A decision making approach to the choice to seek medical treatment

1990 ◽  
Author(s):  
Mark S. Anspach ◽  
James Shanteau
Keyword(s):  
Decision Making ◽  
Medical Treatment

Of Love and Laetrile: Medical Decision Making in a Child's Best Interests

1979 ◽  
Vol 5 (3) ◽  
pp. 269-294
Author(s):  
Eve T. Horwitz
Keyword(s):  
Decision Making ◽  
Medical Treatment ◽  
Burden Of Proof ◽  
State Intervention ◽  
Convincing Evidence ◽  
State Agency ◽  
Best Interests ◽  
Medical Decision ◽  
Appropriate Treatment ◽  
Life Threatening

AbstractTwo recent cases have raised important questions concerning the appropriateness of state intervention in parental choices of unorthodox medical treatment for children with life-threatening conditions. This Note first discusses whether, and if so, when, state intervention in a child's treatment selection by its parents is appropriate, and then analyzes the tests a court should apply in deciding upon an appropriate treatment. The Note recommends a decision-making approach that requires the appropriate state agency to prove, by clear and convincing evidence, that the parents' choice of medical treatment either is directly or is indirectly harming their child. Under this approach, if the state meets its burden of proof the court then must apply the ‘best interests’ test, rather than the ‘substituted judgment’ test, to choose an appropriate medical treatment for the child.

Certified Patient Decision Aids: Solving Persistent Problems with Informed Consent Law

2017 ◽  
Vol 45 (1) ◽  
pp. 12-40 ◽  
Author(s):  
Thaddeus Mason Pope
Keyword(s):  
Decision Making ◽  
Informed Consent ◽  
Medical Treatment ◽  
Shared Decision Making ◽  
Decision Aids ◽  
Shared Decision ◽  
Legal Doctrine ◽  
Patient Decision Aids ◽  
Patient Decision ◽  
Decision Making Processes

The legal doctrine of informed consent has overwhelmingly failed to assure that the medical treatment patients get is the treatment patients want. This Article describes and defends an ongoing shift toward shared decision making processes incorporating the use of certified patient decision aids.

scholarly journals Computer knows best? The need for value-flexibility in medical AI

2018 ◽  
Vol 45 (3) ◽  
pp. 156-160 ◽  
Author(s):  
Rosalind J McDougall
Keyword(s):  
Decision Making ◽  
Medical Treatment ◽  
Shared Decision Making ◽  
Patient Autonomy ◽  
Ethical Issues ◽  
Treatment Decision ◽  
Shared Decision ◽  
Treatment Decision Making ◽  
Value Judgements ◽  
The Relationship

Artificial intelligence (AI) is increasingly being developed for use in medicine, including for diagnosis and in treatment decision making. The use of AI in medical treatment raises many ethical issues that are yet to be explored in depth by bioethicists. In this paper, I focus specifically on the relationship between the ethical ideal of shared decision making and AI systems that generate treatment recommendations, using the example of IBM’s Watson for Oncology. I argue that use of this type of system creates both important risks and significant opportunities for promoting shared decision making. If value judgements are fixed and covert in AI systems, then we risk a shift back to more paternalistic medical care. However, if designed and used in an ethically informed way, AI could offer a potentially powerful way of supporting shared decision making. It could be used to incorporate explicit value reflection, promoting patient autonomy. In the context of medical treatment, we need value-flexible AI that can both respond to the values and treatment goals of individual patients and support clinicians to engage in shared decision making.

scholarly journals The Professions in Modernity and the Society of the Future: A Theoretical Approach to Understanding the Polyvalent Logics of Professional Work

2017 ◽  
Vol 7 (1) ◽  
pp. e1611 ◽  
Author(s):  
Werner Vogd
Keyword(s):  
Decision Making ◽  
Medical Treatment ◽  
Theoretical Approach ◽  
Professional Work ◽  
Interaction Processes ◽  
Transference And Countertransference ◽  
The Future ◽  
Do So

