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Book Categories |
Preface | xiii | |
Acknowledgments | xvii | |
Why Read This Book? | xix | |
Part I | Basics | |
Chapter 1 | The Decision Crisis | 3 |
Changes, Changes | 4 | |
Medical Decisions: Not What They Used to Be | 4 | |
Information Is Not Enough | 6 | |
Chapter 2 | The Basic Nature of Medical Decisions | 9 |
You Are Not Alone | 9 | |
You Are Not Yourself | 10 | |
What Is a Decision? | 11 | |
Why Decisions Hurt | 12 | |
Decisions Are Relative | 13 | |
Chapter 3 | Some Philosophical Principles | 17 |
Realize That You Have Decisions | 17 | |
Realize That You Must Decide | 18 | |
Realize That Life Is Hard | 19 | |
Realize That Everything Has Risks | 20 | |
Who Is as Important as What | 21 | |
You Need a Captain of Your Ship | 22 | |
Don't Fight Yourself | 24 | |
Take Some Breaks | 25 | |
Part II | The Six Steps of Medical Decision Making | |
Chapter 4 | An Introduction to the Six Steps of Medical Decision Making | 29 |
How We Decide: The Theory | 30 | |
How We Decide: A Practical Six-Step Plan | 31 | |
Step 1 | Identification of Your Options | 31 |
Step 2 | Identification of Tradeoffs | 32 |
Step 3 | Discovery of Data | 33 |
Step 4 | Interpretation of Numbers | 34 |
Step 5 | Gathering Your Beliefs | 35 |
Step 6 | Contemplation of Meaning | 38 |
Chapter 5 | Step 1: Identification of Your Options | 41 |
Use Your Sources | 42 | |
Can I Really Talk to My Doctors? | 42 | |
Keep an Open Mind | 42 | |
Where to Go for Your Medical Care | 43 | |
How to Find and Be Seen at Outside Medical Centers | 45 | |
The Small-Town Syndrome | 46 | |
Whom to Choose for Your Medical Care | 47 | |
Be on the Lookout | 48 | |
Chapter 6 | Step 2: Identification of Tradeoffs | 49 |
You've Been Framed! | 49 | |
How to Shift Frames | 51 | |
Search for Difficult Tradeoffs | 53 | |
Chapter 7 | Step 3: Discovery of Data | 55 |
Preparing to Search | 55 | |
It's Harder Than You Think | 55 | |
Reasonable Expectations | 56 | |
Do Your Homework | 57 | |
Make Sure It's About You | 58 | |
Seek Painful Information | 59 | |
All Sources Have an Agenda | 60 | |
Nobody Tells It Straight | 61 | |
The Sources | 63 | |
Books | 63 | |
Medical Books | 63 | |
How to Use a Medical Textbook | 65 | |
Reference Books | 67 | |
A Warning | 67 | |
Suggested Medical Textbooks and Reference Books | 68 | |
Articles | 72 | |
Medical Articles | 72 | |
How to Read a Medical Article | 74 | |
Practice Guidelines | 77 | |
Newsletters, Newspapers, Television, and Advertisements | 78 | |
The Internet | 81 | |
Beware the Internet | 83 | |
Tips for Internet Use | 84 | |
Before We Begin: One More Word | 86 | |
Suggested Medical Web Sites | 87 | |
How to Search the Web for Medical Web Sites | 96 | |
How to Look at a Medical Web Site | 98 | |
How to Use PubMed | 99 | |
Final Words | 101 | |
Friends and Family | 101 | |
Individuals | 101 | |
Groups | 103 | |
How to Benefit from Friends and Family | 106 | |
Your Doctors | 107 | |
A Suggested Strategy for Finding Medical Information | 107 | |
Chapter 8 | Step 4: Interpretation of Numbers | 109 |
Building Skepticism | 109 | |
Trust No One, Believe Nothing | 110 | |
... But You Must Trust Your Sources | 111 | |
Go Beyond Words | 112 | |
It's All in How You Say It | 112 | |
It's All in How You Frame It | 113 | |
How Much Information Is Enough? | 116 | |
What if There Aren't Any Numbers? | 117 | |
Timing Isn't Everything | 118 | |
The Mathematics and Statistics of Decision Making | 119 | |
How to Interpret Percentages | 120 | |
Pitfalls and Special Circumstances of Percentages | 123 | |
The Myth of Zero Risk | 126 | |
Statistics Made Easy | 127 | |
How to Evaluate a Medical Test | 128 | |
More Tests: Backward and Forward | 131 | |
What Happens for Two Events? | 132 | |
When There Are Multiple Options | 133 | |
