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Fixin' Healthcare

Sunday, February 10, 2008

Such Is Life

Close examination leaves no room for doubt as to the importance of human behavior for life on earth. How people behave determines whether they can co-exist, maintain health, achieve happiness, succeed with endeavors, and build for the future. Human behavior is the source of economic and social activity; it is the producer and the consumer; it builds enterprises and destroys civilizations; it explores frontiers and imperils the environment and the climate; it appreciates art and wages war. No activity on earth surpasses human behavior for complexity. One would hope the current state of the world is due to incomplete understanding of human behavior and things will get better with time and effort.

Humans are constantly reacting to circumstances of their own making, natural disasters notwithstanding, and it is surprising the effort does not get better with repetition. That society and governments must respond to the dangers and needs in the world is not new. That the outcome ultimately depends upon behavior of individuals is not new. That the behavior of individuals is dependent upon value and belief systems tempered by education and experience is ancient and well known. That value and belief systems, codes of conduct, and rules for ethical behavior are an indoctrination process requiring input over time from all aspects of society is recognized throughout the world. Process, process, process; not easy tasks, to be sure, but there has been a lot of practice.

When the knowledge forming the basis for action is incomplete, as it always is, and the goals are not clear, process becomes the gold standard. It is a tragedy of human behavior that well executed processes vary greatly as to their relationship with the desired goal (true, true, and unrelated). Belief systems are built upon interpretation of fact and belief systems commonly exceed the basis of fact. People know a few things and they believe in many things. Belief systems are the basis for human behavior. Facts expand and change but belief systems and behavior do not change easily or quickly. Dysfunctional social processes can continue for prolonged periods contrary to overwhelming facts. It is not flattering to rational thought that a change in the belief system leads to rapid change in behavior, which, then, stimulates the search for facts to reinforce the belief system. Such is life in an emotional and often irrational world.

Thomas S. Kuhn (1922 – 1996) was a physicist and educator who thought and published about the history of science and became recognized as a philosopher. Dr. Kuhn published “The Structure of Scientific Revolution” (University of Chicago Press, 1970) in which he outlines a process of innovation and change in science (“paradigm shifts”). Scientific frameworks are belief systems compatible with existing facts. Additional facts confirm the framework and contribute to empirical proof. When facts no longer conform to the existing framework, new perspectives arise to overthrow old ones and open the way for new paradigms, new theories, new facts, and new technologies. Scientific frameworks seek facts for confirmation but the facts may lead to new frameworks. Facts have meaning only in relation to the overall framework or perspective. Such is life in a scientific world, which exists within an emotional and often irrational world.

Slowly, society is coming to the perspective that incorporates human behavior as the primary basis for health status, cleanliness and sustainability of the environment, and climate change. Almost certainly, human behavior is the most significant basis linking all three fields. The principles that direct behavior and form the linkage between these fields are those of public health and they are based upon conservation and prevention. These are not easy principles for society to accept or apply. People may not understand these principles or how they apply to their daily lives. But, they can determine whether missing a regularly scheduled bus that left on time means they did not run fast enough or they did not start soon enough.

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