In what ways did Hamlet manage his identity? For what purposes? How did he present both private as well as public identities?

Hamlet manages his public identity by pretending to be mad.  He tells Horatio that he is going to act insane in public so as to deflect any possible suspicion that Claudius might feel as Hamlet goes about his investigations into his father's death.  He then proceeds to act like a mad person in front of Claudius, his uncle and step-father and the man he believes murdered his father, as well as Polonius, Claudius's closest advisor, because he doesn't trust either one. 

He also begins to act crazily in front of Ophelia, his former lover, because she is the daughter of Polonius; she has taken her father's instruction and distanced herself from Hamlet, the man who genuinely loves her.  Hamlet seems to feel somewhat betrayed by her treatment of him, but it is also possible that he wants to protect her from whatever fallout might occur as a result of his investigations into Claudius, and so he keeps the distance between them as a way of keeping her safe from the king. 

Privately, however, with Horatio, Hamlet's best friend and the only person he really trusts anymore, he is the same as he ever was: clever, witty, thoughtful, and so on.  This is one of the ways the reader knows that the persona he presents to the rest of the characters is, in fact, an act.

Which path does the narrator actually take in "The Road Not Taken" by Robert Frost?

The speaker takes the seemingly less traveled road.

The speaker says he came to a fork in the road in the woods, and had to choose between a well-traveled road and one that was not. He chooses the less-traveled road and this made all the difference for him. Many people interpret this to mean you should take risks in life.

The two roads are a metaphor for paths in life. In one path, you do what a majority of people do. In the other path, you do something unique. The speaker cannot really tell which road is more used because both are covered with leaves, so he chooses the one he thinks fewer people take.

I shall be telling this with a sigh 

Somewhere ages and ages hence: 

Two roads diverged in a wood, and I— 

I took the one less traveled by, 

And that has made all the difference.

The speaker is telling us about the roads years after he made his choice. He took the road few took, and it made a big, presumably positive difference in his life. When you make your own choices, it can be difficult but often very rewarding.

In life, many people take the road less traveled. You could be an inventor, an artist, or a writer. Doing something different than others means there may not be many examples for you to follow and you may face resistance. It can, however, also work out very well for you and the world to which you contribute.

Once he chose a road, the narrator knows the chances of going back and taking the other were slim. Life is kind of like that. Once you make a choice, you never go back to the person you were. You can make another choice later, but it is not the same choice.

What are assisted living facilities?

Background

Assisted living care is a form of long-term care. Although assisted living facilities (ALFs) cater to populations other than senior citizens (for example, individuals with disabilities), most facilities provide services for retired senior citizens. Those individuals who require assistance with general activities of daily living such as housekeeping and cooking but do not need significant medical care can often avoid an unnecessarily early entry into a nursing home by first living in an assisted living facility. Therefore, these facilities provide varying degrees of daily assistance for otherwise healthy and independent seniors.

Although assisted living as a practice is regulated throughout the United States, not all states use the same terminology, making comparisons difficult. States use various terminology—senior housing, board and care, adult foster care—that may or may not espouse the principles of ALFs; accordingly, state regulation of a particular facility may be minimal to nonexistent. For example, some states regulate the type of services while others regulate the building itself. Many of the states with a high percentage of seniors, such as Florida, have adopted an inclusive umbrella model that regulates the entire ALF. However, this lack of consistent federal oversight throughout all states proves confusing for many individuals—especially those searching for long-term care. However, “assisted living facility” is the most common term for long-term care that provides some, but not all, assistance in activities of daily living for its residents.

The ongoing cost of long-term care often consumes the retirement savings of many seniors. The combined expenses of medications, doctor visits, and personal assistance often outweigh simple housing costs, and elderly individuals are often at risk for injury when performing household chores at home. However, seniors now have the option of an ALF, which often provides individual treatment plans that maintain privacy and dignity by permitting broad independence at a fraction of what nursing homes charge. To contain costs, assisted living facilities have replaced comprehensive in-house medical services, such as those available at traditional nursing homes, with individual treatment plans that provide their residents with the optimal amount of help for their particular situations.

Assisted living facilities are fundamentally different from other senior-oriented care options. Similar to child-care facilities, adult day-care facilities provide daytime care for seniors who live with their children. Often, adult day-care facilities cater to individuals who have cognitive dysfunction (for example, memory loss or Alzheimer’s disease). Adult day-care facilities typically operate during the weekday work hours, providing caregivers respite either during the day or during their work commitments. In contrast to ALFs, residents leave the facility at the end of the day.

