The caesarean section decision: Patients' choices are not determined by immediate emotional reactions

SummaryOne hundred and seven women performed a lottery test to determine at what excess risk of fetal death associated with labour they were indifferent about whether they underwent elective caesarean section, assuming no excess maternal mortality. The results ranged from a fetal risk of 0.05 or less per 1000, to 250 per 1000. A subgroup of women who had requested home delivery were indifferent at higher risks and one of pregnant women at slightly lower fetal risks. In 36 cases the degree of interference in a colour naming task by two groups of emotionally significant words (bad outcome and medical intervention words, respectively) was also measured. Interference in colour naming occurred with both groups of words, but the ratio between the degree of interference by bad fetal outcome words and that by medical intervention words did not correlate with the levels of indifference on the lottery. This suggests that for most people expressed utilities are not determined by immediate emotional responses.

[1]  G. Torrance Measurement of health state utilities for economic appraisal. , 1986, Journal of health economics.

[2]  F P McKenna,et al.  Colour naming of phobia-related words. , 1986, British journal of psychology.

[3]  M. Weinstein,et al.  Clinical Decision Analysis , 1980 .

[4]  A. Tversky,et al.  On the elicitation of preferences for alternative therapies. , 1982, The New England journal of medicine.

[5]  J. Neumann,et al.  Theory of games and economic behavior , 1945, 100 Years of Math Milestones.

[6]  H. Hoffman,et al.  Cesarean section and subsequent fertility: results from the 1982 National Survey of Family Growth. , 1985, Fertility and sterility.

[7]  J. Williams,et al.  Distraction by emotional stimuli: use of a Stroop task with suicide attempters. , 1986, The British journal of clinical psychology.

[8]  R. Lilford,et al.  Management of the selected term breech presentation: assessment of the risks of selected vaginal delivery versus cesarean section for all cases. , 1987, Obstetrics and gynecology.

[9]  J. A. Freiman,et al.  Prophylactic cesarean section at term. , 1985, The New England journal of medicine.

[10]  A. Gupta,et al.  PLACENTA PREVIA AND PREVIOUS CESAREAN SECTION , 1981, Acta obstetricia et gynecologica Scandinavica.