Literature DB >> 14662815

Priority setting in cardiac surgery: a survey of decision making and ethical issues.

L Ridderstolpe1, G Collste, H Rutberg, H Ahlfeldt.   

Abstract

OBJECTIVES: The aim of this study was to examine priority setting for coronary artery bypass surgery, and to provide an overview of decisions and rationales used in clinical practice.
METHOD: Questionnaires were sent to all permanently employed cardiologists, cardiothoracic surgeons, and anaesthesiologists at nine Swedish hospitals performing adult cardiothoracic surgery.
RESULTS: A total of 208 physicians responded (a 44% return rate). There was considerable agreement concerning the criteria that should be used to set priorities for coronary artery bypass interventions (clusters of factors in synthesis). However, there was a lack of accord regarding the use of national guidelines for priority setting and risk indexes.
CONCLUSIONS: Basic training and the strong support of ethical principles in priority setting are lacking. The respondents indicated a need for clearer guidelines and an open dialogue or discussion. The lack of generally acknowledged plans and guidelines for priority setting may result in unequal, conditional, and unfair treatment.

Keywords:  Empirical Approach; Health Care and Public Health

Mesh:

Year:  2003        PMID: 14662815      PMCID: PMC1733799          DOI: 10.1136/jme.29.6.353

Source DB:  PubMed          Journal:  J Med Ethics        ISSN: 0306-6800            Impact factor:   2.903


  9 in total

1.  Recent advances. Medical ethics.

Authors:  P A Singer
Journal:  BMJ       Date:  2000-07-29

2.  Ethics, medicine and economics: integration in a hospital environment.

Authors:  Max M J Griffiths; Ian T Dunlop
Journal:  Med J Aust       Date:  2002-03-04       Impact factor: 7.738

3.  Should every human being get health care?: priorities in health care and the principle of human dignity.

Authors:  G Collste
Journal:  Ethical Perspect       Date:  1999-07

4.  The second phase of priority setting. Goodbye to the simple solutions: the second phase of priority setting in health care.

Authors:  S Holm
Journal:  BMJ       Date:  1998-10-10

5.  The second phase of priority setting. Fairness as a problem of love and the heart: a clinician's perspective on priority setting.

Authors:  J E Sabin
Journal:  BMJ       Date:  1998-10-10

Review 6.  Urgency and priority for cardiac surgery: a clinical judgment analysis.

Authors:  F Kee; P McDonald; J R Kirwan; C C Patterson; A H Love
Journal:  BMJ       Date:  1998-03-21

7.  Priority points and cardiac events while waiting for coronary bypass surgery.

Authors:  N W Jackson; M P Doogue; J M Elliott
Journal:  Heart       Date:  1999-04       Impact factor: 5.994

8.  Setting priorities and selecting topics for clinical practice guidelines.

Authors:  R N Battista; M J Hodge
Journal:  CMAJ       Date:  1995-11-01       Impact factor: 8.262

9.  Information needed to decide about cardiovascular treatment in primary care.

Authors:  J Robson
Journal:  BMJ       Date:  1997-01-25
  9 in total
  1 in total

1.  The acceptability of waiting times for elective general surgery and the appropriateness of prioritising patients.

Authors:  Jurriaan P Oudhoff; Danielle R M Timmermans; Martin Rietberg; Dirk L Knol; Gerrit van der Wal
Journal:  BMC Health Serv Res       Date:  2007-02-28       Impact factor: 2.655

  1 in total

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