BHH Seminar Series: "Motivational Barriers to Care and the Ethics and Encouragement"

The Department of Bioethics and Health Humanities and The Samuel G. Dunn Lectureship in the Medical Humanities 

Proudly Presents:

"Motivational Barriers to Care and the Ethics and Encouragement"

by Dr. Christopher Masciari
Clinical Ethicist
Fellow MD Anderson-Houston  

Tuesday, June 11, 2024
9-10 AM
HEC 3.201

Abstract: 
The Shared Decision-Making Model has seen a surge over the past several decades. It has gained in popularity since it diverges from traditional decision-making models which are either overly paternalistic (the paternalistic model) or overly demanding on the patient (the informative model) (Emanuel and Emanuel, 1992). The benefit of this model, then, is that it is both anti-paternalistic, but also that it does not place unreasonable demands on the patient to decide their own course of treatment. Importantly, the shared decision-making model also has the added benefit of increasing patient adherence to treatment plans because the patient shares the plan. However, even if a plan is one’s own, people often fail to act in accordance with their long-term treatment goals. These possibilities are further worsened by the unpleasantness and difficulty of many treatments as well as the stress of having certain diagnoses and the perceived uncertainty of one’s future given their illness. In this talk, I argue that using methods of encouragement, derived from the field of cognitive neuroscience, can potentially offer a non-paternalistic remedy for some cases of non-adherence. First, I highlight the virtues of the standard model of decision-making in medicine. I then provide an explanation for why patients sometimes fail to be motivated to adhere to treatment. I argue that if we understand their lack of motivation in the context of delay discounting, we can use extant suggestions from cognitive science to remedy the problem. I end by responding to two objections.

Contact:     Email: Kathryne Dunn     

For: The School of Public and Population Health     Phone: 409-772-1128