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Financial Surrogate Decision Making: Lessons from Applied Experimental Philosophy

Published online by Cambridge University Press:  20 September 2016

Adam Feltz
Adam Feltz*
Affiliation:
Michigan Technological University (USA)
*
*Correspondence concerning this article should be addressed to Adam Feltz. Michigan Technological University. Cognitive and Learning Sciences. 1400. Townsend Dr. Houghton Michigan. 49931. Michigan (USA). E-mail: adfeltz@mtu.edu
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Abstract

An estimated 1 in 4 elderly Americans need a surrogate to make decisions at least once in their lives. With an aging population, that number is almost certainly going to increase. This paper focuses on financial surrogate decision making. To illustrate some of the empirical and moral implications associated with financial surrogate decision making, two experiments suggest that default choice settings can predictably influence some surrogate financial decision making. Experiment 1 suggested that when making hypothetical financial decisions, surrogates tended to stay with default settings (OR = 4.37, 95% CI 1.52, 12.48). Experiment 2 replicated and extended this finding suggesting that in a different context (OR = 2.27, 95% CI 1.1, 4.65). Experiment 2 also suggested that those who were more numerate were less likely to be influenced by default settings than the less numerate, but only when the decision is whether to “opt in” (p = .05). These data highlight the importance of a recent debate about “nudging.” Defaults are common methods to nudge people to make desirable choices while allowing the liberty to choose otherwise. Some of the ethics of using default settings to nudge surrogate decision makers are discussed.

Keywords

autonomydecision makingethicsnudgingsurrogate
Type
Research Article
Information
The Spanish Journal of Psychology , Volume 19 , 2016 , E56
Copyright
Copyright © Universidad Complutense de Madrid and Colegio Oficial de Psicólogos de Madrid 2016 

