TIME: We Only Think We’re Making Our Own Choices. It Matters How Options are Framed.

From TIME Magazine. Choice architecture refers to the many aspects of how a choice is posed that can be manipulated, intentionally or inadvertently, to influence the decisions we make. The options may be the same, but the presentation can change your choice. Before you make a decision, someone has molded many of the characteristics of that choice for you, and these design decisions will in some way affect what you choose. Many people, when first introduced to the concept, are uncomfortable with or even afraid of it. They are afraid their choices might be influenced by something outside their control, without their awareness, and that they might be exploited. As designers, they worry about influencing others, unintentionally or in harmful ways. In a remarkable study by Scott Halpern and colleagues, patients with terminal illnesses made choices about end‑of‑life care that actually determined their treatment. The advance directive given to them by the researchers first asked what their goal for care was: life extension or comfort care. For a third of the patients, the directive had a comfort‑care default, indicated by a pre-checked box. A second group had no preselection, and the third group had the life‑extension goal already checked. Comfort care was selected 77 percent of the time when it was the default, 66 percent of them time when no option was preselected, and only 43 percent of the time when life extension was the default. This means that the default affected specific interventions, like having a feeding tube. It is remarkable that the default had such a large effect on such an important decision. But what happened next is even more informative. Read the full story at TIME Magazine.