Coronavirus Omission Bias

David Krueger MD

In a fairly well-known psychological experiment, subjects were asked the following question: “Imagine that there had been several epidemics of a certain kind of flu that everyone contracts that can be fatal to children 3 years of age or younger. Roughly 10 out of every 10,000 children with this flu will die from it. A flu vaccine which eliminates the chance of getting it causes death in 5 out of every 10,000 children. Would you vaccinate your child?”

Logically, an easy call. You would choose to do it since not vaccinating has twice the mortality as the vaccination. However almost all parents in the survey opted not to vaccinate their children. The reason: it caused 5 deaths per 10,000. Even though without the vaccine their children faced twice the death from the flu, those who would not permit vaccinations said that they would “feel responsible if anything happened because of the vaccine.” However, those same parents dismissed the idea that they would feel responsible if anything happened because of failure to vaccinate. In other words, parents felt more responsible for a bad outcome when is followed their own actions than from an outcome that resulted from their inaction.

This omission bias has subtle everyday manifestations. We may feel that telling a direct lie is worse than withholding the truth. Declining to eat healthy food may be a poor choice, but eating junk food is deemed as worse. We have more regret over giving a wrong answer than not giving a correct one.

Cognitive psychology has shown that we view inaction as less blameworthy and less harmful than action even when the outcomes are the same or worse. In medicine, law, and business we have the same omission bias. Neglecting a positive action is less painful than committing a negative action. Play not to lose rather than play to win. We avoid actual errors rather than focusing on missed opportunities.

Jeff Bezos stated in a 2009 management conference, “People over-focus on errors of commission. Companies over emphasize how expensive failure’s going to be. Failure is not that expensive … the big cost that most companies incur is much harder to notice, and those are errors of omission.”

We see the decisions of our leaders in failing to make adequate preparation for what is now known to be a global crisis, failing to make adequate preparations, not making the unpopular hard calls where guts are tested, as an omission bias. We have to learn from these things.

The definition of a blind spot is that you can’t see it. Unconscious biases are a default mode of human behavior. Yet a blind spot illuminates someone’s internal prejudice by their attempt to label it in others and assign blame. The statement, though directed at someone else, directly reflects the speaker: a self statement.

And once you recognize an unconscious bias, it’s no longer unconscious.

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