Another senior-oriented care option is a nursing home. Nursing homes are similar to ALFs in that the resident lives full time at the facility; however, nursing homes manage medical routines, provide intensive medical care, and provide 100 percent of daily care—often including dressing, bathing, and additional self-care activities.

Types of Assisted Living Facilities

Although differences abound in ALFs, there are basic similarities. Assisted living facilities typically require residents to be generally in control of the majority of their activities of daily living. Residents are expected to perform their own bathing, dressing, and personal care, including medication routines. Although some residents might have minor memory impairments, most are generally in good physical and psychological health, and ALFs strive to create an environment to foster the continued good health of their residents. Strong social connections can often form between residents at cohesive ALFs, an important element of the aging process. Research suggests maintaining strong social interactions is key to maintaining health and well-being as one ages.

There are as many living arrangements as there are ALFs. Some ALFs resemble hostels with eight or more beds in one room, several rooms to a floor, and a separate communal bathroom. Because of the high volume of residents, these ALFs often do not offer individualized treatment plans and, in a situation reminiscent of nursing homes, independence and autonomy are often replaced by resident infantilization. Although these ALFs lack privacy and the staff-to-resident ratio, by necessity, is high, these are generally the least expensive among all the ALFs. General health and well-being often decline rapidly after admittance, forcing relocation to a more care-intensive facility. Accordingly, these ALFs have the quickest resident turnover of all the long-term care facilities.

On the opposite end of the ALF spectrum is the assisted living retirement community. These facilities mimic in-home care as precisely as possible. Whereas retirement communities are generally populated by completely healthy and independent older adults, assisted living retirement communities offer all the amenities and privacy of retirement communities as well as daily in-home care. Often these communities have extensive amenities, including recreation facilities, swimming pools, and other outside sport facilities. In addition, they frequently have numerous staff members dedicated to organizing and maintaining these amenities. Accordingly, these facilities are generally the most expensive but offer the greatest privacy and most closely resemble the aging-at-home experience.

Between crowded communal living and luxurious retirement-style living is the most common form of ALFs, the apartment-style assisted living facility. Constructed as typical apartments, these facilities provide each resident with a complete and separate living facility. Each unit generally has a complete bathroom, bedroom, and living room—full kitchens are often not included. Each resident lives independently but eats in a communal dining room with other residents. Communal social rooms and twenty-four-hour security and staff presence are standard amenities. High-end facilities may provide shuttle services, hairdressers, comprehensive exercise facilities—often with a full-time activity director—and monthly visits from nurse practitioners or medical doctors. Regardless of their size, most ALFs often look and feel like home for the residents and their visitors.

Safety Concerns

The expansion of assisted living facilities benefits the long-term care industry writ large. Prior to the large numbers of ALFs, nursing homes bore the brunt of aging seniors. Seniors experiencing even the smallest impediment in independence were forced into nursing homes. Because nursing homes are designed to cater to the most dependent seniors, even the most functional seniors often experience precipitous drops in functioning from early entry. The same health impediments that nursing homes cater to are, conversely, also a struggle for ALFs.

The line between whether someone should remain in his or her home versus residing in an ALF can be difficult to determine for a spouse and other family members. Often safety concerns become the final determinant. An inability to cook for themselves or minor memory concerns (for example, forgetfulness with the stove) are often used to rationalize a difficult decision. This decision may be easier in the future, however, as research suggests that ALFs prolong independence compared to remaining in one’s residential setting. Often removing one’s responsibility for a few activities of daily living relieves stress and mental reserves, allowing the senior to focus on other personal care routines. The independent orientation of ALFs stands in contrast to nursing homes, which often contribute to dependency rather than facilitate independence.

Just as safety concerns may lead to the move to an ALF, the decision to discharge a resident from an ALF is also often driven by safety concerns. Because ALFs do not provide twenty-four-hour intensive service, residents are free to come and go from the facility and use the bathroom or other accident-prone areas. Residents who are either cognitively impaired or whose health has declined dramatically are often asked to leave the ALF, and for many seniors the next move is into a nursing home.

