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  1. Use of ethical criteria in medical decision making : corneal transplantation.

    Article - En anglais

    Objectives 

    To determine for a defined procedure the prevalence of the use of 15 criteria currently or historically relied on to select recipients of scarce medical resources, and to compare this use with the determinations of a report of the American Medical Association Council on Ethical and Judicial Affairs identifying many of these criteria as ethically appropriate or inappropriate for such use.

    Design 

    Survey.

    Participants 

    All US members of a national cornea society were sent survey instruments.

    Approximately 63% (214/340) responded.

    Main Outcome Measures 

    Mean ratings on a scale of 1 to 5 (not important to very important) for each of the allocation criteria with regard to degree of influence on the decision to perform a corneal transplantation.

    Results 

    Ethically appropriate criteria tended to receive high overall ratings, and inappropriate criteria, low ratings.

    Conclusions 

    Certain ethically inappropriate criteria may have been viewed as influencing graft survival and thus thought to have ethically appropriate aspects, mitigating to some degree the aforementioned three ratings.

    Nonetheless, the study supports the need for standard setting and educational efforts about criteria for the allocation of medical resources to ensure that ethically inappropriate criteria are consciously excluded from decision making and to stimulate discussion and raise consciousness regarding this important issue.

    Mots-clés Pascal : Greffe, Cornée, Critère décision, Ethique, Traitement, Homme, Chirurgie

    Mots-clés Pascal anglais : Graft surgical, Cornea, Decision criterion, Ethics, Treatment, Human, Surgery

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 95-0500086

    Code Inist : 002B25B. Création : 01/03/1996.