Author Affiliations: Division of General Medicine, University of Michigan Medical Center and Ann Arbor Veterans Affairs Medical Center, Ann Arbor (Drs Goold and Williams); and Division of General Internal Medicine, Center for Bioethics and Health Law, University of Pittsburgh, Pittsburgh, Pa (Dr Arnold).
Conflicts between physicians and families about end-of-life decisions
create challenging and emotionally difficult situations. In this article,
we propose a "differential diagnosis" of such conflicts, distinguishing and
describing the characteristics of families, physicians, and organizations
and society that contribute to the "etiology" of the situation, as well as
strategies for "diagnosing" the dominant factors. As a medical model, the
differential diagnosis can be a useful tool to help physicians understand
and manage conflicts about end-of-life care.
Goold SD, Williams B, Arnold RM. Conflicts Regarding Decisions to Limit TreatmentA Differential Diagnosis. JAMA. 2000;283(7):909-914. doi:10.1001/jama.283.7.909