[Perspectives] Deciding with, not for

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Source: The Lancet

Original: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00156-X/fullt...

Published: 2026-01-31

People show an omission bias in medical decisions, preferring passive non-intervention to active interventions such as vaccination, even though these reduce risk.[2][3] The study tested whether preferences for active interventions increase when making decisions for others versus oneself.[1][3] Participants assumed four roles: a patient, a physician treating a patient, a medical director creating guidelines, or a parent making a decision for a child, and evaluated scenarios about a fatal flu shot and treatment for a slow-growing cancer.[3] Of the 2399 participants, more were willing to choose active treatments in the roles of physician (vaccination 73%, chemotherapy 68%) or director (vaccination 63%, chemotherapy 68%) than as patients (vaccination 48%, chemotherapy 60%).[3] Similarly, parents preferred vaccination in 57% and chemotherapy in 72% versus 48% and 60% of patients, respectively.[3] Emotional reactions were stronger in responsible roles and associated with a lower tendency to omit.[3] The authors recommend reframing decisions so that patients consider the situation from another's point of view, which promotes a better understanding of the risks.[1][2]