This book explores medical decision-making and emphasizes the role of various biases that affect our decisions, usually unconsciously. Overall, it's a pretty good book and I can recommend it, but it's somewhat heavy on narratives of case histories and light on systematic presentation of the key findings - basically opposite of a textbook and apparently targeted more at the general reader.
I personally would have preferred a more systematic presentation, but I went ahead and compiled my own summary of the key findings:
(1) In general, the findings described in the book apply to everyone involved in making medical decisions: patients, patient advocates, physicians, nurses, researchers, administrators, etc.
(2) Our backgrounds predispose us towards taking varying general approaches to making decisions, such as being a minimalist (as little treatment as possible, letting the body primarily take care of itself), maximalist (treating aggressively, including treating preventively), naturalist (favoring natural CAM treatments rather than conventional allopathic medicine), technocrat (favoring modern high-tech medicine), and pragmatist (choosing from the whole range of treatment options as each particular situation warrants).
(3) The way information is framed can greatly influence our decisions. For example, "40% of patients are cured by this treatment" sounds more encouraging than "this treatment fails to cure 60% of patients." An implication is that statistics for treatment outcomes have to be looked at carefully, and looking at only summaries of statistics can be misleading.
(4) Anecdotal cases (as reported in this book) can be informative, but they can also excessively influence our decisions (availability bias).
(5) Serious illness and strong emotions can result in poorer decisions.
(6) Recommendations of doctors can vary considerably due to biases resulting from personal background, training, institution where they work, outcomes of the patients they've cared for (again, availability bias), and the treatments they're most familiar with. An implication is that it's often preferable for patients to seek multiple opinions, though that leaves patients having to make decisions when the provided opinions diverge.
(7) Ideally, patients and doctors should work together to make decisions, but patients vary widely in what role they want to take, ranging from wanting to be in primary control (and thus doing considerable work to investigate their condition and treatment options, and possibly seek multiple opinions) to delegating all decisions to their doctors.
(8) Advance directives for end of life decisions often don't work well because (a) people have difficulty anticipating how they'll feel when the time to decide comes, so they're prone to changing their minds and (b) even if directives aren't changed, it's often not clear what decisions will best comply with directives in particular circumstances.
(9) Advocates often have difficultly making decisions on our behalf. Part of the difficulty is the tension between trying to know what we would decide for ourselves versus deciding what they consider best for us.
(10) In general, following a systematic decision process tends to reduce regret if an outcome turns out to be disappointing (can at least say that the best possible effort was made). However, this doesn't mean that decision-making can be reduced to a formulaic "by the numbers" approach, for several key reasons: (a) there will always be uncertainty and complexity, so judgment inevitably will be required, (b) biological variability among patients means that treatments need to be individualized to patients, and (c) subjective values and goals are usually involved, so there may be no objectively "correct" decision.