New Neurological Understanding Could Enhance Patient–Doctor Co-operation - European Medical Journal

New Neurological Understanding Could Enhance Patient–Doctor Co-operation

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INSIGHTS into neurological mechanisms underpinning individual attitudes to freedom of choice have been uncovered by researchers from the University of Bern, Bern, Switzerland. The study, which reported brain activations in response to restrictions on freedom of choice, could lead to the introduction of new methods to increase the levels of patient co-operation with instructions they are given by doctors.

Attitudes to Freedom of Choice

While some people react negatively to having their decision dictated by someone else, others have no problem with this. Until now, there had been no explanation as to why urges for freedom of choice vary between individuals. To try and better understand potential brain mechanisms that lie behind this, the team devised an experiment that included recording brain activations in 51 volunteers.


Money was allocated between the participants and another person, with the other person either allowing the participants to choose freely how to divide the money or prohibited the participants choosing the most unfair option. Brain activations were recorded with a MR scanner whilst the participants made their decisions and they were also asked about their thoughts and feelings during the process.

Communication Strength

The results showed that many of the participants who were restricted in the choices they could make reacted with defiant behaviour and chose less generous allocations than they otherwise would have done when they could freely decide. However, others were willing to be generous in any case. The brain scans revealed that stronger communication between certain areas of the brain resulted in more defiant behaviour. This was particularly the case in two areas centrally involved in complex decision-making and attention: the parietal lobe and the frontal lobe. The strength of communication also mirrored whether or not the restriction was perceived as a sign of distrust by the participants and the extent to which this perception influenced their decision-making.

Increasing Co-operation

The study results not only enhance the knowledge of neurobiological mechanisms, but also could help doctors better understand the different responses they get from patients to instructions and restrictions. “Our findings have implications for many areas, such as the health system,” commented Dr Sarah Rudorf, University of Bern. “By better understanding the responses to restrictions we can derive more efficient measures to increase co-operation.”


James Coker, Reporter

For the source and further information about the study, click here.

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