Royal College of Physicians Sunday 7 May 2006

Let me first express my thanks to this College for the honour of delivering this year’s annual oration in memory of Arthur Mills.

Let me also acknowledge, on my own behalf and on behalf of the College, the Aboriginal Australian people of the greater Cairns region – the Idinji, the Irukanji and the Djabugay. I mean this as no perfunctory acknowledgement of past traditional ownership of the lands upon which we have the privilege of meeting. I mean that there are living human beings, whose standing descends from the peoples who occupied and owned this land for millennia before the coming of Europeans, who are indeed entitled to recognition of their moral and legal claims to their traditional inheritance. What is left for them to be accorded today is but a remnant of their ancient estates – mere slivers of land that have not been alienated during the course of two centuries of dispossession – but they are past due their now belated recognition and justice. It leaves me with deep chagrin to think how miserable this country continues to be notwithstanding the articulation of the grounds for recognition and justice in the High Court’s 1992 decision in Mabo v The State of Queensland.

I know nothing about medicine and would not presume to say anything on the subject, except that my audience is this evening estopped from objecting on the grounds that you have afforded me the pulpit of this oration – and I will make reference to the current controversy around the allegation that today’s medical graduates are anatomically challenged, and that the teaching of core subjects has been compromised by an apparent emphasis on matters such as “cultural sensitivity”. Of course that old dead horse – “political correctness” – is said to be the reason for this potentially fatal development. Now I am a keen hunter and have had my share of elbow-deep groping around the bloody and putrid viscera of wild animals – so I have a general idea of the terrain – but I would hope that your profession maintains the highest standards of navigation in respect of the human body. But I wish to make a short point about how the campaign over the past decade against “political correctness” in this country has come to be a licence for all species of yobbo insensitivity and chauvinism – as well as a bone-headed obscurantism and tabloid anti-intellectualism. True it is that the intramural cultural left of the 80s and 90s constructed the more ridiculous and easily mocked aspects of what became known as political correctness. True it is that much of the excesses of leftist political correctitude were anti-intellectual and part of a political and cultural agenda against the right.

But I wonder whether a leftist political certitude based on anti-intellectual premises, has been replaced by a rightist one? In the same way as the left on campus used PC as a club with which to beat the so-called Neanderthals of the right – and discovered the benefits of so doing – the right are now in the ascendancy in the cultural wars, and they now proudly wear the mantle of Neanderthal insensitivity and anti-

intellectualism. And it has yielded much fruit for the parties of the right in their electoral successes of the past decade.

Most of the intellectual and cultural surf in our country are echoes of the main currents emanating from Stateside, and the cultural wars in Australia are usually a callow reproduction of the raging themes, albeit time-delayed like an international phone call. The indigenous application of the latest insights and themes usually lacks the depth, insight, wit or interest of the original sources – but as long as they furnish an emotional argument, they serve their purpose, and we will press those buttons until the stones bleed dry. Emotional appeals to the “orthodox” Australian right to be offended by notions of sensitivity, cultural respect and an iterative dedication to tolerance and our common humanity – obviously works well electorally. But these emotional resonances obscure the chances for true maturation in a society. Instead the scourge of leftist political correctness is replaced by its rightist equivalent.

Given my dismay at our antipodean immaturity, it is ironic that it was an Australian, the expatriate intellectual Robert Hughes, who set out the first proper elucidation of the problem of political correctness in the United States in a lecture series at the New York Public Library in 1992, subsequently published as Culture of Complaint: The fraying of America1. Hughes does not just attack Political Correctness, Afrocentrism and Post Modernism – he attacks the populist demagogy of Reagan and the American right, with its appeal to mono-cultural nativism and the disingenuous attack on elites. If the torturing of the English language became the easiest way of mocking leftist PC – it was not the American left that invented enduring words like “collateral damage”, “corporate rightsizing” and so on. As Hughes said about the free speech wars: “Palaeo-conservatives and free-speech therapists are both on the same wagon, the only difference being what they want to ban”.2 The same could be said of the tactical device – used fulsomely here in Australia – of condemning so-called “elites”: the truth is that both the right and the left variously condemn and support elites, it just depends which elite you are talking about.

