This paper examines the importance of the context in which medical alternatives are presented to individuals. In a series of experiments, subjects were given information and asked to make choices in hypothetical medical situations. In each experiment, probability information was presented in either a positive or a negative frame. One study demonstrated that the probability that a subject would elect surgery for a terminal liver disease was a function of both the probability of survival and the framing of the probability information. That is, at each probability level the chances of accepting surgery were greater if the information was presented in a positive frame. In a second study the recommendation that a haemophilia carrier would abort a child was more likely if there was a 50 per cent chance of having an ‘affected’ son than if there was a 50 per cent chance of having a ‘normal” son. The third study considered competition for a bed in an intensive care unit. Subjects were more willing to endorse the return of a patient described as their ‘father’ to the regular floor if his ‘ chances of surviving were presented as 90 per cent in comparison to a group that was told his chances of dying were 10per cent. These findings suggest that individuals are more willing to select risky medical options when probabilistic information is worded positively rather than negatively. Furthermore, when the choice of a medical option involved another individual’s health outcome, subjects_were still more likely to endorse riskier treatments when outcomes were presented in a positive rather than negative context. However, when the medical decision involved a stranger’s health outcome, the context effect did not occur. Implications for health care professionals are discussed.
Wilson, D. K., Kaplan, R. M., &Schneiderman, L. J. (1987). Framing of decisions and selections of alternatives in health care. Social Behaviour, 2(1), 51-59.