they attached to me. Probably a more common situation is that a hospitalized patient will demand to speak to the doctor at dinner, and as the doc enters their room, says angrily "They keep telling me this is a full-sized dinner, but look at this thing!" And they gesture to their plate, exactly one half of which is eaten. So, you turn the plate 180 degrees, and they grunt, and finish the other half of their dinner, now that it exists. Now, if tonight I complain to my wife that she only gave me half a serving of dinner, and she glared at me and reached over and did something I didn't understand and suddenly my plate was full again as if it had passed partway through my dimension like a sphere in Flatland, I think I would say "Whoa! You just magically produced food out of the fourth dimension! I don't understand how you did it, but could you do it again?" But that's not how people usually react, which implies there's a loss of insight or ability to update associated with this condition. It should not be missed that most neglect is left neglect (meaning, a right-sided lesion), and that one theory of delusion holds that somatic delusions can be caused by right frontal lesions, and that some sort of functional right hypofrontality is required for the lack of insight inherent to all delusions, somatic or otherwise.

In Medicine, Rounding Works

Rounding is a time-honored tradition where doctors meet to talk about cases, either in a meeting room (the "rounding room" was named after a specific room at Hopkins) or at/near the bedside. Most often associated with inpatient medicine teams especially in training environments, the treating physician will present the case and discuss it with her colleagues. Not only is it thought that in this way, medical decision-making benefits from collective intelligence, but the anxiety provoked by immediate criticism (especially in trainees) sharpens one's thinking. A study in JAMA Network Open supports this. Teams here were internal medicine teams composed of multiple levels of training, from med students up to attendings. I don't think the findings would be too domain specific, but at a guess, I imagine the benefit would be even greater for psychiatry than for internal medicine, as psychiatry's diagnoses are fuzzier and more subjective.

Groups don't always arrive at better decisions than individuals - especially groups of non-expert individuals with no feedback - but teams with people who are experts, and who do get feedback benefit from collective intelligence, do better than individuals alone. So qualitatively this isn't surprising, but a problem in medicine is lack of quantitative thinking; especially in my specialty, psychiatry, where studies are constantly coming out showing that medical or psychiatric illness X increases the risk of psychiatric illness Y. No kidding! By how much is what we want to know. So what's the actual benefit of rounding?

For groups of 9, on average you need to treat about 4 people before you make a diagnosis that an individual would have missed (i.e. NNT is about 4.)

For groups of 5, NNT = 6.

For groups of 2, NNT = 8.

The simple plot below shows the % accuracy improvement per person based on group size, and again not surprisingly, there's a diminishing marginal return for adding more people. (Where does it go to zero? Nine is already on the big size for a rounding team.)


This of course doesn't take into account rounding time, which is a real consideration, and big teams are slow. Maybe the % improvement per minute drops at a certain point.

Therefore, don't hesitate to curbside-consult your colleague, because just by talking to one other person, every eight patients you're making a more accurate diagnosis.

Barnett ML, Boddupalli D, Nundy S, Bates DW, et al. Comparative Accuracy of Diagnosis by Collective Intelligence of Multiple Physicians vs Individual Physicians. JAMA Netw Open. 2019;2(3):e190096. doi:10.1001/jamanetworkopen.2019.0096

An Obvious Healthcare Cost-Savings Proposal, That Doctors and Patients Will Obviously Resist

Arnold Kling draws attention to a proposal by Karl Denninger, which includes the following:

No government funded program or government billed invoice will be paid for medical treatment where a lifestyle change will provide a substantially equivalent or superior benefit that the customer refuses to implement. The poster child for this is Type II diabetes, where cessation of eating carbohydrates and PUFA oils, with the exception of moderate amounts of whole green vegetables (such as broccoli) will immediately, in nearly all sufferers, return their blood sugar to near normal or normal levels...This one change alone will cut somewhere between $350 and $400 billion a year out of Federal Spending and, if implemented by private health plans as well, likely at least as much in the private sector.

The tone gets even more pointed, and more accurate, further on.

Denninger further points out the core values-disconnect that makes talking about healthcare so difficult. That disconnect is that we are trading dollars and human suffering back and forth, and there's no way around this brute fact, ever, except to hide it from both buyers and sellers. This makes the system nauseatingly inefficient, whether we're talking about centralized planning or a free market.

Americans, and especially health care providers, do not want to think of health care as a commodity. The providers want to be paid, but they do not want to think of themselves as selling their services, so the payment comes from third parties and the price is hidden to consumers...All surgical providers of any sort must publish de-identified procedure counts and account for all complications and outcomes, updated no less often than monthly. Consumers must be able to shop not only on price, but also on outcomes.

