Part 2 of 2: A Paradigm Shift

During the early 1900s participants of the Progressive movement were troubled by the plight of the urban poor. They worried that the ‘promise’ of the American system did not extend evenly (Rothman 1980) to all segments of society – it did not penetrate the ghetto or the slum. The progressives rejected the social Darwinists’ logic that the poor and the criminals among them, were biologically inferior and had fallen to society’s bottom rung because they were of lesser stock. In order to address increasing poverty and inequalities the movement spurred an age of reform where government could be trusted to create and administer agencies that could affect social change.

In the 1970s neo-conservatives promoted supply side economics: the doctrine that tax cuts could be had for free (incentive effects would generate new activity and so higher revenues) without causing budget deficits. Its creators never believed the initial supply side economics; it was promoted as a credible theory in order to create a political doctrine to unite the right. Supply side economics was amalgamated with ‘starve the beast’ theory to create trickle-down economics. John Kenneth Galbraith, an economist who warned of the dangers of deregulated markets and corporate greed, observed, “the modern conservative is engaged in one of man’s oldest exercises in moral philosophy, that is, the search for a superior moral justification for selfishness.”1

Claims of objectivity or rationalization can be considered as a means of presenting one’s own ideology as a screen for an established fact. Knowledge that is pluralistic is incompatible with the concept of one objective reality. Pluralism in politics is about acknowledgement of diversity. In a pluralistic vision, though, members of most groups will share the most important meanings that hold society together. They may, however, disagree on customs and the choice of lifestyle. The theory is that political power in society does not lie within the electorate but is distributed between a wide number of groups. In democratic politics, pluralism is a guiding principle which permits the peaceful coexistence of different interesting convictions and lifestyles. In this system it is imperative that members of society accommodate their difference by engaging in good-faith negotiations. Pluralism also implies the right of individuals to determine values and truths for themselves, instead of being forced to follow the whole society. The common good, the ideas of individuals and groups to ensure that all the wants and needs of society are taken care of, is established within the pluralist framework. In an oligarch society, where power is concentrated and decisions made by a few members, there is no widespread negotiation or participation or ownership in decisions.

Getting ahead is ostensibly based on individual merit, which is generally viewed as a combination of factors including supposedly objective criteria of abilities, working hard, having the right attitude, and having high moral character and integrity. There is a gap between how people think the system works and how the system actually does work. Rationalization of authority is the process and a meritocratic order the end. In a true trickle-down economy, the benefits of productivity and innovation would be shared fairly by all stakeholders, not just the select few with authority to dictate compensation and how the profits of a company are distributed. In the 21st century, the top down economic system of control is about cheap money and power staying concentrated with a small group at the top of the economic pyramid. Trickle down economics links the welfare of the working class directly to the prosperity of the rich, protecting the interests of the few at the top of the economic pyramid.

Meritocracy consists of an elite group of people whose progress is based on ability and talent rather than on class privilege or wealth. In a meritocracy, all citizens have the opportunity to be recognized and advanced in proportion to their abilities and accomplishments. The ideal of meritocracy has become controversial because of its association with the use of tests of intellectual ability, such as the Scholastic Aptitude Test, to regulate admissions to elite colleges and universities. Many contend that an individual’s performance on these tests reflects his or her social class and family environment more than ability. Marx observed that all social systems have a small minority of powerful elites. Meritocracy has become a rationalization that allows the rich to abrogate any sense of duty to those less fortunate.

Soren Kierkegaard was critical of rationalism. He believed that humanistic rationalism leads to the loss of all meaning. The only way to be sure of truth is eliminating every ulterior motive or bias to what one says. Kierkegaard and Nietzsche focused on subjective human experiences rather than the objective truths of mathematics and science. The objective thinker is interested in what defines existence, while the subjective thinker is interested in how existence is defined. The objective thinker has a need to quantify certain probability while the subjective thinker ultimately must accept uncertainty.

Kierkegaard argues that the falsehood of objectivity may be revealed by a lack of need for personal commitment, and by lack of need for decision-making, while the truth of subjectivity may be revealed by a need for personal commitment, and by a need for decision-making. The speculating thinker attempts to stand apart from his or her own existence, and attempts to view existence objectively. In contrast, the subjective thinker realizes that he or she cannot stand apart from existence, and that the truth of his or her own existence is found in his or her own subjectivity.

