From:
Risk,
The Science and Politics of Fear
by
Dan Gardner, 2008
Excerpted
mostly from chapters 2, 4, 6, 8, 10, 11
Four
decades ago, scientists knew little about how humans perceived risks, how we
judged which risks to fear and which to ignore, and how we decided what to do
about them. But in the 1960s, pioneers like Paul Slovic, today a professor at
the University of Oregon, set to work. They made startling discoveries and over
the ensuing decades, a new body of science grew. The implications of this new
science were enormous for a whole range of different fields. In 2002, one of
the major figures in this research, Daniel Kahneman, won the Nobel Prize in
economics, even though Kahneman is a psychologist who never took so much as a
single class in economics. What the psychologists discovered is that a very old
idea is right. Every human brain has not one but two systems of thought. They
called them System One and System Two. One is Head, the other, Gut.
So
we have, in effect, two minds working semi-independently of each other. Further
complicating our thoughts is the constant, complex interaction between the two.
ItÕs possible, for example, that knowledge learned and used consciously by Head
can sink into the unconscious mind, to be used by Gut. Every veteran golfer has
experienced this process. When you first pick up a club, you consciously follow
instructions. Keep head back, knees bent, right arm straight. Beginners think
about each of these points consciously and carefully. They canÕt just step up
to the tee and swing. But do this often and long enough and you no longer have
to think about it. Proper form just feels right and it happens much more
quickly and fluidly. In fact once it has been internalized, consciously
thinking about what youÕre doing can interrupt the flow and hurt performance
– which is why professional athletes are taught by sports psychologists
to avoid thinking about the motions they have done thousands of times before.
Even
the most cerebral actions can undergo this shift from Head to Gut. Neophyte
doctors faced with a common ailment consciously and carefully think about the
checklist of symptoms before making a diagnosis, but old hands ÒfeelÓ the
answer in an instant. Art historians whose job is to authenticate antiquities
make the same transition. In the now-famous anecdote that opens Malcolm
GladwellÕs book Blink, a Greek statue that had supposedly been authenticated by a
battery of scientific tests was nonetheless instantly dismissed as a fraud by
several art historians. Why? The experts couldnÕt say. They just felt that something was wrong
– one called it Òintuitive repulsion.Ó Testing later confirmed the statue
was indeed a fraud, a truth the experts were able to feel in an instant because
they had studied and analyzed Greek statues for so long that their knowledge
and skills had been absorbed into the unconscious operations of Gut.
I
know this because the questions IÕve asked come from a study conducted by
German psychologists Fritz Strack and Thomas Mussweiler. They asked people two
versions of the Gandhi questions. One version is to ask whether Gandhi was
older or younger than 9 when he died. The other began by asking people whether
Gandhi was older or younger than 140 when he died, which was followed by the
same direction to guess GandhiÕs age when he died. Strack and Mussweiler found
that when the first question mentioned the number nine, the average guess on
the following questions was 50. In the second version, the average guess was
67. So those who heard the lower number before guessing guessed lower. Those
who heard the higher number guessed higher. Psychologists have conducted many
different variations on this experiment. In one version, participants were
first asked to construct a single number from their own phone numbers. They
were then asked to guess the year in which Attila the Hun was defeated in
Europe. In another study, participants were asked to spin a wheel of fortune in
order to select a random number – and then they were asked to estimate
the number of African nations represented in the United Nations. In every case,
the results are the same: The number people hear prior to making a guess
influences that guess. The fact that the number is unmistakably irrelevant
doesnÕt matter. This is the Anchoring Rule.
By now, the value of the Anchoring
Rule to someone marketing fear should be obvious. Imagine that you are, say,
selling software that monitors computer usage. Your main market is employers
trying to stop employees from surfing the Internet on company time. But then
you hear a news story about pedophiles luring kids in chat rooms and you see
that this scares the hell out of parents. So you do a quick Google search and
you find the biggest, scariest statistic you can find – 50,000 pedophiles
on the Internet at any given moment – and you put it in your marketing.
Naturally, you donÕt question the accuracy of the number. ThatÕs not your
business. YouÕre selling software.
Four
decades ago, Kahneman and Tversky collaborated on research that looked at how
people form judgments when theyÕre uncertain of the facts. When Kahneman and
Tversky began their work, the dominant model of how people make decisions was
that of Homo economicus ÒEconomic manÓ is supremely rational. He examines evidence. He
calculates what would best advance his interests as he understands them, and he
acts accordingly.
ÒFor every problem there is a solution that is simple,
clean and wrong,Ó wrote H.L. Mencken, and the Homo economicus model is all that. Unlike Homo
economicus, Homo sapiens is not perfectly rational. Proof of that lies not in the fact
that humans occasionally make mistakes. The Homo economicus model allows for that. ItÕs
that in certain circumstances, people always make mistakes. We are
systematically flawed. In 1957, Herbert Simon, a brilliant
psychologist/economist/political scientist and future Nobel laureate, coined
the term bounded rationality. We are rational, in other words, but only within
limits. Amos Tversky died in 1996. In 2002, Daniel Kahneman experienced the
academic equivalent of a conquering generalÕs triumphal parade: He was awarded
the Prize in Economic Sciences in Memory of Alfred Nobel. He was probably the
only winner in the history of the prize who never took so much as a single
class in economics. The amazing thing is that the Science article, which sent
shock-waves out in every direction, is such a modest thing on its face.
Kahneman and Tversky didnÕt say anything about rationality. They didnÕt call Homo
economicus a
myth. All they did was lay out solid research that revealed some of the
heuristics – the rules of thumb – Gut uses to make judgments such
as guessing how old Gandhi was when he died or whether itÕs safe to drive to
work.
Like
the paper itself, the three rules of thumb it revealed were admirably simple
and clear. The first – the Anchoring Rule – weÕve already
discussed. The second is what psychologists call the representativeness
heuristic, which IÕll call the Rule of Typical Things. And finally, there is the
availability heuristic, or the Example Rule, which is by far the most
important of the three in shaping our perceptions and reactions to risk.
