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Medical decision-makingFrom: Zach Newton (zbnewton@mindspring.com)Sun Jul 29 16:29:45 2001
Robert Woolley wrote:
> Brody and Thompson adopted a Bob- Medical decision-making, as any judgement endeavor, is, of course, imperfect. Can't change that. All decision making must include a variety of concepts to achieve best outcome, as defined by responsible party. Enter value assignment (risk acceptance). Enter discount rate (acceptable loss). Enter velocity of change. Enter capital base (resource availability). Enter bias (can't live without 'em). Clinical pathways weaken as the intensity of the threat of morbidity and mortality increases, it might be argued. The neural network of competent attendants at max force will beat a pathway any day of week in critical situation. As change in status transfers to non-linear from linear progress, call code blue for interventionists. Therapeutic nihilism, as in watchful waiting, is not the solution when the meassage is, "Houston, we have a problem." Don't feel a little cheated that you don't carry a knife to work?
-- Zach Newton Z. B. Newton, III, M.D. Atlanta/Gyn
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