Author: Margaret Heffernan
Why do doctors ignore glaring evidence which will help their patients? Why do partners turn a blind eye to infidelity? Why does child abuse go on for years unchallenged? Why do people blindly obey their corporate, professional, or military superiors? These and several other questions are brilliantly discussed in this book. The author says wilful blindness, the purposeful avoidance of the opportunity and responsibility to be informed (page 3), is widespread. This origin of this ‘human phenomenon to which we all succumb in matters little and large’ (page 4) is traceable to our need for reassurance, security and certainty. This need drives us to ‘seek out communities, systems and cultures that reaffirm our values but which blind us to alternatives’ (page 8). She says ‘…our blindness grows out of the small daily decisions that we make, which embed us more snugly inside our affirming thoughts and values…as we see less and less, we feel more comfort and greater certainty. We think we see more-even as the landscape shrinks’ (page 27). ‘We become blind because we are so afraid of what we might see and what we might feel’ (page 38).
With anecdote after another, the author paints a vivid picture of the grave consequences of wilful blindness. She covers a diverse range of topics, from economics to politics, from oil industry disasters to corporate takeover failures. The book addresses the influence of wilful blindness on house market crashes, genocide, environmental disasters, and space shuttle failures. It is pertinent however that some of the most striking examples she relates are medical. She attributed some prominent cases of medical wilful blindness to its hierarchical structure; this structure partly explains why the medical establishment ignored Alice Stewart, the brilliant epidemiologist, who had shown that X-rays given to pregnant women resulted in subsequent childhood leukaemia. Wilful blindness was also responsible for the prolonged campaign fought by the whistleblower, Steve Bolsin, to expose serious failings in a paediatric cardiac surgery unit where he practiced as an anaesthetist, doing so at great cost to himself. The book also discusses the malign influence of money on medical practice, and the blindness of regulatory agencies to some unsafe drugs.
The author however made the case that wilful blindness is not inevitable. She discusses the Cassandra syndrome in chapter 11; this describes people who see the truth that others somehow cannot or will not acknowledge. She says that the world needs such people who are ‘…willing to ask the awkward questions, trace tricky connections and challenge embedded assumptions’ (page 267); people who ‘…believe that if you can overcome wilful blindness, and force people to see what is happening, that that alone will bring change’ (page 288). It is reassuring that ‘the world is full of Cassandras’ (page 265).
Throughout the book the author supports her arguments with psychological ideas; she referred to the concepts of motivated reasoning and cognitive dissonance: how people avoid or resolve the anxiety and guilt that arise from knowing or holding contradictory facts or beliefs. She relates the classical psychological studies of Stanley Milgram on blind obedience, and of Solomon Asch on conformity. She explored biased reasoning in chapter 3, tunnel vision in chapter 4, the bystander effect and diffusion of responsibility in Chapter 8, and power distance in chapter 9. She refers to the functional MRI studies of the neuroscientist, Gregory Berns, which suggest that groupthink may arise from the influence of social factors on how we perceive issues.
This is an excellently presented book with well thought out and arranged chapters. I thoroughly enjoyed the insights it gives and the appropriate anecdotes. The author writes clearly and supports her arguments with scientific concepts and anecdotes. Her experience in a variety of fields of human endeavour shows in her sage-like approach to the topic. She graphically demonstrates the consequences of turning a blind eye and the difficulty of standing up to be counted when it matters. Her discussion of whistleblowing and Cassandra are particularly relevant to healthcare.
We have all, at one time or another, kept quiet when we should have spoken up and the book makes uncomfortable reading for this reason. This is however a credit to the book. There was very little to criticise about the book apart, perhaps, from the cover which I thought could have been better designed.
The concept of wilful blindness is relevant to doctors and to healthcare. The book is a clarion call to be vigilant at all times. It urges us to speak up rather than look away, and to brace ourselves for the consequences of seeing clearly when others turn a blind eye. I strongly recommend the book.
Here is the author talking wilful blindness at a TED talk
- Publisher, place and year: Simon and Schuster, London, 2011
- Number of chapters: 12
- Pages: 391
- ISBN: 978-1-84737-770-8
- Price: £14.99
- Rating: 5 stars
- Other related book by author: A Bigger Prize