The framing effect: the same truth, two different decisions

The "rare disease" problem of Amos Tversky and Daniel Kahneman (1981), the study with doctors and patients on surgery and radiation, and how to protect yourself from words that push you

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Translated from the Albanian original by the editors. Shqip

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Illustration: letters set in different frames, a symbol of how wording changes decisions
Original illustration by the lexoshpejt editors. Not a historical photograph or object.
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Imagine a country is preparing for a rare disease expected to kill 600 people. Two programmes have been proposed. With programme A, 200 people will be saved. With programme B, there is a one-third chance that all 600 will be saved, and a two-thirds chance that no one will be saved. Which would you choose?

The experiment

This was the question Amos Tversky and Daniel Kahneman put to students in their study published in Science in 1981. Most, about 72 per cent, chose programme A, the sure outcome.

Another group was given the same situation in other words. With programme C, 400 people will die. With programme D, there is a one-third chance that no one will die and a two-thirds chance that all 600 will die. Here most, about 78 per cent, chose programme D, the gamble.

But programmes A and C are the same: 200 saved means 400 die. Only the frame changed. When the outcome was presented as a gain, people preferred certainty. When it was presented as a loss, they preferred to take a risk.

Doctors too

In 1982 Barbara McNeil and colleagues presented patients, students and doctors with data on treating lung cancer with surgery or radiation. When the results of surgery were presented as survival rates, far more people chose surgery than when the same data were presented as mortality rates. The effect was seen even among experienced doctors.

Words do not change the facts. But they change how we feel them.

Where we meet it

  • "90 per cent fat-free meat" sounds better than "10 per cent fat".
  • "Save 50 lek" feels different from "lose 50 lek if you don't pay now".
  • Health news: "doubled risk" may mean from 1 to 2 in a thousand.

How to protect yourself

  1. Reframe it yourself: if you are told "90 per cent success", ask "so 10 per cent failure?" and see whether the feeling changes.
  2. Ask for absolute numbers, not only percentages or comparisons.
  3. Beware of deadlines and loss phrases in adverts: "offer ends tonight".
  4. In important decisions, write the options in neutral words before choosing.

Sources and further reading

  1. Tversky, A. & Kahneman, D. (1981). The framing of decisions and the psychology of choice. Science, 211(4481), 453–458. PubMed
  2. McNeil, B. J., Pauker, S. G., Sox, H. C. & Tversky, A. (1982). On the elicitation of preferences for alternative therapies. New England Journal of Medicine, 306(21), 1259–1262. PubMed

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