Rules of all kinds help us make good decisions all day long, but how does that affect our responsibility for these decisions?
Decision-making is effortful. Even if we have only two options to choose from, they often both have numerous pluses and minuses that need to be weighed up. Thankfully, we can often rely on rules that act as shortcuts and take much of that hard work away.
Many such rules we develop and adopt ourselves. After using the toilet, we don’t every time consider the upsides and downsides of washing our hands – it is a habit we mindlessly carry out. Neither do we spend a lot of time, every week, working out whether we will do the shopping on Friday evening, Saturday afternoon, or – why not indeed? – on Wednesday after work. Most of us have a routine, same day, same time, that we follow pretty well. And we all make use of heuristics: we associate certain brands of products with the features we value and choose on that basis, rather than by time and time again evaluating all the alternatives.
Other rules are imposed on us by others, but we still mostly happily embrace them. If, as is the case for most workers, our employer tells us which days and hours to work, we conform and fit our lives around these rules. Picture the counterfactual, in which we’d have to work out every day first whether to work, and if so, at what time and until when. We’d rather not. Although we could technically wear any clothes at all when we leave the house, rules of decency and appropriateness limit what we can actually choose (and just as well or we might starve to death in front of the wardrobe). In traffic, we tend to follow the rules of the road, rather than make conscious decisions about our speed, positioning, use of indicators and so on. That is generally much safer (not least because means less cognitive load and gives us more capacity to deal with the unexpected). And at work too, we are subject plenty of rules: specific job instructions, procurement guidelines, approval procedures, compliance requirements and many more. All these rules restrict our freedom to act, but in return they reduce the burden, and make our life more efficient.
Even moral rules, the foundation of deontological ethics, from the 10 biblical commandments to Kantian philosophy and the variants it spawned operate in a similar way. They relieve us from the need to evaluate the costs and the benefits of our actions, and in return provide us with simple obligations, permissions and prohibitions.
Replacing our judgement
In essence, rules replace our judgement. They are constructed on the basis of a set of assumptions which, if we just follow them, are not verified. And as long as these assumptions hold sufficiently true, following the rules will produce a satisfactory outcome.
But there is another angle to following rules that replace our judgement, related to our responsibility. In the days when a particular American computer manufacturer dominated the information technology market, there was a popular adage claiming “Nobody ever got fired for buying IBM”. This was the perfect CYA (“cover your backside”) method for IT procurement managers dreading having to spend a lot of time and effort evaluating alternatives, weighing up purchase cost, performance, maintenance, interconnectivity, training and whatnot, and arguing the case for whatever they judged to be the best option. Instead they could save themselves the trouble, buy the kit from IBM, and be assured they would not be responsible for any problems.
Yet we often do have the choice whether or not to follow a rule. We can choose to verify whether the assumptions the rule was based on are valid, or to consider the full consequences of following the rule, and on that basis decide whether or not to overrule the rule and engage our judgement.
This occurred to me as we received the good news in November of last year that several COVID-19 vaccine candidates successfully completed their final trials and were being submitted for approval. Rules do indeed play a prominent role in the process of authorizing and administering vaccines – both existing and new rules.
Understandably, approvals bodies apply strict rules for evaluating candidate vaccines, governments have rules for authorizing their use, and there are rules for who is qualified to deliver the shots. Furthermore, specific rules would be needed to determine when and where the vaccination will take place, the sequence in which citizens would be inoculated, how to ensure efficient use and avoid waste of vaccine etc. Together, these rules have a significant influence on how quickly herd immunity would be reached, and hence how the number of deaths, and the social, educational and economic damage could be kept as low as possible.
Opportunities to break the rules
And we saw some intriguing differences appear.
Some countries were quick to authorize vaccines, and had embarked on intensive inoculation programmes with many tens of thousands of people receiving the jab each day, while other countries were still in the process of evaluating them – following their prevailing rules. In some countries the vaccination is taking place 24/7, while others seem to be planning to adhere to a more conventional Monday-Friday, 9-5 schedule. Overall vaccination capacity can be increased by engaging volunteers, but some countries are confronting candidates with a heap of bureaucratic requirement for documents and training. Rules, rules, rules.
The UK approved the Pfizer-BioNTech vaccine on 2 December and started vaccination less than a week later. The EU approval happened 19 days after the UK’s, and – in some EU countries at least – the administration also started about a week later. At the time the EU started vaccinating, the UK had already administered the first dose to nearly 800,000 high-risk individuals, or more than 1% of its population. (Meanwhile the UK has also approved the Astrazeneca vaccine and began administering it on 4 January. It has not yet gained approval in the EU.) Imagine the EU had decided to accept the UK’s medicine agency’s approval of the vaccine, and proceeded in parallel. Nearly six million EU citizens might have had their first shot by the time the EU campaign kicked off.
Israel is vaccinating around the clock, including on the Shabbat, and despite starting its programme later than the UK (on 20 December), more than 18% of Israelis have received their first dose on 6 January, while in the UK the number was about 1/10th of that (and most other countries are lagging much further behind). Imagine every country had adopted the intensive approach Israel pursues (in which even religious rules were set aside), and – subject to supply constraints – 10% or more of their population would have been vaccinated in less than a month’s time. The light at the end of the tunnel might be a good deal nearer.
In the UK, the tweet of a retired anaesthetist attempting (and another one from a general practitioner who has giving up) starkly illustrates how rules can hinder, rather than facilitate efficiency. As Dr Jones says, “I can remember how to do an intramuscular injection”. Yet, she has to upload 17 different documents, or undergo training on subjects like Fire Safety and Preventing Radicalization before she can help immunize the population. Imagine what capacity level could be reached if, without this burden, plainly qualified people could be brought in to staff up the vaccination programme in a matter of days.
Whether or not we adhere to rules when we make decisions is ultimately our choice and our responsibility. Sometimes following rules is the responsible thing to do, on other occasions acting responsibly is precisely going against the rules.
When COVID-19 is finally under control, and the differences in outcomes – like the number of dead and on the damage done to society – will be plain for all to see, we will be able, together with the decision makers, to judge whether adhering to the rules will have been worth it.