13 May 2011

Unhealthful News 132 - Question rhetoric

[In case anyone does not know, Google managed to kill Blogger for more than a day (I wonder if they will blame it on Facebook?) so this could not go up on day 132.  It was ready, though, so I am still going to call my streak unbroken.]

I spent most of today writing a government submission about tobacco harm reduction (it was in response to this and we will put our response up on the THR blog within a day or two for those who are interested) and have run out of thoughts for the day, so I am going to recycle some points from that in a Sunday-style post.

Sometimes questions are rhetoric.  I do not mean "rhetorical questions", but rather questions that embed rhetoric in them.  Sometimes this rhetoric is a factual or ethical claim directly embedded in the phrasing of the question.  Rather more difficult to deal with are cases where the question is a trap.

I had a theme I used for talks a while ago, that I called "unasking the wrong questions".  That is a counterpart to asking the right questions, obviously, but it requires greater attention and effort.  There are some questions such that your best answer to still tends to undermine the point you would like to make.  I am inclined to make the blanket suggestion:  Do not trust reporters and researchers who ask questions like that; they are pretending to be inquiring, but really have a narrative in mind and are asking someone to step into it.  The classic example is the reporter asking the politician "is it true you stopped beating your wife?"  An honest question phrased "is it true..." should have a yes-or-no answer.  But if the politician just answers that question ("no" is a true answer if he never beat is wife), then something very wrong is communicated. 

One of the questions I commented on today was:
How can practitioners deliver the complex messages about harm reduction without weakening advice about the benefits of stopping smoking?
(As background, harm reduction refers to the substitution of low-risk nicotine products for smoking.) 

What is wrong with this question?  One problem is the reference to "practitioners", which is a bit ambiguous but seems to refer to medics (this was a British document).  But why does the message "dear smokers, you can get your nicotine from a source that is 99% less harmful" need to come from anyone in particular?  Not a very powerful piece of rhetoric, but it does tend to limit one's thinking. 

A second problem is that imbedded testimony that this is a complex message.  It is not.  The quote in the previous paragraph gets about half the message, with the other half being a list of those low-risk sources.  For the "health promotion" types, you could even throw in the message that 99% is not quite as large a reduction as 100%, just in case someone might miss that.  It would probably be useful to add in a few pamphlets about how to effectively use the alternative products and what to expect (and what to expect to lose, and a reminder of why it is worth giving up) when switching.  But that is about as complex as informing someone about brushing his teeth.  If you want, at that point you can provide some more material about what the evidence is about that residual 1% risk, what that risk consists of (it is actually speculative that it even exists), etc.  But it is still simpler than tooth brushing.  On top of that is how absurd the question itself is.  How, exactly, would offering people an additional way to quit smoking, taking away none of the existing options, going to weaken the case for stopping smoking?

But notice what the assumption does:  If the question is accepted, it becomes part of the discussion that the message is complex and until proven otherwise might for unfathomable reasons be pro-smoking.  Thus, anyone who points out how simple the message really is, and that it is already being delivered, and it would work if government would just stop spreading disinformation against it, is not Serious because they are overlooking how terribly Complex the message is and that it might magically convince people to smoke.  Moreover, there is a built in delay, which will please the harm reduction opponents who are in power, because if a Complex message is needed, and it must be proven that it does not have impossible consequences it is going to take years to work it out.

Another question we addressed was:
Are there any unintended consequences from adopting a harm reduction approach…?
This one does not have any testimony built into the question, but it is still rhetorically loaded in that context.  The answer is obviously "yes" – every action has unintended consequences.  But notice first that the phrase "unintended consequences" usually evokes the specter of something bad, when it does not actually say that.  Then realize that in political games like those surrounding THR, there is a subtext that somehow there is something sacred about the status quo and so if an alternative would have any downside then this trumps any benefits it might have.  So the mere act of asking and answering this question, despite the lack of any important information content, is a successful volley against harm reduction.

A similar theme came up in a conversation I had today with Jeff Stier who has been attending the discussions surrounding the U.S. government policy on THR.  I hope to write more about this later, but for now I will just note that his observations suggest were (adding some of my own spin) that opponents of harm reduction are bunkering into the position that for any proposed product or effort for harm reduction we have to rule out all possible downsides before allowing it to happen.  This is obviously an insane way to make public policy, refusing to act on the information we have because there might be some unearthed downside to a particular choice, but that is a topic for another day.  The tie-in is that in a context where there is a risk of such bad reasoning, if we just give the obviously-true simple answer to a rhetoric-laden question it damages the cause. 

It is really easy to see it happening – I have had a lot of reporters try to play this game at my expense.  It is much more difficult to recognize the results out of context.  But sometimes it is useful, when reading those rare news stories that actually admit there is controversy and uncertainty, to look carefully for interviewee answers that suggest that one side that was obviously be set up to look wrong.  Ask yourself,  "I wonder what the reporter actually asked to product that rather odd, self-defeating response?"

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