John Launer: Living with Leviathans

Like many doctors working beyond retirement age, I now work for various institutions within the NHS and outside it, including universities. They’re all splendid organisations in many ways, but they have their annoyances too. Many of these are due to the increasing dominance of regulation, governance, and risk avoidance.

Let me give a couple of examples. On a single day recently, I received two requests. The first came in an automated email with a mystifying heading along the lines of “PLOB expiry alert,” from a “noreply” address at a department with a name like “Flowmail Admindesk.” It warned me that I needed to complete some online mandatory training I’d never heard of. After trying three or four different browsers and devices I managed to log in and found that it concerned computer screens and their hazards, including the positions of keyboards and chairs. All the guidance related to fixed office desktops, even though I do all my work on portable devices. I skipped the training module, guessed the 30 answers required in the assessment as quickly as I could, and duly downloaded my certificate.

The second request, from another organisation, was more challenging. Relating to the organisation’s policy on conflicts of interest, it was clearly designed for full time employees who might want to register one or two other commitments such as board memberships. I wrote a couple of paragraphs explaining that I don’t hold any such posts but that I teach around the UK and abroad and write for various publications such as The BMJ. I mentioned that in any month I might have five or six employers, with the list constantly changing and impractical to keep updated. I assured them that I would observe the requirements of their 25 page probity policy. My response may have caused some consternation, since it was escalated to a senior governance manager. I await their judgment.

These systems exist not because they’re meaningful but because they’re technologically possible. They’re unlikely to prevent the risks they aim to avert, although they may indemnify organisations by passing responsibility downwards. Although it’s easy to feel cross with the individuals who design and implement them, these people are also victims, like us, of the social and cultural forces we’re all caught up in.

The political historian David Runciman has named our age the Leviacene.1 Drawing on the philosopher Thomas Hobbes, who first described the state as a Leviathan or monster, Runciman regards our society as being dominated by a range of Leviathans consisting of states, corporations, technological networks, and artificial intelligence. He argues that these things have a life of their own and increasingly regulate our lives and ways of thinking. We mostly join in compliantly rather than protesting at their inhumanity.

Runciman warns that we urgently need to take control of these Leviathans before they take us to a dark place. “They are meant to work for us,” he writes, “but it is possible we will end up working for them.” It certainly feels like this at times.