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Palliative Care EthicsA Companion for All Specialties$
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Fiona Randall and Robin Downie

Print publication date: 1999

Print ISBN-13: 9780192630681

Published to Oxford Scholarship Online: November 2011

DOI: 10.1093/acprof:oso/9780192630681.001.0001

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Process of clinical decision making

Process of clinical decision making

(p.103) 5 Process of clinical decision making
Palliative Care Ethics

Fiona Randall

R.S. Downie (Contributor Webpage)

Oxford University Press

This chapter begins by examining responsibility for outcomes, and then deals mainly with the process of decision making. It clarifies the moral issues that arise in the traditional methods of decision making and explores the moral difficulties inherent in the use of some more recently developed formal systems, such as flow charts and clinical guidelines, which have been proposed as improvements on the traditional process. In palliative care, clinical workers have to make decisions in circumstances that entail factual complexities, uncertainties, and difficult moral choices. Nevertheless, a decision has to be made. Letting someone die is permitted in certain circumstances whereas killing is prohibited. The doctrine of double effect, which relies on a moral distinction between intended and foreseen events, allows the use of measures to relieve suffering even those events carry a significant risk of shortening life.

Keywords:   palliative care, carer autonomy, clinical decision, letting someone die, relieve suffering, patient autonomy

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