I would be interested to see what people think of some other options:
4) “I’ll tell you later.” [Fails to answer the question; is neither a Technical Lie nor actively misleading; may lead the patient to believe it’s a painkiller or similar anyway]
5) “I’m doing everything I can to help you; please don’t distract me.” [True statement and a request; may lead the patient to believe it’s a painkiller or similar anyway]
6) “It’s a 300-osmolarity isotonic solution of chloridated alkali metal.” [Technobabble; the average patient will have no clue what this means. Unless I’m misusing chemical terms found on Wikipedia, it’s completely accurate. Will probably discourage further questions, especially if stated rapid-fire in a curt tone.]
“It’s a 300-osmolarity isotonic solution of chloridated alkali metal—the strongest painkiller I have. I’ll explain the details later, but now please don’t distract me—I’m doing everything I can to help you.” (stated rapid-fire in a curt tone.)
I think ‘not actively misleading’ is just another form of Not Technically a Lie. If you’re saying X in the hope that it will lead them to believe a false statement Y, your statement is either a lie or a NTaL, regardless of how cleverly you construct X.
These three are all basically honest, but their effects are unpredictable. 6 and especially 4 may actually make the patient significantly worse off, since the first is evasive and abrasive, and the second is meaningless and prone to misinterpretation (“chloridated alkali metal!? I had no idea it was that serious!”). 5 does no harm, but likely does little good and may be seen as evasive. Given that placebos can actually still work when people know they are recieving them, 1 may be better than all these options, as may 1+3, which seems essentially honest.
If I were the patient, I imagine I would shut up and be (relatively) content with 5, but would be royally pissed off with the doctor for saying either 4 or 6. Unless I were very seriously intimidated, I think I would be extremely likely to follow up 4 with “Why can’t you tell me now?” and 6 with “But what is it for?”
I’d read through the technobabble in 6 and I suspect a large number of other people would too. (You only need high school chemistry.) I’d back calculate the reason and it would end up a nocebo. Don’t bank on people being dumb—plenty aren’t.
5 sounds the best to me. 4 could be read as 5, as condescension, or as near-overt dissembling depending on tone and content.
And furthermore, lots of people are really, really dumb. I got an A in honors high school chem and that was only five years ago, and I had to visit Wikipedia to check every word more obscure than “solution” in that description of saline—the average patient probably did worse or didn’t take the class at all, took it longer ago if they did take it, and remembers less. Heck, there’s probably a scarily high percentage of people who wouldn’t even understand you if you told them it was saline.
Now there is an interesting question: can you be held morally responsible for lying if you just don’t have the time/patience/ability to explain something moderately complex to someone really stupid? What if they don’t even know the word “placebo”—then what do you do? Explain scientific controls and psychosomatic effects while you’re trying to extract a bullet, or what have you, from your patient?
I would imagine that’s not a case of stupidity, but of the brain working in a way that’s (usually, more or less) efficient. Instead of analyzing the specific words you’re using, the nurse, who has no reason not to trust you, analyzes the content of what you’re saying, the urgency and manner with which you’re presenting the evidence against this chemical that’s just “blahblahblah” to the brain.
This is a way of filtering out irrelevant content and only paying attention to what is (likely) to be relevant. I had a related problem when learning to drive—my brain doesn’t instantly process “right” or “left” as belonging to the specified direction, but when the instructor or person giving the test bellowed a word at me, I knew to turn and turned whichever way made more sense to me in context—which wasn’t always the right decision. I don’t think everyone has this thinking style, as evidenced by my instructor’s irritation with me, but it’s certainly not overall a bad one—in general, it’s probably better to pay attention to information from the environment when operating heavy machinery, to the emotional content of a social situation rather than to etymological clues, and so on.
