Book contents
- Frontmatter
- Contents
- Preface
- List of contributors
- 1 Bioethics and health informatics: an introduction
- 2 Medical informatics and human values
- 3 Responsibility for computer-based decisions in health care
- 4 Evaluating medical information systems: social contexts and ethical challenges
- 5 Health care information: access, confidentiality, and good practice
- 6 Ethical challenges in the use of decision-support software in clinical practice
- 7 Outcomes, futility, and health policy research
- 8 Meta-analysis: conceptual, ethical, and policy issues
- Index
7 - Outcomes, futility, and health policy research
Published online by Cambridge University Press: 12 November 2009
- Frontmatter
- Contents
- Preface
- List of contributors
- 1 Bioethics and health informatics: an introduction
- 2 Medical informatics and human values
- 3 Responsibility for computer-based decisions in health care
- 4 Evaluating medical information systems: social contexts and ethical challenges
- 5 Health care information: access, confidentiality, and good practice
- 6 Ethical challenges in the use of decision-support software in clinical practice
- 7 Outcomes, futility, and health policy research
- 8 Meta-analysis: conceptual, ethical, and policy issues
- Index
Summary
If only they could predict the future, health professionals would know in advance who will live, who will die, and who will benefit from this or that treatment, drug, or procedure. Foreknowledge would come in very handy indeed in hospitals and, in fact, has been a goal of medicine since antiquity. Computers dramatically improve our ability to calculate how things will turn out. This means we can use them in clinical decision making and, at the other end of the health care spectrum, in deciding which policy, method, or budget will produce the desired results. This chapter takes as its starting point the use of prognostic scoring systems in critical care and reviews their applications and limitations. It concludes that such systems are inadequate in themselves for identifying instances of clinical futility, in part because it is not logically appropriate to apply outcome scores to individual patients; such scores should be regarded as a point in an evidentiary constellation, and should not alone be allowed to defeat other considerations in the care of critically ill patients. Similarly, the rapid increase in the use of computers to derive practice guidelines across the health care spectrum represents an important extension of requirements that decisions be informed by the best available evidence. But computers cannot determine whether guidelines are applicable in individual cases, or develop guidelines that are. These, like other tasks in health care, belong to humans, especially when resource allocation is at stake.
- Type
- Chapter
- Information
- Ethics, Computing, and MedicineInformatics and the Transformation of Health Care, pp. 116 - 138Publisher: Cambridge University PressPrint publication year: 1997
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