Hughes’ critique still represents the best that has been written upon the subject of closing minds. He is of liberal and conservative temper by provenance, but his book is keen and incisive, and has a moral keel whose balance is instructive and his arguments are compelling and the pungent writing rewards a first-time reading, and indeed a re-reading, for those seeking to understand some of the key questions lying obscured but unresolved in the Australian sub-terrain in 2006.

Let me just conclude my brief diversion into the matter of political correctness in the professional development of physicians and make the modest proposal that perhaps we should aim to have doctors who possess both an un-compromised and rigorous knowledge of anatomy as well as training in cultural sensitivity?

Let me now turn to the main subject of my oration. I wish to set out some of my thoughts on social norms, what they are and how they are critical to successful societies.

  1. 1  Robert Hughes, The Culture of Complaint, Oxford University Press, Oxford, 1993.
  2. 2  ibid, p.19.

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I am much interested in social norms.

Given the predicament of my indigenous people in Cape York Peninsula, I have had reason to reflect on what made our indigenous society so dysfunctional, and what we need to do to overcome our problems, to seize our opportunities, capitalise on our talents and mobilise our passions. What is it that makes societies successful, and what is our development challenge?

In my work with Cape York Partnerships over the past 6 years and the work of the Cape York Institute in the past 2 years, we have come to appreciate the work of the Nobel Prize winning economist, Amartya Sen, from whom we take as the end goal of our Cape York Agenda the following aim: For our people to have the capabilities to choose lives they have reason to value. In my view Sen’s articulation of the policy end goal for a good society, is of universal relevance: good societies equip their members to have capabilities to choose lives they have reason to value.

Sen’s breakthrough thesis married a social democratic commitment to social investment in what he calls “capabilities” – good health and education being key underpinnings of capabilities – with a liberal commitment to the importance of markets and choice, as powerful motivators of personal action and the efficient allocation of resources. People are truly free when they have the capabilities to choose.

In our Cape York Peninsula context we were convicted about the need for a third aspect of a good society: the importance of social norms. Social norms are so taken for granted it is perhaps easier to appreciate the importance of norms in societies where they have collapsed. Many Third World societies, stricken by poverty, nevertheless maintain strong social and cultural norms. The development challenge in these societies is to invest in the development of capabilities, whilst ensuring that these investments are mindful of the power of incentives and individual choice. The prices must be right.

Our context is different in Cape York Peninsula: ours is not just a condition ofpoverty, ours is a condition of passivity – and my contributions over the past half decade have been aimed at increasing understanding of the profound differences between poverty and passivity. Whilst on the surface these problems exhibit similar symptoms, passivity is much more profound because it goes to the heart of human motivation, hope and responsibility. People stricken with poverty will respond to opportunities, and they have not given up the struggle for a better life: indeed they cannot afford to stop struggling. People stricken with passivity will often not even respond to opportunities and have often abandoned responsibility and hope. This explains the paradox of the condition of indigenous peoples in First World countries such as those of North America and Austral-Asia often being more parlous that many more economically poorer peoples in the Third World.

I have sought to underline the role that passive welfare has played in the development of this condition of passivity. I have also explained the relationship between passivity and the rise of substance abuse epidemics amongst our people, and how historically three tragic things happened at the end of the 1960s and the early 1970s:

  • Equal Wages in 1965 carried with it the removal of Aboriginal stock-workers from employment in cattle industry to sedentary life in settlements and the fringes of country towns
  • Citizenship in 1967 carried with it the right to enter pubs and drink alcohol
  • The Commonwealth Government provided the now idle Aboriginal men with

    unemployment benefits which they could use to buy alcohol

    Idle time, free money and the right to drink proved to be a disastrous cocktail, which belied the fact that these changes were intended to be positive: equal citizenship, freedom from discrimination and entitlement to welfare.

