Most behavioral decision research takes place in carefully controlled laboratory settings, and examination of relationships between performance and specific real-world decision outcomes is rare. One prior study shows that people who perform better on hypothetical decision tasks, assessed using the Adult Decision-Making Competence (A-DMC) measure, also tend to experience better real-world decision outcomes, as reported on the Decision Outcomes Inventory (DOI). The DOI score reflects avoidance of outcomes that could result from poor decisions, ranging from serious (e.g., bankruptcy) to minor (...) (e.g., blisters from sunburn). The present analyses go beyond the initial work, which focused on the overall DOI score, by analyzing the relationships between specific decision outcomes and A-DMC performance. Most outcomes are significantly more likely among people with lower A-DMC scores, even after taking into account two variables expected to produce worse real-world decision outcomes: younger age and lower socio-economic status. We discuss the usefulness of DOI as a measure of successful real-world decision making. (shrink)

The desire to maintain current beliefs can lead individuals to evaluate contrary evidence more critically than consistent evidence. We test whether priming individuals’ scientific reasoning...

Background: It is not known how neonatologists address the affective and cognitive loads on parents deciding whether to resuscitate infants born extremely preterm. This study explores expert neonatologists' views on these decision-making processes and their own roles in counseling parents. Methods: Semistructured interviews asked internationally recognized experts to share their perspectives on perinatal consultations. Their responses were subjected to thematic analysis. Results: Eighteen of 22 invited experts participated. Approximately equal numbers reported employing a physician-driven approach, a parent-driven approach, and a (...) combined approach during these consultations. Those who followed a physician-driven approach typically focused on conveying standard information about adverse outcomes. Those who followed a parent-driven approach typically focused on addressing parents' information requests, guiding their decision making, and providing affective support. Nearly all experts, in each group, endorsed addressing the child's quality of life, in terms of functionality, when discussing long-term outcomes. Although many believed that families adjusted to life with a disabled child, few discussed the topic during prenatal consultations. Most, in each group, reported trying to alleviate future “decisional regret” for parents whose premature infants subsequently became disabled. None spoke to parents about possible decisional regret after deciding to forgo resuscitation. Conclusions: Expert neonatologists are deeply concerned that parents understand the decision facing them. However, they differ on what information they offer and how they balance parents' need for cognitive and affective support. They expressed more concern about parents' decisional regret should their child survive resuscitation, but have severe disability, than about decisional regret after foregoing resuscitation. (shrink)

Counting casualties in conflict zones faces both practical and ethical concerns. Drawing on procedures from risk analysis, we propose a general approach. It represents each death by standard features, having either essential value, for capturing the social and cultural meaning of individual casualties, or instrumental value, for relating patterns of casualties to possible causes and effects. We illustrate the approach with the choices involved in attempts to record casualties in Iraq and the Israel-Palestine conflict, and with natural disasters, as exemplified (...) by Hurricane Katrina. We advocate institutionalizing the approach, so that recording casualties increases understanding, rather than suspicion. (shrink)

If the United States were subject to a terrorist nuclear attack, its president would face overwhelming political pressure to respond decisively. A well-prepared response could help both to prevent additional attacks and to bring the perpetrators to justice. An instinctive response could be cataclysmically ineffective, inflicting enormous collateral damage without achieving either deterrence or justice. An international security doctrine of Mutually Assured Support can make the response to such attacks more effective as well as less likely—by requiring preparations that reduce (...) the threat. The doctrine requires all subscribing nations to mobilize fully in support of the attacked nation, in return for a promise of nonretaliation. It provides a vehicle for domestic and international leadership, allowing the president to engage the American people, from a position of strength, around an issue that has had little public discussion. The authors describe its rationale, implications, and implementation. (shrink)

Early career scientists sometimes observe senior scientists engage in apparent scientific misconduct, but feel powerless to intervene, lest they imperil their careers. We propose a Secure Reporting Procedure that both protects them, when pursuing those concerns, and treats the senior scientists fairly. The proposed procedure is, we argue, consistent with the ethical principles of the scientific community, as expressed in the codes of its professional organizations. However, its implementation will require changes in procedures and regulations. Those efforts will be a (...) small price to pay for protecting the scientific community’s integrity and fidelity to its principles. We begin by describing the circumstances motivating the proposal, then sketch its design, and, finally, illustrate next steps in its application in two national settings. (shrink)