from the world's big
Why Today's Healthy You Has Trouble Planning for Tomorrow's Sick You
An aging man, a physician, learns he has Alzheimers. Determined to avoid the worst of it, he assembles a lethal collection of pills. As the next few years pass, the bottle in his nightstand comforts him with the thought that he'll have them when the right moment comes. But what comes instead is the moment when he can't remember what the pills are for. This is a true story. I heard it by the man's son, because we'd been talking about living wills, advanced medical directives and other instruments Americans are encouraged to wield at the end of life. I'd asked him about a nagging doubt I had: It concerns the gap between I, David, aged 54 and in good health, creating my instructions for end-of-life care, and I, David, aged 84 and terminal, who has to live under those instructions. Those two aren't the same guy.
I think of this as the Krapp's Last Tape problem (after the Beckett play in which 69-year-old Krapp torments himself by listening to the taped ramblings of men he scorns and despises: Himself, at age 39 and age 20.) We are expected to make these immensely consequential decisions about how we wish to be treated when when we are sick, feeble, demented—but those choices are to be made when we're none of those things. Should we be confident we know today what we'll want tomorrow?
Research suggests we should not be. For instance, in this paper (pdf) on the legal implications of people's "incorrect, intuitive theories about the impact of disability on happiness," Peter A. Ubel and George Loewenstein note that paraplegics and blind people aren't markedly less happy than typical people; nor do colostomy patients and dialysis recipients report sadder lives than ordinary people. Yet those ordinary people estimate that being paralyzed, blinded, having kidney failure or getting a colostomy must be life-ruining catastrophes. The research on colostomy patients, detailed in this study, was especially revealing: The researchers found the expected gap—people with colostomies adapted and felt OK, non-patients asked about colostomy said they expected it would be a terrible thing. Here, though, is a wrinkle: Colostomies, in some cases, are reversible. So the authors could compare people who had permanent conditions with those who had been through the experience and returned to a more typical life. It turns out the former colostomy patients also thought the procedure was terrible. They recalled their lives with colostomy bags in a very negative light, while people who must live with such a bag for the rest of their lives felt pretty much fine. (Ubel, a physician and social scientist now at Duke's Fuqua School of Business, calls this effect "the dark side of hope.")
In academia, "Rational Economic Man" is a model of the mind and a theory of human behavior, and it's under assault. However, in the institutions that organize our lives, Rational Economic Man is an unspoken assumption—an article of faith that can't be challenged because it's not even stated explicitly. So it is with end-of-life planning. Creating a medical directive involves estimating what will be acceptable and what will be unbearable to us in some future state, and the evidence is that we're terrible at making such estimates. Why the mismatch? Because our legal structures for this stage of life are based on "rational economic man" assumptions: first, that people see supposedly objective facts in the same way, no matter their own situation; and, second, that people are coherent and consistent over time, so we can assume that their preferences expressed at age 39 are still valid at age 69; and, third, that because of the first two, you can be sure you know today what you will want in that final hospital bed 25 years from now.
A pretty unfortunate situation, all in all. What to do?
That's not a rhetorical question. I'd very much like to hear from you, readers, on two points. First, have any of you had an experience, yourself or with a loved one, in which this problem came up? Second, are any of you aware of any practical approaches to end-of-life planning that take the Krapp's Last Tape problem into account? Please leave your thoughts and stories in the comments section, or if you prefer, email me at the address in my bio.
Illustration: The Seven Ages of Man, 1820.
Follow me on Twitter: @davidberreby
Ubel, P., & Loewenstein, G. (2008). Pain and Suffering Awards: They Shouldn’t Be (Just) about Pain and Suffering The Journal of Legal Studies, 37 (S2) DOI: 10.1086/529072 Smith, D., Sherriff, R., Damschroder, L., Loewenstein, G., & Ubel, P. (2006).
Misremembering colostomies? Former patients give lower utility ratings than do current patients. Health Psychology, 25 (6), 688-695 DOI: 10.1037/0278-6220.127.116.118
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From "if-by-whiskey" to the McNamara fallacy, being able to spot logical missteps is an invaluable skill.
- A fallacy is the use of invalid or faulty reasoning in an argument.
- There are two broad types of logical fallacies: formal and informal.
- A formal fallacy describes a flaw in the construction of a deductive argument, while an informal fallacy describes an error in reasoning.
