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March 13, 2014 | Posted By Wayne Shelton, PhD

Efforts to educate the public are based on the assumption that human beings can be persuaded by good reasons and evidence in formulating their responses to important questions about public health. But are things this straightforward? Are humans really this rational in how they make their decisions? 

Think of any social problem that is predicated on how people understand and use information to make good decisions for themselves, especially decisions that have significant social costs. For example, consider the question: does having a gun in one’s home make one more or less safe? A recent piece from the New York Times is typical of the clear evidence presented from social science research to show that guns in the home “were fired far more often in accidents, criminal assaults, homicides or suicide attempts than in self-defense. For every instance in which a gun in the home was shot in self-defense, there were seven criminal assaults or homicides, four accidental shootings, and 11 attempted or successful suicides.” Moreover, there is a strong risk factor of having a gun in the home for female homicides and intimidation of women. These data do not prevent gun rights advocates from passionately arguing against any limitations place on guns including assault rifles. In fact some pro-gun advocates falsely claim that any limitation of assault weapons would in fact make women less safe as though that the typical woman would not have the full ability to protect herself. It appears many people view the evidence through the lens of their preexisting set of assumptions, which makes them ignore the scientific evidence or to see it as biased; thus, they continue to believe that having guns in their homes make them safer.

When people formulate their responses to and make their decisions about many questions, there is often more at stake than using accurate information as the motivating factor. Often there is a motivating factor at the individual psychological level in terms of how new information, even if acknowledged to be true, makes us feel about ourselves. This was the topic of a recent NPR broadcast that reported the results of a social science research project about the effects of an educational intervention to increase vaccination rates. Ironically it is a story about how informing people about the scientific facts can actually have the opposite intended effect.

This study was based on survey data obtained from more than 1,700 parents across the United States. The researchers first assessed how parents viewed vaccine safety and then provided those same parents with scientific information the MMR vaccine, i.e. the vaccine against measles, mumps and rubella. They found that parents who hear the message are more likely to think that the vaccine is safe. But knowing this information, ironically, also makes the parents less likely to say they would vaccinate a child with MMR vaccine. This effect was strongest for those parents who had the most negative attitudes about vaccines from the beginning. That’s right, when parents with the strongest negative attitudes about vaccines come to understand that the vaccinations were safe, they were less likely to have their kids vaccinated. So, well-intended educational intervention promoting public health initiatives could in fact that the opposite effect. What is going at the psychological level that would account for this effect?

It would appear that new information, even it is believed to be true, may be a threat to how one feels about oneself, especially to one’s self-esteem. If it were fully accepted and acted on, one would have to change one’s position and beliefs, which in effect would be a change of identity. New information would not only lead the parents to a new understanding of the facts pertaining to vaccines, but also to the uncomfortable realization that they must change themselves at a deeper level—that one’s old self is somehow inadequate and a new orientation is needed. This means that public health initiatives that present new information to people should worry as much about how their audience is affected by the information as the information itself. Until we know more about how to present information in a non-threatening way, information alone is not likely to change minds. Indeed, as we see, it could have the opposite effect.

When considering topics across the bioethics and public policy spectrum about which there are scientific facts relevant to having justifiable views, it may be that the source of disagreements are often not at the factual level. Rather the source may be at the unconscious, psychological level that has to do various ideological or moral positions with which one identifies. This is a topic that should be discussed and researched more in bioethics and clinical ethics. I will have more to say about this in future blogs.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

2 comments | Topics: Communication, Public Health Ethics, Vaccines

Comments

Natalie Nussbaum

Natalie Nussbaum wrote on 03/22/14 11:08 PM

That reminds me of Festinger's classical studies of people who believed the world would end at a certain time and when it didn
't they somehow formed even stronger beliefs--Festinger termed it cognitive dissonance. I don't recall if he had any strategy to counteract it, but it would be worth looking in to.
Tara Lindsley

Tara Lindsley wrote on 03/26/14 9:33 AM

If you are interested in the possible neurological underpinnings of this response to evidence that contradicts ones worldview or self-identity, I recommend the book, "The Republican Brain: Why They Deny Science-and Reality", by Chris Mooney. The title is misleading. The author describes and discusses research comparing progressives and conservatives on psychological, social and neurological measures. The conclusions are intriguing, especially with regard to how the resulting insights can inform our interactions with one another.

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BIOETHICS TODAY is the blog of the Alden March Bioethics Institute, presenting topical and timely commentary on issues, trends, and breaking news in the broad arena of bioethics. BIOETHICS TODAY presents interviews, opinion pieces, and ongoing articles on health care policy, end-of-life decision making, emerging issues in genetics and genomics, procreative liberty and reproductive health, ethics in clinical trials, medicine and the media, distributive justice and health care delivery in developing nations, and the intersection of environmental conservation and bioethics.
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