Welcome to the Nexus of Ethics, Psychology, Morality, Philosophy and Health Care

Welcome to the nexus of ethics, psychology, morality, philosophy and health care

Friday, January 4, 2019

The Objectivity Illusion in Medical Practice

Donald Redelmeier & Lee Ross
The Association for Psychological Science
Published November 2018

Insights into pitfalls in judgment and decision-making are essential for the practice of medicine. However, only the most exceptional physicians recognize their own personal biases and blind spots. More typically, they are like most humans in believing that they see objects, events, or issues “as they really are” and, accordingly, that others who see things differently are mistaken. This illusion of personal objectivity reflects the implicit conviction of a one-to-one correspondence between the perceived properties and the real nature of an object or event. For patients, such na├»ve realism means a world of red apples, loud sounds, and solid chairs. For practitioners, it means a world of red rashes, loud murmurs, and solid lymph nodes. However, a lymph node that feels normal to one physician may seem suspiciously enlarged and hard to another physician, with a resulting disagreement about the indications for a lymph node biopsy. A research study supporting a new drug or procedure may seem similarly convincing to one physician but flawed to another.

Convictions about whose perceptions are more closely attuned to reality can be a source of endless interpersonal friction. Spouses, for example, may disagree about appropriate thermostat settings, with one perceiving the room as too cold while the other finds the temperature just right. Moreover, each attributes the other’s perceptions to some pathology or idiosyncrasy.

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