This will be unpopular as both patients and doctors want to avoid responsibility for bad choices - but now that we're all paying for people to keep eating McDonald's and performing poorly-evidence-supported surgeries so they can buy a vacation home - we will have to make some hard choices.

A Picture from a Recent Trip to Vienna I Somehow Forgot to Post

...before my residency's required psychoanalytic training ended and grades were in. This is the Freud Museum in Vienna, which used to be his flat and office, and is still a regular (nice) apartment building. (A hand-written sign taped to a current resident's door on the ground floor by the entrance explained in unsubtly annoyed German that the Freud Museum was upstairs.) I do have to admit a grudging admiration for Freud's self-promotion. At this point, I invite you to say pseudo-profound things in an Austrian accent about how my early life experiences led me to struggle against authority, I want to kill my father, etc. I loved Vienna and Central Europe generally, even including this museum. You will note I did grow a beard for the occasion, but at no point had a cigar.


The most interesting thing in the museum was the microtome on display, which he used to make brain sections. I imagine him thinking, "You can never get anywhere doing it this way...maybe I'll convince people I have the power to do the same thing by talking to people!" There was also a picture of him with fellow Viennese intellectual socialites, one of whom was an immediately striking and intense woman who turned out to be Ludwig Wittgenstein's sister. Also, in German the parts of the subconscious are just rendered in German (not Latin), as "Das Ich Und Das Es" ("The Ego and the Id") which somehow takes away some of the authoritative punch.

American English: Examples of Within-Our-Lifetime Language Change

I once saw a translation of Beowulf from the early twentieth century, which used "throve" as the past tense of "thrive." Interestingly, this means that even the "modern" translation is now outdated, since during the twentieth century "thrived" replaced "throve." Language waits for no one.

I have noticed one particular shift in American English: "buck naked" has become "butt naked." No doubt readers younger than mid-30s will have never heard "buck naked" and wonder what I’m talking about. The explanation for the shift is that in some varieties of Black American English, the "k" sound at the end of buck becomes a glottal stop, which is then heard and reproduced as a t in most accents of American English. In conclusion - it’s BUCK, not butt, and you kids get off my lawn.

Also, many Californians pronounce the "-ing" verb suffix as "-een"; it's more prominent the further south you go in the state (Think Blink 182 - they’re from San Diego), which suggests it's from language contact with Spanish. When asked about this, people who clearly produce the morpheme this way, some people have insisted to me that they say it it the same as an -ing; this is common for people who speak non-received dialects that differ subtly, since they actually cannot hear the difference between the two phones. I once saw a young student learning to spell, write out a verb phonetically that way, ie "bildeen" for building. I mention this because as California becomes more prominent in American culture, I expect its dialect to become more prestigious, and people elsewhere will start imitating it - so by mid-century, people in e.g. the Midwest may be saying -een instead of -ing.

Serious Parfitians Should Strongly Support the Genesis Project

Genesis is a project to seed bacterial life elsewhere in the universe, founded by Claudius Gros. The aim is to build spacecraft that would deliberately seed nearby exoplanets with bacteria, in geological time, kick-starting life in the universe. This gives those planets a head start on eventually evolving something like intelligence. This would seem not only to multiply the numbers of being capable of having lives worth living, but to dramatically increase the chances of an intelligence (a species with a life most worth living) that escapes its home system to avoid black swan apocalypses, singularities, etc. and spreads indefinitely, filling the universe with happiness.

A Parfitian could well respond that it's anything but certain that such a project would produce a universe-filling life form capable of happiness, and she would be right. But choosing an action with limited information is the problem with all action selection. On the spectrum of uncertainty, seeding the universe with life > friendly singularity > avoiding biological disaster > avoiding nuclear war > electing the right people in your country > cleaning your room. The problem is that the consequence to total happiness is in the same order.

So what's the argument for the pursuing a friendly singularity, over seeding exoplanets? Or singularity issues over cleaning your room?

I submit that we don't really know. That's not to say that the singularity or bio-apocalypse can't happen. Unfortunately I'm worried that as we become more powerful but not better at estimating uncertainty, something like this will eventually be fatal for us, and Drake's omega variable will be a little clearer.

See also GENU, the Gambit of Extreme Negative Utility.

Decision-making for Profound Life Choices Isn't Much Like Decision-Making

There's a great article in the New Yorker about how life's biggest decisions seem to...just kind of happen. There's a short round-up of books and articles considering the paradox, some explaining it in terms of not knowing what the thing you want will actually be like, some by examining how aspiration is really meta-wanting (wanting to want something), and some by pointing out that our values and goals change over time in ways we could not have predicted ahead of time. On this last point I would superimpose a mechanism of biological imperatives; you don't decide to start wanting kids any more than you decide to get a carb craving.

