[Skip to Navigation]
November 1982

Decision-Making Strategy for Clinical-Ethical Problems in Medicine

Author Affiliations

From the Section of General Medicine, Department of Medicine, University of Chicago-Pritzker School of Medicine, Chicago.

Arch Intern Med. 1982;142(12):2178-2179. doi:10.1001/archinte.1982.00340250144021

Medical education and training should prepare physicians to make decisions, because that is what they do routinely in medical practice. When physicians determine that a diagnostic procedure is warranted, or when they recommend a particular form of treatment, or even, when they assess whether and when a patient who telephones with a medical problem should be seen in the office (or in the emergency room), physicians are making decisions. None of these decisions is easy, because medicine is, as Osler described it, a science of uncertainty and an art of probability. Nevertheless, physicians generally reach clinical decisions and feel reasonably comfortable doing so.

In contrast to clinical decisions, physicians find clinical-ethical decisions of the following sort extremely difficult: Should "no-code" orders be written (for example, on a patient with irreversible senile dementia and an acute, treatable pneumonia)? Should an infant with Down's syndrome and duodenal atresia be treated with maximal

First Page Preview View Large
First page PDF preview
First page PDF preview