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philosophybear
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Placebo and pain
There’s a common argument that psychedelic trials are invalid because they’re not truly double blind.
But If psychedelics work in part because people know they have taken psychedelics, they still work. And in the first instance that’s the important thing.
“But what if the fact that it’s partly caused by unblinding means there are less dramatic ways we could get the result with less risky side effects”—well find them! No one is stopping you, and the possibility of one day verifying less risky mechanisms for treatment isn’t a good argument against approval now. By all means fund these trials, they could be immensely useful, but again this is not a reason to delay effective treatments now.
Moreover, there are reasons to be sceptical of the whole unblinding/blinding framework in antidepressants. Consider the ideal anti-depressant, you take it and your depression is instantly cured. Of course such a drug will have abysmal blinding rates! Like running a double-blind study of parachutes and worrying that people knew their parachute had triggered.
I think this is related to a larger dynamic. There is, I think, an assumption in psychiatry that the ideal anxiety/depression has subtle effects. This is partly out of a fear of creating new drugs of abuse. But if we take mental health seriously, we should be willing to risk, where appropriate, dramatic effects. Human welfare matters, deep and pathological unhappiness is one of the worst of all possible conditions, and it is worth taking risks to prevent it.
I strongly suspect, partly on the basis of having worked in an osteoarthritis clinic, that there is a pervasive tendency in medicine to place far too little weight on pain as a source of moral and clinical urgency in comparison to function. During COVID we used a scale to evaluate whether or not we could still see people for physiotherapy. Almost all of the items were about function rather than pain. I suspect the bias towards the subtle is deeply linked with insufficient concern about hedonic tone.
My preferred style is clear communication with at least one point, but that doesn’t have to mean a single thesis.
I disagree on the distinction you are trying to draw between cynical and ruthless (disregard for rules versus disregard for harm), I’ve seen both used for both. But mileage may vary, and people can make up their own mind.
I have recieved that pushback from others, re: cynicism, but I must admit I find it confusing. “He acted cynically in accepting the bribe” is a fairly commonplace construction in English as is: “The cynicism of Ford in marketing the Pinto despite its tendency to explode was breathtaking”. Ruthlessness looks to me like the closest synonym to cynicism here. I suppose one reply here would be that “cynicism” as a description of taking a bribe might be something like a euphemism? More to think about.
I don’t believe that all essays should have one point. This is American compositional orthodoxy, but in many (not all cases) I prefer an older, more meandering style. I quite like the idea of an essay that walks across a conceptual terrain more in an attempt to map it, and the potential dialectical moves it can accomodate. The way I see it, I guess, is that points come and go, but a new terrain to argue over and explore is lasting.
Points I’m making include:
We tend to equate non-awareness with moral virtue, this is odd when it is called out.
Certain people see the world in a highly gears-and-levers way when it comes to interacting with others, this is both phenomenologically and morally interesting. We can name it, for tracking purposes, instrumentality.
I give a moral threshold theory of manipulation, which is a response to certain debates in the philosophy of manipulation literature.
Althought the philosophical literature does not see it this way, many ordinary people think of manipulation as being too aware of what you are doing with your words, and in particular, engaging in too much strategy.
This folk theory of manipulation can’t work because of the Josh counter-example.
There is a geninue, and devestating loss that arises as a result of awareness- moral alienation.
But then again, it has advantages, and there are equally real problems of non-awareness.
Instrumentality, because it is typically unavoidable, cannot be morally wrong as such because of the ought-implies-can doctrine.
No, I don’t think either is better or worse than the other, I think they’re both just a mix of advantages and disadvantages.
I don’t really have a key premise, just making observations. In the last section I argue for the modest conclusion that instrumentality is not vicious, but that’s it as far as key premises go. I would reject what you take to be the key premise, I think it’s false. for one thing, I am skeptical of the idea that the concept of ‘manipulation’ is a particularly coherent one {beyond the moral threshold concept I lay out}, or that there is a clean difference between manipulation and non-manipulation, and I think the philosophical literature on the subject tends to point towards this. For another I think there are all sorts of disadvantages to being conciously aware of what one is doing, as I describe.