I've noticed a similar experience with not having access to my own calculations, more for my decision to become a physician than to become a dad, although even with fatherhood, why now, here, with this person, is similarly hazy.

Valence vs Priority Disagreements in Public Debate; Plus, The Gambit of Extreme Negative Utility

1. In public discourse, usually, most people do not have valence differences when they disagree, but rather differences of priority. This is especially true in politics. Concrete example: most people agree that racism is bad. The disagreement tends to be about how important it is to eliminate racism right now, relative to other problems. A valence disagreement occurs in this case when a white supremacist says no, actually, racism is good. Valence disagreements are of course much more intractable. Online discourse over the past few years has raised disagreements about priority to the same level of intractability, by turning priority disagreements into valence disagreements, e.g., "You shouldn't be talking about anything else right now but keeping out illegal immigrants. I don't care if you say you're against illegal immigration, if fighting illegal immigration isn't your number one priority, then you're actually for illegal immigration."

2. One trick to make your argument demand top priority is to claim that there is a massively, or even infinitely negative consequence for not adjusting one's actions in the ways required of a rational actor if the argument is true - or claiming that there is such a consequence even for ignoring the argument. Organized religion makes the most famous such claims, but the outcomes feared by certain political ideologies (if they don't get their way) can approach the same severity. This is the Gambit of Extreme Negative Utility (GENU.) Related to this, a counterargument to Pascal's wager is that you don't know which version of which religion is the right one, but as I saw a very clever Christian argue online, you have to assume infinite religions to choose from for the expected utility to work out in favor of ignoring Pascal's claim (although this still doesn't tell us which one to choose.) So what do we do? Do we set an arbitrary cut-off for utility beyond which we assume someone is lying to get our attention? This seems very dangerous, unless we think there are no rare events with far greater negative utility than we expect beforehand. So if we throw out Hell, Orwell's boot on a human face forever, and white supremacists' fear of a world overwhelmed by non-white barbarism, don't we also have to stop worrying about the Great Filter, the technological singularity, and CRISPR-derived biological weapons made by suicide cults? [Added later: turns out that Pascal's Mugging, a concept in the rationality world, captures the essence of this - any risk/benefit scenario can be overwhelmed by claimed arbitrarily large or infinite negative utility, which Christians like Pascal call "Hell".]

3. It matters which arguments we spend time and attention considering, because although humans seem to have an implicit assumption of infinite time and attention to consider arguments, of course we do not.

Hence, most authorities use some form of agenda-setting and distraction to influence discourse.

Biomass on Earth, by Taxon

From Bar-On, Phillips, and Milo in PNAS, 2018. Immediate stats that come to mind which are maybe more applicable to astrobiology: how many calories (or molecules or glucose) produced per unit energy of sunlight, per unit mass of plants? How about per overall energy produced by the sun (decreased by distance from sun and cloud cover on Earth)? How about base pairs per unit mass of taxon? Viruses probably win that one handily. And finally - an animation over time, where we see the branches appear, mass extinctions, and finally at the end a blossoming of birds and mammals which is really just livestock (or DOES livestock actually out-mass the pre-Holocene wild mammal and bird mass?)



The only thing here that really surprises me is that molluscs are higher mass than I expected, and nematodes lower mass.

Lying and Intention

Some years ago, I went to see a movie with a friend who has since passed away. (This is actually one of my favorite memories of her.) Relevant: the movie was Blair Witch Project. My friend was badly scared by horror movies (why did she go? I don't know, but she's a grown up, not my problem) and when I took her back to her house, she was still quite worked up.

I should add that it had been a very hot day, and her house didn't have A/C. It was still sweltering, even after midnight, so she knew if she wanted to sleep she would have to open all the windows, which she did. This is also relevant, because a) her room was a very small addition to the house, with windows on both sides of, and behind, her bed, in fact so close to the bed that a cruel person who likes scaring his friends could actually reach in from outside and grab her; and b) I am in fact the kind of person who would do something like that, and lie about my intentions, and had done such things many times before. (I'm quirky that way.)

"Can't you please just stay until my roommates get home?" she implored.

"No, I have to go home and go to bed."

A look of horror crept across her face and her eyes widened. "I know what you're going to do! You're going to drive two blocks away like you're going home, then park, and silently walk back, and wait outside the window until you see me nodding off, then grab me and scare the crap out of me!"

"No, I would never do that!"

"Yes! Yes you will! I know that's what you're going to do no matter what you say!"

"No. No, I am definitely going to go home, and go to bed." Despite her pleas, I walked out. I then got in my car, drove home, and went to bed. I slept very well.

