Inconsistent Decision Making: Framing

Real-life choices appear to be affected by how they are presented. In fact, framing appears to be one of the strongest decision-making biases. Framing is especially relevant to health decisions because the stakes are high and because older adults (who are more likely to have to make health decisions) appear more likely to use shortcuts that cause framing bias.

A standard way of illustrating framing bias is via a treatment choice problem. Treatment 1 is guaranteed to save 200 of 1,000 people with a fatal disease. Treatment 2 offers a 20 percent chance of saving 1,000 lives and an 80 percent chance of saving no one. Which do you prefer? Most people prefer treatment 1 because it seems less risky.

Now consider another scenario. If you choose treatment 3, 800 of 1,000 people with a fatal disease will die. With treatment 4, you have an 80 percent chance that everyone will die and a 20 percent chance that no one will die. Which do you prefer? Most people choose treatment 4.

The only difference between these two scenarios is that the first is framed in terms of how many people live and the second is framed in terms of how many die. They are otherwise identical, yet choices typically dif- fer. By changing the emotional context of a decision, framing can change choices.

Framing can take several forms. It can describe the attributes of choices in different ways, describe the outcomes of choices in different ways, and describe the risks of choices in different ways.