Decisional autonomy undermines advisees' judgments of experts in medicine and in life.

Autor:	Kassirer S; Kellogg School of Management, Northwestern University, Evanston, IL 60208; samantha.kassirer@kellogg.northwestern.edu., Levine EE; Booth School of Business, University of Chicago, Chicago, IL, 60637., Gaertig C; Booth School of Business, University of Chicago, Chicago, IL, 60637.
Jazyk:	angličtina
Zdroj:	Proceedings of the National Academy of Sciences of the United States of America [Proc Natl Acad Sci U S A] 2020 May 26; Vol. 117 (21), pp. 11368-11378. Date of Electronic Publication: 2020 May 07.
DOI:	10.1073/pnas.1910572117
Abstrakt:	Over the past several decades, the United States medical system has increasingly prioritized patient autonomy. Physicians routinely encourage patients to come to their own decisions about their medical care rather than providing patients with clearer yet more paternalistic advice. Although political theorists, bioethicists, and philosophers generally see this as a positive trend, the present research examines the important question of how patients and advisees in general react to full decisional autonomy when making difficult decisions under uncertainty. Across six experiments ( N = 3,867), we find that advisers who give advisees decisional autonomy rather than offering paternalistic advice are judged to be less competent and less helpful. As a result, advisees are less likely to return to and recommend these advisers and pay them lower wages. Importantly, we also demonstrate that advisers do not anticipate these effects. We document these results both inside and outside the medical domain, suggesting that the preference for paternalism is not unique to medicine but rather is a feature of situations in which there are adviser-advisee asymmetries in expertise. We find that the preference for paternalism holds when advice is solicited or unsolicited, when both paternalism and autonomy are accompanied by expert guidance, and it persists both before and after the outcomes of paternalistic advice are realized. Lastly, we see that the preference for paternalism only occurs when decision makers perceive their decision to be difficult. These results challenge the benefits of recently adopted practices in medical decision making that prioritize full decisional autonomy. Competing Interests: The authors declare no competing interest.
Databáze:	MEDLINE
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