The
Rule of Typical Things
Linda is 31 years old, single, outspoken, and very
bright. She majored in philosophy. As a student, she was deeply concerned with
issues of discrimination and social justice, and also participated in
anti-nuclear demonstrations.
How likely is it that Linda
¥
is
a teacher in elementary school?
¥
works
in a bookstore and takes yoga classes?
¥
is
active in the feminist movement?
¥
is
a psychiatric social worker
¥
is
a member of the League of Women Voters?
¥
is
a bank teller?
¥
is
an insurance salesperson?
¥
is
a bank teller and is active in the feminist movement?
When
Kahneman and Tversky gave this quiz to undergraduate students, 89 per cent
decided it was more likely that Linda was a bank teller who is active in the
feminist movement than that she is a bank teller alone. But if you stop and
think about it, that makes no sense. How can it be more likely that Linda is a bank
teller and a
feminist than that she is solely a bank teller? If it turns out to be true that
she is a bank teller and a feminist, then she is bank teller – so the two
descriptions have to be, at minimum, equally likely. WhatÕs more, there is
always the possibility that Linda is a bank teller but not a feminist. So it has to be
true that it is more likely that she is a bank teller alone than that she is a
bank teller and a
feminist. ItÕs simple logic – but very few people see it.
So
Kahneman and Tversky stripped the quiz down and tried again. They had students
read the same profile of Linda. But then they simply asked whether it is more
likely that Linda is (a) a bank teller or (b) a bank teller who is active in
the feminist movement? Here, the logic is laid bare. Kahneman and Tversky were
sure people would spot it and correct their intuition. But they were wrong. Almost
exactly the same percentage of students – 85 per cent – said it is
more likely that Linda is a bank teller and a feminist thank a bank teller
only.
Kahneman and Tversky also put both versions of the ÒLinda
problem,Ó as they called it, under the noses of experts trained in logic and
statistics. When the experts answered the original question, with its long list
of distracting details, they got it just as wrong as the undergraduates. But
when they were given the two-line version, it was as if someone had elbowed
them in the ribs. Head stepped in to correct Gut and the error rate plunged.
When the scientist and essayist Stephen Jay Gould took the test, he realized
what logic – his Head – told him was the right answer. About that
didnÕt change what intuition – his Gut – insisted was true. ÒI know
[the right answer],Ó he recounted, Òyet a little homunculus in my head
continues to jump up and down, shouting at me – Ôbut she canÕt just be a
bank teller; read the descriptions.Õ ÓWhatÕs happening here is simple and
powerful. One tool Gut uses to make judgments is the Rule of Typical Things. At
least, it makes no sense to Head.
To
Gut, it makes perfect sense. One of GutÕs simplest rules of thumb is that the
easier it is to recall examples of something, the more common that something
must be. This is the Òavailability heuristic,Ó which IÕll call the Example Rule.
Kahneman and Tversky demonstrated the influence of the Example Rule in a
typically elegant way. First, they asked a group of students to list as many
words as they could think of that fit the form _ _ _ _ _ n _. The students had
60 seconds to work on the problem. The average number of words they came up
with was 2.9. Then another group of students was asked to do the same, with the
same time limit, for words that fit the form _ _ _ _ ing. This time, the
average number of words was 6.4.
Look carefully and itÕs obvious thereÕs
something strange here. The first form is just like the second, except the
letters ÒIÓ and ÒgÓ have been dropped. That means any word that fits the second
form must fit the first. Therefore, the first form is actually more common. But
the second form is much more easily recalled.
Armed with this
information, Kahneman and Tversky asked another group of students to think of
four pages in a novel. There are about 2,000 words on those four pages, they
told students. ÒHow many words would you expect to find that have the form _ _
_ _ ing?Ó The average estimate was 13.4 words. They then asked another group of
students the same question for the form _ _ _ _ _ n _. The average guess was
4.7 words.
This experiment has been repeated in many different forms and
the results are always the same: The more easily people are able to think of
examples of something, the more common they judge that thing to be.
Note
that it is not the examples themselves that influence GutÕs intuitive judgment.
It is not even the number of examples that are recalled. It is how easily examples come to mind. In a
revealing study, psychologists Alexander Rothman and Norbert Schwarz asked
people to list either three or eight behaviours they personally engage in that
could increase their chance of getting heart disease. Strangely, those who
thought of three risk-boosting behaviours rated their chance of getting heart
disease to be higher than those who thought of eight. Logically, it should be the
other way around – the longer the list, the greater the risk. So what
gives? The explanation lies in the fact – which Rothman and Schwarz knew
from earlier testing – that most people find it easy to think of three
factors that increase the risk of heart disease but hard to come up with eight.
And it is the ease of recall, not the substance of what is recalled, that
guides the intuition.
The most dramatic example was nuclear power.
Laypeople, like experts, correctly said it inflicted the fewest fatalities of
the items surveyed. But the experts ranked nuclear power as the 20th most risky
item on a list of 30, while most laypeople said it was number one. Later
studies had 90 items, but again nuclear power ranked first. Clearly, people
were doing something other than multiplying probability and body count to come
up with judgments about risk.
SlovicÕs analyses showed that if an
activity or technology were seen as having certain qualities, people boosted
their estimate of its riskiness regardless of whether it was believed to kill
lots of people or not. If it were seen to have other qualities, they lowered
their estimates. So it didnÕt matter that nuclear power didnÕt have a big body
count. It had all the qualities that pressed our risk-perception buttons, and
that put it at the top of the publicÕs list of dangers.
Slovic's
Checklist
¥
Catastrophic
potential: if fatalities would occur in large numbers in a single event –
instead of in small numbers dispersed over time – our perception of risk
rises.
¥
Familiarity:
Unfamiliar or novel risks make us worry more.
