The Impact of Personal Expectations on Counterfactual Thinking About Life and Death Medical Decisions

UMMS Affiliation

Department of Family Medicine and Community Health



Document Type



Community Health and Preventive Medicine | Preventive Medicine | Psychiatry and Psychology | Psychology


We examined the impact of social perceivers' self-referent norms (i.e., their own expectations of what should occur) on counterfactual thinking in health care decision making regarding treatment termination. We presented participants with a "patient's dilemma" in which continuing or stopping medical treatment raised the risk of death for the patient and/or her developing fetus. Participants (N = 217) recommended a course of action to the patient, predicted consensus with that recommendation, and assessed the likely risks of both actions. We exposed them to an outcome in which the patient either continued or stopped treatment with either positive or negative consequences. Disagreement with the patient's treatment decision was associated with attributions of greater predictability, regret, and responsibility when the outcome was negative, suggesting the prompting of counterfactual processes.

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Citation: Wellman, R. J., & Sugarman, D. B. (2006). The impact of personal expectations on counterfactual thinking about life and death medical decisions. Basic and Applied Social Psychology, 28, 81-89. doi:10.1207/s15324834basp2801