Appeal to privacy<p>When someone behaves in a way that negatively affects (or could affect) others, but then gets upset when others criticize their behavior, they're likely engaging in the appeal to privacy — or "mind your own business" — fallacy. Examples:<br></p><ul><li>Someone who speeds excessively on the highway, considering his driving to be his own business.</li><li>Someone who doesn't see a reason to bathe or wear deodorant, but then boards a packed 10-hour flight.</li></ul><p>Language to watch out for: "You're not the boss of me." "Worry about yourself."</p>
Sunk cost fallacy<p>When someone argues for continuing a course of action despite evidence showing it's a mistake, it's often a sunk cost fallacy. The flawed logic here is something like: "We've already invested so much in this plan, we can't give up now." Examples:<br></p><ul><li>Someone who intentionally overeats at an all-you-can-eat buffet just to get their "money's worth"</li><li>A scientist who won't admit his theory is incorrect because it would be too painful or costly</li></ul><p>Language to watch out for: "We must stay the course." "I've already invested so much...." "We've always done it this way, so we'll keep doing it this way."</p>
If-by-whiskey<p>This fallacy is named after a speech given in 1952 by <a href="https://en.wikipedia.org/wiki/Noah_S._Sweat" target="_blank">Noah S. "Soggy" Sweat, Jr.</a>, a state representative for <a href="https://en.wikipedia.org/wiki/Mississippi" target="_blank">Mississippi</a>, on the subject of whether the state should legalize alcohol. Sweat's argument on prohibition was (to paraphrase):<br></p><p><em>If, by whiskey, you mean the devil's brew that causes so many problems in society, then I'm against it. But if whiskey means the oil of conversation, the philosopher's wine, "</em><em>the stimulating drink that puts the spring in the old gentleman's step on a frosty, crispy morning;" then I am certainly for it.</em></p>
Slippery slope<p>This fallacy involves arguing against a position because you think choosing it would start a chain reaction of bad things, even though there's little evidence to support your claim. Example:<br></p><ul><li>"We can't allow abortion because then society will lose its general respect for life, and it'll become harder to punish people for committing violent acts like murder."</li><li>"We can't legalize gay marriage. If we do, what's next? Allowing people to marry cats and dogs?" (Some people actually made this <a href="https://www.daytondailynews.com/news/national/cats-marrying-dogs-and-five-other-things-same-sex-marriage-won-mean/dLV9jKqkJOWUFZrSBETWkK/" target="_blank">argument</a> before same-sex marriage was legalized in the U.S.)</li></ul><p>Of course, sometimes decisions <em>do </em>start a chain reaction, which could be bad. The slippery slope device only becomes a fallacy when there's no evidence to suggest that chain reaction would actually occur.</p><p>Language to watch out for: "If we do that, then what's next?"</p>
"There is no alternative"<p><span style="background-color: initial;">A modification of the </span><a href="https://en.wikipedia.org/wiki/False_dilemma" target="_blank" style="background-color: initial;">false dilemma</a><span style="background-color: initial;">, this fallacy (often abbreviated to TINA) argues for a specific position because there are no realistic alternatives. Former British Prime Minister Margaret Thatcher used this exact line as a slogan to defend capitalism, and it's still used today to that same end: Sure, capitalism has its problems, but we've seen the horrors that occur when we try anything else, so there is no alternative.</span><br></p><p>Language to watch out for: "If I had a magic wand…" "What <em>else</em> are we going to do?!"</p>
Ad hoc arguments<p>An ad hoc argument isn't really a logical fallacy, but it is a fallacious rhetorical strategy that's common and often hard to spot. It occurs when someone's claim is threatened with counterevidence, so they come up with a rationale to dismiss the counterevidence, hoping to protect their original claim. Ad hoc claims aren't designed to be generalizable. Instead, they're typically invented in the moment. <a href="https://rationalwiki.org/wiki/Ad_hoc" target="_blank">RationalWiki</a> provides an example:<br></p><p style="margin-left: 20px;">Alice: "It is clearly said in the Bible that the Ark was 450 feet long, 75 feet wide and 45 feet high."</p><p style="margin-left: 20px;">Bob: "A purely wooden vessel of that size could not be constructed; the largest real wooden vessels were Chinese treasure ships which required iron hoops to build their keels. Even the <em>Wyoming</em> which was built in 1909 and had iron braces had problems with her hull flexing and opening up and needed constant mechanical pumping to stop her hold flooding."</p><p style="margin-left: 20px;">Alice: "It's possible that God intervened and allowed the Ark to float, and since we don't know what gopher wood is, it is possible that it is a much stronger form of wood than any that comes from a modern tree."</p>
Snow job<p><span style="background-color: initial;">This fallacy occurs when someone doesn't really have a strong argument, so they just throw a bunch of irrelevant facts, numbers, anecdotes and other information at the audience to confuse the issue, making it harder to refute the original claim. Example:</span><br></p><ul><li>A tobacco company spokesperson who is confronted about the health risks of smoking, but then proceeds to show graph after graph depicting many of the other ways people develop cancer, and how cancer metastasizes in the body, etc.</li></ul><p>Watch out for long-winded, data-heavy arguments that seem confusing by design.</p>
McNamara fallacy<p>Named after <a href="https://en.wikipedia.org/wiki/Robert_McNamara" target="_blank">Robert McNamara</a>, the <a href="https://en.wikipedia.org/wiki/United_States_Secretary_of_Defense" target="_blank">U.S. secretary of defense</a> from 1961 to 1968, this fallacy occurs when decisions are made based solely on <em>quantitative metrics or observations,</em> ignoring other factors. It stems from the Vietnam War, in which McNamara sought to develop a formula to measure progress in the war. He decided on bodycount. But this "objective" formula didn't account for other important factors, such as the possibility that the Vietnamese people would never surrender.<br></p><p>You could also imagine this fallacy playing out in a medical situation. Imagine a terminal cancer patient has a tumor, and a certain procedure helps to reduce the size of the tumor, but also causes a lot of pain. Ignoring quality of life would be an example of the McNamara fallacy.</p><p>Language to watch out for: "You can't measure that, so it's not important."</p>
A new study looks at what would happen to human language on a long journey to other star systems.
- A new study proposes that language could change dramatically on long space voyages.
- Spacefaring people might lose the ability to understand the people of Earth.
- This scenario is of particular concern for potential "generation ships".
Generation Ships<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="a1e6445c7168d293a6da3f9600f534a2"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/H2f0Wd3zNj0?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span>
Many of the most popular apps are about self-improvement.
Emotions are the newest hot commodity, and we can't get enough.