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True or false?

The past year has revealed a lot about the human race and how we accumulate knowledge. Conspiracy theories have surged in popularity, and people have failed to agree on a set of facts—or a process for arriving at them. It wouldn’t be such a problem if we disagreed about subjective things, such as what makes good art. But we disagree about objective things, such as whether the virus that causes COVID-19 was manufactured by people (it wasn’t), or whether 5G cellular networks are tools for mind control (they aren’t). False information arises around things that we don’t see well or understand properly. Human health, in particular, is fertile ground for high-stakes misinformation. It has all the right ingredients—complexity, varied efficacy, diversity in culture, and eight billion personal experiences of treatment going right or wrong. Health also interfaces with science and technology at the highest level. We can kickstart someone’s heart, we can help them breathe with artificial lungs, but we can’t answer basic questions: Why do some people thrive, and some people do not? Why have some people recovered from COVID-19, while some remain desperately sick a year later, and others never even realised the virus was inside their bodies? Based on the machines we’ve invented and the mechanisms we understand, it seems as though we should be able to answer some of these other questions. But we can’t. And that leaves our species—one that craves certainty—with the one thing we struggle to accommodate: uncertainty. Belief arises where certainty is in short supply. And that’s where things get murky. Human health is deeply entangled with our beliefs. This is best illustrated by the placebo effect—the phenomenon where pretending to give a patient medicine or treatment makes them feel better. Study after study has shown that someone’s health can improve if they receive not treatment but only the ritual of treatment—the examination, the pill, the anaesthesia, the hospital stay. Even when someone knows the treatment is fake—the pill is sugar—they may improve. Equally at play is the nocebo effect, where negative expectations of a treatment lead to worsening health. We don’t entirely understand why this is. The placebo and nocebo effects are limited to us as individuals. But beliefs are contagious, and can spread through social groups, to helpful or harmful ends. In this issue, we look at misinformation, myth and belief. How do we form our beliefs? How do they change? We’re surrounded by things we take on faith, because it’s impossible for any of us to assess all the evidence about everything. We may trust methods, like science. We may trust institutions, if we perceive them as helpful. We definitely trust our friends and communities. We know in groups, just like we live in groups. I don’t really like the thought that my ideas aren’t my own, that perhaps I haven’t selected them for their objective rightness. But the notion that I act entirely without influence is a dangerous one. Recognising what influences us is one thing. Shifting our understanding of the world is another. Hayden Donnell’s story on page 54 looks at people who’ve undergone epistemological transformations—they changed their minds. They moved from an understanding of the world based on false ideas to one based on evidence. It’s a more difficult transition than it sounds, and it was made possible by the empathy of others—the greatest influencer of all.