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Archived Comments for: Rationality versus reality: the challenges of evidence-based decision making for health policy makers

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  1. Is rational choice a rational standard?

    Paul Falzer, VA Connecticut Healthcare System

    6 July 2010

    The claim that humans are inherently lacking the capacity to make sound judgments on a consistent basis has been made cogently by Fischhoff, Howard, and Kahneman, among others. Perhaps the most compelling case was made by Descartes and became a foundation of modernity. One wonders how advocates of current dual process models of cognition could have arrived at their conclusions without beginning at the same place as Descartes and Bayes, and with the same purpose in mind – to demonstrate that humans are inherently lacking the capacity to exercise rational judgment.

    Note that the claim of inveterate irrationality depends on its presumption. The circularity exemplifies a certain charm that compels our attention and turns us inside out, offers no solution and no hope of extricating. It also takes us off the hook to claim that humans by nature are not up to the task of surmounting our biases and acting as rational beings.

    Malcolm pointed the way toward a solution when he noted that as Descartes was making an argument against sensation he was throwing a log on the fire. Simon took up the irony and developed the notion of bounded rationality. As Gigerenzer elaborated, Simon’s message was not about deficiency, but rather about the ways that we adapt to our circumstances. Humans cannot fly, but we can build airplanes.

    Nonetheless, our decisions are fraught with error. When managers and engineers employed a rational choice model in the Gulf of Mexico, they made a huge mistake with tragic consequences. Perhaps the model is right in most cases but wrong in his one. On the other hand, perhaps the error lies less with the model than with our desire to use it. If a standard is impossible to attain, it may also be undesirable to pursue.

    Competing interests