In the sixth book of the Republic, a Socratic dialogue on just government, the Ancient Greek philosopher Plato likens the Athenian city-state to a ship [1]. On the ship are the ship’s owner and its sailors, while the position of captain is vacant. The question underpinning the dialogue is this: who should be captain? Who should be in charge of steering the ship, and on what basis?
Should it be the shipowner? “The shipowner is bigger and stronger than everyone else on board, but he’s hard of hearing, a bit short-sighted, and his knowledge of seafaring is equally deficient”. It would appear not. While the shipowner is characterised as possessing the superior physical strength, the insensitivity of his senses and the inadequacy of his knowledge constrain him from taking up the role.
Should it be the sailors? “The sailors are quarreling with one another about steering the ship, each of them thinking that he should be the captain, even though he’s never learned the art of navigation, cannot point to anyone who taught it to him, or to a time when he learned it. Indeed, they claim that it isn’t teachable and are ready to cut to pieces anyone who says that it is”. Due to their interminable quarrelling, the sailors believe the person who ought to be captain is the one who possesses the superior rhetorical skills, the person who can persuade the shipowner that he is the right person for the job, “they call the person who is clever at persuading or forcing the shipowner to let them rule a “navigator,” a “captain,” and “one who knows ships,” and dismiss anyone else as useless”. Socrates begs to take a different view, “they don’t understand that a true captain must pay attention to the seasons of the year, the sky, the stars, the winds, and all that pertains to his craft, if he’s really to be the ruler of a ship. And they don’t believe there is any craft that would enable him to determine how he should steer the ship, whether the others want him to or not, or any possibility of mastering this alleged craft or of practicing it at the same time as the craft of navigation”.
For Socrates, a true captain, the person best qualified to steer the ship of state, is the person who has mastered the craft of navigation–by understanding not only how to steer the ship, but also by paying attention to the prevailing conditions or environment within which steering the ship occurs. It is this combination of steering skill, plus attention to environmental conditions that determines, along with the requisite feedback let us say, who ought to steer the ship. While Socrates is not optimistic about the attitude the ship’s occupants will take towards a true captain, or indeed the usefulness of a philosopher to the majority of people, the point being made in the exchange is that the captain is the person who has not only mastered the craft of navigation but is also guided by a form of truth that exists beyond the vested interests being debated. Irrespective of our agreement or disagreement with Plato’s position, the simile raises the following questions ‘Who ought to steer’? Along with the normative question of why they ought to steer and therefore be accepted as the steersman by the others on board ship.
With some poetic license let us say that on board ship, stored on a disc in the captain’s quarters, is a precious cargo of patient data–a key resource for the effective delivery of a city’s patient care. However, not only is the patient data a resource of value to the city and to its citizens, it is also a resource of value to healthcare researchers, and to commercial companies. The captain, the destination of the ship, and with whom the ship’s cargo will be shared has not yet been confirmed. Against the recent background of recent initiatives like Care.data, Project Nightingale, and Alexa Healthcare Skills, who ought the guardians and steersmen of our patient data be? And why?
[1] The simile has become known as the Ship of State. All citations are from Cooper, J.M. (1997) (ed.) Plato: Complete Works. Cambridge: Hackett Publishing Company. The key passage is contained in Republic VI, 487e7– 489a6, p.1111-1112.
Ship’s Log 