Reply to What is a good medical choice?

Cancer ◽  
2021 ◽  
Author(s):  
Christopher P. Filson ◽  
Fangxin Hong ◽  
Niya Xiong ◽  
Rachel Pozzar ◽  
Barbara Halpenny ◽  
...  
Keyword(s):  
Medical Choice

scholarly journals Public Transportation Environment and Medical Choice for Chronic Disease: A Case Study of Gaoyou, China

2019 ◽  
Vol 16 (9) ◽  
pp. 1612
Author(s):  
Yang Cao ◽  
Feng Zhen ◽  
Hao Wu
Keyword(s):  
Built Environment ◽  
Low Income ◽  
Patient Preferences ◽  
Public Transportation ◽  
Supply And Demand ◽  
Socioeconomic Background ◽  
Medical Facilities ◽  
Patient Questionnaires ◽  
Medical Choice ◽  
The Impact

Current research on the built environment and medical choice focuses mainly on the construction and optimization of medical service systems from the perspective of supply. There is a lack of in-depth research on medical choice from the perspective of patient demand. Based on the medical choice behaviour of patients with chronic diseases, this article identifies the spatial distribution and heterogeneity characteristics of medical choice and evaluates the balance between medical supply and demand in each block. On this basis, we explored the mechanism of patient preferences for different levels of medical facilities by considering the patient’s socioeconomic background, medical resource evaluation, and other built environment features of the neighbourhood by referring to patient questionnaires. In addition to socioeconomic characteristics, the results show that public transportation convenience, medical accessibility, and medical institution conditions also have significant influences on patient preferences, and the impact on low-income patients is more remarkable. The conclusions of the study provide a reference for the promotion and optimization of the functions of urban medical resources and the guidance of relevant public health policies.

Aortic Dissection: A Review of the Pathophysiology, Management & Prospective Advances

2020 ◽  
Vol 16 ◽  
Author(s):  
Ahmed Sayed ◽  
Malak Munir ◽  
Eshak I. Bahbah
Keyword(s):  
Aortic Dissection ◽  
Endovascular Repair ◽  
Medical Condition ◽  
Connective Tissue Diseases ◽  
The Elderly ◽  
Invasive Technique ◽  
Type B ◽  
Optimal Intervention ◽  
Conventional Open Surgery ◽  
Medical Choice

: Aortic dissection is an emergent medical condition, generally affecting the elderly, characterized by a separation of the aortic wall layers and subsequent creation of a pseudolumen that may compress the true aortic lumen. Predisposing factors mediate their risk by either increasing tension on the wall or by causing structural degeneration. They include hypertension, atherosclerosis, and a number of connective tissue diseases. If it goes undetected, aortic dissection carries a significant mortality risk; therefore, a high degree of clinical suspicion and a prompt diagnosis are required to maximize survival chances. Imaging methods, most commonly a CT scan, are essential for diagnosis; however, several studies have also investigated the effect of several biomarkers to aid in the detection of the condition. The choice of intervention varies depending on the type of dissection, with open surgical repair remaining of choice in those with type. A dissections; however, the role of conventional open surgery has considerably diminished in complicated type B dissections, with endovascular repair, a much less invasive technique, proving more effective. In uncomplicated type B dissections, where medical choice reigned supreme as the optimal intervention, endovascular repair is being explored as a viable option which may reduce long term mortality outcomes, although the ideal intervention in this situation is far from settled.

Medical Choice in a Mexican Village. JAMES CLAY YOUNG

1982 ◽  
Vol 9 (3) ◽  
pp. 609-610
Author(s):  
DAVID LANDY
Keyword(s):  
Medical Choice

A Defense of Self-Medication

2017 ◽  
Author(s):  
Jessica Flanigan
Keyword(s):  
Informed Consent ◽  
Regulatory Agency ◽  
Access To Medicines ◽  
Public Officials ◽  
Self Medication ◽  
Medical Decisions ◽  
Making Choices ◽  
Doctor's Office ◽  
The Right ◽  
Medical Choice

The same considerations that justify rights of informed consent also justify rights of self-medication because paternalism is wrong at the pharmacy and in the doctor’s office. Rights of self-medication require that patients have legal access to medicines without a prescription and without authorization from a regulatory agency. Like informed consent, the right of self-medication does not rely on a single, potentially controversial normative premise. From a consequentialist perspective, patients should be entrusted with making choices for themselves because they are generally most knowledgeable about which decision will further their interests. From a rights-based perspective, medical decisions are often intimate and personal choices that are especially significant to patients. Furthermore, even if a medical choice is not intimate, personal, or especially significant, people are more generally entitled to choose how they live their lives without being subjected to benevolent interference by physicians or public officials.

scholarly journals On Pediatric Vaccines and Catholic Social Teaching

Horizons ◽  
2018 ◽  
Vol 45 (2) ◽  
pp. 287-316
Author(s):  
Conor M. Kelly
Keyword(s):  
Human Dignity ◽  
Common Good ◽  
Catholic Social Teaching ◽  
Social Teaching ◽  
Ordinary Life ◽  
The Common Good ◽  
Self Interest ◽  
The Common ◽  
Pediatric Vaccines ◽  
Medical Choice

Determining whether, and when, to get one's children vaccinated has become an increasingly controversial decision, often leaving parents fearful of making the “wrong” choice. Part of the challenge stems from the fact that what is rationally optimal for an individual is inherently at odds with the best outcome for the community, meaning that if everyone acted out of self-interest with respect to pediatric vaccines, communal health would suffer significantly. Given these tensions, the issue of pediatric vaccines benefits greatly from the nuanced assessment of Catholic social teaching. Specifically, the Pontifical Council for Justice and Peace's “four permanent principles” of human dignity, the common good, subsidiarity, and solidarity highlight the issues involved and help parents navigate this significant medical choice with a more informed conscience and a greater sense of their moral responsibilities. The end result is a fruitful alignment between Catholic social teaching and ethics in ordinary life.