The next morning around 6 a.m. - probably not coincidentally, around the time the sun rose - I was awakened by my phone ringing. It was my friend. "What," I mumbled as I picked it up.

"You asshole."

"What?" I said. "Me asshole? You asshole. You're waking me up at six in the morning."

"You bet I am! I've been sitting here on tenterhooks all night waiting for you to reach in the window and didn't sleep at all and you actually went home and went to bed!"

I said nothing, but I smirked.

"I can hear you smirking! This is exactly what you planned isn't it?"

"Listen," I said, "I did exactly what I said I would do. I told the truth. I did the morally correct thing, and you chose not to believe me, even though I was telling you my true intentions, and then acted on those intentions. So that's your problem. Now if you'll excuse me I have to get some more sleep." I hung up and turned off the phone. I slept very well.

One frequently discussed problem in the analysis of what constitutes moral behavior is that of the contribution of an actor's intention, if any, to the morality of the act.

I someone hits me with a car, if I am a consequentialist, I have no grounds to say that the act was more or less moral based on the intent of the person. If someone hits me with their car at 35 mph and breaks my femur, to a consequentialist shouldn't care if the person did it intentionally and was pleased by this outcome, or accidentally and horrified by it.

This is correct - only if the definition of "consequentialist" is narrow, and really means "near-sighted consequentialist" - someone who just cares about single, isolated acts, which in the confines of a thought experiment, is often the (unintentional) implicit assumption. But of course this isn't the case, and it violates our moral intentions and (if the two are separable) the actual reactions we have in such situations, or even just hearing about such situations. Even taking out the egocentric anger and desire for revenge likely to be incurred by someone who you know hit you intentionally and enjoyed it, you would be right to be concerned that this person is out there running around loose where they can hurt someone else - and a monster like that is unlikely to limit themselves to cars in such endeavors. That is - their intention predicts future actions, which is why it matters, even (especially!) to a consequentialist. The person who is horrified is less likely to do such things again, although even in that situation, if their horror is misaligned with choices they keep making (they were texting, they were under the influence, etc.) then this also figures into our evaluation - because it predicts future actions. A stronger statement is that without intention as a predictor and link to future actions, to talk about the morality of an isolated act is meaningless.

The law in most OECD countries actually gets this right, at least for murder, where it differentiates by degree. The difference in intent between accident and non-accident is obvious enough, but the difference between first and second degree murder is also important. There is something very different and more threatening about someone who murders after planning it out, rather than by unchecked impulse. If someone had a bizarre neurological disorder causing them to helplessly pick up long objects and swing them at everyone around them, you wouldn't want them walking around loose, but you would see that they were horrified themselves at this tragic illness, so you also would recognize that this is not a person who intends harm and whose other actions are suspect as well. (If someone you know to be unfortunately afflicted as a neurological-disease-stick-swinger calls you - from far away, hopefully - and asks for a donation to a charity, you're much more likely to think the charity is legitimate than if you get a call from someone you know to be an intentional, actually-enjoying-hitting-people stick-swinger.)

This is the same problem which makes certain human behavioral patterns appear irrational in the context of a necessarily limited, close-ended experiment, when in fact they are not. For example, it's a well-studied result in game theory that humans are willing (in fact, eager!) to punish cheaters even if the damage is done, and enacting the punishment has a non-zero cost. Yes, in a true one-round game, the rational thing to do is to stop one's losses and walk away - think of not getting in a pissing match with someone who cuts you off on the freeway - but this is a rare circumstance. The small bands we've lived in throughout most of history, where you were around the same people all the time and kept score on each other, would predispose exactly such a behavior to emerge - and in game theory experiments or one-time encounters in large populations, we may not be able to override our programming. Granted, in those relatively rare encounters, it is irrational not to override it - but again, these encounters are rare. And tellingly, unless you're planning to be the cheater, you likely minimize your time around, and interactions with, complete strangers. I've come to refer to these kinds of situations (either game theory experiments or in real-life, like each day on the freeway) as GOOTs - Games Of One Turn. Many finite-round games are known to strongly affect decision-making. For example, if you're playing a certain number of rounds of prisoner's dilemma, you know that there is no more revenge possible after the last round, so you plan to defect the last round. And your frenemy in the game knows it, and you know they know it, etc. So you defect one round earlier...et cetera, until the rational player who is optimizing payout and playing a finite game defects immediately on the first round.


HOW DOES THIS APPLY TO LYING?

There are truth-telling absolutists (Kant is the obvious example, but a modern defender is Sam Harris) who have difficulty ever justifying an intentional mistruth. In Harris's case this is especially interesting as he (correctly) defends the role of intention in moral acts generally. The morally justified lie in the murderer-at-the-door thought experiment that challenged Kant was most famously and tragically realized in the example of Anne Frank (Varden 2010), and in comparing Kant's argument to this specific event it often takes rather more argument than we might hope it should to justify why it was acceptable to deceive the murderous fascist occupiers.

