Confirmation Bias and Medicine [Morality]

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Nautilus
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Confirmation Bias and Medicine [Morality]

Postby Nautilus » Fri Aug 26, 2011 3:48 pm UTC

I have known multiple people who have decided that they have a given disease and refuse any attempts to convince them otherwise. They reject doctors and friends who disagree. This isn't hypochondria; it's more like a confirmation bias. Now, normally I won't begrudge someone their beliefs- I'll have a conversation with them about new-earth creationism but I won't try to bring them around to my point of view. It's a waste of energy. We all believe what we believe.

However, medicine tries to be an empirical science. There genuinely are right and wrong anwsers. A result from a clinical trial should be trusted. And, if someone decides to go the wrong way, their life and health is genuinely at stake.

What is the correct course of action in this situation? If someone is abusing their right to a second opinion to get the diagnosis/treatment that they want, should they be challenged? Intervened with? Or supported in their decisions?

*note: not posted in Advice because I don't actually need advice, I just thought it posed an interesting moral dilemna
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Fedechiar
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Re: Confirmation Bias and Medicine [Morality]

Postby Fedechiar » Fri Aug 26, 2011 8:27 pm UTC

I think anyone has the right to make bad decisions.

Exploiting others' bad decisions and ignorance, however, is another matter: a charlatan doctor who prescribes expensive procedures and drugs to people who don't actually need them (even if they believe they do) or a pseudo-doctor who convinces them of the power of their "alternative treatment", are actually scammers.

If a person I cared for were in this situation, I'd obviously try and convince them of the truth (if I know enough about the subject for my opinion to actually be of any value, of course) and immediately go to the police if I believed they were being scammed, but in the end, it's their health, so you basically have to acceot the choices they make and hope for the best

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Vaniver
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Re: Confirmation Bias and Medicine [Morality]

Postby Vaniver » Fri Aug 26, 2011 9:35 pm UTC

Nautilus wrote:A result from a clinical trial should be trusted.
Er, medicine is riddled with false positives, and doctors make errors pretty frequently. Your friend might be wrong, or they might be right, and it's their life- just arguing they should trust the medical establishment is probably not going to help either you or them.
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Glass Fractal
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Re: Confirmation Bias and Medicine [Morality]

Postby Glass Fractal » Sat Aug 27, 2011 3:12 am UTC

Nautilus wrote:However, medicine tries to be an empirical science. There genuinely are right and wrong anwsers. A result from a clinical trial should be trusted.


What empiricism tells us is that doctors can only tell you the odds. With massive sample sizes false results are actually fairly common, some places have you return multiple times to be sure but not all of them. From what I heard doctors are not well educated on how accurate their tests really are and if you go to a different doctor about a result you disagree with he's likely to just look at that previous result and be done with it.

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poxic
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Re: Confirmation Bias and Medicine [Morality]

Postby poxic » Sat Aug 27, 2011 4:14 am UTC

There is being your own advocate, and sometimes that means being unreasonable. Sometimes, also, people can be unreasonably unreasonable, which it sounds like the OP is concerned about.

Personal anecdote time: I had to spend about a year (of an appointment every three months) convincing my doctor to send me for a second blood sugar test. The first, the simple one, came out "you're fine" so the doctor decided that was the end of it. Thing is, people who are fine don't have feet that feel like they're burning all the time, or like they're walking on nails. When he finally sent me for a full glucose tolerance test, I was found to have hypoglycemia. (Not diabetes, like I'd feared, but still. I gotta eat right or it might well become that.)

Impersonal anecdote: a local journalist died of cancer a few years ago after years of trying to get doctors to believe him that something was wrong. (The most relevant part of his final writings in the Georgia Straight.) This sort of thing does happen.

An offsetting, semi-personal anecdote: a friend once gave me the story of his grandmother. She would find a new doctor, list every symptom she perceived that she had, and the new doctor would dutifully send her for a gigantic list of tests. They would all come back negative. After a few years of this, the doctor would dutifully suggest that she try talking to a counselor about her problems. As soon as that happened, she dropped that doctor and found a new one. Rinse and repeat. This had been going on for at least a decade, I think, when my friend told me about it. There was really nothing to indicate actual ill health -- objectively, she was as healthy as someone over 75 could be -- other than the mental/emotional possibilities, which she refused to consider.


tl;dr: Anecdotes indicate that sometimes being stubborn is the right thing to do. And sometimes it isn't. Um.
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Fishcuit
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Re: Confirmation Bias and Medicine [Morality]

Postby Fishcuit » Sun Sep 04, 2011 3:58 am UTC

Seems to me there are two issues here: can thinking you have a disease when you don't be harmful? If so, should you try to persuade someone from their erroneous belief?
On the first, I had a colleague at university who believed he had diabetes when he didn't - and started insulin injections (they were a med student) and died from an overdose. An extreme case, but I am sure less versions happen.
So I not let it slip again. But the persuasion is a harder job. I have designed experiments for folk to check whether they have the condition: "well if that is true then you should find ...", and then they have have been curious, checked, and dropped the belief.


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