Disclosure and rationality: Comparative risk information and decision-making about prevention

With the growing focus on prevention in medicine, studies of how to describe risk have become increasing important. Recently, some researchers have argued against giving patients “comparative risk information,” such as data about whether their baseline risk of developing a particular disease is above or below average. The concern is that giving patients this information will interfere with their consideration of more relevant data, such as the specific chance of getting the disease (the “personal risk”), the risk reduction the treatment provides, and any possible side effects. I explore this view and the theories of rationality that ground it, and I argue instead that comparative risk information can play a positive role in decision-making. The criticism of disclosing this sort of information to patients, I conclude, rests on a mistakenly narrow account of the goals of prevention and the nature of rational choice in medicine.

经济学评价在临床决策中的应用探讨

医生在临床工作中做出明确诊断,并据此给予有效的处理均属于决策过程。制定决策的整个过程,同时也是进行决策思维的过程。近年来,高新技术的迅猛发展以及医疗费用急剧增加,使制定决策更加复杂。如何进行正确的决策思维,做出最切实可行的和最佳的决策,对避免决策的盲目性具有重要的现实意义。     

大连市171名中老年人两周患病及用药调查

为了解中老年人群患病和用药情况及其影响因素,在大连市某社区随机抽取171名50岁以上的居民进行问卷调查。结果发现,患病人群中80.6%患的是慢性病,以高血压、其他心血管疾病、糖尿病为主,应当加强中老年人的自我保健意识,真正做到以"预防为主",减少中老年人的发病率,根据处方用药,减少自我用药,并避免不良反应的发生。     

People Wait Longer when the Alternative is Risky: The Relation Between Preferences in Risky and Inter‐temporal Choice

In two experiments, we demonstrate that despite indicating indifference when probed about risk or delay in isolation, when forced to explicitly trade‐off between the two, participants prefer delayed over risky rewards. This pattern of findings sets a boundary condition for any common utility‐based comparison process involving both risk and delay. Furthermore, this change from indifference‐in‐isolation to delay‐preference‐in‐a‐trade‐off strengthens as reward amount increases. Exploratory modeling results suggest that the shift in preference can be explained by allowing for different discount rates for delay‐only choices compared with when delay is in competition with risk. This explanation is better than one in which probability weighting is different between risk‐only choices and risks considered in the presence of a delay. Together, the empirical and modeling work lays a path for future investigations of why and when people's evaluation of the properties of risky and delayed choices vary as a function of the alternatives on offer. Copyright © 2017 John Wiley & Sons, Ltd.     

Materialism Moderates the Effect of Accounting for Time on Prosocial Behaviors

Accounting for time is defined as putting a price on time. Researchers have demonstrated that accounting for time reduces the time individuals spend on others; however, its association with monetary donations has not been examined. We hypothesized that accounting for time will activate a utility mindset that would affect one’s allocation of time and money. In Study 1, the mediating effect of utility mindsets on the relationship between accounting for time and prosocial behavior was examined. In Study 2, we examined the effect of accounting for time on time spent helping and donating money, and the moderating role of material values on the relationship between accounting for time and prosocial behavior. Results showed that accounting for time activated a mindset of utility maximization that, in turn, reduced participants’ prosocial behavior; moreover, materialism moderated the effect of accounting for time on prosocial behavior.     

Double Reference Points: the Effects of Social and Financial Reference Points on Decisions Under Risk

The existing literature is inconsistent about how social comparison affects risk attitudes. We propose a framework where the total utility is composed of the social and financial utilities. The financial utility is consistent with prospect theory (i.e., an S‐shaped utility function with a financial reference point), whereas the social utility is affected by both social and financial reference points. Therefore, social risk attitudes are determined by interaction between gains/losses in both social and financial contexts. On the basis of safety‐first principle, we propose that when experiencing financial gains, individuals tend to seek upside potential and take social risks (i.e., a convex social utility function). In contrast, when facing financial losses, people would be more risk seeking in social gains but more risk averse in social losses to maximize security (i.e., an inverse S‐shaped utility function). We also propose that the relative importance of financial and social utilities depends on the saliency of the reference points and size of stakes. Studies 1 and 2 showed that individuals were risk seeking in both social gains and losses with social reference points alone. Studies 3 and 4 demonstrated that when both financial and social reference points were salient, participants were risk averse in both social gains and losses when facing financial gains, but risk seeking in social gains and risk averse in social losses when facing financial losses. The hypotheses derived from the theoretical framework were in general supported by our experiments. Copyright © 2015 John Wiley & Sons, Ltd.     

The relation between depression and appreciation: The role of perceptions of emotional utility in an experimental test of causality

The present research examined the potential role of perceived utility of appreciation in depressive symptoms. In a between-subjects design, participants were induced to increase their experience of appreciation or their perceived usefulness of appreciation. Self-reported perceptions of emotional utility, actual experience of emotion, as well as depression scores gathered from semi-structured interviews, were obtained at baseline and post-induction. As predicted, although participants in both groups evidenced lower levels of depressive symptoms at post-induction than at baseline, there was a greater decrease among participants in the appreciation-utility condition than among those in the appreciation-experience condition. Further, perceived utility of appreciation was an important mediator in moderated mediation models.     

Hume on sympathy and agreeable qualities

Hume says that sympathy is the source of our moral feeling of approval for useful qualities. But does Hume give the same psychological explanation of our approval of immediately agreeable qualities as he does to our approval of useful qualities? Does he trace our moral approbation of immediately agreeable qualities to sympathy? Some commentators, including Rachel Cohon and Don Garrett, argue that he does not. Let us call this view the ‘narrow view’ of sympathy in contrast to the ‘wide view’ of sympathy, which holds that sympathy is required for every moral sentiment. There is indeed some apparent textual evidence in Hume’s work that seems to support the narrow view. My aim in this paper is to examine that evidence and show how it is merely apparent, in particular by showing how a number of passages can be and are misread. I thus want to argue indirectly for the wide view.     

Perceived Utility (not Sympathy) Mediates the Proportion Dominance Effect in Helping Decisions

The proportion dominance effect (PDE) refers to a higher motivation to help when the victims are part of a small (you can help 56 out of 60) rather than a large (you can help 56 out of 560) reference group. In two studies using different experimental paradigms, we investigated possible mediators of the PDE. Study 1 (N = 168) was conducted in three separate steps in order to test each link of the mediator model independently. Students read six vignettes where it was possible to help a fixed number of victims but where the size of the reference group was either small or large. When the reference group was small, helping motivation and perceived utility were higher, whereas sympathy toward the victims and perceived rights were not. A within‐subject mediation analysis showed that perceived utility mediated the PDE. Study 2 (N = 36) presented four versions of a single helping situation in a joint evaluation mode where the size of the reference group became gradually smaller in each version. All participants compared and responded to each version. Helping motivation increased as the reference group became smaller, and this effect was mediated by perceived utility rather than by distress, sympathy, or perceived responsibilities. Our results suggest that unlike, for example, the identifiability and singularity effects, which have been suggested to be mediated by emotional reactions, the PDE is mediated by perceived utility. Copyright © 2013 John Wiley & Sons, Ltd.