Regardless of the size, philosophical orientation, or services provided, ALFs provide a much-needed option in long-term care. Seniors with minor impairments can extend their functional independence for many years, and seniors in ALFs actually experience prolonged independence over remaining in home. In tandem with the rapidly aging population, ALFs are evolving even as they struggle with their own identity nationally and within each state.

Perspective and Prospects

Assisted living facilities burgeoned as the aging baby boomers began to approach retirement. Baby boomers, the generation born between 1946 and 1964, are healthier and more independent than retirees of the past, and the long-term care industry responded to this demographic shift with the expansion of ALFs. Prior to the broad expansion of ALFs, seniors in need of even the smallest amount of assistance were forced into nursing homes unless they could afford costly in-home care.

Developments in long-term care have involved graduated levels of care in one facility to accommodate residents’ needs as they age. In contrast to assisted living–only facilities, where residents must move out after they become unable to bathe, dress, or manage their general health successfully, facilities that offer an increased level of care as needed permit residents to move through their retirement years in a single location. Providing flexible services is especially important to a senior’s quality of life, as familiarity and daily routines often can mask advancing stages of mental confusion.

These facilities, sometimes referred to as continuing-care retirement communities, have residence fees that are typically higher—depending on the size of the apartment and the geographic location the prices vary and can be upwards of $100,000—thus limiting this option to the most wealthy of seniors. Nevertheless, these facilities are an important part of the ongoing redefinition of independent living. Where pure ALFs provide a designated set of services, continuing care communities can adapt to the particular needs of each resident throughout the aging process.

This revolution in long-term care has also carried over to nursing homes and has led to the creation of green nursing homes. These nursing homes house approximately ten residents in a large houselike structure and provide a full range of personal care and medical services. As in ALFs, the focus in these green homes is on independent thriving. Whereas nursing homes were historically viewed as the last option for seniors, these green nursing homes are often abundant with plants, domestic animals, homelike furnishings, and daily visitors and volunteers who try to keep the residents and staff cheerful and healthy.

Irrespective of any particular facility or philosophy of care, assisted living facilities are the favored choice of aging seniors. No spouse or family member wants to watch a loved one lose control of daily functioning. Overworked and economically strapped children of aging parents often find themselves faced with a difficult decision. By focusing on dignity, independence, and freedom, assisted living facilities make these choices easier for many.

Bibliography

Allen, James E. Assisted Living Administration: The Knowledge Base. New York: Springer, 2004.

Connell, Linda H. Nursing Homes and Assisted Living Facilities: Your Practical Guide for Making the Right Decision. Naperville, Ill.: Sphinx, 2004.

Eldercare Locator. "Assisted Living." US Department of Health and Human Services, April 13, 2012.

Health in Aging. "Assisted Living." American Geriatrics Society Foundation for Health in Aging, March 2012.

Mollica, Robert, et al. Residential Care and Assisted Living Compendium: 2007. Washington, D.C.: Department of Health and Human Services, 2007.

NIH Senior Health. "Long-Term Care." National Institutes of Health, 2012.

Polzer, Karl. Assisted Living State Regulatory Review. Washington, D.C.: National Center for Assisted Living, 2009.

In Shakespeare's The Merchant of Venice, why does Shylock hate Antonio and want revenge against him?

Shylock and Antonio have a bad history. For one, they both disdain one another because of their religions. Shylock sees Christians as sanctimonious, like Antonio, or wild, like Gratiano and his friends. Antonio also expresses antisemitism. Shylock says to Antonio, “You call me misbeliever, cut-throat dog, / And spit upon my Jewish gaberdine.”

On top of that, the two have very different views of money, partly because Shylock’s main source of income is through charging interest. This is due to his outsider status as a Jewish man in Venice. Not many job opportunities were available to him. Antonio’s practice of lending “out money gratis” (without interest) undercuts Shylock’s business. Antonio sees Shylock as greedy and predatory, “and he rails, / Even there where merchants most do congregate, / On me [Shylock], my bargains and my well-won thrift.”

There is also a personal animosity between the two men. Antonio has kicked, insulted, and spat upon Shylock. When Shylock justifies usury by using examples in the Bible, Antonio compares him to the devil, “An evil soul,” “a villain,” and “A goodly apple rotten at the heart.”

Shylock’s fury is released when his daughter Jessica runs off with a Christian and steals his money. He decides to take out his anger on Antonio. It is then that he clearly describes his hatred against Antonio:

He hath disgraced me, and hindered me half a million; laughed at my losses, mocked at my gains, scorned my nation, thwarted my bargains, cooled my friends, heated mine enemies; and what's his reason? I am a Jew.

