Deciding About Surgery

By | May 12, 2015

Jeremy Bentham was the father of modern utilitarianism and it is his terminology that we will use when we begin our analysis tomorrow.

Jeremy Bentham was the father of modern utilitarianism and it is his terminology that we will use when we begin our analysis tomorrow.

We are finally ready to begin to consider the question of how the decision about back surgery is made. Notice I said is made, not should be made, because the ways of approaching this decision are as different as the different people who face the decision. After watching patients struggle with this decision for many years here at Schlesinger Pain Centers, I can say that as with most important decisions people fall into two distinct groups, the rationalists and the non-rationalists. A word about terminology is in order here. The meaning of a rational decision is fairly clear, but two other important terms are often confused. Very few of my patients make irrational decisions, which would be to look at a decision that has a clear logical answer and then to simple choose the wrong answer. Non-rational decisions are ones where factors other than logic and rationality are more important and motivate the decision. These factors include emotion, instinct, cultural biases and the like. The language that we will use to describe this analysis will be that of personal and social utility as developed by John Stuart Mill and Jeremy Bentham in the beginning of the19th century. The tools that we will use to carry out the analysis will that of game theory as developed by John von Neumann in the middle of the 20th century.


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