The claim "lying is always wrong" - hereafter referred to as the naive theory of lying - fails because three related assumptions are clearly falsified, all of which are present in the true account I provided above.

1. Bad Assumption #1 - identical agency: Humans are all equally capable of identifying and acting on truth; that is, we all have an identical set of beliefs about the world, are equally able to reason about them, and will therefore respond to the same information in the same way. (Kant's Golden Rule fails for this reason as well.) This could occur because of false beliefs, biases, or any other departure from rationality that leads to suboptimal computing of beliefs. (Sometimes an immoral person will deliberately create those false beliefs ahead of time and then deceive by telling the literal truth, as I did.)
2. Bad Assumption #2 - moral isolation of speech from other actions: Speech is capable of communicating unfiltered truth mind-to-mind, and that the moral weight of a statement comes from how true it is, rather than the effect that you are intending to have with your statement. In this, speech is qualitatively different from other actions. (My intention was to use my speech as an act to deprive my friend of sleep and keep her up all night. That I told the truth should not disqualify from being, as she correctly identified me, an asshole.)
3. Bad Assumption #3: cooperation-independence: Truth-telling applies to all humans, even if they are not cooperating with even your most basic interests (e.g., preservation of life and avoidance of needless suffering.) This alone justifies lying to the Nazi at Anne Frank's door. I would agree that it is correct that intentionally creating a false impression in someone else's mind is immoral because it's a form of harming them, but a) if someone intends to harm you, harming them in attempt to stop this is not immoral and b) one can certainly create a false impression by telling the truth, as will be explained below. (In my true story, if my friend had said "Okay, go home, I'll be right here" and then gone to someone else's house to spend the night, would that have been immoral? That is, would I have been justified getting mad at her if I had acted her on her lie, come to the window to scare her, and she was gone? How dare she deceive me like that!)

Because these bad assumptions are false, applying the naive theory of lying to behavior produces inconsistent results with respect to harm we cause by speaking to people. This makes it an inadequate moral rule. (If your theory of morality does not have a place for harm minimization in general, the argument we would have to have is at a much more profound level.)

It is telling and under-appreciated that children as they develop a theory of mind often test the (widely accepted) naive theory of lying against the principle of harm minimization. Right now you can probably think of a smirking child who told you something that was technically true, but intended to deceive you or cause you some other problem. Cute at first, but if they keep doing it through to adulthood, you realize you're dealing with an immoral person.


FALSIFYING THE NAIVE THEORY OF LYING - ABSTRACT AND CONCRETE

There are infinite scenarios that illustrate this, but in the abstract, the most common scenario is this. (Concrete examples follow each abstract description.)

Person P believes fact X. Q believes not-X. In reality, not-X is true. (That is to say, P violates naive theory of lying Bad Assumption #1 - identical agency.) Not only is Q quite confident that not-X is true, but they quite clearly understand that P believes X, and for bad reasons. Q tells P fact Y (which is true!), knowing full well that this will cause P, based on P's false belief of X, to perform action A, which harms P. (Or, Q just makes no effort to convince P that not-X, allowing the false belief to stand.) (Bad Assumption #2 violated - moral isolation of speech from other actions.)

Notice that nowhere did Q lie. Q identified a false belief of P that warped P's judgment, and told P something true that will make P do something harmful to himself in the context of P's warped judgment, intending for his true statement to make P harm himself. Q did not lie, but rather used a true statement to create a false conclusion in P's mind that harmed P. Q is immoral.

There are many, many concrete examples in the world of financial transactions, where person P either has a false idea about the value or quality of an item, or the movement of a market - which Q does not correct because they benefit from the transaction.[1]

Let's say you're at the base of a cliff you've climbed before, and you know the view from the top is beautiful. As a local, you know that what appears to be the most obvious route is actually quite dangerous, because the rock is crumbly and anchors can pop out, risking that the climbers will fall and die - in fact this has happened many times, especially to outsiders who won't listen to the locals. A couple of tourist climbers show up, and you overhear them talking about how this rock face looks like sturdy solid granite, and they're planning to go up the obvious (but unknown to them, most dangerous) route. If you say nothing (to warn them about the crumbly rock), you're immoral. If you say, "The view at the top is great!" you're falsifying Bad Assumption #2, and you're really immoral.

The obvious objection is that you are, in a sense, lying by omission. You would tell the person it's dangerous, and you certainly shouldn't induce them to try it! (Yes, obviously, but again, by the naive theory of lying, you would've done nothing wrong.)


