Obedience and informed decision-making
We have seen how important the source of a message is to persuasion. Holding
legitimate authority is an especially powerful attribute in relation to social influence.
When people occupy a role in which they accept that another person has the right
to direct other people’s actions, they are more easily persuaded. This was powerfully
demonstrated in Milgram’s (1974) experiments in which he showed that people would
deliver (what they thought were) electric shocks to others to a much greater extent
than was predicted, so long as they accepted the experimenter (ordering the shocks)
as a legitimate authority figure. Following this work, Rank and Jacobson (1977)
investigated nurses’ obedience to an apparent order from a doctor to administer a drug
in too large a quantity, that is to give a patient a drug overdose. They concluded
that nurses were less likely to obey the mistaken order if they were familiar with
the drug and had time to confer with other nurses. This emphasizes a more general
point relevant to all those involved in health care decisions, namely, that being well
informed and having time to confer before decisions are made and action is undertaken
is likely to minimize mistakes, whether the decision-makers are managers, doctors,
nurses or patients.
Overcoming resistance to change
Persuasion is necessary because often people do not want to change. We do not like
others trying to influence us, we often find persuasive communications threatening or
unbelievable and we feel it is too difficult to change everyday routines in the face of
many competing demands. Reactance (Brehm, 1966) is an emotional response to
attempts at coercion, prohibition and regulation. Reactance leads people to take the
opposite view to that imposed and motivates people to do the opposite of what is
recommended. Thus it is important to prepare for and manage social influence
attempts. If a persuasion attempt is insensitive to the needs of the target audience it
may have no impact or even be counterproductive.
We have noted the importance of perceptions of the message source and this extends
to the way in which the persuasive attempt is delivered. Explicit persuasive attempts
may be resisted. For example, it means that tone of voice and non-verbal indicators
of power within a relationship can undermine social influence in one-to-one settings.
For example, Ambady et al. (2002) taped surgeons’ consultations with patients and,
on the basis of 10-second clips, rated dominance and concern/anxiety in their voices
(regardless of content). Higher dominance and lower concern were significantly
associated with greater number of previous malpractice claims initiated by their
patients! This has important implications for doctor–patient communication, which
we will consider in Chapter 10.
Governments need to persuade populations that public health legislation is in the
public interest before enacting such legislation (e.g. necessitating seat-belt wearing in
cars or banning smoking in public places). Otherwise enforcement may be costly and
there is a risk that unpopular legislation may be overturned. Thus reassuring a target
audience that what is offered is caring advice, which is primarily in their own interest,
is a crucial foundation for persuasion.
Reactance and resistance can be minimized by presenting persuasion attempts as
choices, by highlighting the ease with which change can be managed and by focusing
176 MOTIVATION AND BEHAVIOUR