BMJ

How cognitive biases affect our interpretation of political messages

Author(s): Martin McKee and David Stuckler
Source: BMJ: British Medical Journal, Vol. 340, No. 7753 (1 May 2010), pp. 936-937
Published by: BMJ
Stable URL: http://www.jstor.org/stable/40701932
Accessed: 09-10-2015 17:33 UTC
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Competing interests: Allauthors

have completed the Unified
CompetingInterestformat
www.icmje.org/coLdisclosure.
pdf(available on request from
the correspondingauthor)and
declare: (1) No financialsupport
forthe submittedworkfrom
anyone otherthan theiremployer;
(2) No financialrelationshipswith
commercialentitiesthatmight
have an interestinthe submitted
work;(3) No spouses, partners,
or childrenwithrelationshipswith
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have an interestinthe submitted
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Provenance and peer review:
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peer reviewed.
Citethis as: 8/W/2010;340:c2043
doi:10.1136/bmj.c2043

inoverdiagnosis
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explanations
social(com- 1 WHO. DeclarationofAlma-Ata:InternationalConferenceon Primary
behavioural
health
attitudes,
behaviour),
(values,
Health Care,Alma-Ata,USSR, 6-12 September 1978. www.who.int/
insureconomic
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Interpretation
CancerJClin2004;54:78-93.
status
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WHO.
Commission
on
Social
Determinants
of Health. Closingthe
3
potential
gap in a generation:health equitythroughaction on the social
whichcouldreduce
andnoinformanotassessed,
differences,
determinantsof health. FinalReportofthe Commissionon Social
orethnicity.
tionwasavailableoncomorbidity
Determinantsof Health. Geneva, 2008. www.searo.who.int/LinkFiles/
SDH_SDH_FinalReport.pdf.
intreatforthevariation
Thestudy
noexplanation
provides
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LyratzopoulosG, BarbiereJM,GreenbergDC,WrightKA,Neal DE.
intreatment
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involved
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Population based timetrendsand socioeconomic variationin use
of radiotherapyand radical surgeryforprostatecancer: continuous
andfunctional
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(comorbidity
survey.5/Wy2010;340:cl928.
Furtherand
status),complications, patients'preferences.
5
Kogevinas M, Pearce N,Susser M, BuffettaP,eds. Social inequalities
and cancer. IARCScientificPublicationNo 138. InternationalAgency
in
thesedifferences
more,wedo notknowhoweliminating
forResearch on Cancer, 1997.
insurvival.
to 6
wouldreduceinequalities
treatment
Strategies
AA,LitwinMS. Geographicand socioeconomic
KrupskiTL,Kwan L,Afifi
variationinthe treatmentofprostatecancer,j ClinOncol
insurvival
tosocioeconomic
status
reducedisparities
related
2005:23:7881-8.
oftheir
cause.
mustbebasedonan understanding
Cross W,FormanD.Trends in non7
FairleyL, Baker M, WhitewayJ,
inmanagement
Onepossible
reasonforvariations
metastaticprostatecancer managementin the northernand Yorkshire
bysocioregionof England,2000-2006. BrJCancer 2009;101:1839-45.
merabouttherelative
economic
statusisthelackofevidence
8
BarryMj. The prostatecancer treatmentbazaar: commenton
areavailable(including
Severaltreatments
itsoftreatments.
"physicianvisits priorto treatmentforclinicallylocalized prostate
cancer." ArchInternMed 2010:170:450-2.
combihormonal
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cryotherapy,
surgery,
WiltTJ,MacDonald R,RutksI, ShamliyanTA,TaylorBC, Kane RL
9
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Systematicreview:comparativeeffectivenessand harmsof
treatmentsforclinicallylocalized prostatecancer.AnnInternMed
them.810
fewtrials
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Hence,treatment
decisions
2008:148:435-48.
cannotbe madeon evidencealonebutrequirea doctor's 10 DamberJE,Aus G. Prostatecancer. Lancet 2008:371:1710-21.
Better
educated 1 1 Zeliadt SB, RamseySD, Penson DF,Hall IJ,Ekwueme DU, Stroud L,
withthepatient.
andnegotiation
judgment
et al. Whydo men choose one treatmentover another?A review
moreeasily,anddoctorpatients
mayprocessinformation
of patientdecision makingforlocalized prostate cancer. Cancer
when
orfluent
2006;106:1865-74.
communication
maybemoreeffective
patient
12 SchrderFH,Hugosson j, Roobol MJ,TammelaTL,CiattoS, Nelen V,et
n
socialbackgrounds.5
havesimilar
doctor
andpatient
in a randomized European
al. Screening and prostate-cancermortality
has increasedthe
Prostate
study.NEnglJMed 2009;360:1320-8.
antigen(PSA)testing
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ourinterpretation
biasesaffect
Howcognitive
ofpolitical
messages
whatwearetold
from
different
What
wehearisoften
very
Martin McKee professorof
European publichealth,London
School of Hygieneand Tropical
Medicine,London WG E 7HT
martin.mckee@lshtm.ac.uk
David Stuckler research fellow,
Christchurch
College, Universityof
Oxford,Oxford0X1 1DP
Citethisas: BMJ2010;340:c2276
doi:10.1136/bmj.c2276

readersoftheBMJwillsoongettovoteon thecomBritish
atthegeneralelection.
visions
ofthepolitical
parties
peting
each
claimthemiddle
the
mainstream
parties
Although
in howtheywill
differences
ground,thereareimportant
thatlieahead,withpotentheeconomic
challenges
approach
forhealthandhealthcare.Howfast
majorimplications
tially
be?Aretargets
andhowdeepshouldcutsinpublicspending
roleofprivate
Whatistheappropriate
a goodora badthing?
healthcare
providers?
answersthey
Votersmustdecidewhichofthedifferent
betweenleading
disputes
agreewith,yet-as seeninrecent
deficit-it
is
abouthowtotacklethegovernment
economists
groupsofpeoplefacedwith
possiblefortwowellinformed

