In “Forced to be Free”, Neil Levy surveys the raft of documented decision-making biases that humans are heir to, and advances several bold proposals designed to enhance the patient's judgment. Gratefully, Levy is moved by the psychological research on judgment and decision-making that documents people's inaccuracy when identifying courses of action will best promote their subjective well-being. But Levy is quick to favour the patient's present preferences, to ensure they get “final say” about their treatment. I urge the opposite inclination, raising doubts about whether the patient's “present preferences” are the best expression of their “final say”. When there is adequate evidence that people, by their own lights, overemphasize their present preferences about the future, we should carefully depreciate those preferences, in effect biasing them to make the right decision by their own lights.
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Competing interests None.
Provenance and peer review Commissioned; internally peer reviewed.
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