User Experience

Online Persuasion: The Life-Or-Death Consequences of Decision Paralysis

One of the topics I’ll be touching on in my April 27 Webinar is Decide-O-Phobia: How offering too much choice can lead to decision paralysis.

In a previous post, I gave one example of decide-o-phobia. In that case, the stakes were low. (Deciding which flavor of jam to buy.)

Today I’d like to demonstrate how decide-o-phobia isn’t limited to trivial matters, but can actually influence life-changing decisions.

In a 1995 study* published in The Journal of the American Medical Association, doctors were given a scenario involving a patient with osteoarthritis and asked which treatment they would recommend.

    • Half of the doctors were given just two treatment options to choose from Surgery or a medication, “Drug A”.
  • The other half were given three treatment options: Surgery, Drug A, or Drug B. (Both medications were valid choices.)


Logically, you would think that under the second scenario, fewer doctors would recommend surgery. After all, Drug A is still offered as a treatment option, but now doctors are given a second non-surgical option.

Yet just the opposite was true:

    • When the choice was between surgery or Drug A, 28% recommended surgery.
  • When Drug B was added as an additional option, 47% recommended surgery.

The study also examined decisions made by neurosurgeons concerning artery surgery, and by even by legislators regarding hospital closures. Similar results were found.

The researchers concluded that the introduction of additional options increases decision difficulty and, therefore, the tendency to choose a distinctive option or maintain the status quo.

They also concluded that awareness of this cognitive bias may lead to improved decision-making in complex medical situations.

So you see? Understanding the Contrast Principle and Decide-O-Phobia truly can be a matter of life or death.

* D.A. Redelmeier and E. Shafir (1995). Medical decision making in situations that offer multiple alternatives. January 25, 1995, Vol. 273 No. 4. Copyright 1995 by The Journal of the American Medical Association.

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