title: Risk, rationality, and regret: responding to the uncertainty of childhood food anaphylaxis.
abstract: Risk and uncertainty are unavoidable in clinical medicine. In the case of childhood food allergy, the dysphoric experience of uncertainty is heightened by the perception of unpredictable danger to young children. Medicine has tended to respond to uncertainty with forms of rational decision making. Rationality cannot, however, resolve uncertainty and provides an insufficient account of risk. This paper compares the medical and parental accounts of two peanut allergic toddlers to highlight the value of emotions in decision making. One emotion in particular, regret, assists in explaining the actions taken to prevent allergic reactions, given the diffuse nature of responsibility for children. In this light, the assumption that doctors make rational judgments while patients have emotion led preferences is a false dichotomy. Reconciling medical and lay accounts requires acknowledgement of the interrelationship between the rational and the emotional, and may lead to more appropriate clinical decision making under conditions of uncertainty.
authors.affiliation: Department of Allergy, Immunology, and Infectious Diseases, The Children's Hospital at Westmead, Locked Bag 4001, Westmead NSW 2145, Australia. wendy.hu@unsw.edu.au
authors.forename: W
authors.initials: W
authors.lastname: Hu
authors.forename: I
authors.initials: I
authors.lastname: Kerridge
authors.forename: A
authors.initials: A
authors.lastname: Kemp
mesh_terms: D000707:Anaphylaxis / Q000517:prevention & control*; D002648:Child; D003657:Decision Making; D004644:Emotions; D004645:Empathy; D004837:Epinephrine / Q000008:administration & dosage* / Q000627:therapeutic use*; D019317:Evidence-Based Medicine; D006801:Humans; D007223:Infant; D007267:Injections / Q000941:ethics; D010290:Parents / Q000523:psychology*; D021183:Peanut Hypersensitivity / Q000188:drug therapy*; D010817:Physician-Patient Relations; D010820:Physicians; D011364:Professional Practice / Q000941:ethics; D011788:Quality of Life; D018570:Risk Assessment; D035501:Uncertainty
chemical_list: D004837:Epinephrine