¥
Understanding:
If we believe that how an activity or technology works is not well understood,
our sense of risk goes up.
¥
Personal
control: if we feel the potential for harm is beyond our control – like a
passenger in an airplane – we worry more than if we feel in control
– the driver of a car.
¥
Voluntariness:
If we donÕt choose to engage the risk, it feels more threatening.
¥
Children:
ItÕs much worse if kids are involved.
¥
Future
generations: if the risk threatens future generations, we worry more.
¥
Victim
identity: identifiable victims rather than statistical abstractions make the
sense of risk rise.
¥
Dread:
If the effects generate fear, the sense of risk rises.
¥
Trust:
if the institutions involved are not trusted, risk rises.
¥
Media
attention: More media means more worry.
¥
Accident
history: Bad events in the past boost the sense of risk.
¥
Equity:
If the benefits go to some and the dangers to others, we raise the risk
ranking.
¥
Benefits:
If the benefits of the activity or technology are not clear, it is judged to be
riskier.
¥
Reversibility:
If the effects of something going wrong cannot be reversed, risk rises.
¥
Personal
risk: If it endangers me, itÕs riskier.
¥
Origin:
Man-made risks are riskier than those of natural origin.
¥
Timing:
More immediate threats loom larger while those in the future tend to be
discounted.
ThereÕs
plenty of evidence for rationalization but the most memorable – certainly
the most bizarre – was a series of experiments on so-called split-brain
patients by neuroscientist Michael Gazzaniga. Ordinarily, the left and right
hemispheres of the brain are connected and they communicate in both directions
but one treatment for severe epilepsy is to sever the two sides. Split-brain
patients function surprisingly well but scientists realized that because the
two hemispheres handle different sorts of information, each side can learn
something that the other isnÕt aware of. This effect could be induced
deliberately in experiments by exposing only one eye or the other to written
instructions. In one version of his wok, Gazzangia used this technique to
instruct the right hemisphere of a split-brain patient to stand up and walk.
The man got up and walked. Gazzaniga then verbally asked the man why he was
walking. The left hemisphere handles such ÒreasonÓ questions and even though
that hemisphere had no idea what the real answer was, the man immediately
responded that he was going for a soda. Variations on this experiment always
got the same result: The left hemisphere quickly and ingeniously fabricated
explanations rather than admit it had no idea what was going on. And the person
whose lips delivered these answers believed every word.
When a woman
tells a researcher how risky she thinks nuclear power is, what she says is
probably a reliable reflection of her feelings. But when the researcher ask the
person why
she feels the way she does, her answer is likely to be partly or wholly
inaccurate. ItÕs not that she is being deceitful. ItÕs that her answer is very
likely to be, in some degree, a conscious rationalization of an unconscious
judgment. So maybe itÕs true that what really bothers people about nuclear
power are the qualities on SlovicÕs checklist. Or maybe that stuff is just Head
rationalizing GutÕs judgment. Or maybe itÕs a little of both. The truth is we
donÕt know what the truth is.
In
the years to come, however, the model of a two-track mind – Head and Gut
operating simultaneously – advanced rapidly. A major influence in this
development was the work of Robert Zajonc, a Stanford psychologist, who
explored what we know simply as feeling or emotions. Zajonc insisted that we
delude ourselves when we think that we evaluate evidence and make decisions by
calculating rationally. ÒThis is probably seldom the case,Ó he wrote in 1980. ÒWe
buy cars we ÔlikeÕ, we choose the jobs and houses we find ÔattractiveÕ, and
then justify those choices by various reasons.Ó
In a second experiment,
sonic and Alhakami had students of the University of Oregon rate the risks and
benefits of a technology (different trials used nuclear power natural gas, and
food preservatives).
Then they were asked to read a few paragraphs
describing some of the benefits of the technology. Finally, they were asked
again to rate the risks and benefits of the technology. Not surprisingly, the
positive information they read raised students' ratings of the technology's
benefits in about one-half of the cases. But lots of those who raised their
estimate of the technology's benefits also lowered their estimate of the risk -
even though they had not read a word about the risk.
Later trials in
which only risks were discussed had the same effect but in reverse: People who
raised their estimate of the technology's risks in response to the information
about risk also lowered their estimate of its benefit.
Various names
have been used to capture what's going on here, Slovic calls it the affect
heuristic. I prefer to think of it as the Good - Bad Rule. When faced with something,
Gut may instantly experience a raw feeling that something is Good or Bad. That
feeling then guides the judgments that follows: ''Is this thing likely to
kill me? It feels good.
Good things don't kill . So, no.
don't worry about it."
The Good-Bad Rule helps to solve many
riddles. In Slovic's original studies, for example he found that people
consistently underestimated the lethality of all diseases except one: The
lethality of cancer was actually overestimate One reason that might be is the
Example Rule. The media pay much more attention to cancer than diabetes or
asthma and so people can easily recall examples of deaths rattled by cancer
even if they don't have personal experience with the disease, But consider how
you feel when you read the words diabetes and asthma. Unless you or someone you
care about has suffered from these diseases, chances are they don't spark any
emotions But what about the word cancer it's like a shadow slipping over the
mind.
That shadow is affect - the "faint whisper of emotion,"
as Slovic calls it. We use cancer as a metaphor in ordinary language - meaning
some- thing black and hidden, eating away at what's good - precisely because
the word stirs feelings. And those feelings shape and colour our conscious
thoughts about the disease.
The
Good-Bad Rule also helps explain our weird relationship with radiation. We fear
nuclear weapons, reasonably enough, while nuclear power and nuclear waste also
give us the willies. Most experts argue that nuclear power and nuclear waste
are not nearly as dangerous as the public thinks they are, but people will not
be budged.
On the other hand, we pay good money to soak up solar
radiation on a tropical beach and few people have the slightest qualms about
deliberately exposing themselves to radiation when a doctor orders an X-ray. In
fact, Slovic's surveys confirmed that most laypeople
underestimate the ( minimal) dangers of X-rays.