I would be interested to see what people think of some other options:
4) “I’ll tell you later.” [Fails to answer the question; is neither a Technical Lie nor actively misleading; may lead the patient to believe it’s a painkiller or similar anyway]
5) “I’m doing everything I can to help you; please don’t distract me.” [True statement and a request; may lead the patient to believe it’s a painkiller or similar anyway]
6) “It’s a 300-osmolarity isotonic solution of chloridated alkali metal.” [Technobabble; the average patient will have no clue what this means. Unless I’m misusing chemical terms found on Wikipedia, it’s completely accurate. Will probably discourage further questions, especially if stated rapid-fire in a curt tone.]
3+4+5+6:
“It’s a 300-osmolarity isotonic solution of chloridated alkali metal—the strongest painkiller I have. I’ll explain the details later, but now please don’t distract me—I’m doing everything I can to help you.” (stated rapid-fire in a curt tone.)
I think ‘not actively misleading’ is just another form of Not Technically a Lie. If you’re saying X in the hope that it will lead them to believe a false statement Y, your statement is either a lie or a NTaL, regardless of how cleverly you construct X.
These three are all basically honest, but their effects are unpredictable. 6 and especially 4 may actually make the patient significantly worse off, since the first is evasive and abrasive, and the second is meaningless and prone to misinterpretation (“chloridated alkali metal!? I had no idea it was that serious!”). 5 does no harm, but likely does little good and may be seen as evasive. Given that placebos can actually still work when people know they are recieving them, 1 may be better than all these options, as may 1+3, which seems essentially honest.
If I were the patient, I imagine I would shut up and be (relatively) content with 5, but would be royally pissed off with the doctor for saying either 4 or 6. Unless I were very seriously intimidated, I think I would be extremely likely to follow up 4 with “Why can’t you tell me now?” and 6 with “But what is it for?”
If I were the patient, I imagine I would interpret both 4 and 6 to mean 5, and then cease distracting the doctor from helping me.
But that could just be my imagination.
“Has it got dihydrogen monoxide in it?”
I’d read through the technobabble in 6 and I suspect a large number of other people would too. (You only need high school chemistry.) I’d back calculate the reason and it would end up a nocebo. Don’t bank on people being dumb—plenty aren’t.
5 sounds the best to me. 4 could be read as 5, as condescension, or as near-overt dissembling depending on tone and content.
Very few people retain a high school chemistry background. Fewer retain it when in intense pain.
And furthermore, lots of people are really, really dumb. I got an A in honors high school chem and that was only five years ago, and I had to visit Wikipedia to check every word more obscure than “solution” in that description of saline—the average patient probably did worse or didn’t take the class at all, took it longer ago if they did take it, and remembers less. Heck, there’s probably a scarily high percentage of people who wouldn’t even understand you if you told them it was saline.
Now there is an interesting question: can you be held morally responsible for lying if you just don’t have the time/patience/ability to explain something moderately complex to someone really stupid? What if they don’t even know the word “placebo”—then what do you do? Explain scientific controls and psychosomatic effects while you’re trying to extract a bullet, or what have you, from your patient?
Yes, but we’re retarded, too. Never forget that.
We’re not retarded. We’re advanced
ROFL… no way. I personally fooled a nurse into signing a petition against dihydrogen monoxide.
people are Stupider Than You Realize
I would imagine that’s not a case of stupidity, but of the brain working in a way that’s (usually, more or less) efficient. Instead of analyzing the specific words you’re using, the nurse, who has no reason not to trust you, analyzes the content of what you’re saying, the urgency and manner with which you’re presenting the evidence against this chemical that’s just “blahblahblah” to the brain.
This is a way of filtering out irrelevant content and only paying attention to what is (likely) to be relevant. I had a related problem when learning to drive—my brain doesn’t instantly process “right” or “left” as belonging to the specified direction, but when the instructor or person giving the test bellowed a word at me, I knew to turn and turned whichever way made more sense to me in context—which wasn’t always the right decision. I don’t think everyone has this thinking style, as evidenced by my instructor’s irritation with me, but it’s certainly not overall a bad one—in general, it’s probably better to pay attention to information from the environment when operating heavy machinery, to the emotional content of a social situation rather than to etymological clues, and so on.