The coronavirus pandemic has shifted many personal choices into the public realm, from whether to visit a hair salon to how closely to stand to your neighbor. Some people have bristled at—or even protested against—scientists and policy makers dictating these behaviors.
However, research suggests people want paternalistic, prescriptive guidance when it comes to decisions laden with uncertainty. In fact, not receiving such guidance can undermine trust in the authorities who resist offering it.
Northwestern PhD candidate Samantha Kassirer and Chicago Booth’s Emma Levine and Celia Gaertig devised a series of tests of the idea that individuals prize autonomy over paternalistic advice, particularly when it comes to decisions about their health. For decades, medical practice in the United States has moved toward models in which patients make key choices about their own treatments, with doctors weighing in to provide information but without making subjective recommendations.
The researchers asked two groups to imagine making a choice between medical procedures. Participants in one group received recommendations from a doctor about which procedure to choose, despite the doctor also stating that there was no objectively correct choice, while those in the other were told the doctor “could not give a clear recommendation” and that the choice was theirs to make. Participants given a recommendation were more likely to rate their doctor as competent and helpful, and more likely to say they would return to that doctor and recommend him to others. (In the study, the doctor was male.) The same preferences held when participants were able to choose between a doctor who offered recommendations and one who resisted doing so.
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Why Some Professions Reward DishonestyThis is in contrast to what doctors tend to expect, says Levine. “It’s clear that many of us don’t want to be responsible for difficult decisions, but doctors seem more concerned than other experts that their advice might infringe on autonomy, and more worried about being blamed later.”
The study indicates that the preference for paternalistic guidance could extend beyond doctors. The researchers asked another set of participants to choose between two hypothetical investments, with some participants receiving recommendations from financial advisers, while others did not. And in a different experiment, they asked participants to imagine being given feedback from a boss about an upcoming presentation. In both cases, participants continued to prefer paternalistic advice. Moreover, in a final experiment, they didn’t get angry at advisers for what turned out to be a bad outcome.
The findings may suggest that in the COVID-19 pandemic, many people crave solid guidance from politicians and policy makers, even if officials don’t have all the answers.
Samantha Kassirer, Emma Levine, and Celia Gaertig, “Decisional autonomy undermines advisees’ judgments of experts in medicine and in life,” Proceedings of the National Academy of Sciences, May 2020.
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