Why don't we worry
aborts sun-tanning? Habituation may play a role, but the Good-Bad Rule
certainly does. Picture this: you lying on a beach in Mexico. How does that
make you feel? Pretty good, And if it is a Good Thing, our feelings tell us it
cannot be all that risky The same is true of X-rays. It is medical technology
that saves lives.
They are a Good Thing. and that feeling eases any
worries about the risk they pose.
On the other end of the scale are
nuclear weapons. They are a Very Bad Thing - which is a pretty reasonable
conclusion given that they are designed to annihilate whole cities in a flash.
But Slovic has found feelings about nuclear power and nuclear waste are almost
as negative and when Slovic and some colleagues examined how the people of
Nevada felt about a proposal to create a dump site for nuclear waste in that
state, they found that people judged the risk of a nuclear waste repository to
be at least as great as that of a nuclear plant or even a nuclear weapons
testing site. Not even the most ardent anti-nuclear activist would make such an
equation. It makes no sense - unless people's judgments are the product of
intensely negative feeling to all things "nuclear.
We're not
used to thinking of our feelings as the sources of our conscious decisions but
research leaves no doubt. Studies of insurance, for example, have revealed that
people are willing to pay more to inspire a car they feel is attractive than
one that is not, even when the monetary value is the same. In 1993 study even
found that people were willing to pay more for airline travel
insurance covering "terrorist acts" than for deaths from "all
possible causes." Logically, that makes no sense, but "terrorist
acts" is a vivid phrase dripping with bad feelings, while
"all possible causes" is bland and empty It leaves Gut cold.
They
asked Stanford University students to read one of three versions of a stops
about a tragic death - the cause being either leukemia, fire or murder - that
contained no information about how common such tragedies are. They then gave
the students a list of risks - including the risk in the story and 12 others -
and asked them to estimate how often they kill. As we might expect, those who
read a tragic story about a death caused by leukemia rated leukemia's lethality
higher than a control group of students who didn't read the story. The same
with fire and murder. More surprisingly, reading the stories led to
increased estimates for all the risks, not just the one portrayed. The fire
story caused an overall increase in perceived risk of 14 per cent The leukemia
story raised estimates by 73 per cent The murder story led the pack, raising
risk estimates by 144 per cent. A "good news" story had precisely the
opposite effect - driving down perceived risks across the board.
So
far, I've mentioned things - murder, terrorism cancer - that deliver an
unmistakable emotional wallop. But scientists have shown that Gut's emotional
reactions can be much subtler than that. Robert Zajonc along with psychologists
Piotr Winkielman and Norbert Schwarz. conducted a series of experiments in
which Chinese ideographs flashed briefly on a screen. Immediately after
seeing an ideograph, the test subjects, students at the university of Michigan
were asked to rate the image from one to six, with six being very liked and one
not liked at likely (Anyone familiar with the Chinese, Korean, or Japanese
languages was excluded from the study, so the images held no
literal meaning for those who saw them.)
What the students weren't told
is that just before the ideograph appeared, another image was flashed. In some
cases, it was a smiling face. In others, it was a frowning face or a
meaningless polygon. These images appeared for the smallest fraction of a
second, such a brief moment that they did not register on the conscious mind
and no student reported seeing them. But even this tiny exposure to a good or
bad image had a profound effect on the students' judgment. Across the board,
ideographs preceded by a smiling face were liked more than those that weren't
positively primed. The frowning face had the same effect in the opposite
direction.
Clearly, emotion had a powerful influence and yet not one
student reported feeling any emotion Zajonc and other scientists believe that
can happen because the brain system that slaps emotional labels on things -
nuclear power bad! - is buried within the unconscious mind.
So your
brain can feel something is good or bad even though you never consciously feel
good or bad. (When the students were asked what they based their judgments on,
incidentally they cited the ideograph's aesthetics or they said that it
reminded them of something, or they simply insisted that they "just liked
it." The conscious mind hates to admit it simply doesn't know.) After
putting students through the routine outlined above, Zajonc and his colleagues
then repeated the test. This time, however, the images of faces were switched
around. If an ideograph had been preceded by a smiling face in the first round,
it got a frowning face and vice versa The results were startling. Unlike the
first round, the flashed images had little effect. People stuck to their
earlier judgments An ideograph judged likeable in the first round because -
unknown to the person doing the judging - it was preceded by a smiling face was
judged likeable in the second round even though it was preceded by a frowning
face. So emotional labels stick even if we don't know they exist.
In
earlier experiments - since corroborated by a massive amount of research -
Zajonc also revealed that positive feeling for something can be created simply
by repeated exposure to it, while positive feelings can be strengthened with
more exposure. Now known as the mere exposure effect, this phenomenon is
neatly summed up in the phrase "familiarity" breeds liking ."
Corporations have long understood this, even if only intuitively. The point of
much advertising is simply to expose people to a corporation's name and logo in
order to increase familiarity and, as a result, positive feelings
toward them.
The
Good-Bad Rule also makes language critical. The world does not come with
explanatory notes, after all in seeing and experiencing tunings, we have
to frame them this way or that to make sense of them, to give them meaning.
That framing is done with language.
Life and death are somewhat more
emotional matters than lean and fat beef, so it's not surprising that the words
a doctor chooses can be even more influential than those used in Levin and
Gaeth's experiment. A 1982 experiment by Amos Tversky and
Barbara McNeil demonstrated this by asking people to imagine
they were patients with lung cancer who had to decide between radiation
treatment and surgery One group was told there was a 68 per cent chance of
being alive a year after the surgery. The other was told there was a 32 per
cent chance of dying. Framing the decision in terms of staying alive resulted
in 44 per cent opting for surgery over radiation treatment. But when the
information was framed as a chance of dying that dropped to 18 per cent.