Shylock’s deep resentment cannot be assuaged by pleas for mercy. However, in the end, Antonio is released, and Shylock is the only one to pay for his hatred.

In the text "Do Not Go Gentle into That Good Night" what do the "wise" men realize before they die? How is death presented in this poem?

According to Dylan Thomas' poem "Do Not Go Gentle into That Good Night," wise men, when they reach the end of their lives, "know dark is right." This suggests that they realize that the time has come for them to die--symbolized by "dark." Since they are wise, they know they cannot live forever, but they wish that their words would have "forked ... lightning" during their years on this globe--that is, that they would have been able to, through their wisdom, say things that could have caused positive change among those they are leaving behind. Because they will no longer be able to influence the world, they do not give up their lives easily. 

The repeated lines in the poem present death in two different ways. First, it is "that good night." Dissecting this phrase, we can take the word "that" to indicate it is a well-known commodity; it is something everyone has always had to face, and something that everyone must face sooner or later. It is "good." This seems ironic considering the poet urges his father to not succumb passively to death. Perhaps the "night" of death is good, that is, acceptable, once one gets there, but that doesn't mean one should be in a hurry to leave this life behind. "Night" can have either positive or negative connotations. While night can be a time of fear and isolation, many people enjoy the night because it is a time for sleep and rest, a time to enter into a different dimension in a way--the dimension of sleep. Taking the words "good night" as a unit, they remind us of parting words of blessing before one goes off to sleep. Thus "good night" has an almost soothing feel to it even as it contains ironic and foreboding tones.

The second repeated line describes death as "the dying of the light." This phrase is much less amenable to a positive connotation. Light is universally considered preferable to darkness; it suggests not only understanding, but also joy. One who is alive has an undeniable "light" in his eyes that connects him to others; once that light goes out, the connection with those on this earth is lost. 

Describing death as "that good night" and "the dying of the light" makes death not necessarily fearsome, but definitely poignant and worth resisting until the last possible moment.

Does insurance cover addiction treatment?

History

Although experts have known for some time that rehabilitation treatment is important for sustained
addiction recovery, not until 2008 did health insurers, on a wider scale, begin to cover addiction treatment. Typically, health insurers contract with health care facilities and providers to obtain a discounted reimbursement rate.

Mental health and addiction treatment facilities and providers have been reluctant to contract with health care insurers because they did not want to accept the reduced reimbursement and because many of their patients did not have health insurance covering mental health and addiction treatment. Less than 70 percent of addiction treatment facilities were contracted with public and private insurers. Health insurers, when they did cover addiction services, only covered detoxification. They provided little or nothing for rehabilitation services for the abuser.

A few US states had mandated that health insurers cover addiction treatment. Other states required that health insurers include options for addiction treatment but did not mandate this form of coverage; still other states did not require coverage at all for addiction services. There were exceptions, however. Self-insured employers opted not to cover addiction services, and employers covered by the Employment Retirement Income Security Act of 1974 (ERISA) were exempt from these state requirements.

ERISA is a federal law that sets minimum standards for pensions and health care insurance in private industry, but it does not require pension plans or health care insurance. Many substance abusers were not employed and had no health insurance. This left addiction treatment facilities and providers without any assurance of payment. As a result, addiction treatment facilities and providers frequently required that persons pay in advance for their treatment.

Mental Health and Addiction Coverage

In 2008, after years of lobbying by mental health advocates, the Mental Health Parity and Addiction Equity Act (MHPAE) was signed into law in the United States. This federal legislation requires that health insurance policies with coverage for mental health and substance abuse treatment include coverage at the same level as that for physical treatment. This means that co-payments, co-insurance, out-of-pocket expenses, office visit and days-of-service limitations, and in-network and out-of-network benefits, must be comparable to those for care for physical ailments.

In addition, this law requires equal mental health and substance abuse treatment coverage for self-funded health plans and for ERISA employers’ health plans; exclusions were no longer permitted. However, MHPAE has a large loophole: Health insurers and employers are not required to offer any mental health and addiction coverage.

