Content uploaded by Simona Botti
Author content
All content in this area was uploaded by Simona Botti
Content may be subject to copyright.
A preview of the PDF is not available
Tragic Choices: Autonomy and Emotional Responses to Medical Decisions
Abstract and Figures
We investigate how making highly consequential, highly undesirable decisions affects emotions and preference for autonomy. We examine individuals facing real or hypothetical decisions to discontinue their infants’ life support who either choose personally or have physicians choose for them. Findings from a multidisciplinary approach consisting of a qualitative analysis of in‐depth interviews and three laboratory studies reveal that perceived personal causality for making tragic decisions generates more negative feelings than having the same choices externally made. Tragic decisions also undermine coping abilities, weakening the desire for autonomy. Consequently, participants disliked making decisions but also resented relinquishing their option to choose.
Figures - uploaded by Simona Botti
Author content
All figure content in this area was uploaded by Simona Botti
Content may be subject to copyright.
... Empirical research exists on delegation of tasks from one person to another, with analyses taking place in different contexts for the decision to be made. Contexts range from consequential medical decisions to trivial day-to-day decisions (Botti et al. 2009;Steffel et al. 2016). In general, people often seem to show a preference for making a decision autonomously instead of delegating the decision and let someone else choose on one's behalf (Botti and Lyengar 2004;Botti and McGill 2006). ...
... However, this preference for autonomous decision-making was found to be highly contextual. As such, the preference for it decreases when the decision's outcomes are expected to be highly consequential and undesirable (Botti et al. 2009), or when a decision is becoming too difficult (Kahlen et al. 2018;Steffel and Williams 2018). In the latter case, the option of delegating to others is seen as an appealing alternative to making a decision autonomously that is later regretted or not making a decision at all. ...
As artificial intelligence (AI) can increasingly be used to support decision-making in various areas, enhancing the understanding of human-AI collaboration is more important than ever. We study delegation between humans and AI as one form of collaboration. Specifically, we investigate whether there exist distinct patterns of human delegation behavior towards AI. In a laboratory experiment, subjects performed an image classification task with 100 images to be classified. For the last 50 images, the treatment group had the option to delegate images to an AI. By performing a cluster analysis on this treatment, we find four types of delegation behavior towards AI that differ in their overall performance, delegation rate, and their accuracy of self-assessment. Our results motivate further research on delegation of humans to AI and act as a starting point to research on human collaboration with AI on an individual level.
... The desirability of control, however, varies as choices become more difficult. For example, Botti et al. (2009) studied choices made in highly consequential contexts. They showed that when individuals face a hard decision with substantial consequences (i.e., a medical decision), taking the responsibility to make the choice instantiates negative feelings, and deferring the choice to experts is preferred. ...
We explore the effectiveness of empowerment‐messages in two contexts of fear caused by an existential threat: COVID‐19 pandemic and economic fear. We show in a field experiment that an empowerment‐message, which increased sales of an online retailer by 13% before COVID‐19 lockdowns when fear was low, does not have the same effect post‐COVID‐19 lockdowns when fear is high. Three follow‐up experiments show that when fear is low, an empowerment‐message makes individuals feel responsible and increases purchase. When fear is high, an empowerment‐message does not make individuals feel responsible and does not improve purchase. We find that personal control that is generally desired, does not resonate with individuals in the context of fear caused by an existential threat. This implies that marketers should reconsider their use of marketing efforts that empower consumers in high fear contexts.
... For instance, people who personally make psychologically painful decisions (e.g., ending a life-sustaining treatment) feel more intense negative emotions (such as anger, depression, guilt, and regret) compared to those who face the same outcome (e.g., the death of a loved one) as the result of a decision made by someone else. Personal responsibility adds to the feeling of loss (Botti, Orfali, & Iyengar, 2009). ...
In our information-rich world, people face a great many choice alternatives involving both small and large stakes, from jam and chocolate to health and pension plans. Though classic economics and psychology have both traditionally emphasized the benefits of more information and greater choice, a sizable and parallel body of research has demonstrated that having too much information or too many choices can lead to information and choice overload, choice paralysis, and negative affective states connected with both the decisions process and the choice outcome. This chapter offers a concise summary of evidence collected by researchers for more than half a century on how people deal with large amounts of information and how they make choices from sets with multiple alternatives. The simple cost-benefit model proposed in earlier research is discussed in relation to the mechanism underlying the choice-overload phenomenon.
... While people tend to like choice in a consumer context, they might not like choice in the context of making an unpleasant and stressful medical decision or choosing from a set of undesirable alternatives. In unpleasant choice domains, people often feel increased negative affect when they are personally responsible for the choice and decreased negative emotions when they are allowed to delegate the choice to someone else (Botti & Iyengar, 2006;Botti, Orfali, & Iyengar, 2009). ...
