Take Comfort in the Comfort of Bad News

“Imagine you are suffering from appendicitis, which could be fatal if the appendix ruptures. The only treatment is surgical removal of the appendix. You visit your doctor. She runs a new type of blood test that will determine your risk of appendix rupture. The test will return a score between 1 and 7. A score of 4 or higher indicates you are at 'High Risk' and medical guidelines recommend surgery. A score below 4 indicates you are at 'Intermediate Risk' and it is unclear whether or not surgery is necessary. You will have to decide how to proceed.”
     Those were the instructions given to participants by researchers at Ramon Llull University and Harvard University. Some of the participants were then asked whether they’d prefer to receive from the blood test an intermediate risk score of 3.5 or a high risk score of 4.5. Nearly 40% of that group said they’d prefer to receive the high risk score. They’d prefer to have a high risk of appendix rupture than an intermediate risk.
     The explanation, say the researchers, resides in that phrase in the instructions, “You will have to decide how to proceed.” The high-risk score eased a difficult decision. In other conditions of the study, only 14% of those presented two high-risk scores and only 6% of those presented two intermediate risk scores said they’d prefer the higher of the scores.
     Accompanying studies yielded parallel results for other difficult decisions and gave further insight about the motivation. Some participants were instructed to imagine the score was either 2.5 or 5.5 and they’d chosen to have the surgery, but afterwards were told the surgery had actually been unnecessary. How regretful would the person feel about their decision? Much less when the blood test result had been worse, it turned out. The high score reduced feelings of personal responsibility for a questionable choice.
     Notice that in the earlier study, most people—about 60%—said they’d prefer the intermediate-risk blood test score. This preference for worse news in order to lessen subsequent responsibility depends on an individual’s personality, the nature of the decision, and the context in which the decision is made. Still, health care professionals and others who understandably find it stressful to deliver bad news might take comfort in knowing that when the truthfully bad news eases responsibility, the consumer might actually appreciate it. Delegating a consequential decision often is welcomed

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