    I will not rehearse my thesis on passive welfare, I have dilated enough on the subject in other fora. My point at this stage is to point out that one of the effects of passivity and the rise of substance abuse epidemics has been the destruction of social and cultural norms within our society. Social norms concerning responsibility, respect, authority, obligations and behaviour are in tragic disrepair in our communities in Cape York Peninsula. Expectations about parenthood and social behaviour have collapsed and dysfunction rules.

    Social norms are critical to understanding the dynamics of substance abuse. Following the late Swedish Professor, Nils Bejerot, our analysis of substance abuse3, as social epidemics, is premised on 5 factors being necessary for the growth of substance abuse epidemics. These factors are:

  • Firstly, the availability of the addictive substance or process
  • Secondly, money to acquire the addictive substance or engage in the process
  • Thirdly, time to use the addictive substance or engage in the process
  • Fourthly, the example of use of the addictive substance or process in the

    immediate environment, and

  • Fifthly, permissive social and cultural norms in relation to the use of the

    addictive substance or process

    It is this fifth factor which is critical to whether a substance abuse epidemic will grow in a particular community or society. Social norms represent either a barrier or a facilitator of the social spreading of addiction.

    In articulating our reform agenda for Cape York Peninsula, we have therefore set out a three part description of a successful society comprising Social Norms, Capabilities and Choice4. Our metaphor for social and economic uplift for our people is not a “ladder of opportunity” but rather a staircase. A staircase has three components. The first component is a strong foundation of social norms, and this represents a definite conservative and traditional commitment in our policy thinking. The second component is a strong investment in capabilities, such as health, education and infrastructure, and this represents a definite social democratic commitment in our

    3 Apunipima Cape York Health Council and Cape York Partnerships, Cape York Peninsula Regional Substance Abuse Strategy, unpublished paper, May 2002 (available at www.capeyorkpartnerships.com).

4 Noel Pearson, The Cape York Agenda, Address to the National Press Club, Canberra, 30 November 2005 (available at www.cyi.org.au).

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policy thinking. These are the supports under-girding the staircase. The third component is a strong belief in the power of incentives and choice and this represents a definite liberal commitment in our policy thinking. These are the stairs. After all, incentives need to be rationally aligned so that the stairs head upwards. It also means that choice must ultimately be made by individuals. Individual choice is the most powerful mechanism of social uplift, and it also means that choices will not be prescribed. What lives people have reason to value is a matter of choice.

Let me now turn to some of my theoretical thinking about social norms.

I do not think that “social norms” should be interpreted as a synonym of “social values”.

I think that social norms come into existence when two things coincide: when thewidely accepted values of a social group are matched and supported by widely adopted behaviour.

Norms may be widely held throughout a society, or they may be held by sub- groupings within a society, for example youth engaged in petrol sniffing. So that we maintain clarity it may be useful to talk about social norms when we are talking about society-wide or community-wide norms, as opposed to subgroup norms when we are talking about norms that have become established in smaller groups.

Harvard Professor Herbert C. Kelman devised the classic model for the development of social attitudes5. Kelman suggested that social groups should be viewed as consisting of compliers, identifiers and internalisers, in various proportions.

Compliance is when individuals simply go along with a strong social influence – whether good or bad – but there is no great commitment to the behaviour.

Identification occurs when individuals adopt the behaviour of a person or group that he or she likes and wants to establish or maintain a relationship with. However, when that relationship comes to an end, the person will eventually lose interest in the behaviour.

Internalisation is when a person’s attitude, beliefs or aims coincide with the admired person or group. This person is more likely to maintain the behaviour even if the initial influence is removed.

The point is that a social norm can have force, even though everybody is not an internaliser – there will be compliers who will be influenced by the social norms.

The following questions arise for me in thinking about the fact that the group influenced by a social norm is diverse: what happens when a social norm is established? Is there a “tipping point” when a social norm coalesces?

5 Herbert C. Kelman, “Compliance, identification, and internalization: Three processes of attitude change”, Journal of Conflict Resolution, 2, no. 1 (1958), pp. 51-60.

