of this sort must give us all great reason for concern as potential hospital
patients. Given the recent U.S. Health Care Financing Administration
estimate of a 12 percent daily-medication error rate in American hospit-
als, stays of longer than a week make it likely that we will be recipients
of such an error. What the midwestern study shows is that the mistakes
are hardly limited to trivial slips in the administration of harmless ear
drops or the like, but extend to grave and dangerous blunders.
In interpreting their unsettling findings, the researchers came to an
instructive conclusion:
In a real-life situation corresponding to the experimental one, there
would, in theory, be two professional intelligences, the doctor’s
and the nurse’s, working to ensure that a given procedure be un-
dertaken in a manner beneficial to the patient or, at the very least,
not detrimental to him. The experiment strongly suggests, how-
ever, that one of these intelligences is, for all practical purposes,
nonfunctioning.^8
It seems that, in the face of a physician’s directives, the nurses un-
hooked their “professional intelligences” and moved to a click, whirr
form of responding. None of their considerable medical training or
knowledge was engaged in the decision of what to do. Instead, because
obedience to legitimate authority had always been the most preferred
and efficient action in their work setting, they had become willing to
err on the side of automatic obedience. It is all the more instructive that
they had traveled so far in this direction that their error had come not
in response to genuine authority but to its most easily falsified sym-
bol—a bare title.^9
Clothes
A second kind of authority symbol that can trigger our mechanical
compliance is clothing. Though more tangible than a title, the cloak of
authority is every bit as fakable. Police bunco files bulge with records
of con artists whose artistry includes the quick change. In chameleon
style, they adopt the hospital white, priestly black, army green, or police
blue that the situation requires for maximum advantage. Only too late
do their victims realize that the garb of authority is hardly its guarantee.
A series of studies by social psychologist Leonard Bickman gives an
indication of how difficult it can be to resist requests that come from
figures in authority attire. Bickman’s basic procedure was to ask pass-
ersby on the street to comply with some sort of odd request (to pick up
a discarded paper bag, to stand on the other side of a bus-stop sign). In
half of the instances, the requester—a young man—was dressed in
Robert B. Cialdini Ph.D / 169