Improve Decision-Making by Thinking Explicitly About Values
Ethical decision-making involves explicit recognition and consideration of ethical values: things like liberty, equality, well-being, and privacy. For many organizations, one of the most effective ways to make more ethical decisions is simply to be more explicit about the role values play. A common barrier is that decision-makers focus on getting the facts right at the expense of figuring out how those facts promote some values over others. This is such a common misunderstanding that I’ve coined a term for it: the fact trap.[1] Someone falls into the fact trap when they think that decision-making or resolving a disagreement is only about facts, when it’s actually about values.
This is not to say that facts are unimportant! Understanding the situation correctly is a necessary step for good decision-making, and a shared understanding of the facts is essential for resolving disagreements. Sometimes disagreements actually concern whether something is a fact or not. However, people often focus exclusively on facts, assuming that getting clear on them will settle the issue. When disagreement remains, people are likely to mistakenly conclude that the other person is misinformed or uneducated about the issue when, in reality, the disagreement is about values.
Suppose that you and I are deciding where to go for dinner. I propose that we check out the new restaurant down the road. You respond by saying that you passed by it last night and there was a lineup around the block. I reply that we should go anyway, but you’re unmoved: “You don’t get it: the line was really long.”
Now, it might be the case that we’re having a disagreement about the length of the line. That type of disagreement can be solved in various ways: calling the restaurant to ask about the line, going in person to see, etc. But it’s also possible that we’re really disagreeing about how bad it is to wait in line. My value judgement is something like “if the restaurant is so popular, the food must be really good, so it’s worth waiting,” while your value judgement is “there are other restaurants that will be just fine and I’m hungry now, so waiting isn’t worthwhile.” Getting clear on the nature of the disagreement is important to resolving it. We’d fall into the fact trap by continuing to debate the length of the line without realizing that our disagreement is actually about its importance: how much value we place on eating right away, trying something new, etc.
Fact traps are everywhere, but they’ve become especially visible during the pandemic. When the pandemic first began, I was involved in many meetings with health system leaders about various ethical issues where attendees—including me!—would lament the lack of information we had about the virus. For example, for months there was uncertainty about which medical procedures are aerosol generating and therefore require higher levels of personal protective equipment. Discovering facts of this sort have made a big difference to the way hospitals treat Covid-positive patients while protecting staff and physicians.
At the same time, I realized early on that, in some cases, clarifying the facts would be helpful but wouldn’t settle the issue because the issue was ultimately about deciding which value to prioritize. Everyone is by now familiar with debates about Covid policies that involve people looking at the same numbers (infection rates, deaths, etc.) and reaching different conclusions about what the data justify (e.g., lockdowns, mask and vaccination mandates, closed borders). The resulting debates are essentially like the restaurant example, with many people missing that the disagreement really concerns values: e.g., what is the right balance of liberty with public safety?
A phrase that should set off fact trap alarm bells is “follow the science”. While politicians around the world have adopted this phrase to justify their pandemic policies, it misrepresents what science is capable of. Facts are obviously relevant in deciding, for example, whether a vaccine mandate is justified, but science can’t settle the overall question of justification. To get to an answer, the various values (liberty, safety, equality, etc.) must be identified and weighed.
Covid-19 provides lots of examples of the fact trap in public discourse, but the trap is easy to fall into in other contexts. Organization leaders, in healthcare and in other fields, are always making decisions that prioritize some values over others. Decision-making will be less robust if leaders aren’t aware of those tradeoffs. Further, some of the worst forms of the trap occur when people shape the decision-making process so that it appears that the issue turns on a fact, when actually there are hidden assumptions about values. Usually this is done unintentionally, which means the decision-makers themselves don’t realize how they’ve prioritized certain values over others.
Since facts and values both play important roles in decision-making, it isn’t always easy to figure out the role of each. As with other biases, it’s helpful to simply be aware of the problem and to think explicitly about the role that facts and values are each playing—and should be playing—in decision-making. Healthcare systems have processes to identify value tradeoffs, including research ethics boards and ethics committees, but all leaders should consider ways to include explicit ethical deliberation in their decision-making.
[1] Falling into the fact trap is failing to see what philosophers call the ‘fact-value distinction’.