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Specifically, what are the dynamics when a beneficial social norm collapses? And can a beneficial norm be rebuilt?

I am proposing that – at the level of broadest generalisation – there are three “levels” of norms: positive or traditional, neutral or non-judgmental, and negative.

By “positive” or “traditional” norms I mean norms which contribute to the well-being of the people holding to the norms.

A community with strong positive norms is positively paternalistic and maternalisticin its willingness to prescribe a socially beneficial standard of behaviour.

The neutral or non-judgmental zone or level in the development of social norms is a well-known phenomenon to those who have experience of Indigenous Australian communities. It is therefore important that we develop an analysis that is politically and socially effective, an analysis that can influence community members as well as public opinion and political leaders.

By “neutral” I mean to describe what happens when a positive/traditional social norm has been challenged and is not upheld. When a positive/traditional social norm collapses, it is not immediately replaced by a negative social norm. On the contrary, a casual observer might at first conclude that the positive norm is still relatively strong. When a positive social norm collapses, the values initially remain, privately supported by almost as many people as before the collapse.

What happens is that the traditional norm is challenged by a minority that initially might be quite small. The conservative majority reacts – most likely too slowly – and tries to enforce the norm.

But they are defied and defeated. Perhaps in an attempt to rationalise this shock defeat, the majority becomes non-judgmental.

Perhaps the most profound change is the non-enforcement of behaviours associated with norms.

To the extent that we can call these attitudes a social norm, it is neutral. If it holds to values, individual choice is valued ahead of social prescription.

The shift which I have outlined is much more dramatic in the Indigenous Australian communities I am most familiar with. But similar things have happened in modern western societies such as Australia, which have undergone a retreat from “public morality”, and the confinement of values to “private morality”. There may be public expression of desired social values – but no longer any preparedness to socially enforce the relevant behaviours. This is left to individuals to decide for themselves.

Confusion about what “individualism in society” should mean, as well as understandings of “freedoms”, “rights” and “tolerance” – are probably at the centre of modern western societies having shifted to the neutral/non-judgmental zone when it concerns social norms.

It is not the case in the neutral zone that values will necessarily be neutral or negative – many or even perhaps most individuals will subscribe to positive/traditional values but there is not the social willingness or capacity to uphold the behaviours that reinforce those values. So:

  • individuals or subgroups (even the majority) may hold to the values, and behave accordingly; and indeed
  • the values may be held socially – but there is no social will to uphold the correlate behaviours.

    At this point in our discussion, you might ask whether I am contradicting my own definition of social norms in this description of the zone or level which I call non- judgmental/neutral. I initially defined social norms to be community-wide and to be “the coincidence of values and behaviour”. But a few sentences ago I said that the neutral zone is characterised by widespread acceptance of behaviours which may be against the values held by the majority.

    The difficulty lies in explaining that the neutral social norm which currently holds sway in Indigenous Australian communities is in fact not the same as anarchy. The neutral level or zone is a more complex state than the state where norms are still on the high positive, traditional level. But it is still a system of attitudes that is shared by most community members.

    In an orderly community, some people uphold positive norms because of deep convictions, religious or moral. But a large group of people follow the positive norms simply because of the lack of examples in their environment of other ways of thinking and behaving during their formative years.

    Picture these two individuals: one has a contemplative moral outlook and a behaviour to match his conviction, and the other person has no inclination towards moral reflection but lives by default in approximately the same way as his honest parents. These two people would appear to be similar in an orderly community, but they would probably be more different in a community where the positive norms are challenged.

    This is the difference which I referred to earlier, the difference Herbert Kelman draws between internalisers and compliers.

    When traditional norms are honoured, behaviour is uniform and easy to describe. The norm can easily be described with a few references to work ethic, rejection of substance abuse, et cetera. But if the behaviour in an orderly community is easy to describe – for example, 99.99 percent of people do not commit crimes that land them in jail – that is due to the fact that successfully upheld positive norms hide the range of human complexity and susceptibility.

