Why death for oneself, suffering for others?

Doctors in a study preferred treatments with more chance of death over those with more chance of suffering for themselves more often than for their patients. Robin hypothesises*:

Avoiding death is a primary goal of medicine. Avoiding side effects of treatment is a secondary goal.  So it makes sense that in a far mode doctors emphasize avoiding death, but in nearer mode avoiding side effects matters more

An alternative hypothesis*: the vividness of death doesn’t increase as much as that of suffering in near mode because it is relatively hard to imagine in detail. It basically consists of you not being there, which is pretty nonspecific with regards to other details, and the details you can picture are not ones you have ever experienced or anticipate experiencing. Suffering on the other hand is a very familiar experience with details generally considered too vividly memorable. Particularly when the suffering is of a specific kind, such as the chronic diarrhea used in the study. I expect most people can picture chronic diarrhea in much more horrible detail than they can ceasing to exist.

How to tell between these hypotheses? I expect advisors make the same kinds of trade offs for themselves and others in situations where avoiding death and avoiding injury both seems like secondary goals, for instance in sports coaching and military tactics.

*Based on construal level theory – the idea that we think differently about things that are near and far from us. See more about how we think differently here. See also the potential relevance of this to cryonics, procrastination and euphemisms.

11 responses to “Why death for oneself, suffering for others?

  1. Nice story. I don’t think anyone wants to die really. Immortality is the ultimate cure for death really.
    Check me out at http://www.imdb.com/name/nm4388327/

  2. Pingback: Overcoming Bias : Avoiding Death Is Far

  3. Mitchell Porter

    Doctors are held accountable for what happens to their patients. The death of the patient is generally regarded as the bad outcome, and can lead to lawsuits. But doctors can take greater risks when it’s just their own life at stake. So near/far may have nothing to do with this.

    • Yeah but why would they prefer to avoid suffering rather than death in the first place? Katja’s hypothesis explains this, while Robin’s doesn’t.

      I actually think her theory is more general than his. Death is just Far, whether in yourself or in others (but to various degrees of course). When treating others, *both* death and avoiding side effects are Far. After all, that death is Far doesn’t mean avoiding side effects is not as well. So you still need to explain why in medicine and Far mode, death trumps suffering, but I guess this is not so difficult since if you think about it, it is usually considered worse to die.

      Katja says:

      I expect advisors make the same kinds of trade offs for themselves and others in situations where avoiding death and avoiding injury both seems like secondary goals.

      What matters is the *relative* (Far) importance of death vs. suffering. Not whether they are primary or secondary goals. If the Far importance of death trumps that of suffering enough, then you will see differing behavior in Far vs. Near modes, because in Near mode, suffering trumps death. For example, in others vs. oneself, in your far future vs. in your immediate future. There is more than one way to be Far, when something concerns other people, or when it concerns you but in the future.

      I predict that if you gave someone the option to precommit to a certain kind of treatment in a future event of life threatening disease, they would be more likely (than when they make the decision impromptu) to choose the treatment with less chance of death and more chance of suffering.

      • I predict that if you gave someone the option to precommit to a certain kind of treatment in a future event of life threatening disease, they would be more likely (than when they make the decision impromptu) to choose the treatment with less chance of death and more chance of suffering.

        I’d be interested in seeing this tested. I personally wouldn’t be willing to precommit to too much suffering, but this is an area where I don’t trust my preferences to reflect the norm.

    • That was my basic hypothesis as well.

      Dead patient gets you sued, especially when there’s a “safer option” in the accepted standards of care, even if it involves more likely-but-non-fatal negative side effects.

      (Potentially) Suffering patient has no effect on your career or personal life – at least if the suffering is in accord with the established standard options for treatment.

      When it’s you, you can run the calculus differently, because if you die, there’s no worries about your next of kin suing you for your death…

      The risk/reward calculus is simple enough at a purely economic level.

  4. As for the original topic, it’s worth keeping in mind that if a doctor lets too many patients die, the patients’ friends and family may not like it and may find a way to punish the doctor. Whereas if you let yourself die (to avoid suffering), your friends and family might not like it either, but you won’t experience their displeasure.

  5. It looks that the 2 questions used in the study are just tools for the higher purpose of learning. Sadly, the AP writer couldn’t wipe off his head the word “deadly”. It doesn’t really matter if one alternative is deadlier than the other one. What matters is the difference and where it comes from.

    From a very complex decision such as choosing a medical treatment for patient illness, why do we focus only on the treatment deadliness/suffering? Are these the only factors involved in such decision? What about patient age, physical condition, previous illness, available medical equipment, medical knowledge, money , etc? Also, in the article it is not mentioned which one of the alternatives is right now the medical consensus. Maybe doctors prescribe for patients based on consensus (not appearing as wrong if faced by community) and prescribe the “right thing” for themselves. By the “right thing” I mean what they consider the best based on their knowledge.

    This study is useful for doctors to show other doctors that they are just normal human beings prone to bias and failure. That they must be more careful when assessing medical treatment. That choosing medical treatment could be (even) more systematical and transparent process to the pacient, rather than just trusting blindly in doctor’s judgement. However, it is kind of wrong to extrapolate these results into the idea that doctors choose dead for themselves.

  6. Thanks – where is article source?

  7. Since this community has shown a strong interest in applying construal-level theory, I hope it is appropriate to call your attention to my posting linking construal level to global versus sequential learning styles. “You, too, have an optimal sentence length.” (http://tinyurl.com/7faf9nz)

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