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• Article | Pediatrics | 2012

  Effects of Description of Options on Parental Perinatal Decision-Making

  Marlyse F. Haward, Leslie John, John M. Lorenz and Baruch Fischhoff

  Objective: To examine whether parents' delivery room management decisions for extremely preterm infants are influenced by (a) the degree of detail with which options-comfort care (CC) or intensive care (IC)-are presented or (b) their order of presentation. Methods: 309 volunteers, 18-55 years old, were each randomized to one of 4 groups: 1. detailed descriptions, CC presented first; 2. detailed descriptions, IC presented first; 3. brief descriptions, CC presented first; and 4. brief descriptions, IC presented first. Each received the description of a hypothetical delivery of a 23-week gestation infant and chose either IC or CC. Open-ended and structured questions elicited reasoning. Data were analyzed by chi-square and logistic regression analysis. Results: Neither degree of detail, comparing groups 1+2 with 3+4 (37% v 41%, OR=0.85, 95%CI=0.54-1.34, p=0.48), nor order, comparing groups 1+3 with 2+4 (40% v 37 %, OR=0.88, 95%CI=0.56-1.39; p=0.59), influenced the likelihood of choosing IC. Participants choosing IC were more likely to invoke sanctity of life and religiosity as personal values. Additional reasons for choosing IC were experiences with infants born at later gestational ages, giving the baby a chance, not watching their baby die, and equating CC with euthanasia. Some choosing CC wanted to avoid infant suffering. Conclusions: The degree of detail and order of presentation had no effect on treatment decisions, suggesting that individuals bring well-articulated preexisting preferences to such decisions. Understanding beliefs and attitudes motivating these preferences can assist physicians in helping parents make informed decisions consistent with their values.

  Keywords: Decision Making; Presentations; Mathematical Methods; Personal Characteristics; Attitudes; Motivation and Incentives; Family and Family Relationships; Value; Health Care and Treatment;

  Citation:

  Haward, Marlyse F., Leslie John, John M. Lorenz, and Baruch Fischhoff. "Effects of Description of Options on Parental Perinatal Decision-Making." Pediatrics 129, no. 5 (2012).

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• Case | HBS Case Collection | 2012

  Jess Westerly at Kauflauf GmbH

  John J. Gabarro and Colleen Kaftan

  Jess Westerly is the assistant product owner of CRM applications for computer and office supply wholesalers and retailers at Kauflauf, a fast-growing provider of subscription enterprise software headquartered in Heidelberg, Germany. Only months into her job, outsider Westerly tries and fails to implement a change in field consultants' sales call patterns. Westerly had introduced the changes to the sales organization via a memo that outlined her directive and explained the reasons behind it. Field consultants immediately complained about the infringement on their decisions about how to spend their time and the insensitivity to the relationship-oriented nature of developing business. Three months later, sales statistics show little difference in calling patterns. After explaining, defending, and reshaping her stalled initiative, Waverly presents her amended proposal to key senior executives and is given three weeks to produce an implementation plan. If the plan is deemed acceptable, she will be asked to implement it.

  Citation:

  Gabarro, John J., and Colleen Kaftan. "Jess Westerly at Kauflauf GmbH." Harvard Business School Brief Case 913-527, August 2012.

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• Teaching Note | HBS Case Collection | 2012

  Jess Westerly at Kauflauf GmbH (Brief Case)

  John J. Gabarro and Colleen Kaftan

  Citation:

  Gabarro, John J., and Colleen Kaftan. "Jess Westerly at Kauflauf GmbH (Brief Case)." Harvard Business School Teaching Note 913-528, August 2012.

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