In this article, I draw attention to the societal arrangements that permit or produce the autonomy of professions since professionals have the task of holding the tension among different perspectives. To do so, they must apply differing, irreconcilable logics of reflection and balance them in their decision-making. To gain a differentiated understanding of the complexities of these processes, I propose a metatheoretical conceptualization of the dynamics of professions based on Gotthard Günther’s theory of “polycontexturality,” which can be used both to analyse the interaction processes and to embed them in society. I illustrate this argument with an example from the field of medical treatment. The proposed approach also lays the basis for a differentiated understanding of phenomena, which psychoanalysis has traditionally described in terms of transference and countertransference.

scholarly journals An Artificial Intelligence Fusion Model for Cardiac Emergency Decision Making: Application and Robustness Analysis

10.2196/19428 ◽  
2020 ◽  
Vol 8 (7) ◽  
pp. e19428
Author(s):  
Liheng Gong ◽  
Xiao Zhang ◽  
Ling Li
Keyword(s):  
Decision Making ◽  
Medical Treatment ◽  
Coordination Mechanism ◽  
Theoretical Research ◽  
Medical Decision ◽  
Knowledge Reasoning ◽  
Emergency Medical ◽  
Emergency Decision Making ◽  
Emergency Decision ◽  
Cardiac Emergency

Background During cardiac emergency medical treatment, reducing the incidence of avoidable adverse events, ensuring the safety of patients, and generally improving the quality and efficiency of medical treatment have been important research topics in theoretical and practical circles. Objective This paper examines the robustness of the decision-making reasoning process from the overall perspective of the cardiac emergency medical system. Methods The principle of robustness was introduced into our study on the quality and efficiency of cardiac emergency decision making. We propose the concept of robustness for complex medical decision making by targeting the problem of low reasoning efficiency and accuracy in cardiac emergency decision making. The key bottlenecks such as anti-interference capability, fault tolerance, and redundancy were studied. The rules of knowledge acquisition and transfer in the decision-making process were systematically analyzed to reveal the core role of knowledge reasoning. Results The robustness threshold method was adopted to construct the robustness criteria group of the system, and the fusion and coordination mechanism was realized through information entropy, information gain, and mutual information methods. Conclusions A set of fusion models and robust threshold methods such as the R2CMIFS (treatment mode of fibroblastic sarcoma) model and the RTCRF (clinical trial observation mode) model were proposed. Our study enriches the theoretical research on robustness in this field.

Fairly Bland: an alternative view of a supposed new ‘Death Ethic’ and the BMA guidelines

Legal Studies ◽  
2001 ◽  
Vol 21 (4) ◽  
pp. 618-643 ◽  
Author(s):  
David Price
Keyword(s):  
Decision Making ◽  
Medical Treatment ◽  
Mental State ◽  
Best Interests ◽  
Alternative View ◽  
Common Language ◽  
Net Benefit ◽  
Sanctity Of Life ◽  
Legal Standard ◽  
Polar Opposite

Recently in this journal John Keown attacked the BMA Guidance published on ‘Withholding and Withdrawing Life-prolonging Medical Treatment’, arguing that it was, fundamentally at odds with the sanctity of life doctrine as properly understood, condemning the intentional termination of individuals' lives. In riposte it is asserted that even this modified version of the doctrine cannot support a defensible moral or legal standard for decision-making here, being founded upon an excessive emphasis on the mental state of the clinician and an inappropriately narrow focus on the effects of the proposed treatment on the ‘health’ of the patient, as opposed to being primarily driven by the (best) interests of the patient. The attempt to divorce treatment decisions from broader evaluations of the net benefit or other otherwise able to be attained by the patient from such treatment, including the taking into account of the individual's handicapped state, accordingly fails. Acceptance of such reality is, at the least, the first step toward a common language for further dialogue even between those with polar opposite opinions in this sphere.

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