The Right Answer and the Effective Answer

The comment below was written by an orthopedic surgeon in response to this article

October 8, 2021

Steven Zeitzew, M.D. | West Los Angeles VA Healthcare Center
There is a large difference between being correct and being effective. As an orthopaedic surgeon I learned long ago that telling patients what to do is less effective than informing them effectively about the consequences of the choices before them, and gently guiding them so they can make the correct choice willingly. Sometimes mandates are effective and necessary, such as vaccines for schoolchildren or for healthcare workers in at least some circumstances. What we are learning is that telling people we are forcing them to do the right thing is sometimes not an effective technique for getting them to actually do the right thing. Sometimes telling a "biker dude" that he cannot put weight on his leg after fracture surgery won't work, because he won't do something just because he is instructed to, and is in fact more likely to do the opposite. That same patient is smart enough to make a good decision if he is informed of the poor prognosis associated with excessive premature weight-bearing before fracture healing. That is human nature. We don't like being told what to do. We do like making well-informed decisions on our own. Even a well-intended mandate based on the best evidence will sometimes be a less effective technique for getting people to make the right choice.

It might be more effective to provide reliable information and allow patients to decide about vaccination on their own in many circumstances, even though some will make the poor choice of declining vaccination, in spite of the overwhelming and persuasive evidence supporting COVID vaccination. Liberty and freedom are important to human beings, and threatening to take it away will have consequences. We will find we cannot force all people to do the right thing. We will also find that most people will make the choice to do the right thing when they are allowed to give informed consent, the same standard we use for other medical interventions, even when they face a life and death choice that affects them and those around them. Yes, sometimes we must impose a choice in order to protect others. Forcing our choice may not be the most effective technique in this instance.