LYING TO CONVINCE A DISTORTED BRAIN OF THE TRUTH

So, let's make things more interesting, returning to the abstract formulation and introducing a very real problem, that of differing beliefs causing people to make different decisions (thus violating Bad Assumption #1, identical agency.)

Q (who in this scenario is a better person) does try to convince P that not-X. P refuses to believe Q despite Q giving good reasons. Q recognizes P's false belief structure, and understands that by telling untrue fact Z to P, P will make a choice in their best interest, owing to their distorted beliefs. Q tells fact Z to P - that is, Q lies to P - and P makes a better decision than if Q had told P the truth.

Back to the rock climbers. If you're not a jerk, you go over to visitors and say, "I heard you talking about your route. I have to tell you, this whole cliff is kind of crumbly but the obvious route is really dangerous and people have died on it. I really think you shouldn't try it."

As they sort their gear, the visitors scoff. "Ha. I don't think so. These local yokels might be scared of it. Or maybe they just don't want outsiders climbing their route. People told us the locals here are liars. If you're a local I'm not going to believe anything you say. Are you?"

If you tell them the truth, you will harm them. If you lie and say "Nah, I'm visiting for the weekend from L.A. and a friend of mine there knows someone who died on that route" then maybe they'll listen. If you are scrupulous and try to change their minds, they dismiss you as a local, climb, then fall and die, you would be pretty immoral to say "Well with their false belief they put me in a bad situation, and by choosing to put them in more danger which led to their deaths, I made the right decision."


LYING TO PEOPLE TRYING TO HARM YOU

A final abstraction, for Bad Assumption #3, cooperation independence. Here, Q is again a bad person; maybe even a Nazi at Anne Frank's door.

P knows that Q intends to harm them. Q's harming them requires information about P, provided by P. P tells C to Q, knowing that not-C is actually correct. P lies to Q with the intention of protecting themselves or others.

One way to think about this for the naive theory of lying crowd: if lying is on the spectrum violence, then when someone intends to commit violence to you, lying to them is a form of self-defense, and in fact much better than the physical violence one might otherwise have to employ. This stands independently of the rest of the argument and is consistent with the naive theory of lying.

Back to the cliff. You, the local, are back to being a jerk again. In fact, you've repeatedly gotten visitors to try to climb the most dangerous route by telling them about the view, so that when they fall and die, you can collect their gear. ("Hey, I'm not lying to them! Not my problem if they come to the cliff and are careless about the rock quality on the route!") But the authorities have started to suspect someone is doing this intentionally, so now in your pre-climb conversations with your victims, along with inducing them to climb by extolling the view, you wheedle out of them whether they have any connection to law enforcement. Of course this time, the pair of climbers that comes is indeed law enforcement, but undercover. When you ask, they say "No." They're trying to stop you from doing this to other people, and by identifying themselves, they couldn't do that. They are behaving morally by responding to your violence with defensive, much less severe violence, and trying to stop you from harming others. (Naive-theory-of-lying people: would it matter if instead they technically didn't really lie and instead said "Hey, do we look like law enforcement?" To a five-year-old who doesn't understand theory of mind, possibly.)


THE MORALITY OF LYING AND INTENTION

An improvement on the naive theory of truth-telling is this. If we intend to help people and intend to avoid harm, we should say things that will accomplish these things. Intention is quite important, because as with other actions, it predicts the speaker's future actions. The default assumption should be that this is almost always accomplished by telling the truth. However, once you have evidence that telling someone the truth will not help them or even harm them, and/or that lying in an extremely limited way will help (or that you're dealing with someone with bad intentions, i.e. who's not cooperating with even your basic safety), it is acceptable to say untrue things. We can call this theory of intention and lying helping by intentionally creating an accurate model - HICAM.

In those rare instances where we lie to benefit someone, we can call those pro-social lies. (Intentionally differentiated from white lies - more on that below.) But we can also categorize the ways of causing harm by speaking.

1. Active lying or bullshitting. Actively creating a false impression without the intention of helping someone.
2. Letting weeds grow. Allowing false beliefs to persist with the intention of harming someone.
3. Manipulation WITH the truth. Telling the truth in a way that one intends to create a false impression, often by using pre-existing false beliefs.

Notice that this definition does not justify "white lies", nor have I used the term. A working definition of white lies is lying that spares people's feelings and otherwise have no effect. I might seem to be siding with the naive theory of lying people when I say that white lies are quite dangerous, for the reason that emotional impact absolutely is an important effect, and psychologically, it's a bit too easy to avoid difficult conversations by telling ourselves we're just telling white lies.