Nietzsche believed that human reason is rationalization, and truth is simply the name given to the point of view of the people who have the power to enforce their point of view. Whatever man can make work in order to achieve his purposes becomes the truth in the system. There is no objective reality behind truth – different perspectives produce different truths. Nietzsche believes that science at its best keeps us in a simplified suitably constructed and suitably falsified world, and that the artificial world that concerns us is a fiction. Instead of using truth as the highest standard of value, Nietzsche argues, individuals need to develop their own powers of judgment and to produce ideas and ethics that will strengthen them and help them to live.2

Kierkegaard made a distinction between objective and subjective truth. For Kierkegaard objective truth merely seeks attachment to the right object, corresponding with an independent reality. On the other hand, subjective truth seeks the achievement of the right attitude; an appropriate relation between object and knower. For Kierkegaard it was subjective truth that counts in life: how we believe is more important than what we believe. It doesn’t matter what you believe so long as you are sincere. Existentialists oppose rationalism and positivism.

Subjective thinking can be the basis for a paradigm shift. Although Christianity is objectively merely one of many available religions in the world, it subjectively demands our complete attention. Pope Francis commented on the pursuit of money and criticized inequalities and the excesses of capitalism, based on his sincere belief of the gospels of Jesus of the New Testament. The pope noted that once greed for money drives the economic system, it sets people against each other and harms the common home (ecosystem). The Pope seeks the truth through subjective thinking.

Democratic candidate Bernie Sanders is attracting attention in the US because his campaign proposes a paradigm shift. Saunders is pursuing subjective truths. He claims, “our economic goals have to be redistributing a significant amount [of wealth] back from the top 1 percent… move to a society that provides a high quality of life for all our people.” Sanders notes that erosion of collective bargaining rights over the last 40 years have created an economy that delivers maximum profit to the corporations. Fox News labels Bernie Sanders “too extreme”, but that is the result of filtering Sanders’ public policy through the lens of objectivity which supports the profit paradigm.

There is other evidence of subjective thinking. Elizabeth Warren, a Democratic senator from Massachusetts, made a vigorous defense that the rich got rich courtesy of the social contract, that provides society with the rules and laws that allow a functioning society to proper. Today there is a hereditary meritocracy as the elite in Canada and the US are now self-perpetuating. “Opportunity,” according to Elizabeth Warren, “is slipping away.” Since 2008 there has been a need for more accountability from the big banks on Wall Street. In 2015 the banks are receiving paltry fines after being caught red-handed recently manipulating foreign exchange markets. In other words, there are no practical consequences to these crimes. It is clear why Warren talks about the game being “rigged.”

We can never know how much we do not know. The precautionary principle to protect the environment was defined in 1992 as one of the principles of the Rio Conference on Environment and Development. The accepted principle includes the premise that even if full scientific certainty does not exist of the threat (to health or the environment) that shall not be used as the reason for postponing cost-effective measures to prevent adverse health impacts or environmental degradation. That means that an activity or product should not be used if it cannot be reasonably predicted that it will lead to unacceptable consequences Today this would include epigenetic risk. Epigenetic risk is not merely a medical risk, but implicates the fundamental principles of fairness and justice underlying the present social contract.

Health and wellness is essentially a subjective experience. Gradients in resources and exposures associated with socioeconomic factors may reflect the impact of subjective social status (i.e., where one perceives oneself as fitting relative to others in a social hierarchy determined by wealth, influence, and prestige). A growing body of research in multiple disciplines—including psychology, neurology, immunology, education, child development, demography, economics, sociology, and epidemiology—examines the interplay of socio- economic factors, psychological and other mediating factors, and biology. Evidence has clearly demonstrated that relationships between socioeconomic factors and health are complex, dynamic, and interactive; that they may involve multiple mechanisms including epigenetic processes that alter gene expression; and that, at times, they may only manifest decades after exposure.

All writing and all science are socially constructed and therefore subject to bias. It is important to first describe any bias that is inherent in the argument, and second to seek to determine whether political biases have influenced the selection and interpretation of evidence. We should accept there is no objective truth, only a variety of subjective views developed through dialogue with others. The principles for determining how evidence has been appraised must be explicit and transparent, the means of taking account of bias must be clear, and the thresholds of acceptability which have been used to accept or reject evidence should be open to external scrutiny. Once one controls for bias, it is possible to achieve a paradigm shift by changing from objective thinking to subjective thinking.

The determinants of health operate in a complex, interactive environment, and the effects they produce are often not apparent for a number of years. As a result, causal relationships are more difficult to establish, return on investment occurs quite far in the future. In the new system corresponding policies and initiatives don’t compete well with other more immediate spending for healthcare service priorities. With a paradigm shift, adopting a collaborative approach towards the policies that address the social determinants of health can transform the system leading to healthier individuals, and ultimately addressing the wellness of individuals and providing opportunities for them to reach their full potential.

1Horsman, Greg. (2012) Objectivism Lost and an Age of Disillusionment. p. 147

2Clarke, Maudemarie. Nietzsche on truth and philosophy. http://catdir.loc.gov/catdir/samples/cam034/90036094.pdf

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One Response to Part 2 of 2: A Paradigm Shift

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