Value Functions in Domains of Gains and Losses

Many medical situations incorporating gains and losses involve exchange of present-day costs for future benefits. In our era of chronic illness, with antecedents often distant in time, decision making by physicians or patients is frequently influenced in a significant manner by the principles and practice of discounting. Positive discounting is the term for diminishing value over time. A more diversified use becomes important as we attempt to refine decision models. Temporal effects in the medical preventive context include overeating, smoking, and drinking. Another example is investment in calcium intake or vitamin D to prevent fractures because of osteoporosis.

These are situations where there is a choice between immediate pleasures and the future benefits of good health. The benefits of behavioral change often occur so far in ...