Thursday Review: “Slowing Down Fast Thinking to Enhance Understanding”

Daniel Kahneman and Amos Tversky more or less invented what we now call Behavioral Economics. Tversky passed away in 1996, but Kahneman went on to win the Nobel Prize and his 2011 bestseller, Thinking, Fast and Slow, brought their work to the general public. The big question Kahneman continuously answers in the book is, “How is it possible that we can make decisions that aren’t in our best interest?”

Bringing fast and slow thinking into medicine, Edmund G. Howe describes how he took Kahneman’s ideas and used them to guide patients through difficult decisions in The Journal of Clinical Ethics.

In his article, Howe makes useful and sincere applications to medical ethics and patient care. Going through his work also makes me want to re-read Kahneman’s book.
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Thursday Review: “Narrative Medicine and Decision-Making Capacity”

Greg Mahr’s article on using Narrative Medicine to evaluate the medical decision-making capacity of patients is a wonderful case study in the implementation of the medical humanities. Appearing in the Journal of Evaluation in Clinical Practice, the paper contains frequent, concise insights into the goals and possibilities of Narrative Medicine.

The article is well-written and presents the traditional model of assessing patients’ abilities, the issues inherent in it, Narrative Medicine’s viewpoint, and an alternative, narrative decision-making assessment. (The presentation is very much like a story!) Mahr says, and I agree, that Narrative medicine has been an effective and powerful tool in reshaping medical practice. It’s odd, then, that when contrasting the outcomes of the “traditional” assessment and the “narrative” assessment, narrative assessments should arrive at the same conclusions as traditional assessments, but without the ethical and philosophical difficulties embedded within the traditional assessment.

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