Chapter 9 | Step 5: Gathering Your Beliefs | 137 |
Personal Beliefs | 138 | |
What Do You Believe? And Why? | 138 | |
We See What We Want to See | 139 | |
Judging Books by Their Covers | 140 | |
Beliefs in Wishes and Control | 141 | |
Beliefs in Happy Endings | 143 | |
Beliefs in Medicine | 144 | |
Beliefs About Moral Questions | 145 | |
Challenge Your Beliefs | 146 | |
Hope versus Reality | 148 | |
Beliefs about Data | 148 | |
Beliefs Based on Coincidence: Why We Know What Isn't So | 149 | |
Coincidence versus the Scientific Method | 151 | |
Beliefs Based on Small Numbers | 153 | |
Beliefs Based on Bad Choices: Selection Bias | 155 | |
Beliefs Based on Single Reports | 156 | |
The Need for a Guide | 157 | |
Beliefs About Testimonials | 158 | |
Chapter 10 | Step 6: Contemplation of Meaning | 163 |
Sleep On It! | 164 | |
The Road to Meaning | 165 | |
Use Your Imagination | 166 | |
Repeat It Over and Over | 168 | |
Keep Notes | 168 | |
The Meaning of Risk | 169 | |
The Meaning of Details | 170 | |
The Meaning of Inconvenience | 172 | |
The Meaning of the Past | 174 | |
The Meaning of Style | 175 | |
Thinking the Unthinkable | 176 | |
The Meaning of Faith | 177 | |
Part III | How to Use Your Doctors | |
Chapter 11 | Ambivalence, Anger, and Acceptance | 181 |
Ambivalence | 181 | |
Anger | 182 | |
Do We Really Want a Vote? | 183 | |
Acceptance | 184 | |
Chapter 12 | Managing Your Doctors | 187 |
Finding Doctors | 187 | |
Do I Need a Doctor? | 187 | |
Second Opinions | 188 | |
Small Town versus Big Center | 188 | |
Practical Tips for the Appointment | 189 | |
The Use of Doctors | 192 | |
Use Your Doctor as a Provider | 193 | |
Don't Use Your Doctor as a Friend | 194 | |
Don't Use Yourself as a Doctor | 195 | |
Use Your Doctor as a Doctor | 196 | |
The Use of Doctors-Recap | 197 | |
How to Interpret Your Doctor | 197 | |
Beware Pollyanna | 197 | |
Facts, Opinions, and Value Judgments | 199 | |
Expect a Spectrum | 200 | |
Doctors with Hammers | 200 | |
Multiple Doctors and Captains | 201 | |
The Myth of Informed Consent | 201 | |
Chapter 13 | When Doctors Disagree | 205 |
Know the Issues | 206 | |
Know Your Doctors | 206 | |
Seek Other Opinions | 207 | |
Lump Them Together | 208 | |
Rejecting the Doctor's Advice | 208 | |
Part IV | Deciding for Others | |
Chapter 14 | Deciding for Friends and Family | 213 |
The Thoughts of Others | 214 | |
Relationship Dynamics | 215 | |
Chapter 15 | Deciding for Children | 217 |
General Thoughts: Anxiety and Trust | 218 | |
When Parents Disagree | 219 | |
Does the Child Get a Vote? | 220 | |
Part V | Special Problems | |
Chapter 16 | Pitfalls | 223 |
Some Decision Don'ts | 223 | |
Remembering It All | 225 | |
Insurance and Financial Matters | 228 | |
What If Your Can't Decide? | 230 | |
Chapter 17 | Special Decisions | 233 |
Choosing to Do Nothing | 233 | |
When There Isn't Time | 234 | |
Deciding About Medical Testing | 236 | |
Deciding to Participate in Experimental Trials | 237 | |
Deciding About Alternative Treatments | 239 | |
When There's No Hope | 240 | |
Part VI | You've Made Your Decision; Now What? | |
Chapter 18 | How to Know When Your Medical Decision Is Good | 243 |
Two Criteria | 244 | |
Changing Your Mind | 245 | |
Chapter 19 | The Good and Bad of Afterward | 247 |
Afterward: When Things Go Wrong | 247 | |
Afterward: When Things Go Right | 249 | |
Part VII | How to Begin | |
Chapter 20 | An Example: Cancer | 253 |
Step 1 | Identification of Your Options | 254 |
Step 2 | Identification of Tradeoffs | 254 |
Step 3 | Discovery of Data | 255 |
Step 4 | Interpretation of Numbers | 255 |
Step 5 | Gathering Your Beliefs | 255 |
Step 6 | Contemplation of Meaning | 256 |
Recommended Reading | 259 | |
Index | 261 |
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