Ubel P A, Loewenstein G
Veterans Affairs Medical Center, Philadelphia, PA, USA.
Soc Sci Med. 1997 Mar;44(5):647-56. doi: 10.1016/s0277-9536(96)00217-1.
An important goal of informed consent is to present information to patients so that they can decide which medical option is best for them, according to their values. Research in cognitive psychology has shown that people are rapidly overwhelmed by having to consider more than a few options in making choices. Decision analysis provides a quantifiable way to assess patients' values, and it eliminates the burden of integrating these values with probabilistic information. In this paper we evaluate the relative importance of intuition and systematicity in informed consent. We point out that there is no gold standard for optimal decision making in decisions that hinge on patient values. We also point out that in some such situations it is too early to assume that the benefits of systematicity outweigh the benefits of intuition. Research is needed to address the question of which situations favor the use of intuitive approaches of decision making and which call for a more systematic approach.
知情同意的一个重要目标是向患者提供信息，以便他们能够根据自己的价值观决定哪种医疗选择最适合自己。认知心理学的研究表明，人们在做选择时，若要考虑多个以上的选项，很快就会不堪重负。决策分析提供了一种可量化的方法来评估患者的价值观，并且消除了将这些价值观与概率信息相结合的负担。在本文中，我们评估了在知情同意过程中直觉和系统性的相对重要性。我们指出，在取决于患者价值观的决策中，不存在最佳决策的黄金标准。我们还指出，在某些此类情况下，假设系统性的益处超过直觉的益处还为时过早。需要开展研究来解决哪种情况有利于使用直观决策方法以及哪种情况需要更系统方法的问题。
