Research Seed Grant | 2006-2007

Risk Perception and Life and Death Decision Making in Medicine

by Kristina Orfali, Jack. M. Lorenz (Children's Hospital, New York Presbyterian) , and Pierre A. Chiappori (Economics)

The goal of our project is to analyze decision making by professionals in the context of life and death issues in medicine. We plan to concentrate on the process through which the corresponding risks (of mortality, but also of long term disability and impairment) are perceived and evaluated by physicians. The field of neonantology presents a fascinating context in which hugely important decisions have to be made on the basis of physicians' assessments of the long term consequences of various possible choices. In many cases such assessments cannot be derived from a consensual professional opinion; the situation is thus characterized by a high level of ambiguity, defined as non probabilizable randomness. This provides a unique opportunity to study risk perception and risk assessment by highly trained professionals in a life and death decision context. We shall use specially designed questionnaires in which professionals, faced with highly detailed vignette cases, will be asked to evaluate the probabilities of the various possible outcomes and indicate the decision they believe would be appropriate. In addition, they will be interviewed on their socio-demographic characteristics and their ethical values. We shall then analyze the relationships between risk perception, demographic and social characteristics and individual values. Finally, we plan to adopt a comparative approach to investigate the impact of physicians' socio-cultural environment on their attitude toward uncertainty. The availability of an identical technology in different social and institutional contexts should help identifying the convergences and differences under consideration. In practice, we plan to conduct the same study in the US and in one or two European countries