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Table 4 Cognitive biases and their influence on decision-making [13]

From: Decision-making at the limit of viability: the Austrian neonatal choice context

Cognitive biases

The possible influence of the bias on the communication between NICU professionals and parents

Anchoring effect: tendency to rely on the first piece of information received (the anchor). This piece of information is used to make subsequent judgments.

Speaking about risks before benefits may create a negative anchor on parents’ perception.

Focusing effect: placing too much importance on one aspect of the situation that falsifies the prediction of a future outcome.

Speaking about all possible disabilities an EP infant may have for a lengthy period and not speaking about the likely abilities.

Availability effect: estimation of a probability of an event that is associated with vivid memories of similar events happening before.

If doctors tell the parents that their child is going to die three times, but it survives nonetheless, parents overestimate the chances for survival in case of another event.

Effective forecasting: individuals often predict the future health states inaccurately. Individuals tend to be more resilient than they predict.

Parents may find it difficult to imagine living with a disabled child, but manage it better than they anticipated nonetheless.

Loss aversion: tendency to strongly prefer avoiding losses to acquiring gains (the loss of 100 EURO causes more loss of satisfaction that the satisfaction gained from winning 100 EURO).

Framing the information via losses and gains may have an impact on parents, i.e., losing a child vs getting a child.