Tversky and McNeil repeated this experiment with physicians and got the
same results. In a different experiment, Tversky and Daniel Kahneman also
showed that when people were told a flu outbreak was expected kill 600 people,
people's judgments about which program should be implemented to deal with the
outbreak were heavily influenced by whether the expected program results were
described in terms of lives saved (200) or lives lost (400)
Of
course the most vivid form of communication is the photographic image and, not
surprisingly, there's plenty of evidence that awful frightening photos not only
grab our attention and stick in our memories - which makes them influential via
the Example Rule - they conjure emotions that influence our risk perceptions
via the Good-Bad Rule. It's one thing to tell smokers their habit could give
them lung cancer. It's quite another to see the blackened gnarled lungs of a
dead smoker That's why several countries, including Canada and Australia, have
replaced text-only health warnings on cigarette packs with horrible images of
diseased lungs, hearts, and gums. They're not just repulsive They increase the
perception of risk.
Number may even hinder the emotions brought
out by the presence of one suffering person. Paul Slovic, Deborah Small,
and George Loewenstein set up an experiment in which people were asked to
donate to African relief. One appeal featured a statistical overview of the
crisis, another profiled a seven-year-old girl, and a third provided both the
profile and the statistics . Not surprisingly, the profile generated much more
giving than the statistics alone, but it also did better than the combined profile-and-statistics pitch
- as if the numbers somehow interfered with the empathetic urge to help
generated by the profile of tine little girl. A curious side effect of our
inability to feel large numbers confirmed in many experiments - is that
proportions can influence our thoughts more than simple numbers. When Paul
Slovic asked groups of students to indicate on a scale from 0 to 20
to what degree they would support the purchase of airport safety equipment, he
found they expressed much stronger support when told that the equipment could be
expected to save 98 per cent of 150 lives than when they were told it would
save 150 lives. Even saving "85 per cent of 150 lives" garnered more
support than saving 150 lives. The explanation ties in the lack of feeling we
have for the number 150. it's vaguely good, because it represents people's
lives, but it's abstract. We can't picture 150 lives and so we don't feel 150
lives. We can feel proportions, however. Ninety-eight per cent is almost all.
It's a cup filled nearly to overflowing. And so we find saving 98 per cent of
150 lives more compelling than saving 150 lives.
Japanese
prostitutes were the first women to connect silicone and plumper breasts. It
was the 1950s and American servicemen in Japan preferred breasts like they knew
them back home so prostitutes had themselves injected with silicone or liquid
paraffin. The manufactured silicone breast implant followed in the early 1960s.
In 1976, the United States Food and Drug Administration was given authority
over medical devices, which meant the FDA could require manufacturers to
provide evidence that a device is safe in order to get permission to sell it
Breast implants were considered medical devices but because they had been sold
and used for so many years without complaints the FDA approved their continued
sale without any further research. It seemed the reasonable thing to do.
The first whispers of trouble came from Japanese medical journals. Some
Japanese women were being diagnosed with connective tissue diseases -
afflictions like rheumatoid arthritis, fibromyalgia and lupus. These women had
also been injected, years before, with silicone, and doctors suspected the two
facts were linked.
In 1982 an Australian report described three women
with silicone breast implants and connective tissue diseases. What this meant
wasn't clear. It was well known implants could leak or rupture but could
silicone seep into the body and cause these diseases? Some were sure that was
happening. The same year as the Australian report, a woman in San
Francisco sued implant manufacturers, demanding millions of dollars for making
her sick The media reported both these stories widely, raising concerns
among more women and more doctors. More cases appeared in the medical
literature. The number of diseases associated with implants grew. So did the
number of the media. Fear spread.
In
1990, an episode of Face to Face With Connie Chung aired on CBS.
Tearful
women told stories of pain, suffering, and loss. They blamed their silicone
implants. And Chung agreed. First came the implants, then came the disease.
What more needed to be said? The tone of the widely watched episode was angry
and accusatory, with much of the blame focused on the FDA.
That broke
the dam. Stories linking implants with disease - with headlines like
"Toxic Breasts" and "Ticking Time Bombs" - flooded the
media. A congressional hearing was held. Advocacy groups - including Ralph
Nader's Public Citizen - made implants a top target. Feminists - who considered
breast augmentation to be "sexual mutilating," in the words of best-selling
writer Naomi Wolf - attacked implants as a symbol of all that was wrong with
modern society.
Under intense pressure, the FDA told
manufacturers in early 1882 that they had 90 days to provide evidence that
implants were safe. The manufacturers cobbled together what they could but the
FDA felt it was inadequate. Meanwhile, a San Francisco jury awarded $7.34
million
to a woman who claimed her implants, manufactured by Dow Corning, had given her
mixed connective-tissue disease. The FDA banned silicone breast implants in
April 1992 although it emphasized that the implants were being banned only
because the had yet to be proved safe, as the manufacturers were
required to do, not because they had been proved unsafe. The roughly one
million American women with the implants shouldn't worry, the FDA chief insisted.
But they did worry. Along with the successful lawsuit the FDA ban was seen as
proof that the implants were dangerous. The media filled with stories of
suffering, angry women and "the trickle of law- suits became a
flood," wrote Marcia Angell editor of the New England Journal of Medicine
at the time and the author of the definitive book on the crisis, Science on
Trial: The Clash Between Medical Science and the Law in the Breast Implant
Case.
In 1994 the manufacturers agreed to the largest class-action
settlement in history A fund was created with $4.25 billion, including $1
billion for the lawyers who had turned implant lawsuits into a veritable
industry. As part of the deal, women would have to produce medical records
showing that they had implants and one of the many diseases said to be
caused by implants but they didn't have to produce evidence that the disease
actually was caused by the implants - either in their case or in women generally.
"Plaintiffs' attorneys sometimes referred clients to clinicians whose
practice consisted largely of such patients and whose fees were paid by the
attorneys," wrote Angell. "Nearly half of all women with breast
implants registered for the settlement, and half of those maimed to be
currently suffering from implant-related illnesses." Not even the mammoth
settlement fund could cover this. Dow Corning filed for bankruptcy and the
settlement collapsed. The transformation of silicone implants was complete.
