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Contending Medical Decision Models

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NOTES AND REFERENCES

  1. See Carey, R., Engelhard, C., ‘Academic Medicine Meets Managed Care: a High Impact Collision,’ 71 Academic Medicine no. 8 (Aug., 1996), pp. 839–845.

    Google Scholar 

  2. One could focus on changing patterns of accountability, see Emmanuel, E., Emmanuel, L., ‘What is Accountability in Health Care,’ 124 Annals of Internal Medicine no. 2 (Jan. 15, 1996), pp. 229–239 and see Emmanuel, E., Emmanuel, L. ‘What is Accountability in Health Care,’ 124 Annals of Internal Medicine no. 2 (Jan. 15, 1996), pp. 229–239.

    Google Scholar 

  3. See Silverman, W., ‘Medical Decisions: An Appeal for Reasonableness,’ 98 Pediatrics no. 6 (December, 1996), pp. 1182–1184.

    Google Scholar 

  4. See Beisecker, A., Helmig, L. et al., ‘Attitudes of Oncologists, Oncology Nurses, and Patients from a Women's Clinic Regarding Medical Decision Making for Older and Younger Breasts Cancer Patients,’ 34 Gerontologist no. 4 (Aug., 1994), pp. 505–512.

    Google Scholar 

  5. See Bjarnason, D., Prevost, S. et al., ‘Experiences of a Nursing Ethics Forum,’ 9 Critical Care Nursing Clinics of North America no. 1 (March, 1997), pp. 123–128, et al. See also Brody, H., Noel, M., ‘Dietitians’ Role in Decisions to Withhold Nutrition and Hydration,’ 91 American Dietetic Association Journal no. 5 (May, 1991), pp. 580–585. on the involvement of dietitians.

    Google Scholar 

  6. See Greene, K., Greene, R., ‘Too Much Surgery?’ 13 Self no. 1 (Jan., 1991), pp. 116–118.

    Google Scholar 

  7. For a recent summary of U.S. studies about the relationships of physicians and patients in treatment decision making, see Guadagnoli and Ward, ‘Patient Participation in Decision Making,’ 47 Social Science and Medicine no. 3 (August, 1998), pp. 329–340, which shows the variegated patterns but also the key importance of patient authority.

    Google Scholar 

  8. See Immanuel Kant, e.g. Metaphysics of Morals and Critique of Practical Reason (1788).

  9. See Muramoto, D., ‘Bioethics of the Refusal of Blood by Jehovah's Witnesses... rational non-interventional Paternalism,’ 24 Journal of Medical Ethics no. 5 (Oct., 1998), pp. 295–301.

    Google Scholar 

  10. See Beresford, E., ‘Uncertainty and the Shaping of Medical Decisions,’ 21 Hastings Center Report no. 4 (July, 1991), pp. 6–11 and Redelmeier, D., Rozin, P. et al., ‘Understanding Patient Decisions,’ 270 The Journal of the American Medical Association no. 1 (July 7, 1993), pp. 72–76. Also, see Redelmeier, D., Tversky, A., ‘Occasional Notes: Discrepancy between Medical Decisions for Individual Patients and for Groups,’ 322 New England Journal of Medicine no. 16 (April 19, 1990), pp. 1162–1164, and Asai, A., Fukuhara, S. et al., ‘Medical Decisions Concerning the End of Life,’ 23 Journal of Medical Ethics, no. 5 (Oct., 1997), pp. 323–327.

    Google Scholar 

  11. In re Quinlan and Cruzan v. Missouri and see King, P., ‘The Authority of Families to Make Medical Decisions for Incompetent Patients after the Cruzan Decision,’ 19 Law, Medicine and Health Care, nos. 1–2 (Spring, 1991), pp. 76–79 and Wheeler, D., 'supreme Court's ‘Cruzan Decision’ Triggers Renewed Scholarly Decate over Patients’ Rights to Die,’ 37 Chronicle of Higher Education no. 4 (Sept. 26, 1990), p. 14.

