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Introd.uction

Introduction

On Science-B ased Patmtalism

puRSUITS ARE constantly uncovering the inner workings of our psyches and our worlds, from the quantum to the cosmic level. In this volume, you will find essays that discuss the biota
that fills and surrounds our bodies; animals that mimic and inform
our own behavior; human failures and strengths; the societies and
environments we create and inhabit (and sometimes destroy); and
the technologies we develop and depend on. And although the
journey from microcosm to macrocosm may seem like explorations of very different worlds, you will see that a common thread
runs through the articles. Each of them offers an independent
but complementary musing on the human condition. (Of course,
I may be biased in this interpretation, given my own research focus.) To me, the main theme that surfaces in all of these articles is
the timeless question of what makes us human. Is it the microbes
that constitute the bulk of the cells in our bodies? Our differences

Scrnxtrrrc

from.or similarities to other species in the animal kingdom? Our

ability or irrepressible impulse to manipulate our environments
with a godlike hubris? Our genes, our brains, the pheromones we
emit? Or, as Elizabeth Kolbert suggests in "Sleeping with the Enemy," is it our unique sense of Homo sapims madness? The main
conclusion I've reached, based on the evolution of science in general-and as reflected in this collection-is thatwe are extraordinary yet flawed and predictably irrational creatures'
Contained within each of these articles, and with each new sci-

enrific discovery is the joy of learning for its own sake, which is
considerable in itself. But research is only the first step; we can't
ignore the lingering question of how we can-and should-use
scientific evidence to our advantage. How do we make the most
of science so that it has a greater purpose than merely quenching
our curiosities?
I have always looked at science as a tool to improve our lives
and environment; it's why I got into the field in the first place.
When I was in the hospital manyyears ago being treated for extensive burns, the nurses would rip the bandages off my skin grafts as
quickly as possible. They figured, following convenLional wisdom,
that short bursts of pain were preferable to prolonged (albeit less
intense) periods of pain. Once I was out of the hospital and enrolled in Tel Aviv University, I turned my first academic research
efforts toward figuring out whether people suffere d less when pain
was brief but intense or ionger-lasting but moderate. fu it turned
out, people fared better with the latter. Reflecting on the gap between how my kind and highly experienced nurses had treated me
and what I found in many controlled experiments showed me that
my nurses hadn't figuned out the best way to remove bandages.
Beyond the issues of burn patients, this made me wonder if we rely
on biases and inaccurate beliefs about how the world works across
many aspects of life to the detriment of ourselves and others. We
think we are rational creatures, but time and time again we misjudge our own preferences, make decisions that fall far from our
best interests, and are swayed by forces that we don't recognize.
What this suggests is that there is ample room for improvement
in almost any aspect of human enterprise and that basing our dec!
sions, guidelines, and procedures on scientific findings is the

fght

way (and, in my opinion, the only way) to move forward, This is

the upside of using the scientific method to inform our day-to-day
actions. As Thomas Hayden quotes in "How to Hatch a Dinosaur,"
"What good is a toolkit if you don't use it to build something?"
As we assemble a scientific toolkit of information, we can start
remodeling the world around us to build stronger reinforcements
that support our multifaceted human nature. We can take what we
are learning about the microscopic world of gut biota to develop

probiotics to treat conditions ranging from eczema to allergies.

Or use the perpetually evolving science of genetic engineering to
combat issues from obesity to dengue fever. And if we find that

xvi

Introduction

people are more likely to behave in environmentally friendly ways

when they feel emotionally connected to nature, we can try out
new methods of encouraging conservation that don't use guilt tactics or.information overload. We can test new strategies that promote suStainable behavioral change, and when we figure out the
best ways to reinforce positive outcomes, we can enlist them on a
larger scale.
Scientific findings do not always portray us in a favorable light.
Although we sometimes discover how wonderful we are or how
dfficult it is for computers to reason the way we do so naturally
(see "Mind vs. Machine" by Brian Christian), we occasionally uncover things about ourselves that are not particularly flattering.
As just one example, we overestimate risks that evoke emotion or
are highly salient, and we underestimate risks that fail to give us
the chills. AsJason Daley writes in "WhatYou Don't Know Can Kitl
You," "a risk-perception apparatus permanently tuned for avoiding
mountain lions makes it unlikely that we will ever nrn screaming
from a plate of mac 'n' cheese." And with obesity at an all-time
high, this presents a pretty substantial problem. But we can use
even *re bleakest findings to invent new ways to correct for our
mistakes and improve our lives. Through such contribudons from
science, we are able to learn about our flaws and find solutions
that mitigate their consequences.
The Downsid,e

