Blind Obedience

People are influenced by experts opinions – especially in uncertain situations. In fact, the power of authority can go so far as to lead to blind obedience (Cialdini et al, 2009). On one hand this mental shortcut is efficient of attention and effort, and usually is rewarding and correct; but on the other it can lead to negative behaviour and repercussions.

Hofling, Brotzman, Dalrymple, Graves and Pierce (1966) explored this occurrence in a setting where blind obedience could mean life or death. The experiment involved a stranger calling the hospital, and with a confident calm voice, instruct the nurses to administer 20 milligrams of Astrogen to a patient. This order broke four hospital policies: nurses are not to receive orders of prescriptions via phone or from a stranger, Astrogen is an unauthorized medication, and 20 milligrams is above the maximum 10 milligram dose for Astrogen. To ensure safety, the drug was substituted for a placebo, and nurses were stopped by a secret observer before administering the drug to the patient. Nurses were also debriefed and interviewed after the experiment.

The results were shocking (Table 1). 21 out of the 22 nurses without hesitation, delay or resistance accepted the order and proceeded to find and walk towards giving the patient the medication. In an interview after, 11 of the 22 nurses admitted to being aware of the dosage discrepancy; and 18 out of the 22 admitted to being aware of the impropriety of nonemergency telephone orders. Being aware yet still following orders is an effect of the power of influence. We can see a physical example of this mental conflict, with 17 nurses displaying psychopathology behaviour: mishearing, misplacing of familiar objects, temporarily forgetting and so on.

These results provide support for the influence of authority on changing behaviour. Another explanation for this behaviour change would be the nurses desire to be liked and approved by the doctor, trusting him and working with the efficiency and status of medical care.

Interestingly, this blind obedience is underestimated. All but 2 of a control group of 12 nurses and 21 nursing students predicted that they would not administer the medication (Hofling et al., 1966) (Table 1). Pointing towards a subconscious tactic that needs to be learned more about, especially in important fields, in order to defend against negative repercussions.

Rebecca Zijderveld – Blog 1

References

Hofling, C.K., Brotzman, E., Dalyrmple, S., Graves, N., & Pierce, C. M. (1966). An experimental study of nurse-physician relationships. Journal of Nervous and Mental Disease, 143, 171-180.

Cialdini, R. B. (2009). Influence: science and practice. Boston: Allyn and Bacon.