A worldwide trend among health care providers is to empower consumers with the responsibility of making medical decisions for themselves. The argument is that informed consent supports ethical patient interactions, increases compliance with the expert’s advice, and relieves providers of blame for flawed outcomes.
Researchers at Erasmus University and University of Navarra outlined the process as beginning with a statement of major options: “Here are two possible courses of action.” Next, the provider describes tradeoffs (“The downside of option X is….”) or fit with the consumer’s characteristics (“I believe option Y is compatible with your preferences because….”). The full process concludes with the decision assigned to the consumer: “We’ve discussed the options, and I’ve answered your questions. Please make your choice when you are ready.”
Consumer psychologists view this as empowerment because power is defined as an individual’s control over resources and outcomes. Concerning the medical decisions analyzed by the researchers, the resource is information. But the researchers found that the empowerment from information can lead to bad outcomes.
The study sample was certainly comprehensive, including a total of 11,735 respondents in 17 countries spanning a total of four continents. The study conclusion was that the amount of information necessary for true informed consent often disrupts adherence to expert advice. One way in which this happens is that an abundance of information overloads the consumer’s reasoning and emotions, resulting in unintentional non-adherence. Another way it happens is that the wealth of information bestows overconfidence, leading the consumer to subsequently listen less well to qualified experts and discount expert views different from their own premature conclusions.
Researchers at University of Texas-Arlington and University of Calgary find that empowered consumers of products and services in realms other than health care also fail to adhere to expert advice. In fact, the consumers rebel against the advice. If they feel confident in their conclusions, the rebellion arises from a desire to see themselves as self-sufficient shoppers. If the consumers feel less than high confidence in their conclusions, the rebellion reflects a drive for independence in the face of uncertainty.
Both sets of researchers say this downside of consumer empowerment can be alleviated by giving decision makers information only as they ask for it. It’s the overload which triggers the effects. Still, the wise provider will also check for degree of compliance with expert advice when the consequences of flawed decisions could be serious.
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