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Reconsidering the Impact of Affective Forecasting Responses and Dialogue Reconsidering the Impact of Affective Forecasting NADA GLIGOROV A response to ‘‘Affective Forecasting and Its Implication for Medical Ethics’’ by Rosamond Rhodes and James J. Strain (CQ 17(1)) In the article ‘‘Affective Forecasting and forecasting is as all-encompassing as the Its Implications for Medical Ethics,’’ authors claim. In the next section, I Rhodes and Strain1 present current re- consider the effects of biases in affec- search documenting a psychological tive forecasting on policymakers. I as- bias that affects our ability to correctly sert that, although the research on the predict future emotional states. The impact bias reveals misconceptions bias they discuss is the wrongful esti- about what is needed for happiness, it mation of the emotional impact of does not provide guidelines for en- significant events. Research on affec- dorsing policies. In the third section, I tive forecasting by T.D. Wilson and consider how the bias affects doctors D.T. Gilbert2 indicates that people tend and patients differently. I argue that to overestimate both the positive and doctors are not affected by the bias in negative impact of events. Rhodes and the same way as patients. In the fourth Strain correctly note that the conclu- section, I argue against Rhodes and sions derived from the research—that Strain and claim that affective forecast- bad events do not seem to affect us as ing does not diminish decisional ca- much as previously assumed—has appli- pacity. I argue further that because cations for medicine. In a field where the bias is incorrigible, paternalism doctors are often faced with delivering will not help in restoring patient bad news and offering treatments that autonomy. will significantly alter the lives of their patients, information that bad events Values and the Impact Bias are not as emotionality deleterious as once thought is good news. Wilson and Gilbert’s research purports I argue in agreement with the authors to capture a universal psychological that the research on the impact bias could mechanism. As such, the bias affects support an attitude change in terms of all people who make predictions based how doctors approach and communicate on future emotional states. Rhodes and with their patients. It can contribute, also, Strain claim that ‘‘once we recognize to a change in attitude when doctors are that affective forecasting is part of faced with the grim task of telling patients normal human psychology, we are that they have a chronic illness or that alerted to consider just who in the they are faced with making difficult deci- medical environment is susceptible to sions about their health. its effects. Patients are. The families of I disagree, however, that the pre- patients are. Clinicians are. And poli- dicted impact of the biases in emotional cymakers are.’’3 Cambridge Quarterly of Healthcare Ethics (2009), 18, 166–173. Printed in the USA. Copyright Ó 2009 Cambridge University Press 0963-1801/09 $20.00 166 doi:10.1017/S0963180109090276 Responses and Dialogue Let us first consider the influence ness. Doctors, policymakers, and pa- of this psychological bias on policy- tients share this predicament, but I makers. The research on the impact do not take that to indicate that par- bias cannot offer any help when it ticular policies are the result of the comes to policy issues because the impact bias. Rhodes and Strain’s claim results of the research are explanatory is that affective forecasting biases in- and not predictive. The research shows fluence policymaker’s decisions. Con- that we are not good predictors of our sider policies regarding promotion of future emotional states but it does not health.Wecanconcludebasedonthe allow for predictions about what will new information about the impact bias make us happy. Policies, however, are that not being healthy is not as devas- an attempt to promote or protect uni- tating emotionally as we once thought. versally held values. If the studies on Plenty of people can be happy even affective forecasting were to have an if they have lived through or are still impact on policymaking, they should living with illness. We may not need help in the selection values to be en- health for happiness. But does this dorsed. I claim that the affective fore- mean that policies promoting health casting research cannot be used to do that. are based on biased affective forecast- I take affective forecasting research to ing? I assume that most people would show that there is a disconnect between disagree with that conclusion. Even if some of our values, which are set in we decide that health is no longer termsofwhatweexpectwillmakeus worth promoting, predictions about happy, and what actually makes us which values should be promoted can- happy. The findings indicate that there not be based on affective forecasting. is not a clear connection between what If emotional states do not trail or we value and pursue—like health, em- depend on the events in one’s life, ployment, wealth, and prestige—and one can only conclude that what we happiness. In other words, the research thought were necessary ingredients for shows that there is a cleavage between happiness are not essential to it. Poli- some of our current commonly held cies are meant to endorse generally values and what we require for happi- accepted values that rest on ideas peo- ness. The disconnection between happi- ple have about what is good or worth ness and values was manifested in the promoting. If we do not require good following way: People tend to overesti- events, or the absence of bad events, mate their emotional reaction to nega- for happiness, one has no resources tive events, but also to positive ones.4 It left for making predictions about what is not just that losing a limb does not to promote. One can conclude that make somebody as unhappy as pre- the impact bias research indicates that dicted, but that positive events, such as illness might not devastate your life job promotions, are not likely to make but that research does not provide one as happy as predicted. Significant guidance in the selection of policies events do not seem to make a large, pertaining to healthcare. lasting difference on our emotional con- dition overall. Momentous events might The Impact Bias from Different cause a spike in positive or negative Perspectives feeling, but one ultimately settles back toone’spreviousemotionalstate. Although research on the impact bias The impact bias exposes our deep supports the claim that forecasting ignorance about the nature of happi- biases are part of human psychology, 167 Responses and Dialogue the way in which such biases affect other words, it might be a problem for reasoning is different for patients and me but not for my doctor. At the very those deciding for the patients. least the problem is not of the same Affective forecasting is a first-person nature from the two perspectives. My phenomenon. The research on the bias doctor might know that I will do much supports the view that we tend to be better dealing with my illness than I wrong about our own reactions to expect. She might be able to reason free events. From the first-person point of from bias when it comes to my case. view the bias is incorrigible, because The research itself gives no indication a person who has gone through bad that people deciding for others are events is likely to continue wrongful susceptible to the influence of affective estimates about her future emotional forecasting. Studies only show that states. In fact, we tend to be wrong people are affected with this bias when about how we feel all the time. In they are trying to predict how this or a review of the literature on emotional that event will make them feel. Con- memory, Christiansen and Safer con- ceivably the doctor might reason by cluded that ‘‘there are apparently no adopting the patient’s perspective and published studies in which a group imagine what it would be like for her of subjects has accurately recalled the to be in the patient’s condition. If the intensity and or frequency of their pre- process of reasoning is simulating the viously recorded emotions.’’5 This con- patient’s point of view, the effects of clusion can be explained in part by the impact bias could be transferred to appealing to the workings of the ‘‘psy- the doctor. It strikes one as much more chological-immune system,’’6 so termed likely that when a doctor is thinking by Gilbert and Wilson. A person recov- about future states of her patient, she is ers emotionally from a traumatic event probably doing so based on probabili- by making sense of it.7 The negative ties about what happens on average for event becomes normalized and its emo- a particular population. The doctor’s tional impact is less likely to be re- reasoning will be based on her experi- membered accurately. Past good or bad ence with past patients with similar events become less extraordinary be- conditions. Moreover, if the doctor cause of the ameliorating effect of the takes into account information about psychological immune system. Thus, the impact bias, she may reach a differ- the disconfirmation of the prediction entconclusionthanthepatient.Thedoc- remains unnoticed because our mem- tor’s forecast, then, will be free from ory of past emotional states is often error. inaccurate. If we cannot draw on past In contrast to the patient, the doctor experience to generalize for the future, whose reasoning might be influenced the impact bias continues to affect our by the impact bias is not in the same predictions about emotional states.8 predicament as the patient.
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