Differences making no difference –on numbers and self-inflicted

ignorance

Anna Essén anna.essen@hhs.seMorten Knudsen mk.ioa@cbs.dk

EphemeraStockholm, June 2017

Background

From the use of ignorance tostrategies of ignoring

Data produced – and ignored

The non-use of self-produced data

Theories of ignorance, agnotology, stupidity, (McGoey, Gross, Proctor…)

Dominant theme: the function or use of ignorance, strategic ignorance (of others or of the ignorant)

We: HOW is ignorance produced? That is: strategies of ignoring

Strategies of ignoring

• Observers have structures creating expectation of actions in relation to certain information

• Information has a normative dimension relative to the observer (observers are complex and not only cynicaloptimizers of self-interest)

• How do organisations ignore potentially relevant information to which they are sensitive?

• Ignoring: the simultaneous presence of knowledge and non-knowledge

• It takes work to be ignorant• Strategies of ignoring: ways in which potentially

relevant information is kept un-actualized

How the comparisons wereproduced and ignored

Divisions involved

Divisions involved

Rheumatologists

We havenothing to

hide!

We protectthe registry!

Better than new documentationrequirements

We simply try to identify

variables thatcan be

compared

Creating legitimacy

The comparisonsare not that

relevantAvoiding moredamaginginterventions

We secureregistry

funding !

Divisions involved

National health agency

Our job is not no

interpret the results

The comparisons

will be relevant for X

We are not the

intendedusers

I think the comparisonsare useful for

countycouncils

We have created a democratic system for transparency &

e-surveillance

Better thancreating new e-

surveillancesystems

Creating legitimacy

Avoiding moredamaginginterventionsOtherization

Futurization

Divisions involved

Relatively high prescription ofexpensive drugs in the county

content challengeing the accuracy of prescription patterns

Relatively small share of patients with good health outcomes

X

X

County councils

As measureswill be

improved…

When the search-

function gets better…

WE dont interpret the results. Wedon’t want tothreaten the

professionals’ autonomy!

learningrather than

blamingThe

comparisonsare great! We are

responsible

Creating legitimacy

FuturizationOtherization

Divisions involved

Medical specialist

I expected a lot ofreactions but I

have heard…zero!

I noticed it but I did not suggest

any changes in the action plan

EXPLICIT IGNORIG STRATEGIES

1. Creating a legitimate image

2. Avoiding damaging interventions

The comparisons are useful for reasons other than those officiallyannounced.

Content of the comparisons ignored

Actors produce the comparisons

.

IMPLICIT IGNORIG STRATEGIES

1. Otherization

1. Futurization

The comparisons does/will fulfill itsofficially announced purpose.

Actors keep producing the comparisons

Contributions to the literature

• Irrational organisations/Information as symbol

• Rational parts/irrational whole

• On ignorance/functional stupidity

• Accountability

• Evidence-based management