The role of emotion in decision‐making
| Date | 15 August 2011 |
| DOI | https://doi.org/10.1108/14668201111177932 |
| Published date | 15 August 2011 |
| Pages | 194-202 |
| Author | Hilary Brown |
| Subject Matter | Health & social care,Sociology |
The role of emotion in decision-making
Hilary Brown
Abstract
Purpose – This review of the decision-making literature aims to challenge the rational model of
decision-making upon which the Mental Capacity Act (MCA) 2005 is premised.
Design/methodology/approach – The paper forms part of a larger study commissioned by the Office
of the Public Guardian looking into complex cases.
Findings – The literaturesupported the study findings thatdecisions are not made in a linearway and
identifiedthe importance of historyand memory,motivation and drive, moodand stability,and openness to
influencewhen assessingthe mental capacityof vulnerablepeople, especiallyin the contextof self-neglect.
Practical implications – This paper will inform workers in health and social care about the emotional
factors that influence decision-making and increase their ability to make nuanced assessments.
Social implications – Taken together, with other publications from this project, this paper alerts
practitioners to situations where vulnerable people are out of their depth; when the role of depression
and anxiety may be at least as salient as their understanding of possible consequences and when the
past may exert more control over their actions than their understanding of future options.
Originality/value – The paper’s added value is that it uses ideas that are current within academic
psychology to make explicit some of the factors that lead to complexity when assessing mental capacity
under the MCA, especially in the context of self-neglect.
Keywords Mental capacity, Decision making, Vulnerable adult, Neglect, Self-neglect, Service-refusal,
Psychology, Depression
Paper type Literature review
Introduction
The mainstream press is excitedly debating a new book written by the political commentator
David Brooks (2011) because it challenges politicians to think about voters as ‘‘social
animals’’ who make judgments based on unconscious and not always rational bases. Those
of us who are concerned with implementing and using the Mental Capacity Act 2005 (MCA)
might do well to take note because the MCA is predicated on individuals making rational
decisions in their own best interests even though this is not always the way decisions are
made. This cognitive, linear model of decision-making provides the ‘‘test’ ’ that we use to
assess capacity and assumes that decisions are made on the basis of a cool assessment of
the future outcomes of various options and alternatives through some type of cost– benefit
analysis. A model in which decision-makers are:
[. ..] assumed to evaluate the potential consequences of their decisions dispassionately and to
choose actions that maximized the ‘‘utility’’ of those consequences. Once chosen, it was
assumed that the utility-maximising course of action would be implemented automatically’’
(Loewenstein and Lerner, 2003, p. 619).
But this begs many questions when it comes to the situations that health and social care
professionals routinely face in their day-to-day work with clients and patients including those
cases in which vulnerable adults are prone to self neglect.
PAGE 194
j
THE JOURNAL OF ADULT PROTECTION
j
VOL. 13 NO. 4 2011, pp. 194-202, QEmerald Group Publishing Limited, ISSN 1466-8203 DOI 10.1108/14668201111177932
Hilary Brown is based at
Canterbury Christ Church
University, Canterbury, UK.
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