I’m interested in what you think is sloppy, or which inferences aren’t supported.
I would argue we don’t have clear norms against honest and sincere comments that lead—very possibly without your awareness—someone to think that you’re more seriously into them than not. We have deeply and ambigious and contested norms that people renegogiate to suit their situation and favoured parties. We do have clear norms against 1. Lying in relationships, especially for selfish reasons 2. Conciously orchestrating an impression to get what you want out of someone, but this isn’t either of those cases.
As for the work case, would your opinion change if the boss were, say, an employer at a vital but cash strapped not for profit with growing performance concerns about worker in a fairly vital role? Both cases are intended to be cases where a typical person will go back and forth depending on who they are sympathetic too in the situation.
Good comment, I’ve added a postscript to address this point, and several other similar points made to me.
The monopsony approach to the labor market says they’re the rule. A company doesn’t actually formally have to be the only buyer of labor power in its region to hold monopsony power.
I added this to the blog post to explain why I don’t think your objection goes through:
“[Edit: To respond to an objection that was made on another forum to this blog- advocate for in the context of this section does not necessarily mean the claim is true. If the public thinks the likelihood of X is 1%, and your own assessment, not factoring in the weight of others’ judgments, is 30%, you shouldn’t lie and say you think it’s true. Advocacy just means making a case for it, which doesn’t require lying about your own probability assessment.]”
Here’s an analogy. AlphaGo had a network which considered the value of any given board position. It was separate from it’s monte carlo tree search network- which explicitly planned the future. However it seems probable that in some sense, in considering the value of the board, AlphaGo was (implicitly) evaluating the future possibilities of the position. Is that the kind of evaluation you’re suggesting is happening? “Explicitly” ChatGPT only looks one word ahead, but “implicitly” it is considering those options in light of future directions of development for the text?
Thankyou, I will start to have a read. At first glance, this reminds me of the phenomena of reference magnetism often discussed in philosophy of language. I suspect a good account of natural abstractions will involve the concept of reference magnetism in some way, although teasing out the exact relationship between the concepts might take a while.
I see your point now, but I think this just reflects the current state of our knowledge. We haven’t yet grasped that we are implicitly creating- if not minds, then things a-bit-mind-like every time we order artificial intelligence to play a particular character.
When this knowledge becomes widespread, we’ll have to confront the reality of what we do every time we hit run. And then we’ll be back to the problem of theodicy- the God being the being that presses play- and the question being- is pressing play consistent with their being good people?* If I ask GPT-3 to tell a story about Elon Musk, is that compatible with me being a good person?
* (in the case of GPT-3, probably yes, because the models created are so simple as to lack ethical status, so pressing play doesn’t reflect poorly on the simulation requester. For more sophisticated models, the problem gets thornier.)
Certainly, it is possible, but I see little to guarantee our descendants won’t create simulations that are like the world we live in now.
Our descendants may well not regard sims as having the same rights as persons.
Even if they do, if even a small number of rogue beings (or nations etc.) conducted such simulations, unethical as they may be, it is possible that simulations would soon outnumber real people- especially for critical junctures in history (e.g., right before the discovery of AGI.)
The essay gives at least two ethical reasons which, in my view at least, may offer enough good to outweigh the suffering- such that even a person who cared deeply about sims might still sanction the existence of a world in which they suffer to achieve their aims.
So given those factors, we may be in a simulation, and given that, I think an interesting question is “is our being in a simulation compatible with our simulators being good people”
I have to disagree here. I strongly suspect that GPT, when it, say, pretends to be a certain character, is running a rough and ready approximate simulation of that character’s mental state and its interacting components (various beliefs, desires etc.) I have previously discussed this in an essay, which I will soon be posting.
Thanks for the clarification on how this works