The Blame Game, Pt 2

by twofiftyorless

My limited reading this week has led me to this wonderful article on the assignment of responsibility and blame where the authors state:

While many definitions of causality have been proposed, all of them treat causality as an all-or-nothing concept. That is, A is either a cause of B or it is not…[Considering causality in this manner] is based on counterfactual dependence. Roughly speaking, A is a cause of B if, had A not happened (this is the counterfactual condition, since A did in fact happen) then B would not have happened. As is well known, this naive definition does not capture all the subtleties involved with causality…[Unfortunately] thinking only in terms of causality does not at times allow us to make distinctions that we may want to make. For example…Suppose that Suzy and Billy both pick up rocks and throw them at a bottle. Suzy’s rock gets there first, shattering the bottle. Since both throws are perfectly accurate, Billy’s would have shattered the bottle had Suzy not thrown. Thus, according to the naive counterfactual definition, Suzy’s throw is not a cause of the bottle shattering…This certainly seems counter to intuition.

Thus, the authors prefer to make a distinction:

…in the case of Suzy and Billy, even though Suzy is the only cause of the bottle shattering, Suzy’s degree of responsibility is 1/2, while Billy’s is 0. Thus, the degree of responsibility measures to some extent whether or not there are other potential causes.

The bold is mine, because the emphasis is important: A patient arrives to a clinic in pain and asks for treatment. I lay my hands on the patient and sixty minutes later, the patient feels better. How responsible are my hands for the patient’s reduced symptoms?

…the idea is that A is a cause of B if B counterfactually depends on C under some contingency…It is precisely this consideration of contingencies that lets us define degree of responsibility. We take the degree of responsibility of A for B to be 1/(N + 1), where N is the minimal number of changes that have to be made to obtain a contingency where B counterfactually depends on A. (If A is not a cause of B, then the degree of responsibility is 0.

Again the bold is mine. How many contigencies can you consider when an individual’s nervous system receives tactile input from another? Could you even arrive at an estimation? Would this number be in the hundreds of thousands, or even millions? In the end, this line of thought runs into the proverbial wall when looking at the interaction of one clinician’s nervous system with another’s, because:

When determining responsibility, it is assumed that everything relevant about the facts of the world and how the world works (which we characterize in terms of what are called structural equations) is known.

In the end, I have no greater understanding of my own failings when working with patients in pain now than before, but I have derived something from this: I am increasingly certain that I have very little responsibility for when my patient’s feel better.