Our results challenge current policy and law advocating instructional advance directives as a means of honoring specific patient wishes at the end of life. Future research should explore other methods of improving surrogate decision making and consider the value of other outcomes in evaluating the effectiveness of advance care planning.

If preference-inconsistent information initiates more effortful cognitive analysis than does preferenceconsistent information, then people should be more sensitive processors of information they do not want to believe than of information they do want to believe. Three studies supported this prediction. Study 1 found that inferences drawn from favorable interpersonal feedback revealed a correspondence bias, whereas inferences drawn from unfavorable feedback were sensitive to situational constraint. Study 2 showed this sensitivity to the quality of unfavorable feedback to disappear under cognitive load. Study 3 showed that evaluations of the accuracy of favorable medical diagnoses were insensitive to the probability of alternative explanation, whereas evaluations of unfavorable diagnoses were sensitive to probability information. The importance of adaptive considerations in theories of motivated reasoning is discussed. Experimental psychology has seen few problems as nettlesome as understanding and documenting the influence of wishes, needs, hopes, and fears in human judgment. Beginning with the dispute regarding the phenomenon of perceptual defense that became the Achilles' heel of the "

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The quantity of processing view of motivated reasoning predicts that individuals are more likely to spontaneously question the validity of unfavorable than favorable feedback even when the objective likelihood of the feedback is equivalent. Participants were videotaped self-administering a bogus medical test revealing either a favorable or an unfavorable result. In Studies 1 and 2, unfavorable result participants required more time to accept the validity of the test result and were more likely to spontaneously recheck its validity than were favorable result participants. However, unfavorable results also were perceived as less expected than were favorable results, even though the information supplied about their objective likelihood was identical. Study 3 showed that participants evaluating another student's results perceived favorable and unfavorable outcomes as equally likely, suggesting that the subjective likelihood of positive and negative feedback is also subject to motivational influence.

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