Micro-effects of language on risk perception in drug prescribing behavior.
H. J. Bursztajn, B. Chanowitz, T. G. Gutheil and R. M. Hamm,
Bull. Amer. Acad. Psychiatry & the Law
20(1): 59-66, 1992.
The decision to prescribe neuroleptics for the treatment of psychosis involves a potentially tragic
choice between, on the one hand, a probability of psychosis and a probability of side effects, such
as tardive dyskinesia, on the other. In an experimental paradigm, we examined this decision process.
We hypothesized that linguistic factors considered irrelevant under classical formulations of
individual choice behavior would have a significant effect on this decision. All subjects were
presented with a case vignette involving a potentially psychotic patient. Subjects were then asked
what probability of tardive dyskinesia they would either "accept" or "risk" in order to prevent
psychotic decompensation. In addition this factor was crossed with a contextual factor that varied
the patient's age. The effect of "risk" versus "accept" language was evident in significantly different
patterns of decision making across age groups. The data have important implications for clinical
decision making, the elicitation of informed consent, and the directions that the courts have taken
in malpractice and patient's rights cases.