Hi all, 

 

I joined this ListServ recently. I'm impressed by the wisdom and
exchange of valuable information by so many knowledgeable professionals.
The resources noted by Mark Hochhauser are of particular interest to me
working in immunization health education. We've seen a surge of parents
who question or refuse immunizations for their kids. 

 

We have been working at both the emotional level (sharing of personal
stories) and factual information (fact sheets, expert speakers). The
audience is typically highly educated and claim to want to do lots of
research, but defining scientific credibility of "credible" sources can
also be construed as some sort of a government/big Pharma/western
medical model conspiracy.   

 

I'd be curious to learn of any application of the resources Mark noted.

 

Tammy Pilisuk, MPH

CDPH Immunization Branch

Richmond CA

 

________________________________

From: healthliteracy-bounces at nifl.gov
[mailto:healthliteracy-bounces at nifl.gov] On Behalf Of Mary Jane Jerde
Sent: Wednesday, November 26, 2008 10:17 AM
To: The Health and Literacy Discussion List
Subject: [HealthLiteracy 2517] Re: Treatment refusal and verbal
abilities

 

Hi,

I hope that this is not too late. 

The points you make are excellent. 

It also pays to remember that the medical professionals are also going
through similar processes in their decision making and conversations
with a patient. 

Mary Jane Jerde
NEDP Assessor
Howard Community College

 

________________________________

From: "MarkH38514 at aol.com" <MarkH38514 at aol.com>
To: healthliteracy at nifl.gov
Sent: Tuesday, November 18, 2008 3:12:06 PM
Subject: [HealthLiteracy 2474] Re: Treatment refusal and verbal
abilities




Mary: 

 

Much of the research on informed consent philosophically assumes that
the decision to be treated or not be treated is a logical one. But there
is much emerging research on the brain's role in decision making and the
importance of emotion, logic, and even intuition.  

 

For example, psychologist George Lowenstein and his colleagues published
a paper on "Risk as Feelings." (Lowenstein, G.F., et al. Risk as
feelings. Psychological Bulletin, 2001, 127: 267-286). Because decisions
aren't just logical thoughts, but emotional reactions, it's not
surprising that patients may find it difficult to articulate why they
don't want treatment. 

 

Malcolm Gladwell's 2005 book "blink. The Power of Thinking without
Thinking" described how people use "thin slicing" to extract relevant
information from all the information around them. David Myers, in his
book "Intuition" (2002) describes "knowing without awareness"--how
people can know things automatically (unconsciously) or cognitively
(consciously). He summarized Seymour Epstein's description of
experiential knowing (intuitive, automatic and nonverbal) or rational
knowing (rational, analytic, verbal).  Consent decisions based on
experiential knowing may not be easy for patients to explain verbally. 

 

I've done a few articles that touch on the issue, but may not be
specific enough for your needs. One is available online:  

 

Hochhauser, M. The anatomy of informed consent. Applied Clinical Trials,
March 2005, 82. 

http://appliedclinicaltrialsonline.findpharma.com/appliedclinicaltrials/
Sites+Articles/The-Anatomy-of-Informed-Consent/ArticleStandard/Article/d
etail/149967

 

I can send you pdf versions of: 

 

Hochhauser, M. Emotion and logic in the informed consent process.
Research Practitioner, 2005, 5(4), 138-141. 

 

Hochhauser, M. Informed consent or intuitive consent? SoCRA Source,
February 2006, (Publication of the Society of Clinical Research
Associates, #47, 32-33. 

 

Mark

 

Mark Hochhauser, Ph.D.

Readability Consultant

3344 Scott Avenue North

Golden Valley, MN  55422

Phone: 763-521-4672

Fax: 763-521-5069    

Cell: 612-281-1517

email: MarkH38514 at aol.com

 

 

 

 

 





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