2 Reasons Why People Don’t Complete Advance Directives.

2 Reasons Why People Don't Complete Advance Directives

2 Reasons Why People Don't Complete Advance Directives

I have been reading the new Michael Lewis book, The Undoing Project about Amos Tversky and Daniel Kahneman. Tversky and Kahneman showed how the human mind errs, systematically when forced to make judgments in uncertain situations.   Their work has shaped how we think about evidence based medicine and helped eliminate some of the early mistakes that were made in this field.

What does behavioral economics tell us about advance care planning?

Two of the issues that jump out for me are the optimism bias that people have and the framing of the role of advance care planning that professionals use when initiating the conversation.

  1. Optimism bias is when one is inclined to believe that they can get the benefits of advance care planning without completing an AD.  This might mean thinking that your spouse really knows what you want or not realizing that the default choice is more care than most people would normally choose.
  2. Framing an issue as a potential loss or a potential gain has a significant impact on a persons behavior. Instead of asking people if they have considered advance care planning we could frame the issue in terms of loss or gain.
  • Loss -  Many people say that they are concerned about being a burden to their family. If that is something you are concerned about you should consider completing an advance directive.
  • Gain – Have peace of mind that your wishes will be followed, consider advance care planning

Know of a good article about behavioral economics and medicine or advance care planning? Leave a comment below or pass it along to me at jforringer@mylivingvoice.com