Moral thought experiments (including this one) often use exotic examples, although I bet more people were rock-climbing today than switching trolleys between tracks. But examples in your own life likely abound. That said, if you have kids, you have very likely told a few half-truths or outright whoppers to motivate them, keep them out of trouble, or otherwise improve an outcome when their little brains would likely not have responded as well to a carefully marshaled rational argument. Why? Because children's agency is poorly formed (Bad Assumption #1.)

The same is likely true if you have family members or clients with some neuropsychiatric illness who would otherwise not be cooperating with you or otherwise make horrendous, unintentionally self-harming decisions; for example dementia. Some years ago, a relative of mine with dementia eventually progressed to having no short-term memory. This person was quite attached to her family home. She lived in a nursing home for about two years but believed the whole time that she had just arrived only a few days prior, and would shortly be returning home. Of course the home (which had fallen into disrepair as she deteriorated) had quickly been sold. Most of her visitors avoided the question of how long she had been there or commenting on the house, but at one point a well-meaning person, realizing this lady thought she just arrived and that she would shortly be returning home, told her the truth. This resulted in an emotional meltdown and suicide attempt. The next day of course, my relative had no memory and again thought she had just arrived and would soon be returning home. Was her well-meaning visitor a moral person? Would she have been moral to repeat this episode?

There are many milder but more common versions of this. Someone adheres doggedly to a certain authority. Someone dismisses you because you do not, or you're the wrong religion, ethnicity, political affiliation, etc. These are themselves not very pleasant reasons to be disbelieved, but what is your responsibility here? Say you own an auto shop, and a customer you don't like brings their car in. Inspecting it, you notice that the brakes are about to fail. Because you don't like this customer and you know he's a racist, when he comes to pick up the car to find out what work needs to be done, you intentionally send a black employee (who's in on it) to tell him he needs his brakes replaced, expecting full well the customer will refuse because a black person is telling him this, drive off, and crash when his brakes fail. Yes, he's no prince charming, but if someone told me that story, with that clear intention, I would worry about the shop owner's character and not want to be around him. (In point of fact, when someone is worried that a message will be ignored or taken the wrong way because of something like this, they do often use a messenger more likely to be taken seriously and accurately.)

And finally, ask any physician how they motivate their patients with low motivation, cultural barriers, or poor health literacy to do things that will keep them alive. It's hard enough in primary care. Try psychiatry! The temptation to severely spin the truth to improve outcomes for your patient arises frequently, and sometimes wins.


PROBLEMS AND FURTHER OBSERVATIONS ABOUT HICAM

The obvious (and correct) objection to any non-absolutist model of truth-telling is that it provides a very slippery slope. When you free yourself from a commitment to absolute truth, it becomes maybe a little too easy to justify fibbing in what you've convinced yourself is someone else's actual best interest. Consequently, following these rules, you should still expect opportunities for pro-social lies to come up quite INfrequently, and you also have to commit to real honesty about your motivations for telling what you believe is a pro-social lie. You have to accept that when you tell a lie, when you think you've found a pro-social motivation, you're probably deceiving yourself. The analogy here is to uber-empiricist Hume's statement that (paraphrasing) despite his identification of the problem of induction, still, if you think you've found a violation to the laws of the universe, you've probably just made a mistake.



Above: Left, how most of us think of the relationship between epistemic and instrumental rationality. Right, a more accurate scheme.

However HICAM does relate to some distinctions made in epistemology and observations from the psychology of mood and rationality. Epistemic rationality is what we usually think of as rationality, when you can make a valid argument. Instrumental rationality is action that increases utility, with no semantic component. I am being epistemically rational when I can describe and predict a thrown object's course mathematically; I am being instrumentally rational when I catch it without thinking of that (and so is a dog.) People tend to think of the two rationalities as separate domains or "two sides of the same coin", but a better argument is that epistemic rationality is a subset, a special case of instrumental rationality. Not controversial; speech and thought are actions. Consequently there will be times - rarely - that the actual outcome of computing someone else's statement will be different than what would have occurred if it were computed and acted upon rationally (as with a person who holds false beliefs - Bad Assumption #1, identical agency.) Saying something false or invalid to get someone to do something good for them is one of the rare times that speech is ONLY in the realm of instrumental rather than epistemic rationality (see below.)


