How can we make the choices better?

Asking ‘what are the other choices’ is often the right question

The oncologist offered me a choice of do nothing (die within four to nine months) or have six cycles of a chemo cocktail called FEC-D (fuck-D my dear friend Barbara called it).

Yucky options both.

We asked for a week to research other treatments. We learned of one that, although it wasn’t yet in our health system’s protocol, had hopeful outcomes for Triple Negative Breast Cancer. We brought this third option and my oncologist agreed. After treatment ended new research confirmed our choice improved my chance of survival. Whew.

Maybe this is the wrong question: How can we make better choices?

What would happen if the question was: How can we make the choices better?

When my conflict coaching clients produce a choice of either X or Y, and then agonize over whether to do X or Y, I ask: “What are the other choices?”

Changing the question creates a new conversation

Here’s an example from the news: Canada’s federal politicians debated sex selection abortion; that is, should there be legislation banning termination of female embryos because of a cultural or other preference for sons? Debates included the usual pro-choice and anti-abortion arguments.

The better questions weren’t asked: how do we change mindsets so that girl children are as valued and loved as boy children? What would it take to have the gender of the child irrelevant in matters of wedding costs, succession planning, inheritance patterns, and looking after parents in their old age? If women were valued the same as men, domestic security and outcomes for all children would improve.

How to recognize wrong questions?

Here are two familiar choices I consider the wrong question:

Shall we have an intact environment or have jobs fuelling the economy?

Is it better to reduce taxes so people keep more money each month or fund adequate public services so people spend less on the service individually?

And so on. The best answer is – it depends, but the question is a forced choice.

Wrong questions limit the answer. They’re easy to spot in ‘either – or’ simplified extremes pitted against each other. Does asking better questions generate more (better?) options?

Problems reduced to forced choices often result in decision paralysis. Complex human values reduced to rigid simplicity make both choices feel wrong and decisions become hard.

Choice is a blessing if the options are good

Tuesday I go to my office after almost two years on disability. Am I excited to return to work I love? Yes. Scared? Absolutely! Did I enjoy being home? Yes. Which would I rather do – go to work or stay home? It stops at a simple yes because that question is limited. In this time of transition, I’m grateful to have a choice of two wonderful ways to spend my days.

Having choice is such a luxury. The wisdom in the cancer field is that patients involved in their treatment decisions do better. So, on my last weekend before going back to work, I’m sitting in the spring sunshine appreciating the privilege of having choices because of an expanded list of options.