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模糊痕迹理论与未成年人的医疗决策:青少年与成年人推理过程的差异

Fuzzy trace theory and medical decisions by minors: differences in reasoning between adolescents and adults.

作者信息

Wilhelms Evan A, Reyna Valerie F

机构信息

Department of Human Development, Cornell University, Ithaca, New York, 14850, USA.

出版信息

J Med Philos. 2013 Jun;38(3):268-82. doi: 10.1093/jmp/jht018. Epub 2013 Apr 19.

Abstract

Standard models of adolescent risk taking posit that the cognitive abilities of adolescents and adults are equivalent, and that increases in risk taking that occur during adolescence are the result of socio emotional differences in impulsivity, sensation seeking, and lack of self-control. Fuzzy-trace theory incorporates these socio emotional differences. However, it predicts that there are also cognitive differences between adolescents and adults, specifically that there are developmental increases in gist-based intuition that reflects understanding. Gist understanding, as opposed to verbatim-based analysis, generally has been hypothesized to have a protective effect on risk taking in adolescence. Gist understanding is also an essential element of informed consent regarding risks in medical decision- making. Evidence thus supports the argument that adolescents' status as mature minors should be treated as an exception rather than a presumption, because accuracy in verbatim analysis is not mature gist understanding. Use of the exception should be accompanied by medical experts' input on the bottom-line gist of risks involved in treatment.

摘要

青少年冒险行为的标准模型假定,青少年和成年人的认知能力相当,且青少年时期冒险行为的增加是冲动、寻求刺激和缺乏自我控制等社会情感差异的结果。模糊痕迹理论纳入了这些社会情感差异。然而,该理论预测,青少年和成年人之间也存在认知差异,具体而言,基于要点的直觉(反映理解)会随着发育而增强。与逐字分析相反,要点理解通常被认为对青少年冒险行为具有保护作用。要点理解也是医疗决策中关于风险的知情同意的一个基本要素。因此,有证据支持这样的观点,即青少年作为成熟未成年人的身份应被视为一种例外而非一种假设,因为逐字分析的准确性并非成熟的要点理解。在使用这种例外情况时,应该有医学专家对治疗所涉及风险的基本要点提供意见。

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