Rationality in medical treatment decisions

Is there a sunk-cost effect?

Brian H Bornstein, A. Christine Emler, Gretchen B. Chapman

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Objective: To assess residents' propensity to display the sunk-cost effect, an irrational decision-making bias, in medical treatment decisions; and to compare residents' and undergraduates' susceptibility to the bias in nonmedical, everyday behaviors. Design: Cross-sectional, in-person survey. Setting: Louisiana State University, two locations: Medical Center-Baton Rouge and Main Campus-Psychology Department. Participants: Internal medicine and family practice residents (N=36, Mdn age=27) and college undergraduates (N=40, Mdn age=20). Measurements and main results: Residents evaluated medical and non-medical situations that varied the amount of previous investment and whether the present decision maker was the same or different from the person who had made the initial investment. They rated reasons both for continuing the initial decision (e.g., stay with the medication already in use) and for switching to a new alternative (e.g., a different medication). There were two main findings: First, the residents' ratings of whether to continue or switch medical treatments were not influenced by the amount of the initial investment (p's > 0.05). Second, residents' reasoning was more normative in medical than in non-medical situations, in which it paralleled that of undergraduates (p's < 0.05). Conclusions: Medical residents' evaluation of treatment decisions reflected good reasoning, in that they were not influenced by the amount of time and/or money that had already been invested in treating a patient. However, the residents did demonstrate a sunk-cost effect in evaluating non-medical situations. Thus, any advantage in decision making that is conferred by medical training appears to be domain specific.

Original languageEnglish (US)
Pages (from-to)215-222
Number of pages8
JournalSocial Science and Medicine
Volume49
Issue number2
DOIs
StatePublished - Jul 1 1999

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physician's care
rationality
resident
Costs and Cost Analysis
Decision Making
costs
cost
Family Practice
decision making
Internal Medicine
psychology
Therapeutics
medicine
Psychology
medication
human being
decision
effect
Rationality
Residents

Keywords

  • Biases
  • Decision making
  • Medical education

ASJC Scopus subject areas

  • Health(social science)
  • History and Philosophy of Science

Cite this

Rationality in medical treatment decisions : Is there a sunk-cost effect? / Bornstein, Brian H; Christine Emler, A.; Chapman, Gretchen B.

In: Social Science and Medicine, Vol. 49, No. 2, 01.07.1999, p. 215-222.

Research output: Contribution to journalArticle

Bornstein, Brian H ; Christine Emler, A. ; Chapman, Gretchen B. / Rationality in medical treatment decisions : Is there a sunk-cost effect?. In: Social Science and Medicine. 1999 ; Vol. 49, No. 2. pp. 215-222.
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