Upon enactment of MHPAE, the greatest concern among businesses was that the act would increase the cost of health insurance. Few studies have been performed to determine whether this concern is valid. One study utilizing data from federal employees’ health plans has been performed to evaluate this change. Federal employees were granted mental health parity in 2001. The study used claims data from 1999 through 2002. The mental health costs before parity were compared with those after parity. The study found little increase in the utilization and costs of mental health and addiction treatment. However, out-of-pocket costs for members were lowered significantly.

Another flaw in the mental health parity law is the way that health insurers validate and pay for coverage. Often, they have special criteria for claims’ reimbursement that interfere with payments. For example, a health insurer might require that the mental health or substance abuse patient receive outpatient care before inpatient care. Only if the outpatient treatment fails can the person be admitted for care. Also, visits to a psychiatrist or a counselor are often limited in number by calendar year.

Issues

Even with parity for mental health and addiction treatment, additional reimbursement issues arise. First, a majority of addicted persons have no health insurance. Often they have no job or they have a job that does not provide any health insurance. Second, addicted persons often have relapses. Costs for addiction treatment are controlled through limited admissions for treatment, resulting in limited treatment for relapses.

Third, addiction treatment programs, both outpatient and inpatient, have patient rules. For example, patients cannot take any drugs while they are in the program. They are tested weekly for the presence of drugs in their urine. If they violate this rule, they can be discharged from the addiction treatment program, even if they have health insurance.

Fourth, insurers may require that substance abusers use in-network (contracted) providers. Often, only a few such facilities and providers exist in a given network, and there may be a waiting period for treatment. Programs using cognitive-behavioral therapy are more likely to accept health insurance for payment. If a patient does not respond well to this type of therapy, their health insurance is of little use to them. Fifth, denial is a common symptom of substance abuse. It can be difficult to get the patient to accept their problem and to go for treatment, even if he or she has health insurance.

Bibliography

“Acceptance of Private Health Insurance in Substance Abuse Treatment Facilities.” 6 Jan. 2011. Web. 21 Feb. 2012. http://www.oas.samhsa.gov/2k11/305/305privateins2k11.htm. Examines data on the extent to which treatment facilities are ready to accept private health insurance for substance abuse treatment services.

“Health Insurance and Substance Use Treatment Need.” Substance Abuse and Mental Health Services Administration. 2007. Web. 21 Feb. 2012. http://www.oas.samhsa.gov/2k7/insurance/insurance.htm. Describes health insurance coverage for mental health and addiction services prior to the passing of the mental health parity legislation.

Johnson, Teddi Dineley. “Mental Health Advocates Laud New Federal Parity Law: Equal Coverage for Mental Health Care.” Nation’s Health 38.10 (2008). Print. This article discusses the features of the Federal Mental Health and Substance Abuse parity legislation.

“Understanding the Federal Parity Law.” Substance Abuse and Mental Health Services Administration. Web. 21 Feb. 2012. http://www.samhsa.gov/healthreform/docs/ConsumerTipSheetParity508.pdf. A brief overview of the Mental Health Parity and Addiction Equity Act of 2008.

What are cognitive processes of decision making?

Introduction

Much of what people do, with the exceptions of reflexive and habitual behavior, results from the cognitive processes of deciding. Even a minor decision, such as whether to drive a car, take the bus, or walk to work, involves the coordination of many complex processes. In making this choice, one might take into consideration one’s perception of the weather, guilt about contributing to air pollution, feeling of physical energy, goal of obtaining more exercise, memory of a recent bus trip, desire for company, or judged likelihood of working late. Even such a relatively minor decision can be difficult to make because there are numerous considerations, and some favor one alternative while remaining considerations favor other alternatives. In addition, the decision maker cannot know all relevant information, so there is uncertainty about the outcomes of important events.

A major goal of decision research is to understand the rules that people use in choosing from alternatives. This often means gaining insight into the decision processes that are used when no alternative is clearly preferred. To accomplish this, it is necessary to understand what is meant by a rule and to identify different potential rules for selecting one of a set of alternative courses of action. Some rules are heuristics, or strategies for simplifying choice that limit the evaluation of alternatives. Heuristics can be very efficient. In the transportation example above, if one used a heuristic, one might consider only the amount of time available for getting to work. Such a simplistic analysis of the problem can, however, lead to a poor decision. In other words, the employee might have more regrets after using this heuristic than would be the case if he or she had made a more careful analysis of the alternatives.