The downside is that for each scientific finding, the conclusions

limit our options, both professionally and person"tmay
ally. With each science-based recommendation for policies or procedures, we essentially become a more paternalistic society. And
most of us are (understandably) uncomfortable with paternalism
and its implication of a condescending, one-way relationship in
which our lives can be dictated by others. We value freedom for
freedom's sake, we value the flexibility to make different decisions
depending on our particular circumstances, and we value the abil-.
ity to choose for ourselves. For all ofthese reasons, the prospect of
setting strict top-down limits is undesirable and complicated.
Nelson Mandela once said, "There is no such thing as part
freedom." But was he correct in this senliment? Or do we value
freedom too highly, such that we are harming ourselves as we em-

we arrive

Introduction

xvii

bark on a relentless pursuit for the freedom to @$#Vol up? Alternatively, can we establish a system in which our freedoms are intact
but Iimited in a way that protects us from ourselves? Mayb. Robert
Frost had a more suitable concept of freedom when he noted, "If
society fits you comfortably enough, you call it freedom." Should
we relinquish our romanticized vision of freedom and replace it
with a more realistic version that accounts for our humanness? IJsing our scientific toolkit, we can make society comfortable enough
to feel free, even if we give some concessions in arenas where it is
in our best interest to accept a bit of guidance. For example, we
can take advantage of smart feedback systems like those described
by Thomas Goetz in "The Feedback Loop" to get people to drive
more slowly or take their cholesterol medication, This way, we can
simultaneously preserve their freedom to speed, but we can also
install "speed meters" that effectively discourage it.
Given the complex costs (limiting freedom) and benefits (better outcomes) that such systems would entail, there is no simple
or single answer to how and when we should be paternalistic.
Instead, we should consider each case independently and weigh
its specific costs and benefits before making decisions that could
limit personal freedoms. At the same Lime, as in all scientific ventures, we should look for principles that can guide our decisions
about when to intervene and when to let people make their own
mistakes. I would like to propose two such principles: interdependence and agency.
The Principle of Interdepmdmce

John Stuart Mill's influential definition of freedom, which seerns

to hold up even today, can inform our decisions about when paternalism may be more or less necessary. As Mill said, "The only freedom which deserves the name is that of pursuing our own good
in our own way, so long as we do not attempt to deprive others
of theirs, or impede their efforts to obtain it. Each is the proper
guardian of his own health, whether bodily, or mental or spiritual." In theory as long as we're not harming others, we can do
as we choose. We are free to get blindingly drunk in the comfort
of our own homes as long as we harm only ourselves. But as soon
as we try to drink and drive, our actions become a serious crime
of the consequences.

-regardless

xvru

Introd,uction

With this principle in mind, we can more easily predict some

situations in which a paternalistic stance would be highly advisable.
For example, one arena where we readily accept a high degree
of regulation is driving: we abide by restrictions on age, location,
speed, and parking. People are required to wear seat belts, are
severely punished if they drink and drive, and risk a hefty ticket
when they attempt to use their cell phones. And still, few people
advocate for "freedom from seat belts" (although I'm sure there
are some libertarians open to this discussion).
In contrast, people are generally opposed to the regulation of
private events. If someone chooses to be reckless on his own-juggling chain saws, for example-we consider it up to that person
to decide whether it's a good idea or not. I suspect that very few
people would want to add an age limit or license requirime.nts to
the use of power tools.
However, while the distinction between activities that affect only
ourselves and those that affect others appears fairly easy to determine, in many cases it is not-and in a socially connected world,
this distinction gets even muddier. For example, is the person who
chooses to binge-drink at home, never intending to get behind
the wheel, really hurting only himself? He's not endangering drivers, but what if he has a wife and kids? What if he needs a liver
transplant and is chosen to receive, one over someone who has
not put himself at risk for liv-f damage? I'm not advocating for
greater regulation of alcohol sg,les, but I am suggesting that what
can seem like one person's problem may actually leak outside that

individual's sphere. As society moves forward, we are beginning to

realize how interdependent we are; think about the financial crisis
of zoo8, when subprime mortgages in the United States brought
the world economy to its knees. In areas where our interests and
our personal lives overlap and are increasingly intertwined, we
may need to adopt more paternalistic methods in order to ensure
our safety and well-being.
The Principle of Agmcy

