Imagine that the President convenes his top economic advisors to get a recommendation on a pressing policy issue. They say unequivocally “do X.” The President asks why and they say “its complicated. Do X.” The President, not happy with that, decides he is going to read the economic literature on the pros and cons of doing X. After a thorough study he comes back to his advisors and says “You economists don’t understand your own science. I read the literature and I should do Y.”
I think we would agree that’s a bad outcome. For probably exactly the same reason that Doctors don’t seem to be happy with economist Emily Oster’s apparent advice to pregnant women to drink alcohol “like a European adult.”
But let’s assume that Emily truly can interpret the published statistical literature better than her Obstetrician. There is another reason to question her recommendations.
An advisor’s job is to advise on the risks of an activity. Because the advisor is the expert on that. The decision-maker is the expert on her own preferences. The correct decision is based on weighing both of these.
A recommendation to have up to a glass of wine per day while pregnant confounds the two sides. What it really means is “I like wine a lot. I also read about the risks and decided that my taste for wine was strong enough that I am willing to live with the risks.” Thus her recommendation amounts to “If you like wine as much as I do you should drink up to a glass per day when you are pregnant.”
When I asked my doctor about drinking wine, she said that one or two glasses a week was “probably fine.” But “probably fine” isn’t a number.
The problem is that there is no way to quantify how much she likes wine and so no way for her readers to know whether they like wine as much as she does. Likewise it is too much for Emily to demand her doctors to say much more than “probably fine.”
The doctors’ advice is based on some assumption about the patient’s taste for wine weighed against the risks. Emily’s advice is based on a different assumption. As for the risks, when Emily reads the literature and concludes that the evidence is weak of the danger of drinking alcohol she then jumps to the conclusion that it is weaker than what the doctors thought. She makes the identifying assumption that their recommendation was conservative because they overestimated the risks and not because they underestimated her taste for wine. But there does not seem to be any basis for that assumption because her doctors never told her what they believed the risks to be and they never asked her how much she likes wine.