The Role of Regret in Medical Decision-making

This paper examines the role that regret does and should play in medical decision-making. I assess whether the possibility of a patient experiencing post-treatment regret is a good reason for doctors to advise against, or withhold altogether, a treatment. As things stand, the possibility of post-treatment regret is sometimes taken to a strong reason against a treatment, even when a decision-competent patient makes an informed request for it. Furthermore, medical researchers and practitioners frequently understand post-treatment regret to be a serious problem, which reveals a mistake or flaw in the medical decision-making process. I argue against these views. I show that the possibility of post-treatment regret is not always, or even often, a good reason for withholding a treatment. Indeed, there are occasions when the very reference to post-treatment regret during medical decision-making is inappropriate. This, I suggest, occurs when the decision concerns a “personally transformative treatment”. This is a treatment that alters a person’s identity. Because the treatment is transformative, neither clinicians nor the patient him/herself can know whether post-treatment regret will occur. As a result, what matters when deciding to offer a personally transformative treatment is whether the patient has sufficiently good reasons for wanting the treatment at the time the decision is made. What does not matter is how the patient may subsequently be changed by undergoing the treatment