Informed consent (rarely is) | Seth’s Blog

Adults make choices and live with the consequences.

No one else should tell us what flavor of ice cream we prefer, or what career to choose. We’re good at knowing what we want.

In practice, this works really well for certain kinds of decisions. But when we add the network effect, profit-seeking industrial entities, statistics, long-term impact and side effects, it often falls apart.

Few people with terminal lung cancer made a fully informed decision when they started smoking cigarettes decades ago. Millions of teens who got hooked on a Juul certainly didn’t. We’re tempted to take the “free” case of bottled water that the local market is offering, without considering what’s going to happen to those bottles when we’re done with them. And while it’s easy to overregulate the testing and distribution of pharmaceuticals, it’s even easier to underregulate them.

There’s no right answer, there’s simply a spectrum.

Ideally, we’d each be able to make smart, long-term decisions with accurate information. I consider myself pretty rational, but, like most people, I don’t do a longitudinal study before taking a pill or buying a new product. We use buzz, hype and status to make decisions without statistics or peer-review.

Society might not know the ideal answer about where to draw the line between individual choice and community standards, but it’s worth asking the questions. Are people likely to be misled, confused or tricked into taking actions that hurt themselves and others? Are there incentives in place for consent to be skipped, or profits to be made when people are not fully informed? Are there bugs in our human decision-making processes that are likely to be hacked by organizations that have a different goal than we do? Are there public health implications that have more impact than the benefits to an individual?

Like microeconomics, classic marketing theory happens in a vacuum, not the real world. To put it into widescale practice, we need to think hard about the impact of millions of decisions, often made without clarity or perspective.

September 3, 2023