David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Jack Alan Reynolds
Learn more about PhilPapers
Journal of Medical Ethics 34 (12):863-868 (2008)
The question of whether old age should or should not play a role in medical decision-making for the elderly patient is regularly debated in ethics and medicine. In this paper we investigate exactly how age influences the decision-making process. To explore the normative argumentation in the decisions regarding an elderly patient we make use of the argumentation model advanced by Toulmin. By expanding the model in order to identify normative components in the argumentation process it is possible to analyse the way that age-related value judgements influence the medical decision-making process. We apply the model to practice descriptions made by medical students after they had attended consultations and meetings in medical practice during their clinical training. Our results show the pervasive character of age-related value judgements. They influence the physician’s decision in several ways and at several points in the decision-making process. Such explicit value judgements were not exclusively used for arguments against further diagnosis or treatment of older patients. We found no systematic “ageist” pattern in the clinical decisions by physicians. Since age plays such an important, yet hidden role in the medical decision-making process, we make a plea for revealing such normative argumentation in order to gain transparency and accountability in this process. An explicit deliberative approach will make the medical decision-making process more transparent and improve the physician–patient relationship, creating confidence and trust, which are at the heart of medical practice
|Keywords||No keywords specified (fix it)|
|Categories||categorize this paper)|
Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
|Through your library|
References found in this work BETA
No references found.
Citations of this work BETA
No citations found.
Similar books and articles
Roy Gilbar & Ora Gilbar (2009). The Medical Decision-Making Process and the Family: The Case of Breast Cancer Patients and Their Husbands. Bioethics 23 (3):183-192.
Lars Sandman & Christian Munthe (2009). Shared Decision-Making and Patient Autonomy. Theoretical Medicine and Bioethics 30 (4):289-310.
Dallas M. High & Howard B. Turner (1987). Surrogate Decision-Making: The Elderly's Familial Expectations. Theoretical Medicine and Bioethics 8 (3).
Alan Schwartz (2008). Medical Decision Making: A Physician's Guide. Cambridge University Press.
Joanne Lynn & David Degrazia (1991). An Outcomes Model of Medical Decision Making. Theoretical Medicine and Bioethics 12 (4).
Greg Clarke, Robert T. Hall & Greg Rosencrance (2004). Physician-Patient Relations: No More Models. American Journal of Bioethics 4 (2):16 – 19.
Douglas O. Stewart & Joseph P. DeMarco (2005). An Economic Theory of Patient Decision-Making. Journal of Bioethical Inquiry 2 (3):153-164.
Lars Sandman, Bradi B. Granger, Inger Ekman & Christian Munthe (2011). Adherence, Shared Decision-Making and Patient Autonomy. Medicine, Health Care and Philosophy 15 (2):115-127.
Douglas N. Walton (1985). Physician-Patient Decision-Making: A Study in Medical Ethics. Greenwood Press.
Rivka Grundstein-Amado (1991). An Integrative Model of Clinical-Ethical Decision Making. Theoretical Medicine and Bioethics 12 (2).
Kristine Bærøe (2010). Patient Autonomy, Assessment of Competence and Surrogate Decision-Making: A Call for Reasonableness in Deciding for Others. Bioethics 24 (2):87-95.
Kate Jones (2007). Beyond Informed Consent - Part II. Chisholm Health Ethics Bulletin 13 (2):6.
Gretchen B. Chapman & Frank A. Sonnenberg (eds.) (2000). Decision Making in Health Care: Theory, Psychology, and Applications. Cambridge University Press.
Marc D. Street, Chris Robertson & Scott W. Geiger (1997). Ethical Decision Making: The Effects of Escalating Commitment. [REVIEW] Journal of Business Ethics 16 (11):1153-1161.
John Mark Freeman (1987). Tough Decisions: A Casebook in Medical Ethics. Oxford University Press.
Added to index2010-09-13
Total downloads3 ( #333,674 of 1,410,123 )
Recent downloads (6 months)1 ( #177,589 of 1,410,123 )
How can I increase my downloads?