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References

Arksey, H., Corden, A., Glendinning, C., & Hirst, M. (2008). Managing money in later life: Help from relatives and friends. Benefits, 16(1), 47–59.Google Scholar
Alzheimer’s Association. (2013). Alzheimer’s disease facts and figures. Alzheimer’s & Dementia, 8, 1–67.Google Scholar
Banks, J., O’Dea, C., & Oldfield, Z. (2010). Cognitive function, numeracy and retirement saving trajectories. Economic Journal, 120, F381–F410. http://dx.doi.org/10.1111/j.1468-0297.2010.02395.x Google Scholar
Belsky, G., & Gilovich, T. (1999). Why smart people make big money mistakes-and how to correct them : Lessons from the new science of behavioral economics. New York, NY: Simon & Schuster.Google Scholar
Blumenthal-Barby, J. S., & Burroughs, H. (2012). Seeking better health care outcomes: The ethics of using the “nudge”. American Journal of Bioethics, 12, 1–10. http://dx.doi.org/10.1080/15265161.2011.634481 Google Scholar
Bond, J. B. Jr., Cuddy, R., Dixon, G. L., Duncan, K. A., & Smith, D. L. (2000). The financial abuse of mentally incompetent older adults: A Canadian study. Journal of Elder Abuse & Neglect, 11, 23–38. http://dx.doi.org/10.1300/J084v11n04_03 Google Scholar
Boldy, D., Horner, B., Crouchley, K., Davey, M., & Boylen, S. (2005). Addressing elder abuse: Western Australian case study. Australasian Journal on Ageing, 24(1), 3–8. http://dx.doi.org/10.1111/j.1741-6612.2005.00058.x Google Scholar
Buchanan, A. E., & Brock, D. W. (1989). Deciding for others: The ethics of surrogate decision making. Cambridge, UK; New York, NY: Cambridge University Press.Google Scholar
Buhrmester, M., Kwang, T., & Gosling, S. D. (2011). Amazon’s mechanical turk: A new source of inexpensive, yet high-quality, data? Perspectives on Psychological Science, 6(1), 3–5. http://dx.doi.org/10.1177/1745691610393980 Google Scholar
Cokely, E. T., Galesic, M., Schulz, E., Ghazal, S., & Garcia-Retamero, R. (2012). Measuring risk literacy: The Berlin Numeracy Test. Judgment and Decision Making, 7(1), 25–47.Google Scholar
Cokely, E. T., & Kelley, C. M. (2008). Heuristic processes in normatively superior judgment. International Journal of Psychology, 43, 728–728.Google Scholar
Cokely, E. T., & Kelley, C. M. (2009). Cognitive abilities and superior decision making under risk: A protocol analysis and process model evaluation. Judgment and Decision Making, 4(1), 20–33.Google Scholar
Colby, H. A. (2010). Risk preference in surrogate financial decision making. New Brunswick, NJ: Rutgers University.Google Scholar
Crump, M. J. C., McDonnell, J. V., & Gureckis, T. M. (2013). Evaluating amazon’s mechanical turk as a tool for experimental behavioral research. Plos One, 8, e57410. http://dx.doi.org/10.1371/journal.pone.0057410 Google Scholar
Ditto, P. H., Danks, J. H., Smucker, W. D., Bookwala, J., Coppola, K. M., Dresser, R., … Zyzanski, S. (2001). Advance directives as acts of communication - A randomized controlled trial. Archives of Internal Medicine, 161, 421–430.Google Scholar
Fagerlin, A., Ditto, P. H., Danks, J. H., & Houts, R. M. (2001). Projection in surrogate decisions about life-sustaining medical treatments. Health Psychology, 20, 166–175. http://dx.doi.org/10.1037/0278-6133.20.3.166 Google Scholar
Fagerlin, A., Ditto, P. H., Hawkins, N. A., Schneider, C. E., & Smucker, W. D. (2002). The use of advance directives in end-of-life decision making - Problems and possibilities. American Behavioral Scientist, 46, 268–283. http://dx.doi.org/10.1177/000276402236678 Google Scholar
Fagerlin, A., & Schneider, C. E. (2004). Enough. The failure of the living will. Hastings Center Report, 34, 30–42. http://dx.doi.org/10.2307/3527683 Google Scholar
Feltz, A. (2015). Ethical information transparency and sexually transmitted diseases. Current HIV Research, 13, 421–431. http://dx.doi.org/10.2174/1570162x13666150511143350 Google Scholar
Feltz, A., & Abt, T. (2012). Claims about surrogate decision-making accuracy require empirical evidence. The American Journal of Bioethics, 12, 41–43. http://dx.doi.org/10.1080/15265161.2012.708090 Google Scholar
Feltz, A., & Samayoa, S. (2012). Heuristics and life-sustaining treatments. Journal of Bioethical Inquiry, 9, 443–455. http://dx.doi.org/10.1007/s11673-012-9396-5 Google Scholar
Frey, R., Hertwig, R., & Herzog, S. M. (2014). Surrogate decision making: Do we have to trade off accuracy and procedural satisfaction? Medical Decision Making, 34, 258–269. http://dx.doi.org/10.1177/0272989X12471729 Google Scholar
