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The precautionary principle and medical decision making
1Department of Medical Humanities, The Brody School of Medicine at East Carolina University, Greenville, NC 27858, USA. resnikd@mail.ecu.edu
The Journal of Medicine and Philosophy
|October 30, 2004
Summary
The precautionary principle guides medical decisions when evidence is limited, promoting reasonable actions against serious, plausible threats by balancing benefits and harms. This approach supports humanistic clinical reasoning over strict utility theory.
Area of Science:
- Medical Ethics
- Clinical Decision-Making
- Risk Assessment
Background:
- Physicians and patients often face choices with uncertain outcomes.
- Evidence-based medicine may be insufficient in complex clinical scenarios.
- Existing decision-making models may not fully capture nuanced ethical considerations.
Purpose of the Study:
- To present and defend a version of the precautionary principle for clinical decision-making.
- To explore the role of 'reasonableness' in applying the precautionary principle.
- To offer an alternative to expected utility theory in medical contexts.
Main Methods:
- Conceptual analysis of the precautionary principle.
- Examination of factors defining 'reasonableness' in risk response (benefit vs. harm, realism, proportionality, consistency).
- Comparison with expected utility theory in clinical reasoning.
Main Results:
- The precautionary principle advocates for reasonable measures against serious, plausible threats.
- Reasonableness is determined by a multi-factor assessment, including benefit-harm analysis.
- The principle integrates value-balancing, aligning with humanistic clinical reasoning.
Conclusions:
- The precautionary principle offers a robust decision-making framework for situations with limited evidence.
- It encourages a careful, value-conscious approach to clinical choices.
- This principle provides a valuable alternative to quantitative decision-making models like expected utility theory.