such as "Introduction", "Conclusion"..etc
April 20, 2009 — In the medical realm, people
sometimes need to make very difficult choices, such as deciding to end
life-support for a terminally ill patient. A new study delves into the
question of whether it is preferable for patients' families or doctors
to make those "tragic choices."
Authors Simona Botti (London Business School), Kristina Orfali, and
Sheena S. Iyengar (both Columbia University) say that from the time of
Hippocrates until the 1980s the "paternalistic model" dominated the
field of bioethics. According to this model, doctors made decisions in
their patients' best interest. A newer "autonomous model" assumes that
patients should be informed of the pros and cons of various medical
treatments and make decisions for themselves or family members. When it
comes to tragic choices, how do these two models play out?
The researchers conducted in-depth analysis of nineteen interviews
with American and French parents who had infants in Neonatal Intensive
Care Units. "The experiences of these parents were similar because they
were all confronted by the choice of whether to continue or interrupt
their babies' life-support therapy, the decision to interrupt the
treatment was made, and the baby died. Crucially, however, the decision
model in neonatology varies across the two countries: In the U.S., the
autonomous model is used, so the decision to interrupt life-support
therapy was made by the parents themselves; on the contrary, in France,
the paternalistic model still dominates, so the same decision was made
by the physicians on behalf of the parents."
In that study and subsequent laboratory experiments, the researchers
found that people who made the choices were more confident that the
best decisions were made. But in spite of this higher confidence, they
expressed more negative emotion that those who did not choose. "In
addition, both choosers and non-choosers were ambivalent towards
decision autonomy," the authors write. "On the one hand, they did not
like deciding by themselves, but on the other they also did not like
having the physicians choose for them."
The authors did find, in a final study, that when physicians framed
the withdrawal decision as "the only thing to do," people making tragic
choices were able to distance themselves from the choice and experience
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