Should we do something around complex systems and medicine?

Workspaces OpenCare
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#1

Today @markomanka reminded us that he is the editor of a publication on Complex Systems and Medicine. It consists of “rolling chapters”, published on an ongoing basis. He asked whether we wanted to take advantage of it.

I see two possibilities – maybe there are others, but these ones are obvious.

  1. I would recommend combining the upcoming ScImpulse paper on the economic history of disruption in health care with @lakomaa’s and @tino_sanandaji’s paper on evasive entrepreneurship. EE is definitely complex systems at work: bottom-up economic and societal dynamics route around regulation. Nothing new here, except that the initiatives studied by Erik and Tino are mostly benevolent… so they are do-gooder lawbreakers! Which means there is a secondary emergent effect, that regulation ends up on the wrong side of citizen protection.

  2. I would also propose a second (and longer, and more academic) version of the Scaling digital ethnography paper..

Thoughts?

#2

Hi @alberto

I would like to share a reflection on a side. During our clinics this idea of a law potentially being on the wrong side emerged repeatedly from the grassroots, and I spent quite some efforts in reflecting with our stakeholders about the nature of legal systems.

Since they are to be interpreted in the context of facts, a law is hardly ever “on the wrong side”… a Court will always listen to a well construed and documented narrative… It can happen to be pushed beyond one’s legal comfort zone, and here we fall back on our very early conversations about box-ticking vs meaningful ethics :slight_smile:

I wrote to @tino_sanandaji this morning, and I hope we will find a moment to share a bit of information concerning our drafts.

Concerning the publication, I would love to have also contributions from our edges, about the first hand experience of doing bottom up governed care (@gehan ? )

All the best, Marco

#3

I disagree. Law is (has to be) formalist, not substantialist. Certainly Roman law is. And the proof is even within OpenCare. We were just discussing this with @alessandro_contini in this short thread: see his reply and my reply to the reply.

#4

We will disagree then, @alberto .

In facts, in the Roman legal systems the references to previous cases/court-decisions, publicly tolerated common uses, and potential overlaps with other rules create a vast grey area.
This can be Italian style (useless to discuss of the plague of uncertainty of the punishment), or Dutch style (think of the case of cannabis, illegal by the law, but tolerated by an Executive policy), but it is the same in pragmatic terms everywhere (hence, the right to a fair process, not the automatic execution of a legal code).

Extending the topic of this conversations about rules, there are even forms of strike enacted by strictly enforcing rules without interpretations… but the priority of a well meaning government, at any scale, is to maintain a functioning ecosystem, not to blindly enforce rules without interpretations.

This being said, in your conversation with @alessandro_contini I read that people were wary of potential risks… this concerns the comfort zone. Good-meaning disobedience will often be at the edges of comfort zones, and it is not for everyone, and that seemed to me to be the topic of your conversation. Similar issues exist in finance, and are usually treated by designing risk mitigation measures…

#5

Alberto: My spontaneous comment is that it is an excellent idea to combine the two papers. As you note, EE is mostly discussed in positive terms, though it can clearly be negative. Moreoever the concept is very much focused on theory, and would be complemented by historical and empirical “cases”.

#7

Another fascinating topic of discussion - and one that is a little beyond my knowledge. Though it seems to me to indicate that the same systemic issues regarding the problems that arise through institutionalisation, apply also to the field of law. I do know that I have broken laws during my days as an activist and so can relate to the idea of a law seeming to not only be on the wrong side of citizens but also the environment or commons. My uninformed sense is that this would be both an issue of law and interpretation by the courts - especially given the larger reality that the people who hold positions of power in courts will come from backgrounds of privilege and therefore likely to interpret things within their frame of reference. In a recent conversation with @matteo describing the work taking place for OpenCare in the City of Milan, he mentioned the disconnect between the legislators and the legislated and so whether intentional or otherwise I can imagine this would contribute to the drafting of laws and legislation that would therefore be on the wrong side of citizen protection.
As discussed during our conversation @markomanka, I would be interested in working on a chapter as a ‘contribution from the edges’ that picks up on the learning from bottom up forms of care. I’ll give some thought to what shape this might take but as I said I’d welcome suggestions as to what would make this relevant and interesting to others.

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