Signalling need for care: A neglected functional role of medical treatment

Abstract

Lay summary: People are more inclined to provide care to people with ambiguous symptoms when they undergo medical treatment, particularly if this treatment is aversive. In addition, patients whose illness is delegitimized may be more inclined to accept treatments. Patients may seek treatment to demonstrate the legitimacy of their illness.Supplementary data are available online at https://academic.oup.com/emph/advance-article/doi/10.1093/emph/eoad024/7242224?login=true#supplementary-data .Copyright © The Author(s) 2023. While the primary goals of medical treatment are typically to shorten illness or relieve symptoms, we explore the idea that an important additional goal for some patients is to communicate need. Drawing on signalling theory, we argue that undergoing treatments can help patients legitimize their illness and thereby enable access to crucial support during convalescence. Four pre-registered within-subjects experiments (n = 874) show that participants are more inclined to provide care to people who undergo treatment, especially when that treatment is painful. Results show this incentivizes the use of antibiotic treatments for viral infections as well as drug treatments for mental illness. A cross-sectional study of 194 chronic pain patients shows that those who experience stigma and doubt over the legitimacy of their illness are more likely to accept aversive treatments. Furthermore, two experiments (n = 653) indicate that subtle manipulations to one’s sense of social support may increase willingness to accept treatment. These results indicate that people make decisions to provide care in part based on the presence or absence of treatment and furthermore that patients’ treatment decision making is informed by the social consequences of their choices. Signalling theory may help explain the surprising longevity of some ineffective and costly medical procedures