A second principle that we can use to guide our paternalistic recommendations comes from our view of agency, or the ability of
individuals to make good decisions for themselves and for others. The most salient example is that of parenting. We don't ex-

'Introduction

XIX

actly trust children to be the bestjudges of what to eat or whether

they need to go to school. If my son were left to his own devices,
he would probably build elaborate forts and eat crdme br0l6e all
day. Both David Dobbs's "Beautiful Brains" and David Eagleman's
"The Brain on Trial " confront the issue of agency head on; these
articles point to the complexities of 'human development and diversity and how they relate to the decisions we make, And as Eagleman puts forth, "Perhaps not everyone is equally'free' to make socially appropriate choices." We are not all equipped with the same
genes, environmental surroundings, or life experiences (which is,
of course, a good thing), and it is unfair to treat everyone in exagtly the same way as if we were indistinguishable beings.
But the question of agency is not limited to children and criminals. In fact, much of the research in decision making and behavioral economics highlights how we oveiestimate the amount bf
control we have over our decisions and underestimate the forces
that influence us. To the extent thatwe all suffer from these biases
and a sense of magnified agency, there must be more cases where a
higher degree of paternalism is in order.
From this perspective, let's consider conflicts of interest. While
we may realize that such conflicts exist and that they influence
othns, we fail dramatically in perceiving both the extent of their
effects and our own susceptibility to them. In one of my favorite
studies on conflicts of interest, Ann Harvey, Ulrich Kirk, George
Denfield, and Read Montague asked participants to rate how
much they liked sixty paintings, ranging from medieval to mod'
ern, from the collections of two different art galleries. Half of the
participants were told that their payment ($3o, $roo, or $3oo)
lor tukittg part in the study wut rpottroted by Gallery Ai the other
half were told that. the sponsor was Gallery B. Each painting had
one of the two galleries' logos on it-half of the paintings had Gallery As logo and half had B's. As you may have predicted, participants tended to prefer the paintings from their sponsoring gallery
which could be explained by a subconscious feeling of the need to
reciprocate. However, the story does not end there.
Brain scans of participants showed that the presence of their
sponsoring gallery's logo caused increased activity in the parts of
the brain related to pleasure (particularly the ventromedial prefrontal cortex, a part of the brain that is responsible for higher-order thinking, including associations and meaning). What's more,

fffli:|rlr

xx

J1

itlji:,1

Introd,uction

this activity increased substantially-along with participants' admiration for their sponsoring gallery's paintings-with each rise
in payment. It may seem surprising that a financial favor could
influence one's enjoyment of art, especially considering that the
favor (payment for participaLion) was completely unrelated to the
paintings. But as with many other types of favors, it was all too
easy to create a feeling of gratitude and the desire to reciprocate.
And, importantly, none of the participants thought their payment
had any influence over their decisions. When asked whether they
preferred their sponsoring gallery because of the paynent, they
scoffed at the mere suggestion.
This lack of appreciation for the power of conflicts of interest
is reflected in the real world. A few years ago I gave a lecture on
conflicts of interest to about two thousand members of the American Medical Association. I asked how many of the physicians in
the audience felt that theirjudgments were affected by conflicts of
interest with their hospital, drug manufacturers, insurance companies, med.ical d.evice manufacturers, or pharmaceutical sales representatives-and not a single person raised a hand. But when I
asked whether they believed that the judgments of other doctors
in the room were influenced by conflicts of interest, nearly everyone raised a hand. And again, when I asked whether they believed
that the judgments of the majority of the MDs in the room were
influenced by conflicts of interest, nearly everyone raised a hand.
Once we establish that conflicts of interest create a bias and
that we do not appreciate how this bias influences us, we can ask
whether we shoufd try to eliminate conflicts of interest altogether.
For example, we have laws prohibiting bribery in my'iad forms,
but what about lobbying? And should we allow companies to finance presidential elections through contributions? Should we allow doctors to receive gifts and benefits from pharmaceutical and
device companies? Should we allow bankers to be paid exorbitant
amounts when their investments happen to do well and load them
first onto the lifeboat when they fail? If we recognize that people
are unlikely to see the effects of conflicts of interest on themselves
and are therefore unlikeiy to self-regulate, we should be willing to
consider a more paternalistic approach.
Now, for the sake of "freedom of choice," we might decide that
we want to allow physicians to consult,for medical companies, because without them companies might not improve their products.

