If these be experts, who are the dummies?

February 07, 1997|By Ellen Goodman

BOSTON -- I am not an expert on the subject but allow me to offer my opinion: Experts ain't what they used to be. Of course, if I were an expert, I wouldn't offer you my opinion. I'd give you the data. I'd give you the epidemiological study. I'd give you the risk factors and the odds. And then I would ask for more funding to study the subject more thoroughly.

This screed on expertise follows the sputtering outrage of women in their 40s to pronouncements of the recent ''panel of experts'' on mammograms. Fortysomething women facing the mammogram dilemma now sound like fiftysomething women confronted with the hormone quandary.

What infuriated women wasn't merely the panel's decision not to recommend breast X-rays as part of routine screening. It was the pronouncement that women should weigh the risks and benefits and decide for themselves.

This led to a twofold reaction: (1) What do they think we are doing now? and (2) For this we needed experts?

This has begun to sound familiar. The panelists gathered from the four corners of expertdom tell us that we are on our own. As the experts gathered to figure out Gulf War Syndrome concluded: We don't know, but could it be stress? And the experts appointed to save Social Security declared: Uh, here's three ideas, you decide.

I am not wholly opposed to the deflation of expertise. Consider all the know-it-alls who turned out to know nothing. In the Middle Ages, experts first dated the beginning of the universe at 3963 B.C.; then at 6 p.m. October 22, 4004 B.C.; and finally at 9 a.m. October 23, 4004 B.C. Experts never were what they used to be.

When today's fortysomething women were kids, doctors were considered gods, delivering prescriptions from the mount. Many us called that paternalism and wanted to be treated as grown-ups.

Better informed, more confused

Now, instead of getting and taking ''Doctor's Orders,'' we are often given risk factors. Doctors in turn, as ordered, are less likely to see themselves as authoritarian. Information has become, for better and worse, democratized. Patients are better informed and more confused.

The irony is that expert deflation has come at the same time as expert proliferation. This is a world in which people seek medical information in Internet chatrooms. Every reporter worth a Rolodex has a list of duly and not necessarily legitimately dubbed experts. One of the most ludicrous phrases in modern journalism has become, ''Experts say . . . ''

It's almost like a rule of the market economy: The more of them we have, the less they are worth. At the lowest level, we have experts for hire who will duel on television or in the courtroom.

Nevertheless, when we gather the best and the brightest and the most objective, the designated superpanels, we expect them to help the country sort out the information and misinformation on everything from mammograms to Gulf War illness to Social Security. Instead, they behave like hung juries.

Their uncertainty may reflect a truly ambiguous reality. This is at least part of the mammogram story. It may reflect a growing reluctance of anyone to take responsibility, to reach any conclusion noto 95 percent certain. Or the fear of being proved wrong. Or an inability to reach a consensus when all the data aren't (and never will be) in.

There is something decidedly, hopelessly, inexpert about the opinion that we have to figure things (like mammograms) out for ourselves. As George Annas, another ethicist and amateur expert-watcher says, ''A hung jury is irresponsible. Experts owe us an opinion if they are going to speak in public. Otherwise, what are they good for?''

Interesting question. Shall we call together a national panel of experts for the answer?

Ellen Goodman is a syndicated columnist.

Pub Date: 2/07/97

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