Contributor: Emily Azari – Senior Health Writer, Emmi Solutions
In my last post, we began exploring the cognitive biases (unconscious errors in thinking) that come into play when choosing whether or not to pursue prenatal genetic screening for conditions like Down syndrome. Today I’ll cover two more biases we considered as we developed a decision aid to help women wrestle with that choice.
Present focus bias
We have a hard time imagining and planning for our future selves. This is, of course, why hangovers and credit card debt exist. This “present focus bias” gets in the way of all sorts of responsible health behaviors that have long-term benefits with short-term cost (think exercise, eating salads, and getting check-ups).
What does this have to do with the decision to pursue prenatal genetic testing? Well, you might be pretty good at anticipating how your decision will affect you in the near term, but most people won’t be able to imagine what it would actually be like in the future to raise a child with Down syndrome. This could cut two ways:
- You might figure there’s just no way that you could cope with a child with special needs, when in fact people are extraordinarily resilient, time and time again displaying a capacity to rise to unexpected life challenges
- In contrast, you might assume that raising a child with special needs is not terribly burdensome. But you might not be fully grasping the lifelong issues involved, and it’s hard to imagine yourself in those shoes 30 years from now
Our decision aid tries to help women break out of this present focus tunnel vision. We encourage them to take the time to learn what life is like for families of children with special needs. When thinking through her options, we ask her to consider how the decision would affect the child, herself, and other family members over the long-term — emotionally, physically, and financially.
Part of the reason it’s so hard to imagine different future scenarios is something called “representative thinking,” where we assume what we know is reflective of an entire category. Continue Reading »