Two Minds, One Patient: Clearing up Confusion About "Ambivalence"

Am J Bioeth. 2021 Feb 23;1-18. doi: 10.1080/15265161.2021.1887965. Online ahead of print.

Abstract

Patients who experience difficulty making medical decisions are often referred to as "ambivalent." However, the current lack of attention to the nuances between a cluster of phenomena that resemble ambivalence means that we are not always recognizing what is really going on with a patient. Importantly, different kinds of "ambivalence" may call for different approaches. In this paper, we present a taxonomy of ambivalence-related phenomena, provide normative analysis of some of the effects of-and common responses to-such mental states, and sketch some practical strategies for addressing ambivalence. In applying lessons from the philosophical literature and decision theory, our aim is to provide ethicists and clinicians with the tools to better understand and effectively intervene in cases of ambivalence.

Keywords: Ethics; ambivalence; choice behavior; decision making; indecision; uncertainty.