Once seen as innocuous objects no more dangerous than silicone contact lenses,
implants were now a mortal threat. In surveys Paul Slovic conduced around this
time, most people rated the implants "high risk." Only cigarette
Smoking was seen as more dangerous.
The
breast-implant panic was at its peak in June 1994 when science finally
delivered. A Mayo Clinic epidemiological survey published in the New England
Journal of Medicine found no link between silicone implants and
connective-tissue disease. More studies followed, all with similar results.
FInally, Congress asked the Institute of Medicine (I.O.M.) the
medical branch of the National Academies of Science, to survey the burgeoning
research. In 1999 the I.O.M. issued its report. "Some women
with breast implants are indeed very ill and the I.O.M. committee is very
sympathetic to their distress," the report concluded. "However, it
can find no evidence that these women are ill because of their implants."
In
June 2004 Dow Corning emerged from nine years of bankruptcy; As part of its
reorganization plan, the company created a fund of more than $2 billion in
order to pay off more than 360 claims. Given the state of the evidence
this might seem like an unfair windfall for women with implants. It was unfair
to Dow Corning, certainly, but it was no windfall. Countless women had been
tormented for years by the belief that their bodies were contaminated and they
could soon sicken and die. In this tragedy, only the lawyers won.
In
November 2006, the Food and Drug Administration lifted the ban on silicone
breast implants. The devices can rupture and cause pain and inflammation,
the FDA noted, but the very substantial evidence to date does not indicate that
they pose a risk of disease.
Anti-implant
activists were furious. They remain certain that silicone breast implants are
deadly and it seems nothing can convince them otherwise. Psychologists call
this confirmation bias, We all do it. Once a belief is in place, we screen what we see
and hear in a biased way that ensures our beliefs are "proven"
correct. Psychologists have also discovered that people are vulnerable to
something called group polarization - which means that when people who share beliefs get
together in groups, they become more convinced that their beliefs are right and
they become more extreme in their views. Put confirmation bias, group
polarization, and culture together, and we start to under- stand why people can
come to completely different views about which risks are frightening and which
aren't worth a second thought.
But
that's not the end of psychology's role in understanding risk-.Far from it. The
real starting point for understanding why we worry and why we don't is the
individual human brain. In one of the earliest studies on confirmation bias,
psychologist Peter Wason simply showed people a sequence of three numbers - 2,
4, 6 - and told them the sequence followed a certain rule. The participants
were asked to figure out what that rule was. They could do so by writing down
three more numbers and asking if they were in line with the rule, Once
you think you've figured out the rule the researchers instructed, say so and we
will see if you're right.
It seems so obvious that the rule the numbers
are following is "even numbers increasing by two." So let's say you
were to take the test. What would you say? Obviously, your first step
would be to ask: What about 8, 10, 12? Does that follow the rule?"
And you would be told, yes that follows the rule. Now you are really
suspicious. This is far too easy. So you decide to try another set of number.
Does "14, 16 18" follow the rule? It does.
At this
point, you want to shout out the answer - the rule is even numbers increasing
by two! - but you know there's got to be a trick- here. So you
decide to ask about another three numbers: 20, 22, 24, Right again!
Most people who take this test follow exactly this pattern. Every time their
guess, they are told they are right and so, it seems, the evidence that they
are right piles up. Naturally they become absolutely convinced that their
initial belief is correct. Just look at all the evidence! And so they stop the
test and announce that they have the answer: It is "even numbers
increasing by two."
And they are told that they are wrong. That is
not the rule. The correct rule is actually "any three numbers in ascending
order. "
Why do people get this wrong? It is very easy to figure out
that the rule is not "even numbers increasing by two." All they
have to do is try to disconfirm that the rule is even numbers increasing by
two. They could, for example ask if "5, 7, 9" follows the rule. Do
that and the answer would be, yes, it does - which would instantly disconfirm
the hypothesis. But most people do not try to disconfirm. They do the opposite,
trying to confirm the rule by looking for examples that fit it. That's a
futile strategy. No matter how many examples are piled up, they can never prove
that the belief is correct. Confirmation doesn't work.
Unfortunately,
seeking to confirm our beliefs comes naturally, while it feels strange and
counterintuitive to look for evidence that contradicts our beliefs. Worse
still. if we happen to stumble across evidence that runs contrary to our
views, we have a strong tendency to belittle or ignore
it. In 1979 - when capital punishment was a top issue in the United States -
American researchers brought together equal numbers of supporters and opponents
of the death penalty. The strength of their views was tested. Then they were asked
to read a carefully balanced essay that presented evidence that capital
punishment deters crime and evidence that it does not. The researchers then
re-tested people's opinions and discovered that they had only gotten stronger. They
had absorbed the evidence that confirmed their views, ignored the rest, and
left the experiment even more convinced that they were right and those who
disagreed were wrong.
They power of confirmation bias should not be
underestimated, During the U.S. presidential election of 2004, a team of
researchers led by Drew Westen at Emory University brought together 50
committed partisans - half Democrats, half Republicans - and had them lie in
magnetic resonance imaging (MRI) machines, While their brains were being
scanned, they were shown a series of three statements by or about George W.
Bush. The second statement contradicted the first, making Bush look bad.
Participants were asked whether the statements were inconsistent and were then
asked to rate how inconsistent they were. A third statement then followed that
provided an excuse for the apparent contradiction between the statements.
Participants
were asked if perhaps the statements were not as inconsistent as they first
appeared. And finally, they were again asked to rate how inconsistent the first
two statements were. The experiment was repeated with John Kerry as the focus
and a third time with a neutral subject.