Previous research has shown that neither too much nor too little choice is optimal. Choice sets of an intermediate size offer more positive cognitive and emotional consequences to the decision maker than small and large choice sets. However, the ideal number of choices depends on many factors. This chapter describes the main factors that moderate the effect of choice overload and so determine how much choice is enough. Consistent with Herbert A. Simon’s analogy of a pair of scissors to describe his conception of bounded rationality, where one blade represents the individual cognitive characteristics of the decision maker and the other the structures of the environment, this chapter presents these factors, regrouping them into two main categories: contextual and individual variables.
... health (Gino and Moore 2007;Botti, Orfali, and Iyengar 2009). Inaccurate or biased perceptions by others can adversely affect the treatment of psychologically caused medical signs and symptoms, encouraging delay or avoidance (Corrigan 2004;Vogel, Wade, and Hackler 2007;Clement et al. 2015). ...
How do people assess the severity of health problems? How do they decide whether these merit medical attention? We investigate how beliefs about psychological and physical causes of medical signs affect their perceived severity. Three studies showed that people perceive objective and observable evidence of illnesses (i.e., medical signs) as less severe if they originate from psychological rather than physical causes. For instance, participants rated the same cough as less harsh and scratchy when they believe it was caused by anxiety rather than by drinking contaminated tap water. As a result, participants were less likely to recommend care for medical signs with psychological origins, less likely to prioritize their care among multiple health problems, and reluctant to financially support scientific research for their cure.
... health (Gino and Moore 2007;Botti, Orfali, and Iyengar 2009). Inaccurate or biased perceptions by others can adversely affect the treatment of psychologically caused medical signs and symptoms, encouraging delay or avoidance (Corrigan 2004;Vogel, Wade, and Hackler 2007;Clement et al. 2015). ...
In this final chapter we performed a grounded-theory analysis of the 19 content chapters of this book. We identified 18 grounded theory categories that summarize major themes in the book and grouped them accordingly. The core element of grounded theory is a focus on the emergence of theory from the data (here, the data are chapters) while remaining open to all possible meanings and interpretations of data (Treem & Browning. Grounded theory. In C. Scott & L. Lewis (Eds.), The international encyclopedia of organizational communication. Wiley, 2017). We looked for likenesses among the 19 content chapters and linked them to one or more of the 18 categories elaborated in this final chapter. A fairly disparate group of scholar-researchers began off with exactly the same set of research questions and produced a pleasingly varied—and pleasingly complex—set of answers. Yet the chapters also illustrate the concept: equifinality—namely, they all eventually arrive at pretty much the same place. Important for our purposes here, they have integrative complexity, in which chapter complexity can be represented by the number of different positions created to represent them and the order necessary to integrate them. Our conclusion is that organizational communication technology (OCT) serves as the integrator for the complexity surrounding work life during early stages of coronavirus.
Artificial intelligence (AI) is revolutionizing the medical industry. This paper first investigates the mechanism of patients' medical AI acceptance after experiencing AI service failure from the perspective of responsibility attribution. Using data from 249 patients in China, findings reveal that patients' self-responsibility attribution is positively related to human–computer trust (HCT) and sequentially enhances the acceptance of medical AI for independent diagnosis and treatment. This paper also investigates the moderating role of personality traits. Specifically, conscientiousness and openness strengthen the association between HCT and acceptance of AI for independent diagnosis and treatment; agreeableness and conscientiousness weaken the association between HCT and acceptance of AI for assistive diagnosis and treatment.
While often seeming to investigate rather different problems, research into value-based decision making and cognitive control have historically offered parallel insights into how people select thoughts and actions. While the former studies how people weigh costs and benefits to make a decision, the latter studies how they adjust information processing to achieve their goals. Recent work has highlighted ways in which decision-making research can inform our understanding of cognitive control. Here, we provide the complementary perspective: how cognitive control research has informed understanding of decision-making. We highlight three particular areas of research where this critical interchange has occurred: (1) how different types of goals shape the evaluation of choice options, (2) how people use control to adjust how they make their decisions, and (3) how people monitor decisions to inform adjustments to control at multiple levels and timescales. We show how adopting this alternate viewpoint offers new insight into the determinants of both decisions and control; provides alternative interpretations for common neuroeconomic findings; and generates fruitful directions for future research.
Moral judgments have a very prominent social nature, and in everyday life, they are continually shaped by discussions with others. Psychological investigations of these judgments, however, have rarely addressed the impact of social interactions. To examine the role of social interaction on moral judgments within small groups, we had groups of 4 to 5 participants judge moral dilemmas first individually and privately, then collectively and interactively, and finally individually a second time. We employed both real-life and sacrificial moral dilemmas in which the character's action or inaction violated a moral principle to benefit the greatest number of people. Participants decided if these utilitarian decisions were morally acceptable or not. In Experiment 1, we found that collective judgments in face-to-face interactions were more utilitarian than the statistical aggregate of their members compared to both first and second individual judgments. This observation supported the hypothesis that deliberation and consensus within a group transiently reduce the emotional burden of norm violation. In Experiment 2, we tested this hypothesis more directly: measuring participants' state anxiety in addition to their moral judgments before, during, and after online interactions, we found again that collectives were more utilitarian than those of individuals and that state anxiety level was reduced during and after social interaction. The utilitarian boost in collective moral judgments is probably due to the reduction of stress in the social setting.
