Choosing wisely at the end of life: the crucial role of medical indication.

Détails

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Etat: Serval
Version: Final published version
ID Serval
serval:BIB_87433B729308
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Titre
Choosing wisely at the end of life: the crucial role of medical indication.
Périodique
Swiss medical weekly
Auteur(s)
Borasio G.D., Jox R.J.
ISSN
1424-3997 (Electronic)
ISSN-L
0036-7672
Statut éditorial
Publié
Date de publication
2016
Peer-reviewed
Oui
Volume
146
Pages
w14369
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish

Résumé
At the end of life, several treatments are administered routinely that lack medical indication and may cause significant harm to patients. Examples include artificial hydration and oxygen therapy in the dying phase, as well as enteral nutrition in advanced dementia. Medical indication is defined as the appropriateness of a therapeutic or diagnostic measure in the patient's concrete clinical situation, in light of the best available evidence. The decision about the absence or presence of a medical indication is a core competence of physicians. They have no obligation to perform or even mention measures that are not indicated. The decision about medical indication is a clinical compound decision, composed of both a factual, evidence-based judgement and a value judgement, which should always be patient-centred. Acknowledging the crucial role of medical indication in clinical decision making in medicine generally and at the end of life specifically opens up ways of enhancing patient-physician communication by clarifying roles, responsibilities and competencies. This may facilitate preventing overtreatment, improving patient wellbeing, and realising the patients' goals of care.

Pubmed
Web of science
Open Access
Oui
Création de la notice
25/11/2016 16:21
Dernière modification de la notice
08/05/2019 21:29
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