The discriminating devil’s advocate

September 18, 2012 by · 2 Comments

According to the General Medical Council’s Guidance on Good Practice:

You must tell patients if an investigation or treatment might result in a serious adverse outcome, even if the likelihood is very small.

Sounds like good advice. Seems to ensure the patient makes the best decision. But does it?

Our brains aren’t designed to handle tiny probabilities. When we focus on them, our mind overestimates their significance. For example, if I told you there’s a .0001% chance you’ll die from a certain treatment, statistically you should ignore that piece of information. But you won’t. Death, after all is scary, and anything above a 0% chance of occurrence is impossible to ignore completely. This focusing illusion might steer you towards a bad decision.

So, should doctors withhold all information about extremely rare outcomes? Perhaps, but it’s a difficult question to answer, with both legal and ethical considerations.

In organizations though, where decisions aren’t normally matters of life and death, the question isn’t as difficult. The devil’s advocate, who is usually expected (and encouraged) to voice every risk imaginable, should be a bit more disciplined. She should avoid presenting a catastrophe scenario so unlikely, that the benefits of consideration are outweighed by the focusing illusion it will inevitably create for others.

Now, if you’re the devil’s advocate, reading this might make you nervous. You might think, “But what if it turns out to be the one time the rare event actually does occur?”

Take a deep breath. That’s the focusing illusion talking. It’s insidious.

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  • http://twitter.com/tschwaiger Thomas Schwaiger

    Very very interesting perspective! And there’s a lot of truth in it, i.e. the overemphasis on the negative. This is particularly true in the engineering profession where people are trained to identify problems. The only issue with that is, calling out the risks is not enough. So I’d like to postulate an addition to your suggestion: share a risk only if you have at least an inkling of an idea on how to address it!

  • http://www.brian-shea.com/ Brian Shea

    Great point, Al. It’s relatively easy to list all the possible risks in a project. It’s much harder to identify the truly important risks. It requires (a) the insight to separate the important from the unimportant and (b) the willingness to stand up and make a recommendation about what is important and what is not.

    Hearing a devils advocate list of issues is kind of like getting the booklet of legalese when you sign-up for a credit card, car loan, etc. The list isn’t really for the benefit of the user/buyer/project, it is for the benefit of the person making the list. It’s covers all possible areas of liability.

    Organizations need more people to do insightful work and to stand by it. Not devils advocates.

    I once heard someone say/write that the devil already has too many advocates. Sounds about right :)