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Uncertainty... Reply To Editor's Choice, BMJ

Response #2, May 26, 2017 to Editor's Choice Navigating uncertainty BMJ 2017; 357 doi: doi.org/10.1136/bmj.j2524 (Published 25 May 2017) Cite this as: BMJ 2017;357:j2524 http://www.bmj.com/content/357/bmj.j2524/rapid-responses

Medicine devotes its primary focus to understanding change, from cells to network relationships; change can be perceived as risk or uncertainty depending upon how the assessment is made; risk is quantifiable by sensory input and generates a degree of rational optimism; uncertainty is not quantifiable and evokes fear; trust is key to sharing risk; the measurable financial credit can be a proxy for societal trust; expanding credit dilutes trust; when a credit bubble bursts, so will trust; absence of trust paralyzes systems' relationships leading to disorganized complexity which prevents value creation and heightens the probability of random events; disappearance of value, accompanied by chaos, threatens all systems. From personal health to economic sustainability and collective rationality, most components of current societal systems are not optimized and trust is not in evidence.