The framing of the question is all-important

The challenge for care staff is to gauge the level of understanding. Picture: TSPL

The challenge for care staff is to gauge the level of understanding. Picture: TSPL

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Carers rely on the right response from clients, says Lesslie Young

Remember the last time you were having a conversation with someone in a noisy environment? It might have been at a party or in a pub where loud music was playing. After you’d asked for the umpteenth time for the person to repeat what they had just said it becomes very tiresome for you and for them.

There would have come a point when they paused in what they were saying and met your eyes inquisitively. Being an intelligent person you will have figured out that you have just been asked a question. How did you respond? Did you, with a touch of weariness, ask them to say again? Or did you smile and nod slightly, but not too definitively just in case, hoping that you haven’t committed yourself to any action or any opinion you will later disown or deny?

Human beings are, for whatever reason, much happier saying yes than no. Sales people know this. Politicians know it too. The framing of a question has enormous significance for the confidence you can have in the answer. Not only is yes a more comfortable response for most people but also answering yes to preceding questions makes it more likely that the answer to the key question will also be yes. Pollsters construct questions to avoid this channelling to a specific response. Sales people may not. Politicians?

The framing of the referendum question was important. There were two potential variants, obvious and easy to state, being, “Do you want Scotland to be an independent country?” and “Do you want Scotland to remain part of the UK?” Answering yes to the first implies a different opinion than answering yes to the second. But answering yes at all is already more likely. It is always seen to be better to take a positive view, better to be pro-life or pro-choice than anti-life or anti-choice. It’s all about the framing.

For the independence question, if it was sufficiently important to account for this human desire to say yes, perhaps both questions should have been put on the ballot paper. And to account for the foot-in-the-door effect half of the ballots could have had “Do you want Scotland to be an independent country?” first and half printed with it second. That would probably have made the count very difficult. And it would have raised the intriguing question of what to do with ballot papers where both questions were answered yes, or both no. It would have been a Schrödinger’s Cat of a ballot. We could have had a Quantum Scotland. What an opportunity we missed.

If you have difficulty understanding a question, accounting for the desire to say yes more often than not becomes a challenge to appreciating what you really think. If you have a learning disability or have some kind of injury that affects your ability to understand formal language or other communication then it is a live and permanent issue for those around you who want to know your genuine opinion. The framing question is ubiquitous. It applies to whether someone wants something to eat or drink now or later, to where they want to live and with whom, to whether they want that medical treatment or not.

The challenge for care staff is to gauge the level of understanding and to frame the question correctly. This implies having awareness of the power that they have over someone’s daily life and beyond, and of how to give that power away. It requires a knowledge of how easy it is to abuse language to control someone and acquire the answer you want from them, even if you are convinced that it is the right answer and in their own best interests. In essence it means a carer acknowledging the politician within, the sales person and the pollster, and understanding how these elements can be harnessed or set aside. That is not an easy job to carry off well or consistently.

As far as the referendum goes, all the many outcomes of the vote will take time to be revealed. Inevitably there will be unintended consequences because of the countless interacting variables upon which the result will impact, and all of this leading from a simple one word answer to a question which we have considered, time and again, in the months tending to years since it was framed.

We do not always have the time to fully consider the answer to a question, nor do we always have the time to decide what the proper question ought to be. For a person with impaired capacity to understand or to express themselves the duty of care is first and foremost to form and ask their right question. The consequences of their answer can be just as profound and far-reaching for them as a referendum question for an entire country.

• Lesslie Young is chief executive of Epilepsy Scotland


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