RCTs and the Psychological State
Posted Jun 13, 2014
In a previous post we considered the ways in which the psychological sciences are reshaping how policy makers understand human subjectivity. The classical view of the human ‘[…] as a bounded, unique, more or less integrated motivational and cognitive universe, a dynamic centre of awareness, emotion, judgment and action, organized into a distinctive whole and set contrastively against other wholes […]’ (Clifford Geertz), is being replaced by a much less autonomous vision of human subjectivity. In this new, psychologically-imbued vision of the human subject agency is not only associated with conscious deliberation and action, but also unconscious drivers and contextual prompts. Human subjectivity becomes less Homo Economicus and more Homer Simpson. Putting these broader debates to one side, it is also becoming clear that the rise of the Psychological State is constructing another form of subjectivity: the experimental subject. In this brief reflection we consider the origins of the experimental subject, and what it may mean for our understanding of citizenship in the 21st Century.
In his recent reflections on the contemporary manifestations of the Psychological State,Professor Andrew Dobson observed that within related policy regimes ‘[p]eople are not citizens involved in the co-creation of policy, but experimental subjects to be prodded and poked in the petri dish of the behavioural economist’s imagination’. Dobson’s invocation of the experimental subject if important because it directs us to the methodological practices of policy delivery that are associated with psychologically oriented public policy making. Just as the new behavioural insights of the psychological sciences are reshaping understanding of the human subject, the preferred, experimental methods of these sciences are recasting the ways in which public policy is designed and delivered.
The new “gold standard for public policy delivery and evaluation” (at least in the UK, but increasingly in the US and Australia) is the Randomized Controlled Trial (RTC). RCTs have already been widely used by the UK’s Behaviourial Insights Team in order to test a series of policy interventions. In the UK, the promotion of RCTs is part of a broader move towards a “What Works” style of government. This pragmatic form of government purports to reject ideologically driven policy initiatives in favour of more rigorously evidenced policy. The What Works government initiative is trying to build a “NICE for social policy” (The National Institute for Health and Clinical Excellence [NICE] provides independent guidance to the UK government on health-related policies). In order to build this capacity, the UK government is establishing What Works Centres focusing on crime reduction, local economic growth, ageing, and early intervention. While the preferred methodologies of these centres has yet to be established, it appears likely that in order to facilitate effective comparison and cost benefit analyses, that they will promote controlled experimental forms of intervention.
While it is hard to oppose the promotion of evidence-based policy, the promotion of experimental methodologies within public policy does raise some important epistemological, ethical and political issues, which have not been widely acknowledged. At an epistemological level, it is interesting to note that while controlled experimentation is now being promoted as a “gold standard” for research in the social sciences, that it is far from a universally accepted methodology within the ranks of social scientists. The point is that while controlled experimental trials may be suited to the problems of biology and medicine, they are far less compatible with the more plural explanations that are often perused within the social sciences. At the most fundamental of levels, many social scientists are suspicious of the ways in which experiments tend to partition the world in order to isolate explanations. While experiments clearly have the advantage of offering control, they have the major disadvantage of making it very difficult to identify the broader structures and practices that exceed experimental space, but are still crucial factors in shaping the social actions under scrutiny. It is for this reason that social science experiments may be able to isolate the drivers of short-term behavioural shifts, but are less reliable when it come to understanding long-term patterns of social change. Furthermore, while social science experiments may be effective at generating quantitative measures of specific attributes of change, they are less effective at measuring the broader, qualitative impacts of a given policy intervention (the use of qualitative methodologies, such as ethnographies or interviews, before, during and even after experimental trials would clearly muddy the waters of the controlled environment). It is for these reasons that RCTs are much more compatible with the behavioural than the broader social sciences: where action and agency are seen to reside much more in the individual, and their immediate surroundings, than in the broader society in which they are a part.
Experimentally orchestrated forms of public policy also raise ethical issues. While there has been some discussion of the unfairness of the division of society in to groups who receive a new intervention and those who do not, this is not where we see the real ethical dilemmas. For us, the primary ethical issues associated with controlled, experimental policy concerns how individuals are recruited into trials. While in the social and behavioural sciences people are recruited into experimental trials on a voluntary basis, it is less clear that this will be the case with public policy initiatives. In fact, in the most high profile behavioural trials carried out by the Behavioural Insights Team (supporting job seekers in their attempts to get back to work), concerns were raised that participants in the trials were worries that that their benefits would be cut, or lost, if they did not participate. These trials were embroiled in further controversy, when it was revealed that the psychometric tests that formed part of the trial gave the same results no matter what the participants said about themselves. The point is that while it may be possible to get people to volunteer for pubic policy trials, it is difficult to completely disassociate this voluntary act from the existential threat that non-compliance may generate in the mind in the subject.
These ethical concerns are related to broader political issues. At a political level it is important to consider what the rights of experimental citizens are. While it could be argued that the rights of experimental citizens are no different to those of any subject who is part of government policy—namely that if they want the right to benefit from a government programme then they are subject to the (research) conditions of those programmes—it also appears important to acknowledge that experimental citizens should have the right to know how and why their actions are being studied, and ultimately how and why they are being treated differently to others. Given that those in most need of government services are the most likely to be recruited into policy experiments, there is also a danger that experimental citizens could be drawn disproportionately from the most vulnerable segments of the population.
We support the principle of evidence-based policy, but remain concerned about the ways in which it is currently being pursued. Experimental subjects and placebo citizens are not an entirely new phenomenon, but with the emergence of psychologically-oriented forms of government they are clearly set to become more common. If evidence-based policy must inevitably lead to the creation of more experimental subjects, we need to study carefully the epistemological, ethical and political implications of this process.