It is not from the benevolence of the butcher, the brewer, or the baker that we expect our dinner, but from their regard to their own interest.Adam Smith, Wealth of NationsAs the quote above indicates, economists generally are more comfortable with self interest as a motivating force for social benefit than with altruism. This is because in most instances in a market economy, self interest will lead agents to provide benefits for others. Ultimately this is because the butcher or baker (...) will not get paid unless he does something that others are willing to pay for. This is the source of the famous “invisible hand,” also discussed by Adam Smith.This might sound trivial, except that in discussing aspects of medicine we seem to lose sight of this mechanism and rely on other tools to provide benefits. These tools do not work as well as naked self interest would. Some might say that medicine and medical progress is too important to depend on the market. (shrink)

Encouraging people to consider multiple alternatives appears to be a useful debiasing technique for reducing many biases (explanation, hindsight, and overconfidence), if the generation of alternatives is experienced as easy. The present research tests whether these alternative generation procedures induce a mental simulation mind-set (cf. Galinsky & Moskowitz, 2000), such that debiasing in one domain transfers to debias judgments in unrelated domains. The results indeed demonstrated that easy alternative generation tasks not only debiased judgments in the same domain but also (...) generalized to debias judgments in unrelated domains, provided that participants were low in the need for structure. The alternative generation tasks (even when they were easy to perform) showed no evidence of activating a mental simulation mind-set in individuals high in need for structure, as these individuals displayed no transfer effects. Implications of the results for understanding the role of the need for structure, ease of generation, and mental simulation mind-set activation for debiasing are discussed. (shrink)

This book explores the controversial relationship between physicians and the pharmaceutical industry, identifies the ethical tensions and controversies, and proposes numerous reforms both for medicine's own professional integrity and for effective public regulation of the industry.

The Association of American Medical Colleges (AAMC) is urging academic medical centers to ban pharmaceutical detailing. This policy followed from a consideration of behavioral and neuroeconomics research. I argue that this research did not warrant the conclusions drawn from it. Pharmaceutical detailing carries risks of cognitive error for physicians, as do other forms of information exchange. Physicians may overcome such risks; those determined to do so may ethically engage in pharmaceutical detailing. Whether or not they should do so is a (...) prudential judgment about which reasonable people may disagree. The AAMC's ethical condemnation of detailing is unwarranted and will subvert efforts to maintain a realm of physician discretion in clinical work that is increasingly threatened in our present practice environment. (shrink)