    Google Scholar 

  12. See, e.g., Greider, K., ‘Informed Consent,’ 18 Self no. 6 (June, 1996), pp. 68–70 and a large literature on informed consent. See, e.g. the articles by Bonkovsky and Sass and others in 4 Annual Review of Law and Ethics (1996) and also Gorelick, D., Pickens, R., Bonkovsky, F., ‘Clinical Research in Substance Abuse,’ in Ethics in Psychiatric Research (H. Pincus, ed.), ch. 8, 1999.

    Google Scholar 

  13. See, e.g. Dyer, C., ‘Medical Decisions must be Logically Defensible,’ 315 British Medical Journal no. 7119 (Nov. 22, 1997), p. 1327.

    Google Scholar 

  14. These views were compellingly stated by John Locke (1680), Thomas Jefferson (1776), and by J.J. Roussseau (1784) and were then fully developed in the moral, social, and ontological philosophy of Immanuel Kant (1788) and have dominated western social, political, and moral thinking for two centuries. A powerful later statement is that of J.S. Mill, On Liberty (1846). See also John Locke, Two Treatises on Government, e.g. which is the foundation for the American Declaration of Independence written by Jefferson. For Rousseau see The Social Contract; for Kant see, e.g. Metaphysics of Morals and Critique of Practical Reason (1788).

  15. See Elliott, C., Elliott, B., ‘From the Patient's Point of View: Medical Ethics and the Moral Imagination,’ Journal of Medical Ethics no. 4 (Dec., 1991), pp. 173–178.

  16. See Doty, L., ‘Help for Health Decision Challenges,’ 84 Journal of the Florida Medical Association no. 6 (Aug., 1997), pp. 391–396.

    Google Scholar 

  17. On the team approach, see Kassirer, J., ‘Incorporating Patients’ Preferences into Medical Decisions,’ 330 New England Journal of Medicine no. 26 (June 30, 1994), pp. 1895–1996.

    Google Scholar 

  18. See Elliott, C., Elliott, B., ‘From the Patient's Point of View: Medical Ethics and the Moral Imagination,’ Journal of Medical Ethics no. 4 (Dec., 1991), pp. 173–178.

  19. See Saas, H-M., Bonkovsky, F. et al., Patiententestament und Patientenanwalt, 1995. Also see Sass, H-M., Bonkovsky, F. (eds.), ‘Advance Directives in Multicultural Perspective,’ part IV in 4 Annual Review of Law and Ethics (1996), pp. 329–560 and Sass, H-M., Bonkovsky, F. et al., ‘Advance Health Care Documents in Multicultural Perspectives,’ 4 Annual Review of Law and Ethics (1996), pp. 465–508.

  20. See Journal of the American Medical Association, June 16, 1998, articles by Jane Weeks and by Thomas Smith.

  21. See Saas, H-M., Bonkovsky, F. et al., Patiententestament und Patientenanwalt, 1995 and Sunderland, T., Dukoff, R., 'surrogate Decision Making and Advance Directives with Cognitively Impaired Research Subjects,’ ch. 5 in Pincus et al., Ethics in Psychiatric Research, Washington, D.C., 1999.

  22. See King, P., ‘The Authority of Families toMake Medical Decisions for Incompetent Patients after the Cruzan Decision,’ 19 Law, Medicine and Health Care, nos. 1–2 (Spring, 1991), pp. 76–79.

    Google Scholar 

  23. See Scherer, A., ‘Health Care Proxies and LivingWills,’ 31 New Choices for the Best Years no. 9 (Oct., 1991), pp. 84–86.

    Google Scholar 

  24. See Blondeau, D., Valois, P. et al., ‘Comparison of Patients’ and Health Care Professionals Attitudes Towards Advance Directives,’ 24 Journal of Medical Ethics no. 5 (Oct., 1998), pp. 328–335.

    Google Scholar 

  25. See Sprung, C., Eidelman, L. et al., ‘Is the Patient's Right to Die evolving into a Duty to Die?’ 3 Journal of Evaluation in Clinical Practice no. 1 (Feb., 1997), pp. 69–75.

    Google Scholar 

  26. See Pelligrino, E., ‘Ethics,’ 270 The Journal of the American Medical Association no. 2 (July 14, 1993), pp. 202–203.

