Wisdom is action-oriented. Taking action may lead to resistance, if not outright conflict, from groups affected by your actions. Though conflict may refer to the use of violence, as we often observe in social systems experiencing severe unrest, in the context of this textbook, conflict refers to nonviolent antagonism between two or more groups. This may manifest as groups’ use of all the tactics of power available to them to actively undermine and eliminate the “threat” posed by others.

These conflicts may arise due to incompatible values, differing rationalities, or both.^[1] Let’s explore each of those reasons in turn, as well as ways to manage this resistance.

Disagreements Between Values

Groups may resist you if they perceive your actions as a threat to the values they pursue. These value conflicts may lie across three dimensions: conflicting terminal values, conflicting instrumental values, or the time scales when actions have their impact.^[2]

 Conflicting Terminal Values

Terminal values are the ends we find worth achieving. Conflicts arising out of conflicting terminal values may be difficult to solve because each party is, fundamentally, trying to achieve different things.

You may recall from Chapter IV that organizations use several means to negotiate these conflicts, including the following.^[3][4][5]

• Firewalls: The organization tasks different departments with the pursuit of different values.
• Cycling: One set of values dominate. Over time, resistance grows until a new set of values become dominant.
• Casuistry: Individuals rely on experience with similar conflicts to resolve current ones.
• Bias: One set of values falls out of favour.
• Hybridization: Individuals attempt to reconcile competing values.
• Incrementalism: Individuals slowly favour one value over time.
• Compromise: Competing values each sacrifice some of their aims to accommodate the other value.

Conflicting Instrumental Values

Instrumental values describe the means we find appropriate to achieve an end. Chapter IV presented several examples of situations where groups shared terminal values but had different instrumental values. Even though they each sought the same outcome, their focus on different ways of achieving that outcome led to tension between the groups.

In addition to the tactics described in the preceding section to resolve such conflicts, defining rationality to focus on the terminal values you share might reduce the resistance between groups pursuing different instrumental values.

Conflicting Time Dimensions of Values

Chapter IV discussed how the time scales over which different groups achieve their values might lead to resistance. One group’s actions to reach a value in the long term may compromise another group’s ability to achieve that value in the short term.

Again, using the methods described above to focus on those values that overlap might reduce the resistance you face.

Disagreements Between Rationalities

Sometimes, different types of rationality conflict. For example, technocratic rationality showed that the Seniors Program delayed frailty. Physicians concerned with patient care should, therefore, adopt it.

Economic rationality, however, told doctors that doing so was financially unviable. In that situation, economic rationality won.

Similarly, as Appendix 1 described, when deciding what to call the patients eligible for the Seniors Program, technocratic rationality suggested “pre-frail seniors.”

Seniors, however, disliked this name. These people felt healthy. Their body rationality told them the word “frailty” was inappropriate. Their emotional rationality told them the concept of frailty was frightening, and they were unwilling to have the word applied to them.

In this situation, however, technocratic rationality won, and the fellowship chose to call their target patient “pre-frail seniors.”

Why did technocratic rationality lose to economic rationality when physicians were deciding whether to adopt the Seniors Program but win over body and emotional rationality when deciding what to name the patient?

Generally, when different forms of rationality lead different groups to disagree, the rationality used by the group with the most power wins.^[6]

In Canadian healthcare systems, bureaucratic rationality assigns ultimate authority for treating patients to the physician. They have control over what interventions to prescribe. Thus, when economic rationality informed doctors of their inability to adopt the program, economic rationality won.

When choosing what to name the patient, however, it was physicians who were responsible for identifying which patient was eligible for the Seniors Program. In Canada, doctors practice evidence-based medicine (i.e., technocratic rationality). Thus, the name in the literature–pre-frail seniors–was the name they understood. Since physicians had the power to enroll patients, the fellowship deferred to doctors’ technocratic rationality over the patients’ body and emotional rationality.

The key message is this. When your use of one rationality leads you to disagree with someone using different rationality, your rationality will likely win if you have more power. If the other person has more power, their rationality will win.

As the fellowship’s experience showed, however, even if another person’s rationality wins, you can still make progress if you have good insight into values, rationality, and power systems at work.  The fellowship displayed this when they adjusted bureaucratic structures to change the conclusions of the physicians’ economic rationality.