Academic medicine can cut through culture war stalemates — if it sees the morality on all sides

For doctors and scientists, there is no better way to prove a point than to provide evidence: a study, a set of data, a graph. But amid today’s cultural divisions, providing research-based evidence to Americans to influence them on controversial issues – like vaccines, climate change, and access to health care – often does not work, and sometimes backfires. Some people reject the evidence and harden their views.

This comes as no surprise to Jonathan Haidt, PhD, a social psychologist whose decades of research have focused on morality – research that led him to question conventional beliefs about how people make moral judgments. These judgments do not arise from reasoning, but rather from intuitions that develop through a complex mixture of personal and cultural factors.

“If you think moral reasoning is something we do to find out the truth, you will be constantly frustrated by how stupid, prejudiced and illogical people become when they disagree with you,” wrote Haidt in his bestseller- 2012 book The Righteous Mind: Why Politics and Religion Divide Good People.

So how can people with different political and social beliefs speak constructively about issues of morality? Haidt, a professor at NYU Stern School of Business, believes they must first respect each other’s moral motives. Morally, he says, each side is in some way right about the priorities that worry them most.

On November 9th, Haidt will discuss his theories in a plenary session at the annual meeting of the AAMC, Learn Serve Lead 2021: The virtual experience, which focuses on whether the United States can return to a time of civil discourse where opposing views are also respected. He recently shared some of his thoughts in a conversation with AAMCNews.

The conversation has been edited for brevity and clarity.

You made some statements in The Righteous Mind that might baffle some people in the medical field. You wrote, “You cannot change people’s minds by completely refuting an argument” and “There is no study for non-scientists to believe in.” What does it mean for scientists when you say that empirical evidence is in Discussions about societal issues that affect science may be useless?

Let’s start with the basic psychological question, “How does human thinking work?” My book is an argument that [philosopher] David Hume was right when he said, “Reason is and should only be a slave to passions.” Let’s apply that to medicine.

Let’s say doctors are scientists, doctors are perfectly rational – but they have to deal with all these irrational people. What you should do? This is where doctors and psychiatrists might find the rider-elephant analogy useful.

Most of the cultures that have left us wisdom literature have found that the mind is divided into parts that are sometimes contradicting, such as horse and rider. I prefer to make the animal part much bigger and smarter, so I think the best analogy is that the mind is divided like a little rider on a very large elephant. The rider is our conscious mind and the elephant is the other 99% of the mental processes that take place outside of our consciousness but determine the majority of our behavior.

The rider can sometimes lead the elephant if the elephant is not in the mood at the moment, but usually the elephant is in charge. The rider mostly helps the elephant get where it wants to go. The rider cannot force the elephant to do something he does not want.

What does this mean for how we can influence people’s decisions about what is right?

You can’t just talk to the driver and expect it to change someone’s behavior. If you tell the person, “If you don’t lose weight, you will die in six months,” it sometimes works – but often it doesn’t. You need to feel the person deeply and want to make the change. That’s the first step for doctors: just understanding how to convince those irrational nonscientists out there.

The harder step is to say, “What if doctors are people too? What if doctors and medical researchers are not perfectly evidence-oriented? What if, like everyone else, they are driven by things like self-interest and politics? ”

Focusing on the elephant’s preferences means each side has to understand the other through the world they live in and what motivates them, right? I thought it was wonderful that you cited the film “The Matrix” as a framework to reflect on the bubble we live in – the place where we see and hear things that make up our “big story” of ourselves and confirm to the world. Can you transfer this idea to our current social departments?

The short book I’m about to write is called Life After Babel: How to Live in a World That May Never Again Shared. Because of social media – and media and technological changes in general – we fly into little bubbles of meaning that are often small. You are unstable. And maybe there will never be a stable and common understanding of something important again.

So for some on the left, it’s very easy to see the QAnon people and “the big lie” about the election. It is very easy to see the bubble that people live in on the other side, but very difficult to see on your own side.

For some on the right it is very easy to see the left now imposing all sorts of restrictions on what its members can say about race, gender, environment and trans issues. she [on the right] Receive a constant stream of posts about how people are bullied and fired for saying something that challenges the prevailing narrative.

From my point of view, the Tower of Babel fell around 2015. It can take decades before we can anchor our discussions in a common reality. I don’t think we will see it in our life.

You also write about how tribalism blinds people to the morals and motives of their opponents. Can you apply that to current social issues?

There is this wonderful Bedouin proverb, “Me versus my brother; me and my brother against our cousin; me, my brother and cousin against the stranger. ”As we evolved out of tribalism, we will meet people who were our enemies as long as they are on our side in the current conflict.

There used to be several cross-sectional conflicts between interest groups. Now there is only one left and that is the left / right culture war in America. We have this two-party system, we have a crazy media environment. Everything was sucked into a single tribal department, the Republican / Democrat, left / right.

So in a conversation between people from the left and right, there is very little hope of changing someone’s mind based on evidence-based arguments, as they would have to go against their tribe. They would have to change the way they see who they are and who they identify with.

Correctly. Once people start seeing a person or organization as a member of the red or blue team, it becomes very difficult for them to listen openly to that person or organization. And that’s why I believe that those who run culturally significant institutions and professions have a fiduciary duty – a moral duty – to depoliticize themselves and what they say. You are not allowed to play culture war games. You have to be above the battle to be trustworthy. Any organization that takes sides deserves to lose public confidence. I believe this happened to universities, newspapers, and doctors.

What about those who say it is time for organizations to take sides on some issues because those issues are too important for those organizations to sit on the fence?

I would say people like that will end up advocating an all-out culture war that they cannot win. I think it is crucial that we do not have an all-out war in every institution in our society. When I go to a restaurant, I don’t want that restaurant to fight the Republicans; I want them to cook excellent food. When I go to my doctor, I want my doctor to make me healthy; I don’t want my doctor to use me to advance their other social and political issues. When I send my children to public school I want them to be educated; I don’t want them to be pressured to say things that either side of the Culture War would like.

This is one of the reasons we are falling apart: because many of our institutional leaders have given up their telos to wage the left / right culture war. With almost all of our culturally significant institutions leaning to the left, it means they are losing the trust of the people on the right – they are losing the ability to convince the right.