We must have evolved to judge risk and benefit well. So why are we so bad at understanding risk, particularly as presented in the medical literature?
Gavin de Becker  in “The Gift of Fear” advises us to trust the feeling of knowing without knowing why. We know what to do without thinking about it. I think these gut feelings are engaging brain systems Judgement from the gut uses the brains innate risk judging system. We don’t have cognitive access to it other than that gut feeling.
Mathematical models of risk and uncertainty don’t map onto the mind’s innate systems very well, particularly as odds. What does 1 in 100 mean? we are 1 not 100. Relative risk is a more intuitive way of expressing risk, but focuses on chances of failure. Often we have no idea of the context and the real probabilities of success.
Instead we tend to adopt simplifying, non-probablistic interpretations, e.g. “Cigarettes cause cancer”, Obesity will kill you. Violent rhetoric causes violence. Causation is assumed be certain and mechanistic. Exceptions disprove the simplified model. My uncle smoked every day and lived to age 90.
Maybe rationality doesn’t really work too well in the world. Probability may be more accurate way to model the world, but it causes fear and doubt because it can’t be controlled. The logic of reductionism and cause/effect thinking at least allows mental certainty even if it doesn’t work consistently. After all, what’s the difference between being wrong but knowing the outcome was uncertain and just plain being wrong? Is being wrong for the right reason actually better?
I believe that I can make a compelling argument against adopting the simple cause and effect analysis model. What do you do when you’re wrong? If you believe that going out in the cold with wet hair causes colds, how do you explain all of those guys leaving the gym with wet hair day after day returning perfectly healthy the next day? Abandon your belief? Start creating more complicated chains of events that include age and diet quality? We often end up defensive when what we profess to be the truth is not reflected in reality.
Is there something that is more natural than fixed logic but is closer to the way the world really works? Maybe cultivating the feeling of knowing without knowing why is that way.
But what do we call feeling through decisions? Neuroscience makes it “instinct” some kind of low level, subconscious, inferior urge. Rationality is always placed on a pedestal, elevated to the ideal. But adopting the view of an embodied mind, these feelings are no more or less important or integrated than seeing or understanding. Thirst or hunger are coming to mind as body signals. But where does the gut intuition about choice come from? Must be analysis and decision making by systems we don’t have access to but are using facts and perception. These are deep skills of judgement and decision making that start with natural ability honed by years of practice.
Rationality is very democratic. Knowing without analysis takes expertise, practice, and a commitment to learning over years. Perfect practice that leads to perfecting practice. So against “analysis”, I’ll place “mastery”.
I can’t recall, but you did read Antonio Damasio’s Descartes’ Error? Somatic representations? Emotional memory prunes the decision tree?
Basically, non-congnitive, emotional responses to experiences encoded in memory serve as the basis for the “gut” reaction.
I think I’m recalling that correctly, but it’s been a while. Seemed like a fairly interesting hypothesis, and I found it persuasive.
Damasio has made some very good contributions to linking brain and mind. But he and many others in Neuroscience still talk like dualists- as if the mind were one thing and the brain were another. This leads to the confusion that something like thirst is not the same thing as perceiving thirst which is unnecessary. I think we do better to include all perception as mind, whether perception of the external world, internal state or knowledge.
It takes rationality off the pedestal that I find in the work of folks like Damasio.