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Related Experiment Videos

Life-sustaining therapy. A model for appropriate use.

D J Murphy1, D B Matchar

  • 1Department of Health Care Sciences, George Washington University Medical Center, Washington, DC 20037.

JAMA
|October 24, 1990
PubMed
Summary
This summary is machine-generated.

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New strategies are needed to manage life-sustaining therapies that offer little patient benefit. A proposed model defines inappropriate care based on effectiveness, utility, and cost, aiming for better resource allocation.

Area of Science:

  • Medical Ethics
  • Health Economics
  • Geriatric Medicine

Background:

  • Life-sustaining therapies are increasingly used, even when rarely beneficial.
  • There is a growing need for frameworks to guide the appropriate use of medical interventions.

Purpose of the Study:

  • To propose a novel model for determining the appropriate use of life-sustaining therapies.
  • To define medical and economic criteria for evaluating therapy appropriateness.

Main Methods:

  • Development of a model incorporating therapy effectiveness, patient utility, and marginal costs.
  • Application of the model to analyze out-of-hospital cardiopulmonary resuscitation in chronically ill older adults.

Main Results:

  • Therapies deemed medically inappropriate (rarely effective/desirable) or economically inappropriate (high marginal cost-effectiveness ratio) should not be automatically offered.
Keywords:
Analytical ApproachDeath and EuthanasiaHealth Care and Public HealthProfessional Patient Relationship

Related Experiment Videos

  • The model offers an operational definition of medical futility.

    • Conclusions:

    • The proposed model provides a structured approach to curb inappropriate life-sustaining care.
    • Existing strategies like advance directives and survival prediction are insufficient alone.
    • This framework supports evidence-based decision-making in healthcare resource allocation.