Understanding Pre-Mortem Thinking for Better Decisions

Aug 8, 2024

Lecture Notes: Pre-Mortem Thinking

Introduction

  • Personal anecdote about breaking into own house in extreme cold.
  • Emphasis on mental cloudiness due to stress (cortisol effects).

The Incident

  • Forgot keys in home, resorted to breaking window to enter.
  • Concerns about missed flight and other responsibilities.
  • Realized lack of passport only at airport check-in.

Reflection on Stress and Decision-Making

  • Time spent on back of plane led to introspection about preventing disasters.
  • Introduced concept of "prospective hindsight" or pre-mortem.

Pre-Mortem Explained

  • Definition: Anticipate potential failures before they happen.
  • Contrast with post-mortem analysis after a failure occurs.
  • Aim: Identify and mitigate risks beforehand.

Practical Applications of Pre-Mortem

Organizing Personal Belongings

  • Designate places for easily lost items:
    • Keys, passports, glasses should have specific storage spots.
    • Utilize spatial memory (Hippocampus function).

Travel Tips

  • Take cell phone pictures of important documents (credit cards, IDs).
  • Store images in the cloud for easy access if lost.

Medical Decision-Making

  • Importance of clear thinking under stress (cortisol impact).
  • Patient's right to understand risks when prescribed medications.

Case Study: Statins

  • Understanding Number Needed to Treat (NNT):
    • Example: 300 need treatment to help 1 person.
    • Side effects can outweigh benefits (5% chance of side effects).

Informed Consent in Medical Decisions

  • Importance of discussing side effects with medical practitioners.
  • Example: Prostate surgery statistics suggest high risk vs. low benefit.

Quality of Life Considerations

  • Discuss personal values: shorter pain-free life vs. longer life with pain.
  • Practice discussions ahead of time to prepare for stressful decisions.

Conclusion

  • Acknowledge human flaws and the inevitability of mistakes.
  • Importance of planning and organization to mitigate negative outcomes.
  • Personal commitment to improving organization post-incident.

Key Takeaway: Develop systems and practices (pre-mortem) to anticipate and minimize risks in all aspects of life, especially during stressful situations.