Book contents
- Frontmatter
- Contents
- Preface
- Introduction
- I OVERVIEW PAPER
- II CONCEPTIONS OF CHOICE
- III BELIEFS AND JUDGMENTS ABOUT UNCERTAINTIES
- IV VALUES AND UTILITIES
- V AREAS OF APPLICATION
- 22 BEHAVIOR UNDER UNCERTAINTY AND ITS IMPLICATIONS FOR POLICY
- 23 THE RELEVANCE OF QUASI RATIONALITY IN COMPETITIVE MARKETS
- 24 HOW SENIOR MANAGERS THINK
- 25 PROBLEMS IN PRODUCING USABLE KNOWLEDGE FOR IMPLEMENTING LIBERATING ALTERNATIVES
- 26 ON THE FRAMING OF MEDICAL DECISIONS
- 27 WHETHER OR NOT TO ADMINISTER AMPHOTERICIN TO AN IMMUNOSUPPRESSED PATIENT WITH HEMATOLOGIC MALIGNANCY AND UNDIAGNOSED FEVER
- 28 THE EFFECT OF PRIVATE ATTITUDES ON PUBLIC POLICY: PRENATAL SCREENING FOR NEURAL TUBE DEFECTS AS APROTOTYPE
- 29 DISCUSSION AGENDA FOR THE SESSION ON MEDICAL DECISION MAKING and MINUTES OF A GROUP DISCUSSION ON CLINICAL DECISION MAKING
- Index
26 - ON THE FRAMING OF MEDICAL DECISIONS
Published online by Cambridge University Press: 01 March 2011
- Frontmatter
- Contents
- Preface
- Introduction
- I OVERVIEW PAPER
- II CONCEPTIONS OF CHOICE
- III BELIEFS AND JUDGMENTS ABOUT UNCERTAINTIES
- IV VALUES AND UTILITIES
- V AREAS OF APPLICATION
- 22 BEHAVIOR UNDER UNCERTAINTY AND ITS IMPLICATIONS FOR POLICY
- 23 THE RELEVANCE OF QUASI RATIONALITY IN COMPETITIVE MARKETS
- 24 HOW SENIOR MANAGERS THINK
- 25 PROBLEMS IN PRODUCING USABLE KNOWLEDGE FOR IMPLEMENTING LIBERATING ALTERNATIVES
- 26 ON THE FRAMING OF MEDICAL DECISIONS
- 27 WHETHER OR NOT TO ADMINISTER AMPHOTERICIN TO AN IMMUNOSUPPRESSED PATIENT WITH HEMATOLOGIC MALIGNANCY AND UNDIAGNOSED FEVER
- 28 THE EFFECT OF PRIVATE ATTITUDES ON PUBLIC POLICY: PRENATAL SCREENING FOR NEURAL TUBE DEFECTS AS APROTOTYPE
- 29 DISCUSSION AGENDA FOR THE SESSION ON MEDICAL DECISION MAKING and MINUTES OF A GROUP DISCUSSION ON CLINICAL DECISION MAKING
- Index
Summary
The analysis of medical practice as a decision-making process underscores the proposition that the choice of a therapy should reflect not only the knowledge and experience of the physician but also the values and the attitudes of the patient (McNeil, Weischselbaum, and Pauker, 1981). But if patients are to play an active role in medical decision making – beyond passive informed consent – we must find methods for presenting patients with the relevant data and devise procedures for eliciting their preferences among the available treatments. However, the elicitation of preferences, for both patients and physicians, presents a more serious problem than one might expect. Recent studies of judgment and choice have demonstrated that intuitive evaluations of probabilistic data are prone to widespread biases (Kahneman, Slovic, and Tversky, 1982), and that the preference between options is readily influenced by the formulation of the problem (Tversky and Kahneman, 1986).
In a public health problem concerning the response to an epidemic, for example, people prefer a risk-averse strategy when the outcomes are framed in terms of the number of lives saved and a risk-seeking strategy when the same outcomes are framed in terms of the number of lives lost. The tendency to make risk-averse choices in the domain of gains and risk-seeking choices in the domain of losses is a pervasive phenomenon that is attributable to an S-shaped value (or utility) function, with an inflection at one's reference point (Kahneman and Tversky, 1979, 1984).
- Type
- Chapter
- Information
- Decision MakingDescriptive, Normative, and Prescriptive Interactions, pp. 562 - 568Publisher: Cambridge University PressPrint publication year: 1988
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