The Psychology of Decision-Making and Cancer

Decisions about cancer screening and treatment are among the most difficult and important some people will ever make. In this session, speakers present research on judgment and shared decision-making about cancer among patients and health care providers. Although the goals of shared decision-making are admirable, there are a number of challenges to meaningfully including patients in an effective decision-making processes. Most patients do not have the knowledge or experience required to make informed decisions about cancer treatment, and they require additional support to accurately assess the risks. Inadequate numeracy (i.e., quantitative literacy) among patients poses particular challenges. The speakers argue that a good theoretical understanding of the psychological mechanisms underlying medical decision-making can improve decision support for patients and providers. Whereas earlier approaches emphasized the presentation of precise, detailed numerical information to patients, recent research suggests that integrating the cognitive and emotional dimensions of decision-making in a way that emphasizes the bottom line of decision alternatives, within context, provides better support for medical decision-making. Emerging theoretical perspectives also have ramifications for policy by improving patient-physician communication, reducing preventable medical error, and developing decision aids for patients and health care providers.