There are a lot of things that can kill a smaller sized business - cash flow issues, poor quality, supply issues and so much more. I think that one of the worse things that can happen to a small company is a bad case of indecision - perhaps accompanied with a side of wishy-washyness.
OK, a little word play fun, but seriously - if you can't make decisions and you keep re-visiting and adjusting everything, how can you ever move forward? I think this can lead to a slow and painful death.
So, let's examine the possible causes of these ailments. Why is it difficult for some people to make decisions? In many cases, it is the fear of being wrong. Sometimes it stems from trying to keep certain employees from getting upset (yes, this does happen). It often takes work to make a decision - collecting information in order to determine the right course of action. Those people are just lazy. Some like to avoid any conflict, some just procrastinate by nature, some are simply foolish.
I know I have written this before, but it is worth repeating. There is nothing worse (ok, there are some things that are worse, but you get the idea) than having things just happen through no conscious decision - just happening by chance. You lose all control when this happens and can't easily look back to determine what went wrong. A wrong decision is better than no decision.
The other piece that can wreak havoc is constantly changing your decisions. Of course it is important to regularly re-evaluate plans, review products, procedures, assignments, etc. and make adjustments along the way. But, that does not mean changing objectives, targets, assignments or strategy often is a good thing. Plans need to be given a little time to play out - see what happens. Measurement and review needs to collect enough information to provide a good basis for making changes and enough information to help guide what that change should be. Don't change your pricing scheme after 1 down sales month. Don't re-vamp your successful web site after 2 weeks of reduced site activity. Don't re-assign tasks or people because of 1 complaint.
Although the dinosaurs of old school business should be dead for SMB, and changes should not involve years of study and review, a little moderation and consideration in planning and decision making is an important business concept.