Decision Theories

Decision theory has a long history of identifying normative procedures for decision making. These procedures tell people what rules they should follow in making decisions. A standard rule is to take into account two dimensions for each decision alternative: likelihood and utility. This principle, which is embodied in subjective expected utility theory, is intended to maximize the personal value of one’s anticipated outcomes. A person may be given a choice between a 50 percent chance of winning $100 and a certain $2. The first alternative has an expected outcome of $50 (calculated by 50 percent of $100 = $50), since that is what one would expect to win on average if one played this game many times. The other alternative has an expected outcome of $2 (calculated by 100 percent of $2 = $2). Subjective expected utility theory indicates that one should choose the first alternative, the 50 percent chance of $100, because it has a higher expected outcome. This choice is called “rational” in the sense that it is the choice that is likely to maximize earnings.

The cognitive approach to decision making emphasizes an understanding of the ways in which various factors influence the choices that people make in reality, regardless of whether they follow normative principles. In contrast to the normative approach, the cognitive approach is focused on description of the actual processes that people use. A person may be given a 30 percent chance of $100 or a certain $20. Calculations based on likelihood and value dictate that one should choose the first alternative, since its anticipated outcome of $30 (30 percent of $100 = $30) is more than $20. Many people, however, simply do not want to take the risk of receiving nothing with the first alternative, preferring the security of knowing that they will receive $20 to the uncertainty of getting $100 or nothing. The possibility of an additional $10 is not worth the risk. This is not necessarily “irrational.” As this example shows, normative decision theory cannot predict what many or even most people will choose. For this reason, psychologists have become increasingly interested in examining the processes that people actually use to make decisions.

Illusions and Heuristics

Of particular interest in the cognitive approach to decision making are those factors that lead to miscalculations of likelihood or utility, since they will ultimately contribute to undesirable outcomes. Psychologists Amos Tversky and Daniel Kahneman revolutionized the field of decision making by identifying factors that contribute to poor decision making. Some of these may be called “cognitive illusions,” because they lead a decision maker to a judgment that is in fact a distortion of reality. One type of judgment that is often affected by such illusions concerns likelihood estimation, the chance of an event leading to a particular outcome.

Another type of judgment that is susceptible to illusionary distortion is the estimation of quantity or frequency. In making these estimations, people often use heuristics. In a heuristic for estimating quantity called anchoring and adjustment, one takes any available number as an initial starting point or anchor and then adjusts it to arrive at an estimate. For example, one might predict tomorrow’s temperature by taking today’s temperature and adjusting downward for forthcoming rainfall. Although heuristics can be more efficient than the careful and comprehensive analysis of relevant information, they can also be misleading.

Illusions and heuristics can be detrimental to good decision making because they lead the decision maker to a distorted view of the problem and available alternatives. It is often possible to develop procedures for improving the decision-making process. Elaborate technologies have been developed to assist people in making decisions in nearly every area. Sometimes it is instructive, however, merely to understand the processes that people use and to know their limitations. It must be kept in mind that evaluating the quality of decisions is difficult. One reason for this difficulty is that some decisions that are made with great care, thought, and objectivity can still have disappointing outcomes, while luck can operate to bring favorable outcomes despite poor decision processes. The ultimate key to improving human judgment and decision making is research that integrates normative and descriptive theories.

Expectancy, Utility, and Motivation

The principles of subjective expected utility theory have been applied in a wide variety of problem areas. A distinction between expectancy and utility can be quite useful. For example, two people who choose to continue to smoke may do so for different reasons. One may truly believe that he or she has a high chance of developing a serious disease such as lung cancer; however, that person may anticipate great medical advances and expect that lung cancer will be only a mild problem by the time he or she is diagnosed with it. Though the expectation of a negative outcome is high, the outcome is not particularly negative to this individual. Another person may be convinced that lung cancer will continue to be a painful, expensive, deadly disease within his or her lifetime. Despite the fact that this outcome has great negative utility for this person, he or she may continue to smoke due to an expectation that he or she will not develop lung cancer. Each of these individuals is influenced by different factors. Understanding how the decision to smoke or to quit is made can assist health advocates—and tobacco advertisers—in influencing these decisions.