Garcia-Retamero, R., & Cokely, E. T. (2011). Effective communication of risks to young adults: Using message framing and visual aids to increase condom use and STD screening. Journal of Experimental Psychology-Applied, 17, 270–287. http://dx.doi.org/10.1037/a0023677 Google Scholar
Gigerenzer, G. (2008). Gut feelings: The intelligence of the unconscious. New York, NY: Penguin Books.Google Scholar
Gigerenzer, G., & Gaissmaier, W. (2011). Heuristic decision making. Annual Review of Psychology, 62, 451–482. http://dx.doi.org/10.1146/annurev-psych-120709-145346 Google Scholar
Gigerenzer, G., Todd, P. M., & ABC Research Group. (1999). Simple heuristics that make us smart. New York, NY: Oxford University Press.Google Scholar
Gosling, S. D., Rentfrow, P. J., & Swann, W. B. Jr. (2003). A very brief measure of the Big-Five personality domains. Journal of Research in Personality, 37, 504–528. http://dx.doi.org/10.1016/S0092-6566(03)00046-1 Google Scholar
Hausman, D., & Welch, B. F. (2010). Debate: To nudge or not to nudge. The Journal of Political Philosophy, 18, 123–136. http://dx.doi.org/10.1111/j.1467-9760.2009.00351.x Google Scholar
Hertwig, R., & Ortmann, A. (2001). Experimental practices in economics: A methodological challenge for psychologists? Behavioral and Brain Sciences, 24, 383.Google Scholar
Johnson, E. J., & Goldstein, D. G. (2003). Do defaults save lives? Science, 302, 1338–1339. http://dx.doi.org/10.1126/science.1091721 Google Scholar
Johnson, E. J., Shu, S. B., Dellaert, B. G. C., Fox, C., Goldstein, D. G., Häubl, G., … Weber, E. U. (2012). Beyond nudges: Tools of a choice architecture. Marketing Letters, 23, 487–504. http://dx.doi.org/10.1007/s11002-012-9186-1 Google Scholar
Kahneman, D., Slovic, P., & Tversky, A. (1982). Judgment under uncertainty : Heuristics and biases. New York, NY and Cambridge, UK: Cambridge University Press.Google Scholar
Kelly, B., Rid, A., & Wendler, D. (2012). Systematic review: Individuals’ goals for surrogate decision-making. Journal of the America Geriatrics Society, 60, 884–895.Google Scholar
Kuhberger, A., Schulte-Mecklenbeck, M., & Perner, J. (2002). Framing decisions: Hypothetical and real. Organizational Behavior and Human Decision Processes, 89, 1162–1175. http://dx.doi.org/10.1016/S0749-5978(02)00021-3 Google Scholar
Langan, J., & Means, R. (1996). Financial management and elderly people with dementia in the UK: As much a question of confusion as abuse? Ageing and Society, 16, 287–314.Google Scholar
Lipkus, I., & Peters, E. (2007). The functions of numeracy for risk communication and decision-making processes. Annals of Behavioral Medicine, 33, S8–S8.Google Scholar
Marks, M. A. Z., & Arkes, H. R. (2008). Patient and surrogate disagreement in end-of-life decisions: Can surrogates accurately predict patients’ preferences? Medical Decision Making, 28, 524–531. http://dx.doi.org/10.1177/0272989X08315244 Google Scholar
Marson, D. C., Sawrie, S. M., Snyder, S., McInturff, B., Stalvey, T., Boothe, A., … Harrell, L. E. (2000). Assessing financial capacity in patients with Alzheimer disease - A conceptual model and prototype instrument. Archives of Neurology, 57, 877–884.Google Scholar
Mason, W., & Suri, S. (2012). Conducting behavioral research on Amazon’s Mechanical Turk. Behavior Research Methods, 44(1), 1–23. http://dx.doi.org/10.3758/s13428-011-0124-6 Google Scholar
McCawley, A. L., Tilse, C., Wilson, J., Setterlund, D., & Rosenman, L. (2005). Financial abuse of older people with impaired capacity: Who is minding the money? Australasian Journal on Ageing, 24, A15–A15.Google Scholar
Peters, E. (2012). Beyond comprehension: The role of numeracy in judgments and decisions. Current Directions in Psychological Science, 21(1), 31–35. http://dx.doi.org/10.1177/0963721411429960 Google Scholar
Peters, E., & Levin, I. P. (2008). Dissecting the risky-choice framing effect: Numeracy as an individual-difference factor in weighting risky and riskless options. Judgment and Decision Making Journal, 3, 435–448.Google Scholar
Peters, E., Vastfjall, D., Slovic, P., Mertz, C. K., Mazzocco, K., & Dickert, S. (2006). Numeracy and decision making. Psychological Science, 17, 407–413. http://dx.doi.org/10.1111/j.1467-9280.2006.01720.x Google Scholar
Rabow, M. W., Hauser, J. M., & Adams, J. (2004). Supporting family caregivers at the end of life - “They don’t know what they don’t know”. Jama-Journal of the American Medical Association, 291, 483–491.Google Scholar
