Don’t let doctors decide

A final few words on cheating from Dan Ariely’s behavioural economics MOOC A Beginners Guide to Irrationality on Coursera.

Cheating over time

People start by cheating just a little but at some point some people start cheating all the time. What does it take to reset the fudge factor to get people to stop cheating? Put it another way – what is the logic behind Catholic confession? You should cheat just before confession but it doesn’t work like that. Confession is like resetting to a clean page. in an experiment Dan asked people to write down their transgressions and ask for forgiveness – this decreased cheating but only temporarily.

Does cheating vary across cultures?

In a word, no. How do we balance this finding with a strong conviction in cultural differences. Experiments have no cultural context – they simply test the basic human capacity for moral flexibility. Culture influences specific domains but doesn’t change the core of morality. Culture can either shrink or expand the fudge factor – for example in some countries it is acceptable to bribe the police.

Medical decision-making gone wild

Think of these choices. You have terminal cancer and doctors have no idea how long you have left. Do you take chemo miserably for longer or do you take the palliative care and live as good a life as you can for a shorter time?

Medical decisions are unlike any other – they ask you to imagine the unimaginable.
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People often make bad decisions because they can’t imagine what life will be like going through treatment. Cancer patients feel like they have to do something, anything to get rid of it even if treatment is riskier than doing nothing.

Medical decisions often rely on information from doctors who don’t speak the same language as their patients. But it’s not just the patients that make strange decisions – doctors do too. Doctors over-estimate how long patients have to live because they must have hope that they are doing a worthwhile job. They also over promise to patients and experiments have shown that we weigh decisions differently for others than we do for ourselves.

Sorry if this has been a bit of a downer – let’s fix that with a good tune.


Tune of the week


Buchanan Brothers – Medicine Man

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