How defaults increased comfort-oriented end-of-life care by 16%

IndustryHealthcare
Reading time6 min read

Abstract

When confronted by a decision that has a default option, unless we have strong preferences on the matter, we will probably take the path of least effort and go with the default. Strong preferences form when we are able to observe the outcome of a decision and adjust our preferences accordingly. This trial and error process may not matter for menial decisions, but what about significant once in a lifetime decisions? 

In this study, researchers wanted to find out how default options influence terminally ill patients’ end-of-life care decisions. Seriously ill patients were given one of three advance directives to complete. One had comfort-oriented care as the default, the other had life-extending care as the default, and the third did not have a default selected. The results show that seriously ill patients’ decisions on end-of-life interventions are heavily influenced by default options.

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Sources

  1. Baker, R., Mason, H., & McHugh, N. (2018, May 31). UK spends generously to extend the lives of people with terminal illnesses – against the public’s wishes. The Conversation. https://theconversation.com/uk-spends-generously-to-extend-lives-of-people-with-terminal-illnesses-against-the-publics-wishes-96562
  2. Halpern, S. D., Loewenstein, G., Volpp, K. G., Cooney, E., Vranas, K., Quill, C. M., McKenzie, M. S., Harhay, M. O., Gabler, N. B., Silva, T., Arnold, R., Angus, D. C., & Bryce, C. (2013). Default options in advance directives influence how patients set goals for end-of-life care. Health Affairs, 32(2), 408-417. https://doi.org/10.1377/hlthaff.2012.0895
  3. Kaiser, M., Bernauer, M., Sunstein, C. R., & Reisch, L. A. (2020). The power of green defaults: The impact of regional variation of opt-out tariffs on green energy demand in Germany. SSRN Electronic Journal. https://doi.org/10.2139/ssrn.3646280
  4. Araña, J. E., & León, C. J. (2012). Can defaults save the climate? Evidence from a Field experiment on carbon offsetting programs. Environmental and Resource Economics, 54(4), 613-626. https://doi.org/10.1007/s10640-012-9615-x
  5. Bettinger, E., Long, B. T., Oreopoulos, P., & Sanbonmatsu, L. (2009). The role of simplification and information in college decisions: Results from the H&R block FAFSA experiment. https://doi.org/10.3386/w15361
  6. Cox, J., Kreisman, D., & Dynarski, S. (2018). Designed to fail: Effects of the default option and information complexity on student loan repayment. https://doi.org/10.3386/w25258
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