Clinical Ethics 11 (4):190-199 (2016)

Abstract
Background The aim of this study was to investigate whether physicians who felt strongly for or against a treatment, in this case a moderately life prolonging non-curative cancer treatment, differed in their estimation of medical indication for this treatment as compared to physicians who had no such sentiment. A further aim was to investigate how the notion of medical indication was conceptualised. Methods A random sample of GPs, oncologists and pulmonologists comprised the study group. Respondents were randomised to receive either version of a case presentation; in one version, the patient had smoked and in the other version she had never smoked. The physicians were labelled value-neutral and value-influenced on the basis of their attitude towards the treatment. Results In the ‘value-influenced’ group, there was a significant difference in the estimation of medical indication for treatment depending upon whether the patient had smoked or never smoked ). There was no such difference in the ‘value-neutral’ group. Conclusion This study shows that compared to value-neutral physicians, value-influenced physicians are more likely to base decisions of medical indication on medically irrelevant factors. Moreover, medical indication is used in an ambiguous manner. Hence, we recommend that the usage of ‘medical indication’ be disciplined.
Keywords Resource allocation   clinical ethics   clinical ethics  , health   concept of clinical ethics   health care economics   health care   clinical ethics   right to health care   clinical ethics   public health   clinical ethics
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DOI 10.1177/1477750916657666
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The Concept of Law.Stuart M. Brown - 1963 - Philosophical Review 72 (2):250.
Challenges for Principles of Need in Health Care.Niklas Juth - 2015 - Health Care Analysis 23 (1):73-87.

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