Rational Decision MakingHarrison, Ch. 3

Fred Wenstøp

Fred Wenstøp 2

Emotion and decision making

Case: Phineas Gage Experiment 1:

A group of people, some normal and some suffering from prefrontal deficiency was

Exposed to a fire alarmShown value laden pictures

Experiment 2:Choice of card decks

Fred Wenstøp 3

Damasio’s theory

Amygdala

Prefrontallobes

Neocortex

Emotional responsefrom the body

Primary emotions trigger

Secondary emotions trigger

Stimulus

Feelings

Fred Wenstøp 4

RationalityFøllesdal 1992

Four dimensions of rationalityrationality as logical consistency

• pertains both to values and beliefs

rationality as well-foundedness of beliefs• beliefs are well supported by available evidence

rationality of action• application of decision theory

rationality as well-foundedness of values • reflective equilibrium that gives a stable set of convictions that

are relevant for the decision situation

Fred Wenstøp 5

The rational decision model

Frame A set of mutually exclusive decision alternatives has been

identified A set of relevant objectives has been identified by which to

evaluate the alternatives Well-founded scores (x) have been established

Predicted consequences of the altenatives, beliefs Well-founded weights (w) have been established

Importance of the objectives, represent values Decision Table

Contains all the information above

Fred Wenstøp 6

Rational choice

An evaluating function that is in accordance with the decision maker’s preferences has been identifiedU(x1,x2,..) = f(w1,w2,…,x1,x2,..)

The alternative with the highest expected value is chosen

Fred Wenstøp 7

Common evaluating functions

Linear modelU(x1,x2,x3) = w1u1(x1) + w2u2(x2) + w3u3(x3)

Multiplicative modelU(x1,x2,x3) = w1u1(x1) + w2u2(x2) + w3u3(x3) +

kw1u1(x1)w2u2(x2) + kw1u1(x1)w3u3(x3) + kw2u2(x2)w3u3(x3)

+ k2w1u1(x1)w2u2(x2)w3u3(x3)

These models ensures consistency of preferenceAssumptions

• Value and preference independence

Fred Wenstøp 8

HIV Case: The Decision panel The Panel

Governmental advisor on AIDS matters• Svein-Erik Ekeid

Deputy minister, Ministry of Social Affairs• Emil Hansen

Director of National Institute of Public Health• Bodolf Hareide

Decision contextIdentification of viable program target groups

Value focusingEssential values were identified without discussing

consequences of alternatives

Fred Wenstøp 9

HIV Case: Value structure

R ig h t to p riva cy

A n x ie ty in th e so c ie ty

A n x ie ty in e xpo sed p erso ns

L ife q ua lity o f H IV + 's

P e rson a l stig m a

G ro u p s tig m a

E a rly tre a tm e nt

M in im ize con se q ue n cesfo r the ind iv id u a l a nd

th e so c ie ty

M in im ize fu tu reca se s o f H IV

H e a lth ca re o f A ID S p a tie n ts

C o s ts o f p ro g ram

L o ss o f inco m e

M in im ize e co n o m icco s ts o f p ro g ram

a n d m o rb id ity

M in im ize so cia l e con o m ic co s ts o f th e H IV e p id e m ic

Fred Wenstøp 10

HIV Case: Framing the problem

Decision Criterion Unit Worst value Best valueCases prevented persons 0 4800Rights invasion 1000 persons 12000 0Anxiety creation 1000 persons 12000 0Anxiety reduction 1000 persons 0 1200Life quality reduction person-years 7200 0Personal stigma persons 120 0Group stigma 1000 persons 80 0Economic costs mill. NOK 5000 -9000Early treatment persons 0 2400

Fred Wenstøp 11

HIV Case: Weights

Weight elicitationComputer interactiveDiscussionsEmotional responsesUnanimous result Cases

Rights

Anx. cre

Anx. red

Quality

P.stigma

G.stigma

Costs Early

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Viability study

Target group according to HIV prevalence in home countryDecision Criterion No action Low Medium HighCases prevented 0 665 510 100Rights invasion 0 67 38 4Anxiety creation 0 67 38 4Anxiety reduction 0 7 4 0Life quality reduction 0 141 5700 2370Personal stigma 0 2 95 40Group stigma 0 67 38 4Economic costs 0 -1332 -1027 -203Early treatment 0 47 1900 790Utility 0.285 0.285 0.285 0.285

Fred Wenstøp 13

Infection potential

Europeans American &

Oriental

Sub-Sahara

Size of sexual contact group

15500 3700 480

Annual no. of intercourses

25 34 30

HIV transmis- sion prob.

0.001 0.01 0.05

HIV prevalence 0.01 0.05 0.2

Expected no. of infections, 5 yrs

20 266 376

N

esintercourstransprevNInfections 5)1(1

Fred Wenstøp 14

HIV Case: Conclusion

The viability study showed thatin order to be efficient, any program directed against an

immigrant group must prevent new HIV cases at least:• Europeans 665• Americans & orientals 510• Sub-Sahara Africans 100

A simulation study showed thatif left to themselves they would at the maximum infect

• Europeans 20• Americans & orientals 266• Sub-Sahara Africans 376