    Google Scholar 

  27. See Levine, C., ‘AIDS and Changing Concepts of Family,’ 68 Milbank Quarterly no. 4 (July, 1990), pp. 33–58.

    Google Scholar 

  28. Gilbert, S., ‘Elderly Seek Longer Life, Regardless,’ The New York Times (Feb. 10, 1998), F, 7, shows how patient values differ from and so may too often be ignored by health care professionals.

  29. See Gordts, B., ‘The Containment of Cost of Health Care,’ 96 Acta Chirurgica Belgica no. 2 (April, 1996), pp. 56–58.

    Google Scholar 

  30. See Meyer, H., ‘Alliances in Jeopardy,’ 37 American Medical News no. 9 (March 7, 1994), pp. 1, 29.

    Google Scholar 

  31. See Kosseff, A., et. al., ‘Managed Care Ethics,’ 129 Annals of Internal Medicine no. 8 (October 15, 1998), pp. 672ff.

    Google Scholar 

  32. For exposition, see Yergin, D., Stanislaw, J., The Commanding Heights, New York, Simon and Schuster, 1998. For a critique seeMartin, H-P., Schumann, H., The Global Trap, London, St. Martins Press, 1997.

    Google Scholar 

  33. See Singer, J., ‘The Impending Crisis in the Way Americans get their Healthcare: Medicine and Rational Utility,’ 64 Vital Speeches of the Day no. 4 (Dec. 1, 1997), pp. 117–119.

    Google Scholar 

  34. Greenberg, M., ‘'Linguistic Resistance’ Can Put a Face on Medicine,’ 40 American Medical News no. 2 (Jan. 13, 1997), p. 18.

    Google Scholar 

  35. Hall, R., ‘Ethical and Legal Implications of Managed Care,’ 19 General Hospital Psychiatry no. 3 (May, 1997).

  36. Headden, S., ‘FDAWatching Drug-switch Practices,’ 124 US News and World Report no. 2 (Jan. 19, 1998), p. 6.

    Google Scholar 

  37. Kisor, C., ‘Licensing/Disciplinary Actions: Arizona Court Holds Physician-Reviewer Accountable for Precertification Denial,’ 25 Journal of Law, Medicine, and Ethics no. 4 (Winter, 1997), p. 325.

    Google Scholar 

  38. See Emmanuel, E., Emmanuel, L. ‘What is Accountability in Health Care,’ 124 Annals of Internal Medicine no. 2 (Jan. 15, 1996), pp. 229–239.

    Google Scholar 

  39. See Mechanic, D., Schlesinger, M., ‘The Impact of Managed Care on Patients’ Trust in Medical Care and their Physicians,’ 275 Journal of the American Medical Association no. 21 (June 5, 1996) pp. 1693–1697.

    Google Scholar 

  40. The literature on U.S. ethics committees (EC) is voluminous. In the U.S., EC refers to clinical ethics committees while research ethics is under the oversight of an I.R.B. – Institutional Review Board. For an alternative perspective see the discussion of Norwegian practices in Ruyter, K., Bjornsborg, E. et. al., ‘Clinical Ethics Committees are Tested in Norway’ (Norwegian), 117 Tidsskrift for Den Norske Laegeforening no. 12 (May 10, 1997), pp. 1778–1781.

    Google Scholar 

  41. See van der Kloot-Meijburg, H., ‘The Hospital: Battleground or Meeting Place?’ 238 Journal of Internal Medicine no. 6 (Dec., 1995), pp. 539–549.

    Google Scholar 

  42. Hope, T., ‘Medical Research Needs Lay Involvement,’ 24 Journal of Medical Ethics no. 5 (Oct., 1998), pp. 291–292.

    Google Scholar 

  43. Glasa, J., Holoman, J. et al., ‘Ethics Committees and Achievements of Good Clinical Practice,’ 51 Therapie no. 4 (August, 1996), pp. 369–372.

    Google Scholar 

  44. Kassirer, J., ‘Incorporating Patients’ Preferences into Medical Decisions,’ 330 New England Journal of Medicine no. 26 (June 30, 1994), 1895–1896.

    Google Scholar 

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    Frederick O. Bonkovsky

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Bonkovsky, F.O. Contending Medical Decision Models. Theor Med Bioeth 22, 193–210 (2001). https://doi.org/10.1023/A:1011402814210

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