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我曾住院一段很長的時間,出院幾年後,我重回醫院,燒傷部門的主任見到我非常高興,他說,「Dan,我有個超棒的新療法可以用在你身上。」我非常興奮,隨著他走到他的辦公室。他向我解釋說,當我刮鬍子後,左臉上生有毛髮的地方會留下一些小黑點,但我右臉被嚴重燒傷,所以沒有毛髮,這使我兩頰的外觀缺乏對稱性。他的高招是什麼?他打算在我右臉紋上一些小黑點,讓我兩頰看起來非常對稱。
這聽起來很有意思,他要我去刮鬍子。讓我向你們說明一下,這是一種奇怪的刮鬍子方式,因為我思考這一點,並意識到這會變成我餘生都得使用的刮鬍子方式,因為我必須保持兩邊寬度相同。當我回到他的辦公室時,並不是真的很確定要這麼做。我說,「我能看一些範例照片嗎?」於是,他給我看了一些臉頰上有著小黑點的照片-數量不是很多,我說,「當我老的時候,毛髮變白時要怎麼辦呢?」「哦,不用擔心,」他說,「我們可以用雷射將它變白。」但我仍然有些擔心,所以我說,「你知道嗎,我不打算這麼做。」
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以下為系統擷取之英文原文
So, I was in the hospital for a long time. And a few years after I left, I went back, and the chairman of the burn department was very excited to see me -- said, "Dan, I have a fantastic new treatment for you." I was very excited. I walked with him to his office. And he explained to me that, when I shave, I have little black dots on the left side of my face where the hair is, but on the right side of my face I was badly burned so I have no hair, and this creates lack of symmetry. And what's the brilliant idea he had? He was going to tattoo little black dots on the right side of my face and make me look very symmetric.
It sounded interesting. He asked me to go and shave. Let me tell you, this was a strange way to shave, because I thought about it and I realized that the way I was shaving then would be the way I would shave for the rest of my life -- because I had to keep the width the same. When I got back to his office, I wasn't really sure. I said, "Can I see some evidence for this?" So he showed me some pictures of little cheeks with little black dots -- not very informative. I said, "What happens when I grow older and my hair becomes white? What would happen then?" "Oh, don't worry about it," he said. "We have lasers; we can whiten it out." But I was still concerned, so I said, "You know what, I'm not going to do it."
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這讓我心中升起有生以來最大的內疚感,這是來自一位猶太人的感受,對吧?所以意義重大。(笑聲)他說,「Dan,你是怎麼搞的?你喜歡看起來不對稱嗎?你會從中得到某種變態的快感嗎?會有更多女性因此可憐你而與你發生性關係嗎?」這種好事從未發生過。這讓我感到非常驚訝,因為我歷經過許多治療方法,也有許多我決定不進行的治療方法-而我從未內疚到這種程度,但我還是決定不接受這個治療。我找到他的助手,向他問道,「這是怎麼回事?這個內疚感從何而來?」他解釋說,他們已經在兩名病患身上進行了這個治療,他們需要第三個病患,才能完成他們的正在撰寫的論文。
(笑聲)
現在,你可能認為這傢伙是個白癡。沒錯,似乎正是如此。但我想讓大家以一個不同的角度來看待這個故事。幾年前,我在實驗室裡進行一些我自己的實驗。當我們進行實驗時,通常希望實驗與對照兩組間的表現截然不同,因此,我們希望其中一組表現的非常好,而另一組表現的非常差。當我得到這個結果時,這正是我們想要的,我感到很高興-除了其中一個人。這組中有一個人,本來應該表現的非常棒,但事實上卻表現的相當糟,他將整個平均值拉了下來,毀掉了我實驗代表的統計意義。
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And then came one of the biggest guilt trips of my life. This is coming from a Jewish guy, all right, so that means a lot. (Laughter) And he said, "Dan, what's wrong with you? You enjoy looking non-symmetric? Do you have some kind of perverted pleasure from this? Do women feel pity for you and have sex with you more frequently?" None of those happened. And this was very surprising to me, because I've gone through many treatments -- there were many treatments I decided not to do -- and I never got this guilt trip to this extent. But I decided not to have this treatment. And I went to his deputy and asked him, "What was going on? Where was this guilt trip coming from?" And he explained that they had done this procedure on two patients already, and they need the third patient for a paper they were writing.
(Laughter)
Now you probably think that this guy's a schmuck. Right, that's what he seems like. But let me give you a different perspective on the same story. A few years ago, I was running some of my own experiments in the lab. And when we run experiments, we usually hope that one group will behave differently than another. So we had one group that I hoped their performance would be very high, another group that I thought their performance would be very low. And when I got the results, that's what we got -- I was very happy -- aside from one person. There was one person in the group that was supposed to have very high performance that was actually performing terribly. And he pulled the whole mean down, destroying my statistical significance of the test.
