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Imagining the End of Life: On the Psychology of Advance Medical Decision Making
Authors:Ditto  Peter H  Hawkins  Nikki A  Pizarro  David A
Institution:(1) Department of Psychology and Social Behavior, University of California, California, USA;(2) Present address: Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA;(3) Present address: Department of Psychology, Cornell University, Ithaca, New York, USA;(4) Department of Psychology and Social Behavior, University of California, 3340 Social Ecology II, Irvine, CA 92697-7085, USA
Abstract:Near the end of life, individuals often become too ill to express their wishes about the use of life-sustaining medical treatment. Instructional advance directives (i.e., livings wills) are widely advocated as a solution to this problem based on the assumption that healthy people can predict the types of medical treatment they will want to receive if they become seriously ill. In this paper, we review a large body of research from the psychological and medical literatures that challenges this assumption. This research demonstrates that across a wide variety of decision contexts people show limited ability to predict their affective and behavioral reactions to future situations. We outline several ways that policy and law regarding the use of advance directives could be informed by this research, and suggest a number of issues involved in advance medical decision making that could benefit from additional empirical and conceptual attention.
Contact InformationPeter H. DittoEmail:
Keywords::" target="_blank">:  advance directives  medical decision making  predictive accuracy  affective forecasting
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