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Related Concept Videos

Decision Making01:20

Decision Making

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Decision-making is a fundamental cognitive process that involves evaluating alternatives and selecting among them. This process can range from simple choices, such as deciding what to wear, to complex decisions, like choosing a major in college or a career path. The complexity of the decision often dictates the approach we use, which can be broadly categorized into two types: automatic and controlled decision-making.
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The human brain processes information for decision-making using one of two routes: an intuitive system and a rational system (Epstein, 1994; popularized by Kahneman, 2011 as System 1 and System 2, respectively). The intuitive system is quick, impulsive, and operates with minimal effort, relying on emotions or habits to provide cues for what to do next, while the rational system is logical, analytical, deliberate, and methodical. Research in neuropsychology suggests that the...
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Decision Making: Traditional Method01:14

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Ethical Dilemmas II01:30

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The Availability Heuristic01:08

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A heuristic is a general problem-solving framework (Tversky & Kahneman, 1974). You can think of these as mental shortcuts that are used to solve problems. Different types of heuristics are used in different types of situations, and the impulse to use a heuristic occurs when one of five conditions is met (Pratkanis, 1989):
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Decision Making: P-value Method01:09

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Related Experiment Video

Updated: May 4, 2026

The Adventures of Fundi Intervention Based on the Cognitive and Emotional Processing in Attention Deficit Hyperactive Disorder Patients
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Decision-making capacity should not be decisive in emergencies.

Dieneke Hubbeling1

  • 1Wandsworth Crisis and Home Treatment Team, South West London and St. George's Mental Health NHS Trust, 61 Glenburnie Road, London, SW17 7DJ, UK, dieneke@doctors.org.uk.

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Patients with decision-making capacity who refuse life-saving treatment pose ethical dilemmas. This study proposes limited compulsory treatment in emergencies for patients with anorexia nervosa, depression, or borderline personality disorder.

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Area of Science:

  • Medical Ethics
  • Clinical Psychology
  • Psychiatry

Background:

  • Patients with conditions like anorexia nervosa, depression, and borderline personality disorder may refuse necessary treatment despite having decision-making capacity.
  • This refusal is often ethically challenging due to the severe consequences and potential influence of the illness on the patient's wishes.

Purpose of the Study:

  • To explore ethical challenges in respecting treatment refusal by patients with decision-making capacity.
  • To evaluate existing proposed solutions and introduce a novel approach for managing such cases.

Main Methods:

  • Discussion of clinical examples and ethical considerations.
  • Analysis of proposed solutions, including broadening capacity criteria and considering prior preferences.
  • Proposal of a new framework for compulsory treatment in emergency situations.

Main Results:

  • Existing solutions for assessing decision-making capacity in complex cases have limitations.
  • Broadening capacity criteria may lead to discrimination and reduced transparency.
  • Information on patient preferences during non-ill states is often unavailable.

Conclusions:

  • A time-limited compulsory treatment for patients with decision-making capacity is proposed for life-threatening emergencies when refusal poses a severe risk.
  • Investigating hindsight agreement after compulsory measures is recommended.
  • This approach aims to balance patient autonomy with the need for urgent medical intervention.