Life-Sustaining Therapy: A Model for Appropriate Use
Creator
Murphy, Donald J.
Matchar, David B.
Bibliographic Citation
JAMA. 1990 Oct 24/31; 264(16): 2103-2108.
Abstract
The authors propose a mathematical model for deciding appropriate use of life-sustaining care, using as an example out-of-hospital cardiopulmonary resuscitation for chronically ill older persons. Incorporating determinations of effectiveness, utility, and marginal costs, the model helps physicians and patients decide which life-sustaining treatments are medically and/or economically appropriate. Physicians need not automatically offer patients therapies that have been shown to be neither medically nor economically appropriate. Murphy and Matchar discuss advance directives, health care rationing, and identifying futile therapies based on survival predictions as other mechanisms for limiting life-sustaining care. They conclude that these three options are inadequate alternatives to the appropriate care model. (KIE abstract)
Date
1990-10Subject
Adults; Advance Directives; Aged; Aids; Allowing to Die; Alternatives; Chronically Ill; Costs and Benefits; Critically Ill; Decision Making; Economic Value of Life; Emergency Care; Evaluation; Futility; Health; Health Care; Health Care Rationing; Life; Mortality; Patient Care; Patient Participation; Patients; Physicians; Policy Analysis; Prognosis; Public Policy; Quality of Life; Refusal to Treat; Resource Allocation; Resuscitation; Resuscitation Orders; Risks and Benefits; Selection for Treatment; Standards; Statistics; Terminal Care; Value of Life; Values; Withholding Treatment;
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Life-Sustaining Therapy: A Model for Appropriate Use
Murphy, Donald J. and Matchar, David B. (1990-10-24)