Clinical Decision Making in Paediatric Anaesthesia

Abstract

Decision making is the cognitive process leading to the selection of a course of action among variations. Every decision-making process produces a final choice. Decision making is said to be a psychological construct. This means that although we can never “see” a decision, we can infer from observable behaviour that a decision has been made. Therefore, we conclude that a psychological event that we call “decision making” has occurred. It is a construction that imputes commitment to action: i.e. based on observable actions, we assume that people have made a commitment to perform the action. If the environment is predictable and routine, some decisions and actions can be relegated to an almost automatic level. In contrast, when there is uncertainty, a sustained level of vigilance and attention may be required. At the highest level of cognitive function we can make a decision to monitor our decision-making process: this is meta-cognition [1]. The spectrum of decision-making in medicine runs from simple to complex and is related to the level of uncertainty. There are a variety of tasks with varying degrees of certainty.