The superficial results were
hardly surprising. When Bush supporters were confronted with Bush's
contradictory statements, they, rated them to be less contradictory than Kerry
supporters. And when the explanation was provided, Bush
supporters considered it to be much more satisfactory than did Kerry
supporters. When the focus was on John Kerry, the results reversed. There was
no difference between Republicans and Democrats when the neutral subject was tested.
All this was predictable. Far more startling, however, was what showed up on
the MRI. When people processed information that ran against their strongly held
views - information that made their favoured candidate look bad - they actually
used different parts of the brain than they did when they processed neutral or
positive information. It seems confirmation bias really is hard-wired in each
of us, and that has enormous consequences for how opinions survive and spread.
That's
on the individual level. What happens when people who share a belief get together
to discuss it? Psychologists know the answer to that, and it's not pretty. They
call it group polarization. It seems reasonable to think that when like -minded
people get together to discuss a proposed hazardous waste site, or the breast
implants they believe are making them sick, or some other risk, their views
will tend to coalesce around the average within the group. But they won't.
Decades of research has proved that groups usually come to conclusions that are
more extreme than the average view of the individuals who make up the group.
When opponents of a hazardous waste site gather to talk about it, they will
become convinced the site is snore dangerous than they originally believed.
When a woman who believes breast implants are a threat gets together with women
who feel the same way she and all the women in the meeting are likely to leave
believing they had previously underestimated the damager. The dynamic is always
the same. It doesn't matter what the subject under discussion is. It doesn't
matter what the particular views are. When like-minded people get together and
talk. their existing views tend to become more extreme.
Of
course, it's possible that people's views could be moderated by hearing new
information that runs in the opposite direction - an article by a scientist
denying that implants cause disease. for example. But remember confirmation
bias: Every person in that meeting is prone to accepting information that
supports their opinion and ignoring or rejecting information that does
not. As a result, the information that is pooled at the meeting is deeply
biased, making it ideal for radicalizing opinions. Psychologists have also
demonstrated that because this sort of polarization is based on
information-sharing alone, it does not require anything like a face-to-face
conversation - a fact amply demonstrated every day on countless political
blogs. Still, it is early days for this research. What is certain at this
point is that we aren't the perfectly rational creatures described in outdated.
economics textbooks and we don't review
information about risks with cool detachment and objectivity. We
screen it to make it conform to what we already believe. And what
we believe is deeply influenced by the beliefs of the people around us and of
the culture in which we live.
In that sense, the metaphor I used at the
start of this book is wrong. The intuitive human mind is not a
lonely Stone Age hunter wandering a city it can scarcely comprehend. It is
a Stone Age hunter wandering a city it can scarcely comprehend in the company
of millions of other confused Stone Age hunters. The tribe may be a little
bigger these days, and there may be more taxis than lions, but the old ways of
deciding what to worry about and how to stay alive haven't changed.
The
type of advertising also makes a difference. It turned out that the effect of the emotional
''enthusiasm'' ad was universal - it influenced everybody whether they
knew anything about politics or not. But the effect of the fear-based ad
was divided. It did not boost the rate at which those who knew less about
politics who said they would get involved in politics by voting. But it did
significantly influence those who knew more making them much more likely
to say they would volunteer and vote. So the assumptions of political experts
is wrong. It isn't the less informed who are likely to be influenced by
fear-driven advertising.
It is the more informed. Apparently, greater
awareness and commitment make emotional messages more resonant - and being
better informed is no guarantee that Head will step in and tell Gut to relax.
Still,
if the political experts were wrong about who is more likely to be influenced
by fear, they were dead-on about the central role played by emotion in
political marketing. "The audiovisual 'packaging' may be paramount to their
effectiveness," Brader writes. Remove the word "may" and replace
it with "is" and you have the standard advice supplied by every
political consultant. "A visual context that supports and reinforces your
language will provide a multiplier effect, making your message that much
stronger," advises Republican guru Frank- Luntz in his book Words That
Work. But more than that, "a striking visual context can
overwhelm the intended verbal message entirely." This sort of mismatch
between tragic tale and cold numbers is routine in the media, particularly in
stories about cancer. In 2001, researchers led by Wylie Burke of the University
of Washington published an analysis of articles about breast cancer that
appeared in major U.S. magazines between 1993 and 1997. Among
the women that appeared in these stories, 84 per cent were younger than 50 years
old when they were first diagnosed with breast cancer; almost half were under
40 But as the researchers noted. the statistics tell a very different
story; Only 16 per cent of women diagnosed with breast cancer were younger than
50 at the time of diagnosis, is, and 3.6 per cent were under 40. As for the
older women who are most at risk of breast cancer, they were almost invisible
in the articles. Only a 2.3 per cent of the profiles featured women in their
sixties and not one article out of 172 profiled a woman in her seventies - even
though two-thirds of women diagnosed with breast cancer are 60 or older. In
effect, the media turned the reality of breast cancer on its head. Surveys
in Australia and the United Kingdom made the same discovery.
In
Daniel Krewski's 2004 survey, "natural health products"
were deemed by far the safest of the 30 presented - safer even than X-rays and
tap water. Prescription drugs were seen to be riskier, while pesticides were
judged to be more dangerous than street crime and nuclear power plants. It's
not hard to guess at the thinking behind this, or to see how dominated it
is by Gut. Natural and healthy are very good things so natural health products
must be safe. Prescription drugs save lives, so while they may not be as safe
as "natural health products" - everyone knows prescription drugs can
have adverse effects - they are still good and therefore relatively safe. But
''pesticides'' are ''manmade" and ''chemical'' - and therefore dangerous.
The irony here is that few of the "natural health products" that
millions of people happily pop in their mouths and swallow have been rigorously
tested to see if they work and the safety regulations they have to satisfy are
generally quite weak - unlike the laws and regulations governing prescription
drugs and pesticides.
The
media, in pursuit of the dramatic story are another contributor to prevailing
fears about chemicals. Robert Lichter and Stanley Rothman scoured stories about
cancer appearing in the American media between 1972 and 1992 and found that
tobacco was only the second-most mentioned cause of cancer - and it was a
distant second. Man-made chemicals came first. Third was food addictives.
