Warning: Undefined array key "mm" in /www/wwwroot/www.ai-bt.com/si.php on line 10 Deprecated: trim(): Passing null to parameter #1 ($string) of type string is deprecated in /www/wwwroot/www.ai-bt.com/si.php on line 10 "Not clinically indicated": patients' interests or resource allocation?

Literature DB >> 8461686

"Not clinically indicated": patients' interests or resource allocation?

Abstract

The decision that a particular intervention is not clinically indicated may conceal two quite different ethical assumptions. The first assumption is that the intervention is not of overall benefit to this patient. The second is that limited resources should not be used for this patient. These issues are discussed with reference to cardiac surgery in elderly patients with reference to the main theories of allocation: QALYs, needs theories, the sanctity of life theory, the lottery theory, and market forces.

Entities: Species

Keywords: Health Care and Public Health; Professional Patient Relationship

Mesh：

Year: 1993 PMID： 8461686 PMCID： PMC1676449 DOI： 10.1136/bmj.306.6874.379

Source DB: PubMed Journal: BMJ ISSN： 0959-8138

11 in total

1. Aortic valve replacement for aortic stenosis in persons aged 80 years and over.

Authors: A T Culliford; A C Galloway; S B Colvin; E A Grossi; F G Baumann; R Esposito; G H Ribakove; F C Spencer
Journal: Am J Cardiol Date: 1991-06-01 Impact factor: 2.778

2. An alternative to QALYs: the saved young life equivalent (SAVE)

Authors: E Nord
Journal: BMJ Date: 1992-10-10

3. Open-heart surgery in octogenarians.

Authors: L H Edmunds; L W Stephenson; R N Edie; M B Ratcliffe
Journal: N Engl J Med Date: 1988-07-21 Impact factor: 91.245

4. Natural history of candidates for balloon aortic valvuloplasty.

Authors: J H O'Keefe; R E Vlietstra; K R Bailey; D R Holmes
Journal: Mayo Clin Proc Date: 1987-11 Impact factor: 7.616

5. Predictors of event-free survival after balloon aortic valvuloplasty.

Authors: R E Kuntz; A N Tosteson; A D Berman; L Goldman; P C Gordon; B M Leonard; R G McKay; D J Diver; R D Safian
Journal: N Engl J Med Date: 1991-07-04 Impact factor: 91.245

6. Cardiac operations in patients over 80 years of age.

Authors: M W Rich; J G Sandza; R E Kleiger; J P Connors
Journal: J Thorac Cardiovasc Surg Date: 1985-07 Impact factor: 5.209

7. Aortic valve replacement and combined aortic valve replacement and coronary artery bypass grafting: predicting high risk groups.

Authors: J A Magovern; J L Pennock; D B Campbell; W E Pae; M Bartholomew; W S Pierce; J A Waldhausen
Journal: J Am Coll Cardiol Date: 1987-01 Impact factor: 24.094

8. Cardiac surgery in the octogenarian.

Authors: T P Tsai; J M Matloff; R J Gray; A Chaux; R M Kass; M E Lee; L S Czer
Journal: J Thorac Cardiovasc Surg Date: 1986-06 Impact factor: 5.209

9. Valve replacement in the octogenarian.

Authors: A C Fiore; K S Naunheim; H B Barner; D G Pennington; L R McBride; G C Kaiser; V L Willman
Journal: Ann Thorac Surg Date: 1989-07 Impact factor: 4.330

10. Spontaneous course of aortic valve disease.

Authors: J Turina; O Hess; F Sepulcri; H P Krayenbuehl
Journal: Eur Heart J Date: 1987-05 Impact factor: 29.983

11 in total

1. Justice and the allocation of healthcare resources: should indirect, non-health effects count?

Authors: Kasper Lippert-Rasmussen; Sigurd Lauridsen
Journal: Med Health Care Philos Date: 2010-08

Review 2. Conscientious objection in medicine.

Authors: Julian Savulescu
Journal: BMJ Date: 2006-02-04

"Not clinically indicated": patients' interests or resource allocation?

1. Aortic valve replacement for aortic stenosis in persons aged 80 years and over.

2. An alternative to QALYs: the saved young life equivalent (SAVE)

3. Open-heart surgery in octogenarians.

4. Natural history of candidates for balloon aortic valvuloplasty.

5. Predictors of event-free survival after balloon aortic valvuloplasty.

6. Cardiac operations in patients over 80 years of age.

7. Aortic valve replacement and combined aortic valve replacement and coronary artery bypass grafting: predicting high risk groups.

8. Cardiac surgery in the octogenarian.

9. Valve replacement in the octogenarian.

10. Spontaneous course of aortic valve disease.

1. Justice and the allocation of healthcare resources: should indirect, non-health effects count?

Review 2. Conscientious objection in medicine.

3. Rational non-interventional paternalism: why doctors ought to make judgments of what is best for their patients.

4. Predictors for waiting time for coronary angioplasty in a high risk population.

5. Patients' interests or resource allocation?

Review 6. How should we manage symptomatic aortic stenosis in the patient who is 80 or older?

7. Is choice of general practitioner important for patients having coronary artery investigations?

8. Are the economically active more deserving?

9. Expanding access to coronary artery bypass surgery: who stands to gain?

10. Empirical and philosophical analysis of physicians' judgments of medical indications.