Poiesis as Decision Making: Shklovsky, Tynianov, Bakhtin

This article deals with the theories of Viktor Shklovsky and Iurii Tynianov from the perspective of decision science. It outlines how these two members of the Petersburg Society for the Study of Poetic Language (OPOIAZ) conceived of the writer as a rational agent pursuing a specific goal, and of the means at his or her disposal to attain it. Their approaches, the article illustrates, correspond closely with two specific types of rationality: “instrumental” and “bounded.” To conclude, the essay juxtaposes the formalists’ conceptualization of poetic creativity with Mikhail Bakhtin's view on the subject, arguing that the way he conceives of the strategies available to the literary author fits the label of “interactive rationality.”

Opportunities for theory-informed decision science in cancer control

Cancer prevention and control involves navigation of complex clinical decisions, often laden with uncertainty and/or intricate interpersonal dynamics, which have implications for both physical health and quality of life. Cancer decision-making research in recent decades has primarily focused on working to improve the quality of decisions by providing patients with detailed information about their choices and through an increased emphasis in medicine on the importance of shared decision making. This emphasis is reflective of a model of decision making that emphasizes knowledge, options, and deliberative synthesis of information as primary to decision making; yet, decades of research in psychology, decision science, and behavioral economics have taught us that our decisions are not influenced only by our objective knowledge of facts, but by our emotions, by the influence of others, and by biased cognitive processes. We present a conceptual framework for a future of research in decision science and cancer that is informed by decision science theories. Our framework incorporates greater recognition of the interpersonal dynamics of shared decision making, including the biases (including cognitive heuristics and race-based bias) that may affect multiple actors in the decision-making process, and emphasizes study of the interaction between deliberative and affective psychological processes as they relate to decision making. This work should be conducted with an eye toward informing efforts to improve decision making across the cancer care continuum, through interventions that are also informed by theory.

Risk perception and communication

Public health depends on laypeople’s ability to understand the health-related choices that they and their societies face. The study of risk perception examines that ability. The study of risk communication examines the processes that determine how well communications help (or hinder) their recipients. Although focused on decisions involving risk, such research necessarily considers potential benefits as well, if only the benefits that come from reducing risks (e.g. through medical treatments, lifestyle changes, or improved air quality). Communication is a two-way process. Without listening to people, it is impossible to understand what they know and value, as a foundation for providing relevant information in a comprehensible form. Here, we draw on basic research in decision science (behavioural decision research) to inform the specific challenges faced by public health researchers and practitioners. This chapter seeks to help experts help laypeople make wise health choices.

Does HIV status confer a higher risk of acquiring COVID-19? Using Clinical Decision Science to combat patients’ anxiety

A clinical decision report using: del Amo J, Polo R, Moreno S, et al. Incidence and Severity of COVID-19 in HIV-Positive Persons Receiving Antiretroviral Therapy. Annals of Internal Medicine. 2020;173(7):536-541. https://doi.org/10.7326/m20-3689 for a patient with HIV and concerns about COVID-19 for immunocompromised individuals.