FRIDAY, June 2 (HealthDay News) — Whether it’s cancer, HIV, or even a hypothetical bird flu pandemic, health crises can force people to make tough medical decisions, quickly.

Now, new research suggests a patient makes these decisions in a way that’s very different from that of their family members or doctors.

“When you’re a patient, and you’re sick, and you’re just trying to absorb all the information and the emotions of a new diagnosis, it’s very difficult to grasp the whole story,” said study author Brian J. Zikmund-Fisher, research investigator at the University of Michigan Medical School, in Ann Arbor. In that case, he said, “you grab onto one part of the story and lose sight of the whole picture.”

So, helping patients imagine what their doctor might think of a particular treatment choice, “might be a very good way to help patients get a bigger perspective on decisions they might face,” said Zikmund-Fisher, who is also affiliated with the VA-Ann Arbor HSR & D Center of Excellence.

In their study, published in the June 2006 Journal of General Internal Medicine, his team conducted an Internet survey with nearly 2,400 men and women over the age of 21.

Participants were randomly assigned to one of four groups, each of which was asked to imagine facing two medical decisions as if he or she were a different “player” in the health-care setting: either the patient, the patient’s doctor, a parent making a choice on behalf of their underage boy or girl, or the medical director of the hospital offering treatment.

All companies the respondents faced two scenarios, each requiring serious medical decisions.

The first involved deciding whether or not to get a new vaccine against a deadly flu. Participants were told that without the vaccine, there was a 10 percent chance of dying from the flu. However, the vaccine itself — which was based on a weakened version of the flu — also presented a risk of death estimated at 5 percent.

In the second scenario, a similar risk calculus was presented with respect to a slow-growing cancer. The risk of death attached to doing nothing about the cancer had to be weighed against the risk of death linked to chemotherapy.

Zikmund-Fisher and his colleagues found that the choices made when faced with both “stories” varied significantly depending on which “character” was making the decision.

“Patients” were less likely to choose to vaccination or chemotherapy than all other scenario participants.

In the “deadly flu pandemic” scenario, just 48 percent of people who imagined themselves as the patient said they’d try the vaccine, compared to 57 percent of those deciding for their child, 63 percent who put themselves in the role of vaccinating physician, and 73 percent of people told to act as the medical director of a hospital.

In the “chemotherapy” scenario, the numbers were similar: 60 percent said they would use it if they were the patient, 72 percent chose it for their child, 68 percent said they would advise the treatment to patients as a doctor, and 68 percent said they would support use of chemotherapy in this situation if they ran a busy hospital.

Advanced age did appear to play a role in making decisions, the researchers found. Those 65 and older were much less likely to choose to treat their cancer with chemotherapy than those under 65. By contrast, the elderly were much more likely to get vaccinated against the flu than their younger counterparts.

When asked to describe their emotional state of mind when confronted with these decisions, the authors found that those playing the parental role were the most likely to experience feelings of anxiety, distress, conflict, concern, worry, and responsibility.

“Physicians” were the next highest “emotionally activated” group, foll