The role of decision analysis in informed consent: Choosing between intuition and systematicity

被引:79
作者
Ubel, PA
Loewenstein, G
机构
[1] VET AFFAIRS MED CTR,PHILADELPHIA,PA
[2] UNIV PENN,DIV GEN INTERNAL MED,PHILADELPHIA,PA 19104
[3] UNIV PENN,CTR CLIN EPIDEMIOL & BIOSTAT,PHILADELPHIA,PA 19104
[4] UNIV PENN,LEONARD DAVIS INST HLTH ECON,PHILADELPHIA,PA 19104
[5] CARNEGIE MELLON UNIV,DEPT SOCIAL & DECIS SCI,PITTSBURGH,PA 15213
关键词
informed consent; doctor-patient communication; decision analysis; medical ethics;
D O I
10.1016/S0277-9536(96)00217-1
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
An important goal of informed consent is to present information to patients so that they can decide which medical option is best for them, according to their values. Research in cognitive psychology has shown that people are rapidly overwhelmed by having to consider more than a few options in making choices. Decision analysis provides a quantifiable way to assess patients' values, and it eliminates the burden of integrating these values with probabilistic information. In this paper we evaluate the relative importance of intuition and systematicity in informed consent. We point our that there is no gold standard for optimal decision making in decisions that hinge on patient values. We also point out that in some such situations it is too early to assume that the benefits of systematicity outweigh the benefits of intuition. Research is needed to address the question of which situations favor the use of intuitive approaches of decision making and which call for a more systematic approach. Copyright (C) 1997 Elsevier Science Ltd
引用
收藏
页码:647 / 656
页数:10
相关论文
共 63 条
[21]   EVALUATION STANDARDS FOR PATIENT DECISION SUPPORTS [J].
HOLMESROVNER, M .
MEDICAL DECISION MAKING, 1995, 15 (01) :2-3
[22]  
HOLMESROVNER M, IN PRESS MED DECISIO
[23]  
Janis I.L., 1977, Decision Making
[24]  
JOHNSON JE, 1984, HDB PSYCHOL HLTH, V4
[25]   SPECULATIONS ABOUT DECISION-THEORETIC AIDS FOR PERSONAL DECISION-MAKING [J].
JUNGERMANN, H .
ACTA PSYCHOLOGICA, 1980, 45 (1-3) :7-34
[26]   PERSONAL DECISION COUNSELING - COUNSELORS WITHOUT CLIENTS [J].
JUNGERMANN, H ;
SCHUTZ, H .
APPLIED PSYCHOLOGY-AN INTERNATIONAL REVIEW-PSYCHOLOGIE APPLIQUEE-REVUE INTERNATIONALE, 1992, 41 (02) :185-200
[27]   SCREENING AND INFORMED CONSENT [J].
LEE, JM .
NEW ENGLAND JOURNAL OF MEDICINE, 1993, 328 (06) :438-440
[28]   ANTICIPATION AND THE VALUATION OF DELAYED CONSUMPTION [J].
LOEWENSTEIN, G .
ECONOMIC JOURNAL, 1987, 97 (387) :666-684
[29]  
LOEWENSTEIN G, IN PRESS J EC BEHAV
[30]   REGRET THEORY - AN ALTERNATIVE THEORY OF RATIONAL CHOICE UNDER UNCERTAINTY [J].
LOOMES, G ;
SUGDEN, R .
ECONOMIC JOURNAL, 1982, 92 (368) :805-824