We have a built-in tendency to believe and obey to what we are told by people in positions of authority.

The Eminence-Based Medicine is a common experience among doctors.

In their book Medication Errors: Causes and Prevention, professors Michael Cohen and Neil Davis talk about a strange case of the “rectal earache”.

A physician ordered ear drops to be administered to the right ear of a patient suffering from pain and infection. Instead of writing out completely “Right ear” on the prescription, the doctor abbreviated it, “place in R ear.” The duty nurse misread “R ear” to be “Rear.” Upon receiving the prescription, she promptly put the required number of ear drops into the patient’s anus.

This is laughable and obviously made no sense, but neither the patient nor the nurse questioned it. The important lesson of this story is that in many situations in which a legitimate authority figure has spoken, your common sense seems to become irrelevant.

Stanley Milgram’s work was triggered in the wake of World War II. He wanted to investigate why it was that so many ordinary people either simply said nothing about their leaders clearly abhorrent policies, or even worse chose to follow their example.

Milgram devised a simple but stunningly effective experiment.

Subjects were asked to help in an experiment. They were told they would be administering electric shocks to a ‘learner’ at the instruction of a ‘teacher’. The subjects were told that they were involved in a study on punishment effects on learning and memory.

The subjects sat in front of a box with electric switches on it. The switches displayed the level of volts that was being delivered, and a text description of the level of pain ranging from ‘slight’ through to ‘very strong’ and up to ‘danger severe’, culminating in ‘XXX’. When the buttons were depressed, a buzzing sound could be heard. The ‘teacher’ was a confederate of the experimenters, and wore a white coat and carried a clipboard. They would instruct the subjects when to press the button.

The subject couldn’t see the person they were shocking, but they could hear them.

  • at 75 volts, the ‘learner’ grunts
  • at 120 volts he starts to complain verbally
  • at 150 volts he demands to be released
  • at 285 volts the ‘learner’ makes a response that Milgram said could only be described as ‘an agonized scream’
  • at 425 volts, a grim and deathly silence greeted the participants.

Before conducting the experiment, Milgram’s prior belief was that very few people would administer high levels of shock. Indeed forty psychiatrists canvassed by Milgram thought that less than 1% would give the full 450-volt shock. After all, they reasoned, Americans just didn’t engage in such behaviour. (Sounds like a classic case of the fundamental attribution error doesn’t it!)

The chart below shows the percentage of respondents who progressed to each level of voltage:

  • 100% of ordinary Americans were willing to send up to 135 volts (at which point the ‘learner’ is asking to be released) through someone they didn’t know.
  • 80% were willing to go up to 285 volts (at which point they are hearing agonising screams)
  • Over 62% were willing to administer the full 450 volts, despite the screams and the labels on the machine stating ‘severe danger’ and ‘XXX’!

Similar results were obtained by other researchers in Italy, UK, Holland, Austria, Spain, Germany and Australia.