Who Should We Believe?
This chapter presents a plausible argument for suspecting a significant gap between the promised benefits of the various professions and the actual effects of them. It makes no further claim. How large that gap is in any professional field is a matter for systematic study. In the next chapter, this general argument is followed up with a more detailed argument for the field of psychology and mental health. In both cases, we would expect numerous qualifications and corrections to emerge from further inquiry.
In any case, as consumers of professional knowledge and advice, we need to think critically in deciding who to believe and what to do with such advice. Consider the following excerpt from an article in the New York Times (November 21, 2000):
In this case, some 100,000 investors did not use good thinking in trusting the recommendations of professionals at Dean Witter. As consumers we must develop our ability to evaluate the thinking of the professionals we hire to support our interests. Otherwise we can too easily become victims of those more concerned with serving their interests than ours. We cannot assume, in other words, that professionals necessarily have our best interests in mind. As critical thinkers, we learn to look beyond the rhetoric of professionals to the actions in which they engage. We then analyze that behavior in terms of the thinking behind it.
This chapter and the next are included in the book because, to become a critical consumer of information, it is essential that one gain some sense of how to avoid or deal with the possible problem of bad advice, or worse, malpractice, on the part of professionals. By malpractice we mean any wrongful use of professional knowledge or information that leads to needless waste, unnecessary suffering, gratuitous harm, or injustice.
Of course, the problem is not always confined to the acts of an isolated group of individuals, as in the case of the Dean Witter scandal. Consider the great U.S. Savings and Loan debacle. In this case, a whole industry (through their lobbyists) persuaded the U.S. Congress to remove regulatory restrictions that prevented them from lending money without a specified level of collateral. The slogan of "de-regulation!" substituted for sound thinking. In essence, lobbyists asked the public to guarantee the solvency of Savings and Loan institutions while allowing them to make questionable loans. The result of the collapses that followed was an additional debt burden of approximately $9,000 for every man, woman, and child in the United States.
The asbestos and tobacco industries have engaged in similar self-serving misrepresentations over many years—with significant harm to the public. In these cases, the public was assured by industry spokespersons that there was no danger to them at the same time that numerous official and "professionals" in the industries knew that their product constituted a mortal threat to the consumer. Government officials trusted the integrity of the industry spokespersons, who, it turns out, were more concerned with profit and public relations than the public good.
Or consider the recent report issued by the National Academy of Sciences on medical errors (New York Times, Nov. 30, 1999). The report pointed out not only that medical mistakes cause up to 98,000 unnecessary deaths per year, but also that health care providers could reduce the number of errors by 50 percent in the next five years by simply collecting and analyzing data on unsafe practices, as does the aviation industry. If this article is accurate, then present instruction in the health care professions is resulting in an unacceptable level of errors and malpractice. Ideally, learning to think "medically" should have preempted this large-scale problem from arising in the first instance.
Learning to think about a profession in a rational way requires that we understand both the strengths and weaknesses of the profession. Each profession represents a way of thinking that has power and value. But no professional way of thinking is better than the quality of thinking of the individual professional who applies it. For remember, all professional thinking necessarily occurs within the context of the full humanity of the thinker and in a world in which a struggle for power is continual. One problem of which we need to be aware is the problem of false loyalty to a profession on the part of many if not most professionals. Another is the problem of non-disclosure, of obtaining information that takes into account the behind the scene activities of powerful interests that may set aside the public good for the short-term gains of the few.