Introduction

xxi

We might insist on.paying bankers large bonuses even when their

investments fail, because otherwise "the smartest and brightest

would no longer be attracted to this noble profession." But I suspect that if we truly understood the incredible force that conflicts
of interests have in shaping our behaviors, we would not endorse
such practices, and we would even attempt to eradicate them.

Were Do We

frorn Here?
So here's the issue: if we want to get people to take healthier and
better paths in our complex and tempting modern world, we will
have to prescribe new instnrctions, practices, and regulationsand those in turn will inevitably limit our freedoms. Given that
most of us are apprehensive about surrendering autonomy,.and
for good reason, we should not take such decisions lightly. After
all, allowing people to make their own decisions is important to
our sense of self and independence, and a society without such
basic freedoms is unlikely to be successful or happy.
At the same time, we need to acknowledge that our fallibilities
and our level of societal interdependence are much more extensive than we give them credit for. With such limited agency and
such expansive interdependence, we may want to open the door
to science-based paternalism.
How should we determine when and under which conditions
we should introduce paternalism or phase it out? 1q my view we
should apply a careful cost-benefit analysis to each case. First, we
should consider whether (or to what extent) a particular case is
one in which an individual's actions are likely to darraage others'
Next, we should determine whether in this case people are likely
to naturally make decisions that are in their best long-term interest. If the answers to these two questions are "yes" and "no,"
respectively, we should empirically examine a range of potential
measure the
interventions
-starting with small-scale studies-to
potential costs and benefits of various solutions. To retain personal
freedoms, we should begin by experimenting with more hands-off
approaches that provide better information (such as posting calorie information in restaurants and measuring whether this has any
effect on the consumption of unhealthy foods). And only if we can
document empirically that these interventions fail or fall short of
expectations should we move to more invasive and paternalistic
Go

Introduction

interventions. For example, in the.case of posting calorie information, the evidence across multiple studies (for exampllt r!.
9.eorz study byJ.A. Schwartz,J. Riis, B, D. Elbel, and D. Ariely)'
is quite clear that merely providing calorie information does not

encouragehealthiereating.Thismeansthatitistimetotrymore
aggressive approaches, such as taxation or smaller default portion
sizes.

In the end, the level of paternalism we want in our society is

not going to be fully determined by science because there, is no
way to fully capture the costs involved in restricting the freedom
of people and societies. Perhaps one day we will figure out how
to measure such costs, but until then we should use science as an
input to help us understand which areas of life we should regulate
to a higher degree and to come up with interventions that balance
effectiveness with minimum impact on personal freedoms. It is not
going to be easy, but as our living environments become mqre
and more complex, with more and more temptations surroundiiig
us, it is going to be even more important to figure out where we
can succeed on our own, when we need a little helping hand, arrd
where we need the strength of a whole arm.
For me, this is one of the main goals for science in the years
to come-to figure out the human condition and design our environment to reduce our tendency for error and maximize our

Potential'

Irrationallyyours,
DAN ARIELY

My deepest thanks go to Aline Grirneisen,

help with this book.

P.S.

in particular for

fufnmces
Harvey, Ann, et al., "Monetary Favors and Their Influence on Neural
Responses and Revealed Preference,".,Ioumal of Naroscimu (2010\ .
Schwartz,J. A., et al., "Inviting Consumers to Downsize Fast-Food Portions
Si gnifi cantly Reduces Calorie Consumption," H ealth Alfairs 3 1, no. 2

(2012):399-407,