One of the areas in which subjective expected utility principles have been highly influential is that of motivation. While early theories of motivation viewed behavior as the result of basic drives or personality traits, subsequent theories emphasized the ways in which people thought about their options. From this perspective, it is meaningless to label someone “unmotivated.” Everyone is motivated, in the sense that all people have time and effort to give to activities. People choose how much time and effort to give to each of the various options open to them: work, leisure, and family activities. Employees who do little or no work do not necessarily lack “drive” or have flawed personalities. They have simply decided to spend their time and effort on other things. This does not excuse or overlook the workers’ lack of productivity, but it does suggest methods to alter their lack of performance. The key is to understand how they judge the utilities of outcomes that result from working and their perceived likelihood of obtaining these outcomes by choosing to put time and effort into work activities. Thus, the study of decision making is important to organizational efforts to enhance productivity.

Biases in Decision Making

In one sense, it is easy to observe instances of illusions and heuristics that lead to biases in decision making in real life. Bad decisions seem to be everywhere. As noted, however, decisions that turn out badly may sometimes result from badly made decisions. People are accustomed to judging the actions of others and will label them irrational if it appears that they are choosing alternatives with inferior outcomes for themselves. During the Persian Gulf War of 1991, the American media frequently concluded that Saddam Hussein was “irrational” because he chose not to withdraw from Kuwait by the United Nations deadline. Though it is tempting to label an enemy irrational, it is wise to keep in mind a serious problem in determining irrationality in a decision maker: it is exceedingly difficult to assess the utility of any alternative for the decision maker. By American standards, it would have been better for Iraqi forces to withdraw from Kuwait before suffering enormous loss of life and eventually being forced to withdraw anyway, so it seemed that Hussein could not possibly be evaluating the alternatives realistically. Either he did not understand the potential magnitude of the human and economic losses that would result from a failure to withdraw or he did not understand the virtual certainty of losing the war. Hussein may, however, have understood both perfectly and simply have attached different utilities to the outcomes anticipated from withdrawal versus war. Perhaps from Hussein’s perspective, the loss of life could be offset easily by the opportunity to show himself to the Arab world as someone who stood up to the international community, if only briefly.

Scientific investigations of biases in decision making require that the investigator prove that a given alternative is superior to the one that is chosen by most people. This is often done by means of mathematics or statistics. In one demonstration of the representativeness bias, people are given a brief personality sketch of “Linda” and asked to determine how likely it is that Linda is a member of various categories. Most people tend to judge Linda as more likely to be a bank teller and a feminist than merely a bank teller. In fact, however, there must be at least as many bank tellers as there are feminist bank tellers, since the category “bank teller” will contain all feminist bank tellers as well as all nonfeminist bank tellers. The illusion comes from the erroneous conclusion that because Linda’s personality traits represent both the occupation of a bank teller and the political perspective of a feminist, she is more likely to be both than one or the other. Research such as this helps to determine how people can jump to conclusions and misjudge someone. Overestimating the likelihood that a person belongs to two categories diminishes one’s ability to estimate appropriately the expected utilities of alternatives for decisions about that person.

Decisions in the Workplace and Daily Life

Numerous forces have come together to fuel the study of human decision making as a cognitive process. One of these is the coming of the information age. With the transition from a production economy to a service economy, workers are no longer seen as people who engage in only physical work; rather, workers at all levels deal with information and decisions. It is no longer possible to attribute all the difficulty of making decisions to insufficient information, as decision makers are often overloaded and overwhelmed by information. The real problem they face is knowing which information to select and how to integrate it into the decision-making process.

Within psychology, two areas of study that have had a great impact on behavioral decision making are perception and quantitative psychology. Both Kahneman and Tversky did extensive work in the area of perception before becoming interested in studying the cognitive processes in human judgment and decision making. Many other behavioral decision researchers began their studies in quantitative psychology or statistics. The primary objective in this area is to learn how to make decisions under uncertainty using the laws of probability. Because this is what people routinely face in the course of their work and daily lives, there are many intriguing parallels between statistics and behavioral decision making.

Advances in understanding the rationality of human decision making were furthered, ironically, by
economic theories that assumed rationality on the part of human decision makers. Psychologists who conducted empirical studies of people had data to show that many choices that people make do not follow rational economic models. For example, standard economic theory predicts that people will choose the option that maximizes their own payoff. Yet people often prefer a plan that they deem fair to everyone over one that is financially superior for themselves. Behavioral decision theory attempts to understand the way in which people actually make decisions, not the way that formal models say that they should.

Bibliography

Ariely, Dan. Predictably Irrational: The Hidden Forces That Shape Our Decisions. New York: Harper, 2008. Print.

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