Beyond Informed Choice

Eleanor Roosevelt on choice

Choice is our greatest power. It’s what allows us to use all our resources to live our best lives.  But the consumer culture trains us to make decisions by default rather than by conscious choice. Truth is, questioning the status quo and making conscious choices can seem daunting. Many of us are happy to let others decide because we don’t know how to make choices consciously.

Living by default

Living by default means letting society and those around you determine how you live. On the other hand, conscious choice is the deliberate act of deciding between two or more possibilities. We are choosing with full awareness instead of allowing chance to determine what happens.

Living by default is the easier way, but sooner or later it’s pretty much guaranteed to result in dissatisfaction. We have done what we thought was expected, and the day comes when we recognize life hasn’t turned out as we thought it would. We end up both surprised and disillusioned.

There is an advantage to making your own decisions rather than reacting in a knee-jerk manner to cultural expectations. You get to create your own life.

False choice

The consumer culture doesn’t train us to make conscious choices. We are being conditioned to react to what’s put before us rather than choosing consciously. We are conditioned by the culture to think we have choice.

Many people will disagree, saying we have a huge amount of choice. Go into any mall, any on-line store, and it’s brimming with things to buy. Search the internet for information and you’ll find plenty of ready-made opinions to buy into.

All of those are superficial choices. It reminds me of parenting advice I received when my boys were little. It went like this: To teach them to make choices, start with something like clothing. In the store, preselect two or three options that are acceptable to you, and let the child select which one of those to buy.

That’s fine for teaching children by easing them into the process of making decisions. But they will grow up with a case of arrested development if they don’t learn to make fundamental choices and to take responsibility for the results of making those choices.

I’ve said before that some patients willingly give up their power to their doctor, thus making the doctor responsible for them. It’s unfair to the doctor, but we are not doing ourselves a favour either. The more we live that way, the more we forget that we are meant to be the project managers of our own health.

The missing piece…

Informed choice is a common concept in consumer education. Yet information isn’t enough by itself. We cannot make sound decisions on information only. Self-awareness is equally important, and is often the missing piece.

It’s the lack of self-awareness that makes us afraid of the power of choice, because we don’t have confidence that what we decide is the best solution. This is because we are using logic only, and not drawing on our inner knowing to determine what works best for us.

Conscious Choice


Undoubtedly, information is important when making health decisions. Your doctor is an obvious source of information. But there are downsides to relying solely on that information.

  • Your options are limited to the scope of training of that doctor. For example, conventional medical training includes next-to-no nutrition classes. Unless your doctor has taken nutrition courses in addition to medical training, dietary advice will be vague truisms without the nuances that are understood by a functional nutritionist  or doctor.
  • Advice is framed by that doctor’s bias, which may be different from yours. I have experience with this because my bias is to look for the non-pharmaceutical solutions first. Medical doctors are trained only in pharmaceuticals, so they don’t have any information to help me make decisions about starting with non-drug options. The mismatch is difficult for both of us.


Without self-awareness we are stabbing in the dark.

These things are true…

  • What works for the “average” person isn’t necessarily right for you. I’ve written about this here.
  • Your doctor is not a mind reader. Some of them are intuitive enough to zero in on your problem even if you are unengaged in the process. However, that isn’t their job. I know a doctor who says, “I can’t care more about your health than you do.” He has a point.
  • It’s our right and responsibility to participate in decisions that affect us. If we choose not to, then we have no right to complain if we don’t like the results.
  • Self-awareness increases when we practice mindfulness. Mindfulness is a practice arising out of eastern philosophy. Here are a few definitions: Mindfulness is paying attention with kindness. Mindfulness is sustained present-moment awareness. Mindfulness is a flexible state of mind in which we are actively engaged in the present, noticing new things, and sensitive to context. Mindfulness keeps us from being stuck in single, rigid perspectives that make us oblivious to alternative ways of knowing. Ellen Langer and Rick Hanson are two researchers who teach about mindfulness in the context of daily western life.

Conscious choice in action…

Self-responsibility and conscious choice are sometimes mis-interpreted as being bossy and aggressive. Not so. Remember this old saying: You catch more flies with honey than you do with vinegar.

You are building a relationship with your doctor and that takes time and conscious effort. Here is some excellent advice from a podcast at Phoenix Helix. Host Eileen Laird interviews Dr. Cynthia Li about building effective doctor-patient relationships. We don’t often hear about this topic from the doctor’s perspective, and Dr. Li is very forthcoming. There are detailed show notes accompanying this podcast, and you might want to read them or listen to the podcast, both at this webpage.

Self-Advocacy – What’s the Best Way to Get a Doctor to Listen?

  • Don’t bring research to your very first appointment. That is likely to get you off on the wrong foot. Treat your first appointment as a “meet and greet” where you are simply getting to know each other.
  • Once you have established a relationship with your doctor, you can share studies with them. However, understand that doctors are very pressed for time, so they are unlikely to read books or full articles that you bring to your appointment. Instead, email them an excerpt or abstract summary with a link to the full research article. That’s enough to give them the highlights and they can pursue it further if interested.

What Makes a Good Patient? 

  • Remember that your doctor is human, too.
  • Keep your expectations simple in the beginning. It takes time to build relationships. They don’t form instantly.
  • Remember that this is a partnership, and your participation is as important as the doctor’s.
  • When preparing for the appointment, make a list of things you’d like to discuss. Prioritize them. That way your top priorities will be  met so if the physician has limited time.

Do you relate to any of this? Can you see how any of these ideas could be applied in your own life? Have anything to add? I always appreciate comments.

2 thoughts on “Beyond Informed Choice

  1. Thank you Laurana, for another down to earth and practical blog.
    You put into words things that I know, or have realized, or have done.

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