How to make the choices better?

“How to make good choices” can be the wrong question

When my conflict coaching clients produce a choice of either X or Y, and agonize over the decision, I ask: “What are the other choices?” They often can’t find others. What if the right question is: How do we make the choices better? In other words, does the quality of the question limit the choices?

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, and he asked me to pick one.

How can we make the choices better?

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

Changing the question creates a deeper conversation

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

The better questions aren’t asked: how do we change mindsets so girl children are as valued and loved as boy children? What would it take to have the child’s gender irrelevant to wedding costs, succession planning, inheritance patterns, and looking after parents? If women were as valued as men, then domestic security and outcomes for all children improves.

How to recognize wrong questions?

Here are two familiar wrong questions:

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

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

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.

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