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Friday, April 25, 2008

from Lawrence, Pub Philosophy Group, Sunday meeting: How much are we influenced by fear? + Request

Dear friends,


This Sunday we are discussing : How much are we influenced by fear? This
is something we can all discuss from experience, but for our purposes we
might need to go a bit further than that. I try to outline a framework
of how we can understand this process, but I was not able to write a
very detailed essay. But I think my main points are there.


In the mean time Jose Antonio has asked me to ask you if anyone was
interested in corresponding with him to practice his English writing
skills. Maybe someone who is interested in a pen-pal or the equivalent
of the electronic version. Jose's email is: ja_macia1@mi.madritel.es


Take care and see you Sunday.


Lawrence

IF YOU DON'T GET AN EMAIL BY FRIDAY PLEASE LET ME KNOW

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How much are we influenced by fear?


Fear of course is an emotion we are born with. It is an emotion that
serves an important purpose in our life. It helps us to assess risks,
stops us from acting irrationally in some dangerous situations,
motivates us to protect ourselves and our kin and helps us plan for the
future.


And like all functional mechanisms, fear can go both awry or be
overridden. Social phobias might stop some people from benefitting from
social interaction with others, for example holding down a good job. In
the other extreme irrational fearlessness might cause a person an great
harm, for example by pursuing criminal activities. We might override
fear for altruistic reasons, to save a child from drowning or a soldier
to defend his or her colleagues.


I will limit my discussion to everyday type of fear, the type we have to
deal in our daily life. For example we are afraid of crossing a busy
road, we are afraid of terrorists, we are afraid of catching a cold, we
are afraid of crime, we are afraid of developing a fatal disease and so on.


There are two main issues I will consider here: 1) the role of our
epistemological state in creating and mitigating fear, 2) the ethical
issues that emerge from manipulating fear in others trough the use of
information.


An important characteristic of fear is that fear is forward looking; we
are afraid of what might happen. We are in effect concerned about future
events. But this statement needs qualifying. We are really interested in
either future effects of causes that might happen in the future (the dog
will decide to attack me) or causes that still have not played out their
full effects; a cause that took place in the past but the effects still
have to manifest themselves in the future; have I been infected by some
nasty disease after the dog bit me this morning?


Knowing what future events might be like does not in itself exclude us
from still being afraid. Knowing for example that a tornado is going to
pass over our town does not necessarily stop us from being afraid. But
the difference (from not knowing) is that we might be in a better
position to take action to limit or neutralise the negative effects of
whatever it is that is making us afraid. This model of fear works more
or less in the following manner: some event activates our fear, we look
for information about the event and a possible course of action, we act
(to mitigate the fear; fight or flight).


Thus although fear is a warning mechanism to tell us that we are in
danger, it also causes us to seek information. We might seek that
information from our memories (trying to remember what an article I read
about dog bites) or from new outside sources (go to the doctor). I also
refer to information because I believe that it is the epistemological
state of our mind that needs changing to mitigate the state of fear we
might be in, and not necessarily the quality of that information. My
recollection of what the article might be wrong and a doctor might
misdiagnose some symptoms.


The quality of information might become relevant later, maybe when our
fear has become more manageable, say from panic to concern. Levett and
Dubner, in Freakonomics, give the example of a mother who does not allow
her young child to play in the house of a friend because the friend's
parent s keep a gun at home. Yet the same mother allows her child to
play with a friend whose parents have a swimming pool. The authors point
out that more children die in the US by drawing in swimming pools than
being shot with a fire arm. We also know someone or acquainted with
someone who is more afraid of flying than driving a car. Yet flying has
been shown many times to be safer than driving; the long queues and
delays might be a better reason for not flying. It is clear that in the
context of fear, information is more important than the quality of that
information.


But without this gap between the information we have and the quality of
that information, we might not have ethical issues or problems relating
to fear. In the context of the gun swimming pool example, there ought to
be a strong anti-swimming pool lobby in the same way that there is a
strong anti gun lobby (even though there are other reasons to have a
strong gun lobby in the US). Maybe we ought to have a more vociferous
lobby to protect children from swimming pools or unhealthy foods rather
than fussing too much against parental or school discipline.


