Read this link: “Having doctors squander their time completing multiple checklists that someone else has determined are necessary and which could well be done by others is a huge waste, and leads directly to worse outcomes.”

This is the same criticism I have with the Obama administration’s approach to education – “outcomes” are defined bureaucratically, by adherence to given algorithms, rather than letting highly trained, experienced people work autonomously, the best way they know how. Stupid checklists are substituted for the expertise of people who used to be honored professionals but are being de-skilled, turned into fungible clockworks for the completion of these checklists. It’s an inherently mistrusting, technocratic, anti-democratic system, insisting that all proper procedures emanate from the dead hand of the central office, and that the accumulated knowledge of the actual workers, being particular, variable, and hard to express in numbers, counts for nothing. The Administration’s proposal to rank-order universities and scholars is in the same spirit, and is equally depressing.

Another way to view it is that the last redoubts of autonomous work are finally being subjected to the capitalist Taylorism that long since wrecked the dignity of craft. It’s not a partisan thing, either – both the Republicans and the Democrats love it, because it produces nice graphs that can be taken to the voters, and, all-importantly, reduces taxes. But when you remove what Aristotle called ‘phronesis’ (the practical wisdom of training and experience) from any human agent-patient relation, we are all reduced to cogs in some giant planetary gear of Molochian justification.