Medical Choice in a Mexican Village

Medical Care ◽  
1983 ◽  
Vol 21 (2) ◽  
pp. 251-252
Author(s):  
Robert E. Roberts
Keyword(s):  
Medical Choice

scholarly journals Old Age, Life Extension, and the Character of Medical Choice

2006 ◽  
Vol 61 (4) ◽  
pp. S175-S184 ◽  
Author(s):  
S. R. Kaufman ◽  
J. K. Shim ◽  
A. J. Russ
Keyword(s):  
Old Age ◽  
Life Extension ◽  
Medical Choice

scholarly journals Logic of care versus logic of choice in modern concepts of medical practice

Inter ◽  
2019 ◽  
Vol 11 (20) ◽  
pp. 36-53
Author(s):  
Vitaly L. Lekhtsierv
Keyword(s):  
Comparative Analysis ◽  
Political Theory ◽  
Modern Society ◽  
General Idea ◽  
The Political ◽  
Good Care ◽  
Medical Experience ◽  
Global Trend ◽  
Intellectual Traditions ◽  
Medical Choice

The article compares two fundamental and conflicting principles in the ethical interpretation of clinical experience — the patient's right to medical choice and care as an immanent ethics of healing. Conceptual attempts to theoretically and empirically justify an unconditional priority of care in modern social and humanitarian research of medicine, as well as the desire to include the logic of choice in the logic of care are made from different methodological perspectives and on the basis of different intellectual traditions. Thus it is more important to compare the key concepts of care on this issue in order to reveal the global trend in understanding the essence of medical experience. The article offers a comparative analysis of the following: firstly, the arguments of an American researcher Joan C. Tronto, formulated in the context of universal political theory and ethics, but relevant to the field of medicine, secondly, the theory of care of the German doctor and philosopher of medicine Klaus Dörner and his opposition to the principle of autonomy, carried out in the practice of informed consent, thirdly, “involved ethnography” of the logic of care, carried out by the Dutch philosopher and anthropologist Annemarie Mol. The comparative analysis of the main texts of these authors on this problem revealed many general statements expressed by them, mainly, the general idea that in the case of chronic disease, which is a typical case of pathology in modern society, the most important is the logic of good care, the logic of interdependence of all subjects of care as a process, and that it is not the political opposition of power and equality here that comes to the centre, but the opposition of care and neglect in everyday medical practices.

Decision Making in Pediatric Oncology: Who Should Take the Lead? The Decisional Priority in Pediatric Oncology Model

2006 ◽  
Vol 24 (1) ◽  
pp. 160-165 ◽  
Author(s):  
Simon N. Whitney ◽  
Angela M. Ethier ◽  
Ernest Frugé ◽  
Stacey Berg ◽  
Laurence B. McCullough ◽  
...  
Keyword(s):  
Decision Making ◽  
Pediatric Oncology ◽  
Parental Authority ◽  
Ethical Theories ◽  
Clinical Reality ◽  
Parents And Children ◽  
The Family ◽  
Dominant Characteristic ◽  
Medical Choice ◽  
Decisional Authority

Decision making in pediatric oncology can look different to the ethicist and the clinician. Popular ethical theories argue that clinicians should not make decisions for patients, but rather provide information so that patients can make their own decisions. However, this theory does not always reflect clinical reality. We present a new model of decision making that reconciles this apparent discrepancy. We first distinguish decisional priority from decisional authority. The person (parent, child, or clinician) who first identifies a preferred choice exercises decisional priority. In contrast, decisional authority is a nondelegable parental right and duty, in which a mature child may join. This distinction enables us to analyze decisional priority without diminishing parental authority. This model analyzes decisions according to two continuous underlying characteristics. One dominant characteristic is the likelihood of cure. Because cure, when possible, is the ultimate goal, the clinician is in a better position to assume decisional priority when a child probably can be cured. The second characteristic is whether there is more than one reasonable treatment option. The interaction of these two complex continual results in distinctive types of decisional situations. This model explains why clinicians sometimes justifiably assume decisional priority when there is one best medical choice. It also suggests that clinicians should particularly encourage parents (and children, when appropriate) to assume decisional priority when there are two or more clinically reasonable choices. In this circumstance, the family, with its deeper understanding of the child's nature and preferences, is better positioned to take the lead.

Decision-Making and Decision Support in Acute Care

2013 ◽  
pp. 1-18
Author(s):  
Brett W. Taylor
Keyword(s):  
Decision Making ◽  
Decision Support ◽  
Clinical Decision Support Systems ◽  
Evaluation Process ◽  
Clinical Decision ◽  
Medical Decision ◽  
Information Tools ◽  
Novices And Experts ◽  
And Function ◽  
Medical Choice

Clinical Decision Support Systems (CDSS) are information tools intended to optimize medical choice, promising better patient outcomes, faster care, reduced resource expenditure, or some combination of all three. Clinical trials of CDSS have provided only insipid evidence of benefit to date. This chapter reviews the theory of medical decision-decision making, identifying the different decision support needs of novices and experts, and demonstrates that discipline, objective and setting, and affect of the nature of support that is required. A discussion on categorization attempts to provide metrics by which systems can be compared and evaluated, in particular with regard to decision support mechanics and function. Throughout, the common theme is the placement of clinical decision makers at the center of the design or evaluation process.

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