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Reflexive control in emergency medicine.

Kenneth V Iserson1

  • 1Department of Emergency Medicine, The University of Arizona, Tucson, AZ, United States of America.

The American Journal of Emergency Medicine
|April 27, 2024
PubMed
Summary
This summary is machine-generated.

External influences can manipulate emergency physicians' decisions through cognitive biases, leading to potentially harmful outcomes. Awareness and critical thinking are vital for maintaining independent, ethical patient care.

Keywords:
Cognitive biasesDecision makingEmergency physiciansEthical dilemmasExternal influencesHeuristicsPhysician autonomyReflexive control

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Area of Science:

  • Medical decision-making
  • Cognitive psychology
  • Healthcare ethics

Background:

  • Emergency physicians (EPs) operate under high pressure, relying on heuristics for rapid assessments.
  • External actors can exploit cognitive biases to influence EP decision-making, a phenomenon termed reflexive control.
  • Factors like pharmaceutical marketing and media narratives shape the information landscape EPs encounter.

Purpose of the Study:

  • To explore the mechanisms of reflexive control in emergency medicine.
  • To identify how external influences exploit cognitive biases in EPs.
  • To highlight the potential consequences of manipulated decision-making on patient care and healthcare costs.

Main Methods:

  • Analysis of cognitive biases (anchoring, confirmation, availability) exploited by external influencers.
  • Examination of influence tactics: selective data dissemination, framing, financial incentives.
  • Review of ethical implications and strategies for mitigation.

Main Results:

  • External actors utilize various tactics to exploit cognitive biases in EPs.
  • Reflexive control can lead to misdiagnoses, inappropriate treatments, and increased healthcare costs.
  • EPs may unknowingly serve external interests while believing they are acting independently.

Conclusions:

  • Emergency medicine decision-making is vulnerable to reflexive control.
  • Critical thinking, continuous education on biases, and institutional policies are crucial for EPs to resist external manipulation.
  • Safeguarding patient care requires awareness of reflexive control techniques and robust ethical frameworks.