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The picture in the frame
Published in John Spiers, Philip Booth, Who Decides Who Decides?, 2018
What do first principles tell us about the picture in the frame? What is ‘the framing effect’? They help us to ask the right questions, to take a view of what might count as answers, and to look for these among the following interlinked questions:
Culture and ethics in healthcare
Published in Andrew Papanikitas, John Spicer, Handbook of Primary Care Ethics, 2017
Most real human dilemmas are complex because they occur within actual cultures which determine the form of the question. So, in our own culture, in a world where our evidence base is known to be systematically biased in favour of pharma, to what extent am I obliged to advise treatments favoured by official guidelines if they go against my patients’ initial preferences?19 Should I give my patients medical advice based on relative risk reduction or on number needed to treat, knowing that the framing effect is a major determinant of patient response?20 Should I do more out-of-hours sessions because they are short-handed, or because I need the money, or should I refuse because my family needs me?
Cognition, Language and Intelligence
Published in Rolland S. Parker, Concussive Brain Trauma, 2016
Decision making, as a complex cognitive activity, is affected by the integrity of neurological functioning. Our choices are subject to a framing effect, that is, the manner in which the options are presented. Its association with amygdala activity indicates a role for emotion in decision making. The orbital and medial PFC integrates input from the amygdala, allowing evaluation of the incentive value of various outcomes, which guides future behavior. Those with a better representation of their own emotional biases may be able to modify their behavior, thus avoiding suboptimal behavior. However, reduced susceptibility to the framing effect accompanies orbital and medial prefrontal cortical activity (De Martino et al., 2006). Effective decision making involves evaluating the expected benefits of an action, as well as the costs incurred to obtain them. Examples of costs are time, effort, the risk that a reward may not be forthcoming, or the requirement to endure pain. Yet the components of decision making may be unspecified in the mind of the decision maker. The mind may be made up at an unconscious level, even if the claim is that no decision has been made. Automatic associations may predict future choices. These are associations that come to mind unintentionally, are difficult to control after being activated, and may not be endorsed consciously. After a time, biased processing brings future choices into line with existing automatic associations: Minds are made up although the person does not yet know it (Galdi et al., 2008).
A representation of students with intellectual disabilities in South Korean online newspaper articles using keyword network analysis
Published in International Journal of Developmental Disabilities, 2023
Media is one of the important ways of forming and maintaining people’s social attitudes toward a particular group in society. Media has such an influence because it serves as an interpretative schema that applies to classifying and interpreting information to the public according to how the media emphasizes and reports on a specific topic (Goffman 1974, Ryu 2018). This is called news framing which can be described as three models: framing effect, agenda-setting effect, and priming effect (Scheufele and Tewksbury 2007). First, the framing effect assumes that the way the audience understands can be affected by how the media has characterized the issue in the report. Second, agenda setting assumes that repetitive reports on specific issues will lead the public to perceive these issues as important. Last, priming effect assumes that the information exposed to the media can be used as a basis for evaluation in the decision-making process of related issues. These effects can be formed by various factors such as politics, economy, society, culture that can lead to various changes. Public’s social perception of people with IDs can also be influenced by the media’s representation of them, which can lead to changes of related policies and services (Jo and Berkowitz 1994, Wilkinson and McGill 2009). Therefore, a review of the media on people with IDs can provide useful information to understand the public’s social perspectives as well as how the media has potential to promote inclusiveness.
In Defense of Nudging When the Stakes Are High
Published in The American Journal of Bioethics, 2019
Monica E. Lemmon, Peter A. Ubel
Finally, the impact of individual nudges on patient decision making in actual patient encounters is messy. It is hard to know whether various forms of nudging actually influence patient or surrogate decision making in real time, especially when competing methods of influence are happening in a single encounter. For example, Engelen is very concerned about survival versus mortality risk framing, which he states has a strong, unconscious influence on people’s decisions. But data from real-world clinical encounters show that physician recommendations have much more influence on patients’ decisions than any kind of framing effect (Scherr et al. 2017). Siminoff and Fetting highlighted the relative unimportance of framing in their analysis of 100 conversations between physicians and breast cancer patients making decisions about adjuvant therapy. The authors hypothesized that patient treatment decision would hinge on whether information was presented in a positive (survival or cure) or negative (disease recurrence) frame. Instead, they found no association between the type of frame and treatment decision. Physician recommendation was the single strongest predictor of a woman’s decision; treatment choice aligned with physician recommendation 80% of the time (Siminoff and Fetting 1989). Perception of recommendation strength further influenced whether patients accepted the recommendation of their physician or not; women who perceived the physician recommendation to be weak were more likely to make a different choice (Siminoff and Fetting 1991).
What’s in a Name? How “Deep Brain Stimulation” May Influence Patients’ Perceptions
Published in AJOB Neuroscience, 2018
The framing effect occurs when people respond to the same set of choices differently based on the way that the choices are described (Tversky and Kahneman 1981). It is one of the many ways in which human beings systematically deviate from rational decision making on account of psychological tendencies or cognitive biases. Researchers from various disciplines, such as behavioral psychology and behavioral economics, have developed a number of studies that have both established the prevalence of the effects and identified factors that enhance or minimize the effects (Piñon and Gambara 2005). For example, in one now-classic study, participants were given a description of a scenario in which they had to prepare for an outbreak of an unusual disease expected to kill 600 people (Kahneman and Tversky 1981). Participants were given the choice of two programs as a response to the outbreak, but the two programs were described differently to different groups of participants. When a program was described positively in terms of the number of lives saved (“200 people will be saved”), 72% of participants selected this program. When the equivalent program was described in terms of lives lost (“400 people will die”), only 22% of participants selected the program—even though these options resulted in the same outcome. This suggested that an individual’s perception of the efficacy or attractiveness of each option can be altered by merely adjusting the description of the option without adjusting the option itself Tversky and Kahneman 1981; Kahneman and Tversky 1984).