Ambivalence in Decision-Making: A Podcast with Joshua Briscoe, Bryanna Moore, Jennifer Blumenthal-Barby & Olubukunola Dwyer
episode
GeriPal - A Geriatrics and Palliative Medicine Podcast
51 min
2 speakers
8 chapters
transcribed 9 hours ago
Transcript
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What is the purpose of this episode and who are the expert guests?
This episode of the Jerry Paul podcast is CME eligible.
To claim credit, please go to the CME tab on jerrypal.org.
Welcome to the Jerry Paul podcast. This is Eric Guadera. This is Alex Smith. And Alex Smith. We got a lot of ground to cover today. We're going to be talking about ambivalence with four amazing guests. Who is with us today?
We are delighted to welcome Bri Moore, who is a philosopher and bioethicist, and she's at the University of Texas Medical Branch, where she also directs the Clinical Ethics Fellowship. Welcome to the Jerry Powell Podcast. And we're delighted to welcome back to the Jerry Powell podcast, Jenny Blumenthal-Barbee, who's a philosopher and bioethicist and associate director for the Center for Medical Ethics and Health Policy at the Baylor College of Medicine. Jenny was last on our podcast talking about the ethics of nudging. I know Eric's mentioned that podcast maybe in every podcast since
then. Every podcast since then. The nudging people to listen to the podcast.
That's right. Jenny, welcome back to Jerry Powell.
Good to be here.
And we're delighted to welcome Omeri Dwyer, who is a lawyer and bioethicist and assistant professor at Case Western Reserve and University Hospitals. Omeri, welcome to Jerry Pal.
Thanks for having me.
And we're delighted to welcome back Josh Briscoe, who we last had on talking about the uncanny valley, something we mentioned on the podcast we recorded yesterday with Bob Wachter. He is a palliative care physician at the Durham VA Medical Center in Duke and blogs on Substack at Notes from a Family Meeting. Josh, welcome back to Jerry Pal. Thank you all.
So yeah, we got a powerhouse of guests today. We're going to be talking about ambivalence, what it is, what should we do about it. It's all stemmed from a post that Josh wrote from his Substack notes from a family meeting. We'll have a link to that on our show notes. So a lot of ground cover. But before we do, we always turn to a song request. Jenny, I think you have the song request today. Is that right? I
do. Alex, I'm going to request Peace of Mind by Boston.
Why Peace of Mind, Jenny?
I mean, I feel like it speaks for itself. It's a song about understanding about indecision, but wanting peace of mind. So I thought it was perfect for a podcast on ambivalence.
Great choice. Now, I don't have the full band and my hand's still recovering from being broken. So I'm playing this kind of Jack Johnson style. So let's see if that comes through. Now if you're feeling kinda low about the dues you've been paying Future's coming much too slow And you wanna run but you just keep on staying Can't decide which way to go I understand about indecision But I don't care if I get behind
On a
scale of 1 to 10 for songs that perfectly align with topic, Jenny, I think you got a 10 on that one.
That was great, Alex.
Great choice. Thank you.
So again, for me, this stemmed from reading Josh's notes on a family meeting sub stack post that came from Josh. Is that right? From you reading the 2022 article that was authored. I think the lead was Bri on that. Is that right, Josh?
Yeah. Yeah. This was a paradigm shifting paper for me. Really helpful paper.
Before we go into the paper, because we're going to talk about the paper. Why was it paradigm shifting for you?
Yeah, I think this is a big part of my work as a palliative care doc is helping people make decisions. And 99% of the time, they're not ready to make a decision as soon as you lay out all the facts. You know, there's something that gets in the way. And we can talk some about how clinicians help or hinder that process in a bit. But yeah, it's just something that stuck in my craw and they've just put words to everything I've been struggling with as a clinician.
And I absolutely adore your post. I saw the first comment was Susan Block, who is, for those who don't know, Susan Block is, we actually had her on the podcast, one of the true leaders of our field. I want to then turn to Bri then. Bri, before we talk about what you did in the paper, let's take a step back. Why did you decide to write this paper?
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Chapters
8 chapters
1
What is the purpose of this episode and who are the expert guests?
0:00–9:13
2
Why did the hosts choose “Peace of Mind” by Boston as the song request?
9:13–16:56
3
How did Josh’s Substack post and the 2022 “Two Minds, One Patient” paper spark this discussion?
16:56–24:02
4
How do the guests define ambivalence in clinical decision‑making?
24:02–30:02
5
What are the different ambivalence‑related phenomena (e.g., uninformedness, evolution, vacillation)?
30:02–36:53
6
When is ambivalence a sign of a deeper value conflict versus a decision‑making problem?
36:53–43:39
7
What practical strategies can clinicians use to address patient and provider ambivalence?
43:39–49:43
8
What final advice do the guests give listeners for navigating ambivalence in real life?
49:43–51:31
Speakers
2 identifiedMore from GeriPal - A Geriatrics and Palliative Medicine Podcast
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