Mistakes Were Made (But Not by Me): Why We Justify Foolish Beliefs, Bad Decisions, and Hurtful Acts

by Carol Tavris

their integrity cannot be compromised. Yet every time physicians accept a fee or other incentive for performing certain tests and procedures, for channeling some of their patients into clinical trials, or for prescribing a new, expensive drug that is not better or safer than an older one, they are balancing their patients’ welfare against their own financial concerns. Their blind spot helps them tip the balance in their own favor, and then justify it: “If a pharmaceutical company wants to give us pens, notepads, calendars, lunches, honoraria, or small consulting fees, why not? We can’t be bought by trinkets and pizzas.” According to surveys, physicians regard small gifts as being ethically more acceptable than large gifts. The American Medical Association agrees, approving of gift-taking from pharmaceutical representatives as long as no single gift is worth much more than a hundred dollars. The evidence shows, however, that most physicians are influenced even more by small gifts than by big ones.