This situation is exploited many times for the advantage or benefit of
others. Which brings me to the second issue of my discussion: the
ethical issues that emerge from manipulating fear in others through
information.


In most countries there is a legal principle of informed consent. For
example, in most medical procedures informed consent in necessary before
the health carer can proceed. Informed consent protects the health carer
against honest errors; of course usually some legal court or tribunal
might have to decide the facts and circumstances. But for giving consent
people usually expect a reasonable degree of care and good faith.
Similar consent is usually explicitly or implicitly given in other walks
of life, for example many foods are labelled with the ingredients they
are made with, we consent to travel by public transport on the
assumption that the rolling stock or coaches are fit for purpose.


On the fear model I mentioned earlier, informed consent is the result of
a process that started with fear in the medical procedure or fear of
trains or bus coaches. Thus, the exchange of information by the health
carer or bus operator, maybe in the form we understand it, which helps
us decide in favour of the procedure or journey. And thus both the
supplier and us benefit, not to mention that our consent allows the
supplier to get on with their job. So far so good.


But sometimes this need for information is exploited not necessarily to
disadvantage us but more to benefit others. For example, we buy a rather
expensive appliance or gadget, a tv or a pc, and of course we are
protected by law against faulty goods. However, the shop persuades us to
take out an insurance policy just in case something happens to the
machine. It is true that having extra protection might be useful for us
but it is also true that the goods we buy should be reliable to the
standards we are promised.


In April 2006 there was a story in the media with headline such as
"Drugs companies 'inventing diseases to boost their profits'", this one
from the Times on Line, which referred to a study suggesting that
pharmaceutical companies are trying to turn healthy people into sick
people so they can then sell them the drugs they make for these new
diseases. The BBC website quotes this paragraph from the report (Public
Library of Science Medicine) where the story originated from. "It [the
behaviour of pharma companies] is exemplified mostly explicitly by many
pharmaceutical industry-funded disease awareness campaigns - more often
designed to sell drugs than to illuminate or to inform or educate about
the prevention of illness or the maintenance of health." In a way,
strategies like these are an attempt (intentional or not) to circumvent
the principle of informed consent. We identify ourselves as having the
disease and then readily agree to the treatment. But this strategy is
not exclusive to pharmaceutical companies, maybe with drugs someone
might actually benefit, but what about, say, luxury goods or fashions.
We are told that luxury good X is used by top class A, of course not
belonging to top class A would be a social failure, so we immediately
consent to buying good X. We don't even complain that the good we are
buying is far too expensive.


Fear can be exploited not only by providing biased information, although
the information seems reasonable at face value, but also by appealing to
our internal beliefs about certain causes such as disease or
reliability. Of course, both the retail shop and the pharma company have
legitimate reasons for their actions: appliances do sometime break down
in unexpected ways, and who is going to begrudge the profits of a
company that might actually help them live longer.


In a way discovering that we are receiving selective information does
not solve our ethical problems but rather compounds them. Exploiting our
fears might not necessarily imply that this is bad or unacceptable
behaviour. Although in many cases it might be the case, in the same way
that a dog with an aggressive posture does sometimes attack us.


There is however a practical problem in all this: at which point does
this asymmetric information, as economists call a situation when one
party has more relevant information than the other, maybe even withhold
relevant information, cease to be private information and becomes an
ethical issue. How many people, especially patients, can understand the
technical literature published on a particular molecule? Even if we did
have access to all the published information.


All things being equal, most probably we are influenced by fear as a
function of the information we have available plus our disposition to
process that information. What matters is whether that fear clouds our
judgement. But as I have pointed out, rational judgement based on
information introduces the criterion that information must be quality
information. And leaving aside the question of what is quality
information, if we are unable to bridge the gap between information and
quality information we are surely best advised to take into
consideration this very same gap.


Take care

Lawrence


from Lawrence, Pub Philosophy Group, Sunday meeting: How much are we
influenced by fear? + Request

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