ABSTRACT
This chapter highlights a shift in medical treatment selection from a paternalistic approach, in which the physician has primary responsibility for deciding which treatment is most appropriate, to a more patient-directed one, in which the patient is actively involved in the decision process. When patients are confronted with situations in which more than one treatment option is available to treat a particular medical condition, a number of factors may be involved in the evaluative process; this chapter focuses primarily on the cognitive factors involved in these types of decisions. Perception of risk associated with various treatment alternatives, the amount and type of information provided on which to base decisions, cognitive representations of the medical condition and available treatments, and the role of personal experience and/or prior knowledge of the patient in the decision process are evaluated. Additionally, the contribution of specific cognitive abilities (e.g., memory, comprehension, verbal ability, reasoning ability, and perceptual speed) to the decision process is explored. The potential implications that age-related differences in cognitive factors have on medical care decision making are discussed.