Number 6 was pollution, 7 radiation, 9 pesticides, and 12 was dietary
choices. Natural chemicals came 16th. Dead last on the list of 25 - mentioned
in only nine stories - was the most important factor: aging. Lighter and
Rothman also found that of the stories that expressed a view on whether the
United States was facing a cancer epidemic, 85 per cent said it was. This has a
predictable effect on public opinion. In November 2007 the American Institute
of Cancer Research (AICR) released the results of a survey in which Americans
were asked about the causes of cancer. The institute noted with regret that
only 49 per cent of Americans identified a diet low in fruits and vegetables as
a cause of cancer; 46 per cent said the same of obesity; 37 per cent, alcohol;
and 56 per cent, diets high in red meat. But 71 per cent said pesticide
residues on food cause cancer. "There's a disconnect between public fears
and scientific fact," said an AICR spokesperson.
Lichter
and Rothman argue that the media's picture of cancer is the result of paying
too little attention to cancer researchers and far too much to environmentalists.
As John Higginson noted almost 30 years ago the idea that synthetic chemicals
cause cancer is "convenient" for activists opposed to chemical
pollution, If DDT had threatened only birds, Rachel Carson would probably never
have created the stir she did with Silent Spring. It's the connection between
pollution and human health that makes the environment a personal concern, and
connecting synthetic chemicals to health is easy because the chemicals are
everywhere and Gut tells us they must be dangerous no matter how tiny the
amounts may be. Add the explosive word cancer and you have a very effective way
to generate support for environmental action.
But then, the existence
of an ''epidemic of cancer" is often taken by environmentalists to be such
an obvious fact that its existence hardly needs to be demonstrated. In a 2005
newspaper column, Canada's David Suzuki - a biologist and renowned
environmentalist - blamed chemical contamination for the "epidemic of
cancer afflicting us." His proof consisted of a story about catching a
flounder that had cancerous tumours and the fact that "this year, for the
first time, cancer has surpassed heart disease as our number one killer."
But it is not true, as Suzuki seems to assume. that cancer's rise to leading
killer means cancer is killing more people, It is possible that heart
disease is killing fewer people. And that turns out to be the correct
explanation. Statistics Canada reported that the death rates of both
cardiovascular disease and cancer are falling but "much more so for
cardiovascular disease.
What's left out here is the
simple fact that cancer is primarily a disease of aging, a fact which has
a profound effect on cancer statistics. The rate of cancer deaths in Florida,
for example, is almost three times higher than in Alaska, which looks extremely
important until you factor in FloridaÕs much older population.
"When the cancer death rates for Florida and Alaska are age-adjusted," notes
a report from the American Cancer Society, "they are almost identical."
In
the 1990s, as worries about breast cancer rose, activists of-ten said that
"one in eight" Americans women would get breast cancer in their
lifetimes. That was true, in a sense. But what wasn't mentioned was that to
face that full one-in-eight risk, a woman has to live to 95. The numbers look
very different at younger ages: The chance of getting breast cancer by age 70
is 1 in 14 (or 7 per cent); by age 50 it is 1 in 50 (2 per cent); by age 40 1
in 14 (0.4 per cent); by age 30 1 in 2,525 (0.03 per cent). "To emphasize
only the highest risk is a tactic meant to scare rather than inform."
Russell Harris, a cancer researcher at the University of North Carolina, told U.S.
News and World Report
aging shouldn't affect data on childhood cancers, however, and those who claim
chemical contamination is a serious threat say child- hood cancers are soaring.
They are up "25 per cent in the last 30 years," journalist Wendy
Mesley said in her CBC documentary. That statistic is true, to a degree, but it
is also a classic example of how badly presented information about risk can
mislead. Mesley is right that the rate of cancer among Canadian children is roughly
25 per cent higher now than it was 30 years ago. But what she didn't say is
that the increase occurred between 1970 and 1985 and then stopped. ''The
overall incidence of childhood cancer has remained relatively stable since
1985," says the 2004 Progress Report on Cancer Control from the
Public Health Agency of Canada.
The first step in correcting
our mistakes of intuition has to be a healthy respect for the scientific
process, Scientists have their biases, too but the whole point of science is
that as evidence accumulates, scientists argue among themselves based on the
whole body of evidence, not just bits and pieces. Eventually, the majority
tentatively decides in one direction or the other. it's not a perfect process,
by any means; it's frustratingly slow and it can make mistakes. But it's vastly
better than any other method humans have used to understand reality.
The
next step in dealing with risk rationally is to accept that risk is inevitable.
In Daniel Krewski's surveys, he found that about half the Canadian public
agreed that a risk-free world is possible, "A majority of the population
expects the government or other regulatory agencies to protect them completely
from all risk in their daily lives," he says with more than a hint of
amazement in his voice. "Many of us who work in risk management have been
trying to get the message out that you cannot guarantee zero risk, it's an
impossible goal."
Note: Italics and bold put in by Mr. Duncan
Questions:
1.
What are the two systems of thought in the brain?
2.
Explain the Anchoring Rule using the Gandhi questions.
3.
What proof is there for The Rule of Typical Things?
4.
Give two examples of evidence supporting the Example Rule
5.
Think of a high risk activity and use Slovic's checklist to see how many
criteria is has.
6.
What did the split - brain patients do?
7.
How does the Good-Bad Rule use feelings and words and statistics to affect
people's choices?
8.
Do frowning or smiling images flashed subconsciously affect how choices? What
happens when we try to change those choices once already formed?
9.
How did breast implants become dangerous? Are they really dangerous?
10.
Explain how confirmation bias and group polarization affect the assessment of
risk.
11.
How do types of advertising and audiovisual packaging alter views
12.
What is the author's message about natural foods and about risk of cancer?
13. What two things should we do to manage risk?