FEAR

Fear and anxiety can alter decision making in a wide range of domains, not least of all decisions about one's own health or the health of patients under a physician's care. Past research has demonstrated this influence, including in medicine. Understanding the impact that these basic emotions have on medical decisions, particularly those involving risky and uncertain options, is essential to understanding medical decision making and building accurate predictive models of choice. Traditional economic models of decision making, such as expected utility theory, propose that patients and physicians weigh decision options rationally and choose an action based on the likelihood and the payoff of outcomes. These models rarely include psychological influences on behavior, particularly the emotional ones. In the medical context, an important omission from these models is the effect of patients' and physicians' emotions as they weigh the options associated with treating a serious medical condition and choose an action. Patients and physicians must consider the possible consequences of treatment decisions, and how likely these would be to occur. Decisions involving risky, uncertain outcomes are especially susceptible to the influence of emotions such as anxiety. Anxiety is common in patients with serious illness who must make risky treatment decisions with major consequences: death, functional disability, diminished quality of life and psychological well-being. Their fear and anxiety can significantly alter their decisions. Both patients and physicians can be affected by fear and anxiety when making these decisions.