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Darren Dahl (Editor in Chief)Eileen FischerGita JoharVicki Morwitz

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Tragic Choices: Autonomy and Emotional Responses to Medical Decisions

Simona Botti, Kristina Orfali, Sheena S. Iyengar
DOI: http://dx.doi.org/10.1086/598969 337-352 First published online: 1 October 2009


We investigate how making highly consequential, highly undesirable decisions affects emotions and preference for autonomy. We examine individuals facing real or hypothetical decisions to discontinue their infants' life support who either choose personally or have physicians choose for them. Findings from a multidisciplinary approach consisting of a qualitative analysis of in-depth interviews and three laboratory studies reveal that perceived personal causality for making tragic decisions generates more negative feelings than having the same choices externally made. Tragic decisions also undermine coping abilities, weakening the desire for autonomy. Consequently, participants disliked making decisions but also resented relinquishing their option to choose.

  • Affect/Emotions/Mood
  • Choice (Brand or Product Level)
  • Judgment and Decision Making
  • Public Policy Issues
  • Depth/Long Interviews
  • Ethnography
  • Experimental Design and Analysis (ANOVA)
  • Grounded Theory

I wanted them to decide—doctors I had never met before. … I could not bear the possibility of making the wrong call. Even if I made what I was sure was the right choice for her, I could not live with the guilt if something went wrong. (Gawande 2002)

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