Premortem Examination Can Help Decisions

This was an interesting read in the Sunday paper. Of course, the word “premortem” brought to mind “vivisection” in H.G. Wells’ “The Island of Dr. Moreau”, which I remember reading as a teenager:

Instead of weighing real or imagined pros and cons of two alternative courses of action, imagine the choice has already been made.

“The psychologist Gary Klein has developed a variation on this technique. He calls it a “premortem.” As the name suggests, the approach is a twist on the medical procedure of post-mortem analysis. In a post-mortem, the subject is dead, and the coroner’s job is to figure out the cause of death. In a premortem, the sequence is reversed: “Our exercise,” Dr. Klein explains, “is to ask planners to imagine that it is months into the future and that their plan has been carried out. And it has failed. That is all they know; they have to explain why they think it failed.”

Imagine having to make a difficult treatment decision. Then consider being fast forwarded into the future. Your patient’s surviving spouse says, in a faint voice:

“Doc, you made the wrong decision…”

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