Think social media, chat rooms, the “comments” section following editorials and so on. Online with others, we are too often belligerent, deprecatory or just plain nutty. (I could add “tedious” too, but that’s another matter.) Though we can’t be counted on to be civil on the digital commons, we nevertheless look for “friends” or like-minded individuals. We’ve defined a peculiar electronic world, especially with our social media, and I know of several defunct individuals whose accounts persist posthumously. But never mind; who cares? Avatars can help us become whoever or whatever we want. There’s no recognizable difference between our real selves and bots. And once again, we devolve into disparagement or bullying.
Our troubles reside not in our binary gizmos but in our selves. Our (somewhat) evolved beings carry our base tendencies to lie and maraud, near total self-involvement, just as we bear traits for altruism, justice and fair play that have developed over millennia. The difference seems to be that online our darker selves dominate, especially when the flickering screen and its rabbit holes promise anonymity, and, tapping into anger and dissolving into mob rule, we become unrecognizable in our invective. Recently, to add to our general truculence, we’re told our online search for community is energized through algorithms that surreptitiously feed us stuff we likely want to hear, as well as partners that are not of our own choosing.
Along the way we’ve come to know a lot more about communication and about miscommunication, too. We often divide along the line of whether or not we trumpet “fake news,” on hearing things we don’t like, or whether we are open to argument and persuasion. Fake news, of course, is nothing new and has arguably been round since Gutenberg invented the printing press in 1439. By design it is sensationalist and extreme, resistant to discussion. It turns out there are filters3 in our discourse that support our predilection for half-truths and outright lies.
We can be systematically excluded from specific, contrary information in several ways. In what has been called a “cognitive bubble,” we don’t hear voices with other relevant points of view. They’re just not there. This singularity of voice can be upfront or inadvertent and passively imparted to us by our social contacts. Indeed, when networks developed for social reasons become informational networks, what else can we expect?
“Echo chambers” go a step further. Where a cognitive bubble omits contrary views, an echo chamber – think of cult groups’ chanting – actively distrusts and disparages them. Given early and consistent indoctrination, rationality holds little sway. There’ll be no difficulty maintaining contrary – even bizarre – points of view if, built into our networks, are exaggerated levels of agreement and suppressed levels of disagreement.
When we speak of communication filters and echo chambers, we’re used to thinking along political lines, but there are echo chambers aplenty in health care. Think of the continuing and irrational ruckus that persists with anti-vaccinators, or the guff that attends new diets, colonic cleansing, vitamin additives and so on. Consider as well the medical hucksters who push all manner of potions as wrinkle and appearance cure-alls. Medical advertisements – indeed most advertisements – warrant mention, too, since they generally omit pertinent information regarding utility, risk and expense and are, at end, deceptive flim-flam.
“There’s trouble in River City,” as the song says. We’ve not gotten to a post-truth world. We continue to need substantive reasons to believe whatever it is that could be important to us. Did someone mention the word “evidence?” Isn’t it all about evidence?
Stanford Professor Dr. John Ioannidis’s continuing work stands out here. Much of the medical literature, our Holy Grail repository for evidence, doesn’t stand up to scrutiny and is misleading, exaggerated or just wrong. As expected, non-randomized trials get most criticism but so do a quarter of gold standard, randomized trials and a tenth of what should be platinum-standard large randomized trials. Multiple bias, poor study design, inappropriate fiddling and unsupported conclusions are all at fault, with occasional outright fraud.
We’re left with little comfort. To the extent that the online world is a commons, we need better rules to protect us. To the degree we have wrongly come to think that news and truth are arbitrary, we must work to become less ignorant, less gullible. Lastly, when we look for proof or evidence, we must look hard. We must remain profoundly skeptical.
Some things may have changed in the transition from Living 1.0 to Living 2.0.
But not that much.
References available upon request
Banner photo credit: Pete Linforth, Pixabay