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The application of new technologies to improve literacy among the general public and to promote informed decisions in genomics
Published in Ulrik Kihlbom, Mats G. Hansson, Silke Schicktanz, Ethical, Social and Psychological Impacts of Genomic Risk Communication, 2020
Serena Oliveri, Renato Mainetti, Ilaria Cutica, Alessandra Gorini, Gabriella Pravettoni
Often, individuals tend to overestimate the impact that future (especially negative) emotional events might have on their psychophysical well-being (Shatz et al. 2015): such a tendency is called impact bias. Impact bias, in anticipation of future emotional states, often leads to an overestimation of the perceived risk, both by the patient (affective forecasting bias) and by the doctor, who anticipates his own emotional state (emphatic forecasting bias), characterized by excessive risk aversion. Furthermore, the future anticipation of an excessive emotional intensity referred to one’s own health conditions, is higher in healthy subjects than in actually affected subjects, who, for example, have already been diagnosed with a life-threatening condition (disability paradox). In general, patients tend to overestimate the emotional impact of a positive result (detected mutation) of a genetic test. Evidence in literature reveals that the individual’s level of stress peaks immediately after having received the genetic results for an increased risk of cancer, but the stress returns to normal levels over time (Lerman et al. 2002; Peters et al. 2013). The impact bias might partially explain the underutilization of predictive genetic tests by family members of a proband already classified as being ‘at-risk’.
Paternalism and the practitioner/patient relationship
Published in Kalle Grill, Jason Hanna, The Routledge Handbook of the Philosophy of Paternalism, 2018
A different autonomy-based consideration that can motivate medical paternalism is the idea that the patient is unable to make an autonomous decision because her decision-making process is in some way non-rationally influenced. Empirical studies have indicated that often a patient’s decision can be non-rationally influenced by one or more cognitive biases.12 Patients awaiting a kidney transplant, for example, have been shown to be susceptible to “impact bias,” significantly overestimating the improvement to their quality of life with a transplant (Smith et al. 2008). This is problematic insofar as this overestimation non-rationally influences their decision to undergo treatment such that they would not have pursued the treatment had they known that it would not improve their quality of life very much. Patients have also been shown to be bad at making judgments about the riskiness of various treatment options (Gilovich, Griffin, and Kahneman 2002; Lloyd 2001) and other studies have indicated that whether or not a patient consents to or refuses treatment can be non-rationally influenced by the way in which the information about her treatment options is presented to her. Individuals react differently, for instance, to being told that a medical procedure carries a 10% chance of death than they do to being told there is a 90% chance of survival (McNeil et al. 1982).
An evaluation of newborn hearing screening brochures and parental understanding of screening result terminology
Published in International Journal of Audiology, 2023
Erin M. Picou, Sarah N. McAlexander, Brittany C. Day, Karina J. Jirik, Alison Kemph Morrison, Anne Marie Tharpe
Furthermore, the questionnaire in the current study evaluated expected, self-reported anxiety. It is not clear how parents whose babies did not pass the newborn hearing screening would actually feel in response to a “refer” or a “did not pass” result. Human ability for affective forecasting, or the ability to predict emotion in a future event, is notably influenced by current affective state (Gilbert, Gill, and Wilson 2002; Kramer et al. 2017; Loewenstein, O'Donoghue, and Rabin 2003). In addition, people tend to overestimate the intensity of an affective reaction to imagined events (Wilson and Gilbert 2005). This phenomenon, termed “impact bias,” has also been reported in pregnant people, for example, in preparation for amniocentesis (Ferber et al. 2002). Collectively, previous data suggest parents’ actual anxiety might be different than their imagined anxiety, thus, posing a limitation to the current study.
Brief online implicit bias education increases bias awareness among clinical teaching faculty
Published in Medical Education Online, 2022
Janice Sabin, Grace Guenther, India J. Ornelas, Davis G. Patterson, C. Holly A. Andrilla, Leo Morales, Kritee Gujral, Bianca K. Frogner
As we expected, exposure to the course, Implicit Bias in the Clinical and Learning Environment, resulted in increased bias awareness among academic healthcare providers. Our hypothesis that the strength of provider implicit bias would impact bias awareness change was not supported. An important contribution made by this study is that exposure to the course content increased providers’ bias awareness, even among this motivated and engaged sample of providers, regardless of provider race or gender biases and personal and practice characteristics. We conclude that the meaningful course content and brief online format can be useful to increase bias awareness among healthcare providers regardless of their biases or other characteristics. Increased awareness is a critical component of implicit bias education aimed at increasing healthcare equity [21]. Future research is needed with a nationally representative sample of academic providers who teach to determine whether implicit bias education can impact all providers’ awareness of bias.
Transitions of care
Published in Medical Teacher, 2020
Leah Roberts, Benjamin A. Bensadon
Diverse population health needs have led the academic medical community to respond with unprecedented changes. The clinical relevance of cultural competence and psychosocial aspects of health and illness are now formally recognized, as are clinician bias, burnout, and their iatrogenic behavioral expression via academic medicine’s “hidden curriculum” (Gaufberg et al. 2010). The following narrative from a third-year medical student offers a detailed, first-hand account of the mixed messages and disorienting “double bind” (Ferreira 1960) many learners encounter during their clinical education, where humanistic instincts are overpowered by a hierarchical training culture of fear-based conformity (Beran et al. 2014) and silence (Caldicott and Faber-Langendoen 2005). But unlike most published examples, it illustrates not only the traumatic psychological impact bias in medical training can create, but the protective buffer that faculty recognition and intervention can provide. With adequate emotional support and processing, medical students’ empathy erosion (Hojat et al. 2009) is far from inevitable, and transition from silent observer to empowered advocate quite feasible.