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Another perspective aids in making medical choices

Written by: Staff

NEW YORK, June 7 (Reuters) When faced with a tough medical decision, imagine that you're making it for a friend rather than for yourself; that may make such choices easier, a new study suggests.

''We think that it's understandably easy to get caught up in the difficulty of the moment -- a patient has just been diagnosed with a problem, they're facing a complex treatment decision, it's hard to see the big picture,'' Dr. Brian Zikmund-Fisher of the University of Michigan, Ann Arbor, told Reuters Health. ''It's actually relatively easy for people to gain a different type of perspective by thinking about what they would do if they were recommending for someone else.'' Zikmund-Fisher and his team conducted their study to look at a phenomenon known as ''omission bias,'' in which a person faced with a medical decision may choose passive nonintervention rather than an active approach due to fear of causing harm to themselves.

They asked 2,399 people to imagine themselves as a patient, a physician treating a patient, a medical director creating patient guidelines, or a parent making a decision for a child.

They were then asked to make medical choices in two different scenarios. In one, there is a deadly flu circulating that will kill 10 per cent of people who aren't vaccinated, although the vaccine itself carries a 5 per cent risk of causing death. In the second, participants were asked to decide on whether or not to treat a slow-growing cancer with chemotherapy.

Study participants were more likely to choose the active approach when making a decision as a professional, rather than for themselves. Seventy-three percent of those imagining themselves as doctors would opt for the vaccine, compared to 63 percent of those posing as medical directors and 48 percent making the decision for themselves. Sixty-eight percent of those taking the physician or medical director role opted for chemotherapy, compared to 60 per cent of those in the patient role.

Thinking as parents, 57 per cent of study participants would choose the vaccine for their child, and 72 per cent would opt for chemotherapy. This suggests, Zikmund-Fisher said, that if a child is already sick a parent may feel more comfortable choosing active treatment than when making the decision to choose preventive but potentially risky treatment for a healthy child.

Doctors are increasingly allowing patients to be a part of the decision-making process, Zikmund-Fisher noted, but the findings suggest they shouldn't opt out of advising patients entirely. ''The physician might be able to act as a coach to help guide the decision making process,'' he said. Doctors could propose that patients try to think of themselves as making the decision for a friend, he explained.

''Helping the patient to take a step back might make for a better decision-making process all around,'' he said.


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