What's more, there's an interesting finding in psychology described as depressive realism, where depressed people actually make better predictions about their own performance than non-depressed people. In seeming conflict with this is the robust finding that optimism predicts success (Bortolotti, 2018.) It's as if we have to choose between seeing reality as it is and being depressed, or delusional and happy - and most perplexing, successful. Fellow psychiatrist-blogger Scott Alexander uses the analogy of mood as being like an advisor to someone who motivates their client or pulls them back based on historical performance. Depressed mood is like an advisor to someone who always fails, telling them not to ever try anything, because history predicts they will fail again; as contrasted with the adviser of someone who always succeeds (happiness, optimism.) Here we see another domain where optimizing more for instrumental rationality (the less rational but more motivating optimistic beliefs)[2] produces better outcomes than optimizing for epistemic rationality (the glum, accurate beliefs.)[3] All this is to say, the occasional leaking of speech out of the epistemic domain into the purely instrumental domain - prosocial lies - is entirely compatible with what we know about human behavior. We can think of the distorted beliefs held by optimistic people as prosocial lies we tell ourselves.

All this justification of making false statements as long as they "work" is likely to make rationalists squirm, and indeed the alert reader with supernatural religious convictions might say: "Even if you think religion is false, doesn't HICAM and especially your argument in favor of prosocial lies justify believing it? Isn't religion actually the best example of an instrumentally helpful, though epistemically irrational belief?" Indeed I wrote about exactly this problem some years ago, arguing that as a set of untrue statements - lies - religion is immoral, even if it sometimes inspires good acts that otherwise would not have occurred. (That's one of many reasons.) How can I make such a claim, but defend HICAM? Again - we would expect pro-social lies should be very rare, and require strong justification. Contamination by selfish, anti-social motives is always a danger. Therefore the argument is really a quantitative one - maybe we might expect to tell a pro-social lie a couple time a year, rather than fill an entire book with them. Much more than that, and it's overwhelmingly likely most of them are actually someone telling plain old lies, anti-socially. So if ever you catch me intentionally building a whole delusional world around someone that I claim is in their best interest, I would certainly be acting out of immoral intentions.

Finally: while I've written a lot about the harm that can come about from saying true things to a person whose thought process is distorted by false beliefs (thus leading that person to actually make bad decisions, despite having told them the truth), this is less often a problem than it otherwise might be. The reason is that people who verbally claim false beliefs often find reasons not to act on those claimed beliefs. Example: someone says to you "my favorite football team will definitely 100% win the game tomorrow, since the previously injured quarterback is back in the line-up." But it turns out that 2 minutes ago it was just announced that actually, the quarterback will NOT be playing tomorrow. As an unethical person, you rush to lock down the bet while your interlocutor holds a false belief (letting weeds grow.) But suddenly they get cold feet, often with a disingenous "Gambling is immoral" or "I don't want my fandom to be polluted with money", etc. In fact humans have lots of "speed bump" heuristics, to keep false beliefs from propagating too far and to keep us from overcommitting, even though epistemically we can't really explain it that way (see the endowment effect for one such example.) It's interesting to note that it's often the newly converted who don't have the speed bumps specific to a new set of beliefs who get into trouble. On the other hand, there are people with severe psychiatric illness, who have a brain which is physically different from most other humans. They really believe their delusional beliefs, judging by how they endorse them with action, with no speed bumps.


REFERENCES

Bortolotti L. Optimism, Agency, and Success. Ethic Theory Moral Prac (2018). https://doi.org/10.1007/s10677-018-9894-6

Varden H. Kant and Lying to the Murderer at the Door...One More Time: Kant's Legal Philosophy and Lies to Murderers and Nazis. J Soc Philos, Vol 41(4) Dec 1 2010.


FOOTNOTES

[1] To be clear, this is not a claim that all transactions are immoral. When we trade, we necessarily hold different valuations of the things being exchanged, otherwise the trade would be irrational. As real objects will inevitably have different values to different people in different situations, this is not an obstacle to moral rational trading. However, if one is trading a more abstract entity that only holds value in terms of its tradable utility, or predicting an outcome that is only connected through arbitrary agreement, and especially in zero sum scenarios, then objectively incorrect valuations by one party is likely to play a larger role in the trade. Case in point, bets, commodities, or stock options.

[2] Assuming that our delusional (but success-producing) optimism has been selected for by evolution, I often amuse myself by wondering whether, if Homo erectus could understand psychiatric nosology, they would view their descendants (us) in horror, running around manic all the time as we might appear to them.

[3] Of course different levels of optimism or pessimism are rational for different risk:benefit scenarios, just as in game theory, penalty and payout determine the most rational strategy. Case in point: one of the things that cognitive behavior therapy or social anxiety aims to do is make people re-evaluate the actual risk of social interactions. So what if someone doesn't like you or won't say yes to a date? Does it physically harm you? The payout, while unlikely, is high, and the risk (once you get past your anxiety) is almost zero. On the other hand, this would be a terrible approach for rock-climbing. Antonio Gramsci (quoted by Steve Hsu on his blog) expresses this nicely: "Pessimism of the intellect, optimism of the will."