Reyna, V. F., Nelson, W. L., Han, P. K., & Dieckmann, N. F. (2009). How numeracy influences risk comprehension and medical decision making. Psychological Bulletin, 135, 943–973. http://dx.doi.org/10.1037/a0017327 Google Scholar
Roddy, D. (2007, September 4). Courting trouble: Power of attorney safegaurds though to legislate. Pittsburgh, PA. Pittsburgh Post-Gazette. Retrieved from Post-Gazette webpage http://www.post-gazette.com/frontpage/2007/09/04/Courting-Trouble-Power-of-attorney-safeguards-tough-to-legislate/stories/200709040128 Google Scholar
Roszkowski, M. J., & Snelbecker, G. E. (1990). Effects of “framing” on measures of risk tolerance: Financial planners are not immune. Journal of Behavioral Economics, 19, 237–246. http://dx.doi.org/10.1016/0090-5720(90)90029-7 Google Scholar
Siegel, K., Raveis, V. H., Houts, P., & Mor, V. (1991). Caregiver burden and unmet patient needs. Cancer, 68, 1131–1140. http://dx.doi.org/10.1002/1097-0142(19910901)68:5%3C1131::AID-CNCR2820680541%3E3.0.CO;2-N Google Scholar
Silveira, M. J., Kim, S. Y. H., & Langa, K. M. (2010). Advance directives and outcomes of surrogate decision making before death. New England Journal of Medicine, 362, 1211–1218. http://dx.doi.org/10.1056/NEJMsa0907901 Google Scholar
Sooryanarayana, R., Choo, W. Y., & Hairi, N. N. (2013). A review on the prevalence and measurement of elder abuse in the community. Trauma Violence Abuse, 14, 316–325. http://dx.doi.org/10.1177/1524838013495963 Google Scholar
Steinhauser, K. E., Christakis, N. A., Clipp, E. C., McNeilly, M., Grambow, S., Parker, J., & Tulsky, J. A. (2001). Preparing for the end of life: Preferences of patients, families, physicians, and other care providers. Journal of Pain and Symptom Management, 22, 727–737. http://dx.doi.org/10.1016/S0885-3924(01)00334-7 Google Scholar
Stone, E. R., Yates, A. J., & Caruthers, A. S. (2002). Risk taking in decision making for others versus the self. Journal of Applied Social Psychology, 32, 1797–1824. http://dx.doi.org/10.1111/J.1559-1816.2002.Tb00260.X Google Scholar
Sulmasy, D. P., Terry, P. B., Weisman, C. S., Miller, D. J., Stallings, R. Y., Vettese, M. A., & Haller, K. B. (1998). The accuracy of substituted judgments in patients with terminal diagnoses. Annals of Internal Medicine, 129, 1083. http://dx.doi.org/10.7326/0003-4819-129-12-199812150-00041 Google Scholar
Teno, J. M., Nelson, H. L., & Lynn, J. (1994). Advance care planning priorities for ethical and empirical-research. The Hastings Center Report, 24, S32–S36. http://dx.doi.org/10.2307/3563482 Google Scholar
Thaler, R. H., & Benartzi, S. (2004). Save more tomorrow (TM): Using behavioral economics to increase employee saving. Journal of Political Economy, 112(1), S164–S187. http://dx.doi.org/10.1086/380085 Google Scholar
Thaler, R. H., & Sunstein, C. R. (2003). Libertarian paternalism. American Economic Review, 93, 175–179. http://dx.doi.org/10.1257/000282803321947001 Google Scholar
Thaler, R., & Sunstein, C. (2008). Nudge : Improving decisions about health, wealth, and happiness. New Haven, CT: Yale University Press.Google Scholar
Tilse, C., Setterlund, D., Wilson, J., & Rosenman, L. (2005). Minding the money: A growing responsibility for informal carers. Ageing and Society, 25, 215–227. http://dx.doi.org/10.1017/S0144686X04002983 Google Scholar
Tilse, C., Wilson, J., Rosenman, L., Morrison, D., & Mccawley, A. L. (2011). Managing older people’s money: Assisted and substitute decision making in residential aged-care. Ageing & Society, 31, 93–109. http://dx.doi.org/10.1017/S0144686X10000747 Google Scholar
Todd, P. M., & Gigerenzer, G. (2007). Environments that make us smart: Ecological rationality. Current Directions in Psychological Science, 16, 167–171. http://dx.doi.org/10.1111/j.1467-8721.2007.00497.x Google Scholar
Trout, J. D. (2005). Paternalism and cognitive bias. Law and Philosophy, 24, 393–434. http://dx.doi.org/10.1007/s10982-004-8197-3 Google Scholar
Uhlmann, R. F., Pearlman, R. A., & Cain, K. C. (1988). Physicians and spouses predictions of elderly patients resuscitation preferences. The Journals of Gerontology, 43, 115–121. http://dx.doi.org/10.1093/geronj/43.5.M115 Google Scholar
Welch, B. F. (2013). Shifting the concept of nudge. The Journal of Medical Ethics, 39, 497–498. http://dx.doi.org/10.1136/medethics-2012-101111 Google Scholar
Wilber, K. H., & Reynolds, S. L. (1997). Introducing a framework for defining financial abuse of the elderly. Journal of Elder Abuse & Neglect, 8, 61–80. http://dx.doi.org/10.1300/J084v08n02_06 Google Scholar