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所以我仔細研究這個人,他比這組中其他人的年齡大上20多歲,我還記得那個老醉鬼有天來到實驗室,想賺些好賺的錢,就是那個傢伙。「太扯了!」我想,「把他扔出實驗室吧!誰會讓個醉鬼做實驗樣本啊?」
但幾天後,我和我的學生思考過這一點,我們說,「如果這個傢伙不在酒醉狀態時會發生什麼情形?如果他到會另一組去會發生什麼情形?到時我們該將他排除掉嗎?」我們或許根本看不到這種數據,如果我們看到這種數據,我們或許會說,「怎麼可能!這麼聰明的傢伙怎麼表現得那麼糟!」因為他會將這組的平均值拉低,讓我們的統計結果更有根據,因此,我們決定不排除這個傢伙,並重新進行實驗。
但你們知道,這些故事以及很多我們做過的其他實驗都存在著利益衝突,基本上,這為我帶來了兩個重要觀點。第一點是,我們一生中會遇見很多人,用各種不同方式試著粉飾事物的表面。他們只是擁有讓他們無視於現實的動機誘因,而給予我們一些帶著固有偏見的訊息。我確定有些事我們多少有所瞭解,也目睹它發生;也許我們無法每一次都能意識到,但我們知道它確實發生了。
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So I looked carefully at this guy. He was 20-some years older than anybody else in the sample. And I remembered that the old and drunken guy came one day to the lab wanting to make some easy cash and this was the guy. "Fantastic!" I thought. "Let's throw him out. Who would ever include a drunken guy in a sample?"
But a couple of days later, we thought about it with my students, and we said, "What would have happened if this drunken guy was not in that condition? What would have happened if he was in the other group? Would we have thrown him out then?" We probably wouldn't have looked at the data at all, and if we did look at the data, we'd probably have said, "Fantastic! What a smart guy who is performing this low," because he would have pulled the mean of the group lower, giving us even stronger statistical results than we could. So we decided not to throw the guy out and to rerun the experiment.
But you know, these stories, and lots of other experiments that we've done on conflicts of interest, basically kind of bring two points to the foreground for me. The first one is that in life we encounter many people who, in some way or another, try to tattoo our faces. They just have the incentives that get them to be blinded to reality and give us advice that is inherently biased. And I'm sure that it's something that we all recognize, and we see that it happens. Maybe we don't recognize it every time, but we understand that it happens.
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當然,最困難的是,瞭解到有時我們也被自己的動機誘因所蒙蔽,這是我們該深思的、困難得多的教訓,因為我們看不見利益衝突對我們造成何種影響。當我做這些實驗時,心中認為自己正在協助科學發展,我排除了這個數據,使數據的真實模式得以呈現,我並不是在做什麼壞事。在我心目中,認為自己像個試圖幫助科學發展的騎士。但事實並非如此,我事實上將眾多善良的意圖涉入這個進程。我認為真正的挑戰是,弄清楚在我們生命中,何種情況下會發生利益衝突,並盡量別信任自己的直覺去克服它,而試著做一些能防止我們陷入這些行為的事,因為我們可能會造成許多預料之外的情況。
我希望留給大家一個正面的想法,我的意思是,這非常令人沮喪,是吧?人類存在著利益衝突,我們見不著、摸不到。我認為其中積極的觀點是,如果我們確實能在誤入歧途時有所認知,如果我們能瞭解為何失敗及失敗之處的深層原因,就確實有希望能導正一切。而我認為,這就是希望所在。非常感謝。
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The most difficult thing, of course, is to recognize that sometimes we too are blinded by our own incentives. And that's a much, much more difficult lesson to take into account. Because we don't see how conflicts of interest work on us. When I was doing these experiments, in my mind, I was helping science. I was eliminating the data to get the true pattern of the data to shine through. I wasn't doing something bad. In my mind, I was actually a knight trying to help science move along. But this was not the case. I was actually interfering with the process with lots of good intentions. And I think the real challenge is to figure out where are the cases in our lives where conflicts of interest work on us, and to try not to trust our own intuition to overcome it, but to try to do things that prevent us from falling prey to these behaviors, because we can create lots of undesirable circumstances.
I do want to leave you with one positive thought. I mean, this is all very depressing, right -- people have conflicts of interest, we don't see it, and so on. The positive perspective, I think, of all of this is that, if we do understand when we go wrong, if we understand the deep mechanisms of why we fail and where we fail, we can actually hope to fix things. And that, I think, is the hope. Thank you very much.