Even judges can be nudged

Decision-Making

This time participants were given information on the effectiveness of treatments as a percentage of those cured overall (ranging from 90 to 30 percent). This is known as base rate information. They were also given a story, which could be positive, negative or ambiguous. For instance, the positive story read as follows: Pat’s decision to undergo Tamoxol resulted in a positive outcome. The entire worm was destroyed. Doctors were confident the disease would not resume its course. At one-month post-treatment, Pat’s recovery was certain. The negative story read: Pat’s decision to undergo Tamoxol resulted in a poor outcome. The worm was not completely destroyed. The disease resumed its course. At 1-month post-treatment, Pat was blind and had lost the ability to walk. Subjects were then asked whether they would undergo the treatment if they were diagnosed with the disease.

Treatment A cures 90 per cent of patients. Treatment B cures 30 per cent. Pat takes one of them and recovers completely.

Change Pat’s ending to blindness and loss of mobility. Leave the percentages untouched. The choice now contains a human consequence with a name, chronology and emotional weight. The base rate is still doing the statistical work; Pat is occupying nearly all the attention.

The story still matters. “Failure” can hide very different outcomes. A patient needs to know what recovery involves, how harm unfolds and which risks an average has compressed. A number without lived consequences can be clinically precise and practically useless.

The distortion begins when one narrated possibility starts impersonating its frequency. One person from the unsuccessful 10 per cent receives a face and a terrible sequence of events. Ninety recoveries become two digits and a symbol. Nothing stated is false. The page still loads the decision.

Commercial case studies use the same furniture. The exceptional customer receives photographs, a name and a satisfying before-and-after. Typical outcomes are demoted to fine print. Readers understand that the example is an example, then remember it as a forecast anyway.

Averages conceal things too. Mild benefit for many and severe harm for a few can look respectable in a single figure. An individual case may reveal the tail risk that summary statistics politely buried. The choice needs frequency and consequence on speaking terms.

Order changes the conversation. Put Pat first and the percentage becomes context for an already vivid person. Put the full distribution first and Pat becomes one place inside it. Add a second equally detailed patient with the opposite outcome and the emotional monopoly breaks.

The final decision sheet is less elegant than either version. It contains the distribution, the range of outcomes and two stories that refuse to agree with each other. The patient has more to read, and a less tidy decision to make.