Developmental Theories

Developmental theories concern changes that occur over the lifespan as a result of maturation and experience. The nature of decision making shifts as children become adolescents and, as more recent research shows, as adolescents become adults and adults age. Two major theories of decision making are discussed that are also theories of development: the prototype/willingness model and fuzzy-trace theory. When discussing decision making in a medical context, it is important to keep in mind the key concepts of risk perception and informed consent (including issues of autonomy). How these theories address each of these issues and their implications for development and rationality are discussed.

In discussing what rationality in decision making is, it important to note two approaches offered as criteria: coherence and correspondence. The coherence criterion for rational decision making is that a decision is rational if the process used is internally consistent. For example, decision makers use a logical rule to combine their assessments of the costs and benefits of each option. Furthermore, the choice made must reflect the decision makers' goals. This coherence criterion is what is traditionally referred to when a process is described as rational. For the coherence criterion, the outcome of the decision is not involved in denoting a decision as rational. The correspondence criterion argues that outcomes do matter. To the extent that the decisions made correspond with good outcomes in reality (e.g., they cause no harm to the decision maker or to others), the decision can be considered rational. Researchers who focus on the health of children and youth often emphasize positive outcomes. However, coherent reasoning is also relevant for issues such as whether young people are capable of giving informed consent for medical treatments.

The two theories discussed here are dual-process theories of decision making. These theories argue that there are two ways in which a decision maker can arrive at a decision. One process is rational (in the traditional sense) and analytic. This process involves the decision maker combining relevant factors using a logically defensible decision rule; behavior resulting from this process is a planned and intentional action. The other process is described as intuitive. This process is quick and does not involve deliberation. Although both theories are similar in that they propose a dual-process distinction, they differ in what is proposed for developing and what is considered rational. Crucially, intuition in prototype/willingness theory is developmentally primitive, whereas intuition in fuzzy-trace theory characterizes advanced thinking.