Thinking fast and slow – my “Best of Health” article for February 2020

Best of HealthLast month, I ended with a quote from Dr Dan O’Neill at the 4th International Dog Health Workshop (IDHW4): “We need to stop saying it’s all about the dogs. It is clear that it is really all about the people”. While it’s important to understand canine health and genetics, it’s become apparent that many of the successes and failures of health improvement initiatives are down to human motivation, behaviour, and thinking. One of the underlying themes at the IDHW4 event was “human behaviour change” and, in previous articles, I’ve written about some of the ways this can be influenced. Studying fields such as psychology that are concerned with how people think, behave and make decisions can give us some useful insights into why canine health improvement can be so difficult.

My Christmas reading was Daniel Kahneman’s book “Thinking fast and slow”. Kahneman is a psychologist and economist who won a Nobel Prize for his work on behavioural economics in 2002. Thinking fast and slow is all about why people think what they do and why they make the decisions they make. Kahneman calls “thinking fast”, System 1, and “thinking slow”, System 2.  System 1 operates automatically and quickly, with little effort and without voluntary control. System 2 requires mental effort and concentration.

For example, if you told most dog breeders that 2 of the 3 genotypes from a DNA test are “Clear” and “Carrier”, they would instantly know that the 3rd genotype is “Affected”. System 1 gives us the answer automatically because it’s something we’ve learned through practice and repetition. If, however, I asked you what is the expected proportion of Carrier puppies from mating a Clear and Carrier together, you’d probably have to think more carefully or draw a punnett square. Kahneman claims that we all like to believe we think in a System 2 way; i.e. rationally, and we use that ability to make informed decisions. Unfortunately, that’s not what happens in practice.

System 1 is fine because it uses what we have learned in order to react quickly and lowers the mental load we have to cope with. System 1 often uses “rules of thumb” to make decisions quickly and usually these lead to good decisions. Occasionally, it can also lead to mistakes. Try this: A bat and a ball cost £1.10 between them. The bat costs £1 more than the ball. How much does the ball cost?

Most people answer 10p but the correct answer is 5p. If the ball cost 10p and the bat cost £1 more, it would cost £1.10, making the total cost £1.20. System 1 thinking evokes an answer that is intuitive, appealing and wrong! System 1 causes people to be overconfident and to place too much faith in intuition. Our brains are inherently lazy and we default to System 1 decision-making and with that comes cognitive biases. Only if we come across something unusual or if we make a conscious effort, do we engage System 2.

WYSIATI: What you see is all there is

System 1 is a “machine for jumping to conclusions” on the basis of limited information. Try this:

Jo is 30 years old, outspoken and has tattoos. Jo lives in a Northern city and works as a car mechanic. Which of these statements is more probable?

1: Jo owns a Gundog

2: Jo owns a Terrier

Based on registration statistics it is actually 4 times more likely that 1 is correct, yet some people will jump to conclusions because of their inherent biases or will assume the (irrelevant) storyline is of some significance and outweighs the statistical evidence. It takes more mental effort to apply System 2 thinking and come up with the right answer.

If you’re a breeder and you had 4 out of 5 litters born by caesarean, System 1 could lead you to conclude that most bitches need caesareans and you might be inclined to go for elective caesars rather than wait. Similarly, if you’re a breeder who has never had a dog with a condition that is known to be prevalent in your breed, System 1 may lead you to conclude that “it’s the way everyone else rears theirs”, despite there being no evidence and your experience is based only on your own small sample of dogs.

When you bring individuals with their own supposedly rational views into a group, you can end up with a whole group coming up with completely irrational rejections of robust scientific evidence. System 1 thinking has little understanding of logic and statistics, which is why we all need to be aware of this risk and become more careful and reflective users of breed health data. 

Recognising bias

System 1 takes shortcuts to make decisions; for example, confirmation bias means you tend to agree with information that supports something you already believe. If you’ve heard about a few cases of epilepsy in a breed, you’re more likely to agree with research studies that also found epilepsy, even if they only involved very small sample sizes.

There is also an “availability” bias, where you overestimate the probability of something that you have heard often or that you find easy to remember. This is a particular danger in the world of health improvement where a few cases of a disease might get discussed widely, or a DNA test is developed and people then rush to use that test, while completely ignoring the low incidence of the condition or the fact that other conditions are much more important to address.

Kahneman discusses the “availability cascade”. This is a self-sustaining chain of events that may start with a few media reports of a problem that lead to widespread public panic and eventually result in policy changes by legislators. Often, the emotional reaction (e.g. dogs dying) becomes a story in itself and the story can be accelerated by media headlines, social media groups and campaigning individuals who work to ensure a continuous supply of bad news cases. Scientists who try to try to use data to dampen the fears sometimes face hostility or are accused of a cover-up and we simply don’t get to hear of the 99.9% of dogs that haven’t been affected.

Hindsight bias occurs when people reconstruct a story to exaggerate the probability they knew an event was going to happen. I can’t think of any canine health examples but it’s regularly heard around the ringside just after the Challenge Certificate has been awarded!

System 1 thinking is intuitive and makes our lives easier by reducing the amount of mental effort we need to expend when making decisions. Being aware of this helps us to understand why it’s so hard to change the behaviour of breeders, judges, buyers, and owners. It’s helpful to be aware of these lessons from Thinking fast and slow because, otherwise, we will continue to make the same mistakes and will not see the improvements in canine health and welfare that we all want to see.

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