different
conclusions
thesameevidencetoreachcompletely
such
aboutwhatshouldbe done.Howdo votersinterpret
them?
andwhatinfluences
complexinformation
with
evidence
thatpeoplepresented
Thereisconsiderable
balancedarguments
placeweighton thosetheyalready
bias.2A
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confirmation
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agreewith,1
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newsstory
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offour
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topeoplewhohaddeclareddifferent
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the
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was identical
exceptforhowtheydescribed
cause ofdiabetes.Onesaid nothingaboutthecause (the
whereasthethreeotherscitedgenes,individual
control),
choices,and socialdeterminants.
Theywerethen
lifestyle
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i
Competing interests: Both
authorshave completed the
UnifiedCompetingInterestform
at www.icmje.org/coLdisclosure.
pdf(available on request from
the correspondingauthor)and
declare: (1) No financialsupport
forthe submittedworkfrom
anyone otherthan theiremployer;
(2) No financialrelationshipswith
commercialentitiesthatmight
have an interestinthe submitted
work;(3) No spouses, partners,,
or childrenwithrelationshipswith
commercialentitiesthatmight
have an interestinthe submitted
work;(4) No non-financial
intereststhatmay be relevantto
the submittedwork.
Provenance and peer review: Not
commissioned;externallypeer
reviewed.

whichunderpins
andsociety,
on the betweentheindividual
askedwhethertheyagreedwithtwostatements
many
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and areinfluenced
weremostlikelyto influence
nantsand theothergenes.Democrats
bypoliticalbeliefs.
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and
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not
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sionweresignificantly
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werelessso. Ina secondUS study, whichFoxNews,an outlet
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ona conservative-liberalagenda,was rolledoutacrosscablenetworks
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Politiciansareoftencriticised
it.4
oractuallyreinforced
theirmisperception
thattheythenfailtokeep.
mecha- peopleandformakingpromises
Another
studyexaminedpossibleneurological
as thisgrowing
nismsinvolvedin interpreting
bodyofevidenceshows,theprobpoliticalmessagesin the However,
but
areactually
be
less
what
the
lem
Fast
election.
Presidential
2004
US
tothe
saying
politicians
magnetic
may
run-up
are
heard
and
their
words
rather
how
in
was
used
the
brain
of
resonance
interpreted.
peopleexposed
imaging
to 1 TaberCS, LodgeM. Motivatedskepticismintheevaluationofpolitical
tocontradictory
pairsofmessagesthatwereattributed
beliefs./lm/Po//fSc/2006;50:755-69.
ofbothpartiesand toneutralcommentators.5 2 Taleb
politicians
NN.The blackswan: the impactofthe highlyimprobable.AllenLane,
as Republicans
Whereasthoseregistered
2007.
clearlyidentified
LantzPM,Ubel PA.The polarizingeffectofnews media
voicedbyDemocrat
thecontradictions
politicians,
theysaw 3 GollustSE,about
ofhealth.AmJPubiHealth
the social determinants
messages
and
inthestatements
minimal
contradiction
byRepublicans,
2009;99:2160-7.
the A NyhanB, Reiflerj. Whencorrectionsfail:thepersistenceofpolitical
wereequallycapableofspotting
viceversa.Participants
misperceptions.Po//fe/?a'/2010;doi:10.1007/slll09-010-9112-2.
neutral
commentators.
the
contradictions
Rejectionof 5 WestenD, KiltsC, BlagovP,HarenskiK,HamannS. Theneuralbasis of
by
a combination
on political
evidencearosefrom
motivatedreasoning:an fMRIstudyofemotionalconstraints
contradictory
obviously
judgementduringthe US Presidentialelectionof200h. j CognNeurosa
andswitchwithdistress
associated
neurones
ofswitching
off
2006;18:1947-58.
emotions.
Perversely, 6 WestenD. Thepoliticalbrain.PublicAffairs,2007.
ingonthoseassociatedwithpositive
formaking 7 McKeeM, RaineR.Choosinghealth?Firstchoose yourphilosophy.Lancet
thelatterprovideda "positivereinforcement"
2005;365:369-71.
else- 8 Amodio
authors
described
whichoneofthe
biaseddecisions,
correlatesof
DM,JostJT,MasterSL,Yee CM. Neurocognitive
liberalismand conservatism.NatNeurosa 2007 ''0:' 246-7.
totheterm
a newmeaning
whereas giving
junkie."6
"political
PolitEcon
Grouployaltyand thetasteforredistribution.)
and updatingof 9 LuttmerEFP.
ofinformation
thisprocessing
Crucially,
2001:109:500-28.
circuits 10 HarsanyiD. Nannystate: howfoodfascists,teetotalingdo-gooders,
occurred
rapidly,
bypassing
extremely
preferences
priggishmoralists,and otherboneheaded bureaucratsareturning
to
anditwas thought
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normally
Americaintoa nationofchildren.Broadway,2007.
be outsidetherealmofconsciouscontrol.
1 1 Della VignaS, KaplanE.The FoxNewseffect:media bias and voting.NBER
howviewsabouttherelationship
Thisresearch
Working
PaperNo 12169. NBER,2006.
highlights

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Citethisas: BMJ2010;340:cl862
doi:10.1136/bmj.c1862

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BM] 11 MAY2010 | VOLUME340

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