In this chapter a theory of motivation and emotion developed from an attributional perspective is presented. Before undertaking this central task, it might be beneficial to review the progression of the book. In Chapter 1 it was suggested that causal attributions have been prevalent throughout history and in disparate cultures. Studies reviewed in Chapter 2 revealed a large number of causal ascriptions within motivational domains, and different ascriptions in disparate domains. Yet some attributions, particularly ability and effort in the achievement area, dominate causal thinking. To compare and contrast causes such as ability and effort, their common denominators or shared properties were identified. Three causal dimensions, examined in Chapter 3, are locus, stability, and controllability, with intentionality and globality as other possible causal properties. As documented in Chapter 4, the perceived stability of a cause influences the subjective probability of success following a previous success or failure; causes perceived as enduring increase the certainty that the prior outcome will be repeated in the future. And all the causal dimensions, as well as the outcome of an activity and specific causes, influence the emotions experienced after attainment or nonattainment of a goal. The affects linked to causal dimensions include pride (with locus), hopelessness and resignation (with stability), and anger, gratitude, guilt, pity, and shame (with controllability).
I: Background.- 1. An Introduction.- 2. Conceptualizations of Intrinsic Motivation and Self-Determination.- II: Self-Determination Theory.- 3. Cognitive Evaluation Theory: Perceived Causality and Perceived Competence.- 4. Cognitive Evaluation Theory: Interpersonal Communication and Intrapersonal Regulation.- 5. Toward an Organismic Integration Theory: Motivation and Development.- 6. Causality Orientations Theory: Personality Influences on Motivation.- III: Alternative Approaches.- 7. Operant and Attributional Theories.- 8. Information-Processing Theories.- IV: Applications and Implications.- 9. Education.- 10. Psychotherapy.- 11. Work.- 12. Sports.- References.- Author Index.
Choice conflicts between one's important values may cause negative emotion. This article extends the standard effort-accuracy approach to explaining task influences on decision processing by arguing that coping goals will interact with effort minimization and accuracy maximization goals for negatively emotion-laden decision tasks. These coping goals may involve both a desire to process in a thorough, accurate manner and a desire to avoid particularly distressing aspects of processing. On the basis of this extended framework, the authors hypothesized and found in 3 experiments that decision processing under increasing negative emotion both becomes more extensive and proceeds more by focusing on one attribute at a time. in particular, increased negative emotion leads to more attribute-based processing at the beginning of the decision process. The results are inconsistent with views that negative emotion acts only as an incentive or only as a source of decision complexity.
This article explores the reflexive nature of coping and consumer behavior in people who live for months or years with a heightened sense that they may die sometime in the near future. These themes were explored in the context of a diagnosis of breast cancer. The analysis shows that consumption plays a reflexive role in coping with this crisis and the uncertainty it brings. Various coping behaviors lead to consumption, but consumption can also lead to functional coping and act as a catalyst for forward thinking.
Social trust in health care organizations and interpersonal trust in physicians may be mutually supportive, but they also diverge in important ways. The success of medical care depends most importantly on patients' trust that their physicians are competent, take appropriate responsibility and control, and give their patients' welfare the highest priority. Utilization review and structural arrangements in managed care potentially challenge trust in physicians by restricting choice, contradicting medical decisions and control, and restricting open communication with patients. Gatekeeping and incentives to limit care also raise serious trust issues. We argue that managed care plans rather than physicians should be required to disclose financial arrangements, that limits be placed on incentives that put physicians at financial risk, and that professional norms and public policies should encourage clear separation of interests of physicians from health plan organization and finance.(JAMA. 1996;275:1693-1697)
Three studies investigated a boundary condition on the illusion-of-control effect (the tendency to behave as if one can control random events). Subjects wagered poker chips on the roll of a die, either to win money or to reduce the amount of time they would have to spend on unpleasant tasks. To induce illusory control, half of the subjects were allowed to choose the face of the die on which they would bet and were told they would throw the die. In addition, each chip represented either a small or large amount of money or task time. When potential costs were low, subjects with illusory control wagered more and were more confident of winning than were subjects without illusory control. When potential costs were high, illusory control had no effect on wagers or confidence. Preliminary evidence was found for a mood interpretation of these results. The illusion of control increased positive affect in both the low- and high-cost conditions. When costs were low, this positive affect may have been responsible for...