Recently my cardiologist insisted that a cholesterol lowering drug was beneficial because the Relative Risk Reduction was 25%. I explained that RRR was only a ratio of improvement, the Absolute Risk Reduction indicates the size of the benefit which in this case, was less than 2%. You’d have to treat 67 people for 5 years before 1 of them avoided a mostly non-lethal event. I showed him the FDA guidelines saying RRR could lead to improper medical care. He still didn’t believe it.
Both numbers are accurate, but measure different things. The higher RR leads patients to believe they are getting more benefit than they are. Naturally, that’s the figure promoted by drug manufacturers and used in the studies, seminars, and classes doctors confront daily.
Here’s the problem. No matter how carefully and respectfully I reviewed the numbers with this well-educated intelligent man, he didn’t see the logic.
It’s not just doctors doing the illogical.
- Virginia’s state-controlled religion forces Christians to get permission to pray, while “minority” religions keep their freedom of worship. Even though the first amendment clearly forbids this.
- A recent poll showed 25% of Americans and 44% of Democrats are fine with violence to stop Trump; 23% are ok with assassinating him. Even children know this is morally wrong.
- The AAP still defends gender care treatments knowing the studies they cite say the opposite.
These decisions are from educated people who have proven their capacity to critically think.
What’s really happening.
There are many reasons why intelligent people make bad decisions. Four things that block positive use of critical thinking are:
- Degree arrogance: The highly educated are good at constructing logical sounding justifications for the absurd. Here’s a Reuters Fact Check with an expert witness that goes to great lengths to explain why RRR is preferred even though it’s not the best for patients. The expert dances around the one question only Absolute Risk Reduction can answer and most people care about…How much will this drug help me and how much will it hurt me?
- Tribe pleasing: Others are more concerned with holding the accepted opinion within their group than being factually right. Intelligence just makes the signaling more sophisticated. This is why you see credentialed people defend indefensible positions. The cost of defecting from the tribe exceeds the cost of being wrong.
- Blind spots: A brilliant cardiologist can be a novice at statistics or philosophy and not know it. Expertise in one area can lead to overconfidence in others.
- Incentives: Careers, funding, licensure, and social standing can all be rewarded by saying the approved thing. A person can be smart and still be institutionally or socially captured.
The Process - Convincing yourself the insane is sane.
Each of the above examples follows a similar pattern:
- Start with the end: They begin by establishing a conclusion that pleases a group they identify with or that wins an incentive. Each goal takes precedence over reasoning.
- Channel thinking: Their intelligence then gets redirected toward the pre-determined conclusion.
- Receive rewards: Groups and institutions then reward the conformists and punish the non-conformist.
- Always weighing costs: The cost of mental independence can be social or professional rejection, or financial loss. For many, the truth is too high a price to pay.
The antidote isn’t a higher IQ. It’s independence of mind, a willingness to be the odd one out and to develop a habit of asking “what would it take for me to seek the truth, no matter the cost?” A question most people, smart or not, never seriously ask.
How to overcome it
Critical thinking is essential to solve today’s problems. But too often critical thinking isn’t utilized, it’s recruited to justify illogical, (the cardiologist), asymmetrical (Virginia), and/or immoral (assassination) ends.
At times just about everyone has recruited their critical thinking skills to meet their desired ends. The trick is to catch yourself doing it and reverse course.
The question isn’t whether you do it. Instead, ask yourself:
- In what situations am I directing my critical thinking abilities to justify the end I desire?
- Can I catch myself doing it?
- What does it cost me to admit the truth?
The most dangerous people aren’t the ones who recruit their reasoning. They’re the ones who refuse to catch it mid-stream and ignore that their conclusions are arriving before the evidence has even been collected.
Catching yourself is more than a skill. It’s a discipline that’s far more rare than intelligence.
Next time you see an intelligent person defending something indefensible, don’t ask why they can’t think. Ask what they’re protecting. The answer is almost never “the truth.”
