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Centre for Policy on Ageing | |
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The politics of end-of-life decision-making
— computerised decision-support tools, physicians' jurisdiction and morality | | Author(s) | Beth Jennings |
| Journal title | Sociology of Health & Illness, vol 28, no 3, April 2006 |
| Pages | pp 350-375 |
| Source | http://www.blackwellpublishing.com |
| Keywords | Medical care ; Terminal care ; Information technology ; Computers ; Social ethics ; Attitude ; Doctors ; Social surveys ; United States of America. |
| Annotation | With the increasing corporate and governmental rationalisation of medical care, the mandate of efficiency has caused many to fear that concern for the individual patient will be replaced with impersonal, rule-governing allocation of medical resources. Largely ignored is the role of moral principles in medical decision-making. This analysis comes from a 1999-2001 ethnographic study conducted in three US intensive care units (ICUs), two of which were using the computerised decision-support tool, APACHE-III (Acute Physiological and Chronic Health Evaluation III), which notably predicts the probability of a patient dying. It was found that using APACHE-III presents a paradox regarding concern for the individual patient. To maintain jurisdiction over the care of patients, physicians share the data with the payers and regulators of care to prove they are using resources effectively and efficiently, yet they use the system in conjunction with moral principles to justify treating each patient as unique. Thus, concern for the individual patient is not lessened with the use of this system. However, physicians do not share the data with patients or surrogate decision-makers, because they fear they will be viewed as more interested in profits than patients. (RH). |
| Accession Number | CPA-060606217 A |
| Classmark | LK: LV: UVB: 3O: TQ: DP: QT2: 3F: 7T |
Data © Centre for Policy on Ageing |
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| ...from the Ageinfo database published by Centre for Policy on Ageing. |
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