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Medical Decision-making (medical + decision-making)

Distribution by Scientific Domains

Medical Sciences	50%
Humanities and Social Sciences	50%

Selected Abstracts

Torts to contract¿ moving from informed consent to shared decision-making

JOURNAL OF HEALTHCARE RISK MANAGEMENT, Issue 4 2008
Edward P. Monico MD
Many claims of medical malpractice arise from a breakdown in communication between physician and patient. As a result, medical decision-making may change from an informed consent model to a shared decision-making strategy. Shared decision-making, a contract derivative, will trigger contract obligations and change the face of medical malpractice from tort to contract. [source]

A vitally human medical geography?

NEW ZEALAND GEOGRAPHER, Issue 2 2007
Introducing Georges Canguilhem to geographers
Abstract:, This paper discusses Georges Canguilhem (1904,95), a French historian of science and medicine, tracing themes in his work of normality, pathology and the situated bases of medical decision-making. His conception of the normal and the pathological prompts reconsideration of the move from medical to health geography, suggesting value in a ,return' to the former. His ideas embrace openness to vitalism, a focus on the processes of life that anticipates recent attempts to engage with ,lively' (post-human) geographies. His dialogue between vitalism and humanism, with reference to the ,felt' unwellness of the sick person, signals a path towards a vitally human medical geography. [source]

The Diagnostic Utility of an Electronic Nose: Rhinologic Applications

THE LARYNGOSCOPE, Issue 9 2002
Erica R. Thaler MD
Abstract Objective/Hypothesis The thesis explores the applicability of electronic nose technology in medical decision-making. Specifically, the studies undertaken in the thesis were designed to test the ability of the electronic nose to assist in diagnostic questions encountered in the field of rhinology. Study Design Three separate studies were undertaken. All involved analysis of specimens by the electronic nose, obtained either in vitro or in vivo: known matched sets of cerebrospinal fluid and serum, bacterial samples from known plated specimens, and culture swabs taken from patients suspected of having rhinosinusitis who also had a matched standard bacterial culture taken from the same site. The goal of analysis was to determine whether the electronic nose was able to identify or categorize specimens or groups of specimens. Methods Each specimen was tested using the organic semiconductor-based Cyranose 320 electronic nose. Data from the 32-element sensor array were subjected to principal-component analysis to depict differences in odorant patterns. Distinction of specimens was identified by calculation of Mahalanobis distance. Results The electronic nose was able to distinguish serum from cerebrospinal fluid in pure isolates as well as in isolates collected on small cottonoid pledgets at amounts of 0.2 mL or greater. It was also able to distinguish between control swabs and bacterial samples as well as among bacterial samples collected in vitro. Preliminary work suggests that it may be able to distinguish between presence and absence of bacterial infection in specimens collected on nasal swabs. Conclusions The electronic nose is able to distinguish reliably between cerebrospinal fluid and serum sampled in small amounts, may be able to identify presence and type of bacterial pathogen in vitro, and is able to identify presence or absence of bacteria on nasal swabs. Because this information is available immediately, the electronic nose may be a powerful new technology for diagnostic use, not only for rhinologic purposes but in many other aspects of medicine as well. [source]

,Hitting you over the head': Oncologists' disclosure of prognosis to advanced cancer patients

BIOETHICS, Issue 2 2003
Elisa J. Gordon
The disclosure of prognosis to terminally ill patients has emerged as a recent concern given greater demands for patient involvement in medical decision-making in the United States. As part of the informed consent process, American physicians are legally and ethically obligated to provide information to such patients about the risks, benefits, and alternatives of all available treatment options including the use of experimental therapies. Although not legally required, the disclosure of a terminal prognosis is ethically justified because it upholds the principle of self-determination and enables patients to make treatment decisions consistent with their life goals. To understand oncologists' attitudes about disclosing prognostic information to cancer patients with advanced disease, we interviewed fourteen oncologists and conducted one focus group of medical fellows. Although oncologists reported to disclose prognosis in terms of cancer not being curable, they tend to avoid using percentages to convey prognosis. Oncologists' reported reluctance to disclosing prognosis was conveyed through the use of metaphors depicting the perceived violent impact of such information on patients. Oncologists' reluctance to disclose prognosis and preserve patient hope are held in check by their need to ensure that patients have ,realistic expectations' about therapy. We discuss these data in light of the cultural, ethical, and legal dimensions of prognosis disclosure, patient hope and the doctor,patient relationship, and recommend ways to enhance the communication process. [source]