    In a community with positive norms, there is little apparent variation in values and little behavioural variation. The vast majority is gathered around one point on the behavioural spectrum; when the successfully upheld social norm says “work, do not

gamble, go to church, learn to read and write, et cetera” there is by definition no room for behavioural variation.

The community I just described is my home community of Hope Vale as I remember it from my childhood. It is the community that saw me never miss school, that gave me parents who tended to my need for a safe home, food and clothing within their limited means, and medical attention when I needed it. It is the community that taught my siblings and my contemporaries respect for their elders and their fellow community members.

In a community that has descended to the neutral level, values and behaviours of people will appear to an observer as continuous spectra. It will not be like in a community with positive norms, where the vast majority is gathered around one point at one end of the behavioural spectrum.

In present-day Cape York Peninsula communities there is also a dominant norm. We have labelled it neutral or non-judgmental. At one end of this spectrum are those whose outlook is an awkward and forced amalgam of two contradictory thoughts: a residual private rejection of bad behaviour, and a resigned public tolerance of bad behaviour.

In the middle of this spectrum, there are people who have an unqualified neutral outlook, and no private concerns about what people do: anything goes, laissez-faire.

Then there are those subgroups, usually small minorities, who have completely negative norms; destructive behaviours like petrol sniffing are expected and necessary for peer acceptance6.

Behaviour in a community with a neutral norm must also be described as a spectrum. As I said before, many people will want to think that they privately still adhere to the positive values. But we now have insights about co-dependency in the family of an addict, and I have previously written about the dangerous role of “moderate” drinkers in an Indigenous Australian community with an epidemic of alcoholism.

For these reasons, I think that my model and definition makes sense. The positive norm easily fits our definition: widely accepted values are matched and supported by widely adopted behaviour. The neutral norm also fits our description, but both the norm and the behaviour are spectra rather than being (apparently) the same for all people, as is the case in an orderly community.

I think that the political and social usefulness of the analysis we have adopted here is that it makes clear that the neutral norm and the corresponding behaviour are in factone spectrum of ways of thinking and one spectrum of behaviours. Everybody in a community is responsible for the fact that this paradigm is prevailing. Community members must not try to escape responsibility by making distinctions between their behaviour and the behaviour of more dysfunctional people, and between their private values (which they do not defend) and the values of the more dysfunctional people.

6 Milton James, “Petrol Sniffing on Cape York Peninsula: An Intervention Strategy”, Cape York Partnerships, unpublished paper

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The third level or zone in my model is negative norms.

Usually, I would think that negative norms are subgroup norms. Such norms become established when a subgroup’s values and behaviours challenge and successfully defy any contrary positive/traditional social norm, and the social norm therefore collapses to neutrality/permissiveness.

Neutral or non-judgemental norms are permissive of deviant values and behaviours – and offer no barriers to the formation of negative norms.

Societies or communities ruled by neutral or non-judgmental norms can no longer resist the development of deviant values and behaviours amongst individuals and subgroups within their midst. This is because:

  • even if many or most people continue to hold strong values against the deviance
  • and if many or most people do not engage in the deviant behaviours
  • there is no preparedness to enforce the values and behaviours on deviant

    individuals or subgroups. In conclusion:

    I have talked about three zones or levels of social norms. The question is, are they stages in an historical development, and is this development irreversible? Yes, positive norms, the emergence of neutral norms, the emergence of negative norms in subgroups are stages in an historical development.

    But no, I do not believe that this process is irreversible. If we Indigenous Australians become aware that the current problem is not a problem with a minority of dysfunctional individuals, that it is a problem with a community-wide shift from a positive to a neutral norm, then I think we can reverse the collapse of the positive norm. It is to this end that we are focusing our determination.

    It is not the completely dysfunctional minority that is the main problem. The neutral social norm is the problem. And almost everybody today contributes to the problem, even if they privately retain traditional positive values.

    This realisation, and the determination to change this is one of the changes that are needed if people of the Cape York Peninsula are going to have a better future. And it is not the smallest challenge.