Interesting question, since I really don't know the answer, Ill' ask for some clarifications.
What choices do you typically choose between when deciding on speed of descent ?
Isn't it a decision to save the aircraft with as little impact on the passengers ?
Assuming that the flight crew is safe (masks work, etc.), the passengers react over a range of hazards. If this range is considered (minor impairment = ear aches etc., moderate impairment = loss of conscioness, severe = death) This consideration provides a variable in descent speeds over time. Since the optimum descent speed is unlikely to require instantaneous descision making, why not take your time in assessing the aircraft safety state and adjust in an analog fashion accordingly?