Gigerenzer,G.

Should the patient’s decision depend on how you frame the message? Studies show that people are more inclined to consider surgery when the doctor uses the survival frame (albeit less so when decisions are real rather than hypothetical).1 Isn’t reacting differently to the two frames—called a framing effect—irrational? A 90% chance of survival and a 10% chance of mortality are logically equivalent. In their influential book, Nudge, Thaler and Sunstein argue that framing effects occur because “people tend to be somewhat mindless, passive decision makers” with cognitive deficiencies.2 They say that a rational patient should focus on the message, not how a doctor frames it. Framing effects are said to violate a principle called “description invariance,” which is thought to be an essential condition for rational behaviour.3 In fact, framing effects are one of the justifications for the paternalist programme of the current UK government to “nudge” as opposed to educate people into changing their behaviour.

Gigerenzer, G. (2014). Should patients listen to how doctors frame messages? BMJ, 349:g7091. doi:10.1136/bmj.g7091 (Full text)

Publication year	2014
Document type:	Article
Publication status:	Published
External URL:	http://dx.doi.org/10.1136/bmj.g7091 View
Categories:	EducationHealth
Keywords:	clinicalcommunicationdecision makinginstant messaginglanguagepatient carephysician-patient relations -- evaluation