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Premortem Thinking in Decision-Making
Aug 26, 2024
Lecture Notes on Premortem Thinking and Decision-Making
Introduction
Personal anecdote about breaking into own house in extreme cold.
Highlighted stress and its effects on decision-making.
Key Points from the Experience
Cold winter night in Montreal, forgot keys inside the house.
Broke window to enter house after failed attempts to unlock doors.
Realized forgot passport only at airport check-in, leading to a stressful situation.
Premortem Thinking
Concept introduced by Danny Kahneman, based on work from psychologist Gary Klein.
Premortem
: Anticipating potential failures before they happen to mitigate risks.
Comparison to Postmortem
Postmortem: Analysis after a failure to understand what went wrong.
Premortem: Forward-thinking approach to identify and prevent potential issues.
Practical Applications of Premortem Thinking
Establishing Systems
Home Organization
: Designate specific places for easily lost items (e.g., keys, passports).
Benefits from research on how spatial memory works, particularly the hippocampus.
Travel Preparation
Take cell phone pictures of important documents (credit cards, licenses, passports) and store in the cloud.
Medical Decision-Making
Importance of clear thinking when making medical decisions under stress.
Example: Discussing cholesterol treatment (statins) with a doctor.
Key Statistic to Consider
Number Needed to Treat (NNT)
:
NNT for statins: 300 people need treatment for one person to benefit.
Risk of side effects (5% probability) means 15 people may experience side effects for each benefit.
Ethical Considerations
Medical ethics support informed consent; patients should understand risks vs. benefits.
Importance of having proactive conversations with doctors about treatments.
Additional Considerations
Common NNT in surgeries (e.g., prostate cancer surgery: 49 surgeries to help 1).
Quality of life considerations: weighing shorter, pain-free life against longer life with potential pain.
Conclusion
Acknowledgment of human flaws and the inevitability of failure.
Importance of systems and strategies to mitigate risks and prepare for decisions.
Personal follow-up: Installed a combination lock for future access to home, recognizing organization is a gradual process.
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