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Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.
From the groundbreaking author of The Second Sex comes a radical argument for ethical responsibility and freedom. In this classic introduction to existentialist thought, French philosopher Simone de Beauvoir’s The Ethics of Ambiguity simultaneously pays homage to and grapples with her French contemporaries, philosophers Jean-Paul Sartre and Maurice Merleau-Ponty, by arguing that the freedoms in existentialism carry with them certain ethical responsibilities. De Beauvoir outlines a series of “ways of being” (the adventurer, the passionate person, the lover, the artist, and the intellectual), each of which overcomes the former’s deficiencies, and therefore can live up to the responsibilities of freedom. Ultimately, de Beauvoir argues that in order to achieve true freedom, one must battle against the choices and activities of those who suppress it. The Ethics of Ambiguity is the book that launched Simone de Beauvoir’s feminist and existential philosophy. It remains a concise yet thorough examination of existence and what it means to be human.
A guide for everyone involved in medical decision making to plot a clear course through complex and conflicting benefits and risks.
This comprehensive reference delves into the complex process of medical decision making—both the nuts-and-bolts access and insurance issues that guide choices and the cognitive and affective factors that can make patients decide against their best interests. Wide-ranging coverage offers a robust evidence base for understanding decision making across the lifespan, among family members, in the context of evolving healthcare systems, and in the face of life-changing diagnosis. The section on applied decision making reviews the effectiveness of decision-making tools in healthcare, featuring real-world examples and guidelines for tailored communications with patients. Throughout, contributors spotlight the practical importance of the field and the pressing need to strengthen health decision-making skills on both sides of the clinician/client dyad. Among the Handbook’s topics: From laboratory to clinic and back: connecting neuroeconomic and clinical mea sures of decision-making dysfunctions. Strategies to promote the maintenance of behavior change: moving from theoretical principles to practices. Shared decision making and the patient-provider relationship. Overcoming the many pitfalls of communicating risk. Evidence-based medicine and decision-making policy. The internet, social media, and health decision making. The Handbook of Health Decision Science will interest a wide span of professionals, among them health and clinical psychologists, behavioral researchers, health policymakers, and sociologists.
This book illuminates issues in medical ethics revolving around the complex bond between healer and patient, focusing on friendship and other important values in the healing relationship. Embracing medicine, philosophy, theology, and bioethics, it considers whether bioethical issues in medicine, nursing, and dentistry can be examined from the perspective of the healing relationship rather than external moral principles. Distinguished contributors explore the role of the health professional, the moral basis of health care, greater emphasis on the humanities in medical education, and some of the current challenges facing healers today.
The Power of Colleagues What happens when primary care clinicians meet together on set aside time in their practice settings to talk about their own patients? .....Complimenting quality metrics or performance measures through discussing the actual stories of individual patients and their clinician-patient relationships In these settings, how can clinicians pool their collective experience and apply that to ‘the evidence’ for an individual patient? .....Especially for patients who do not fit the standard protocols and have vague and worrisome symptoms, poor response to treatment, unpredictable disease courses, and/or compromised abilities for shared decision making What follows when discussion about individual patients reveals system-wide service gaps and coordination limitations? .....Particularly for patients with complex clinical problems that fall outside performance monitors and quality screens How can collaborative engagement of case-based uncertainties with one’s colleagues help combat the loneliness and helplessness that PCPs can experience, no matter what model or setting in which they practice? .....And where they are expected to practice coordinated, evidence-based, EMR-directed care These questions inspired Lucia Sommers and John Launer and their international contributors to explore the power of colleagues in “Clinical Uncertainty in Primary Care: The Challenge of Collaborative Engagement” and offer antidotes to sub-optimal care that can result when clinicians go it alone. From the Foreword: “Lucia Sommers and John Launer, with the accompanying input of their contributing authors, have done a deeply insightful and close-to-exhaustive job of defining clinical uncertainty. They identify its origins, components and subtypes; demonstrate the ways in which and the extent to which it is intrinsic to medicine...and they present a cogent case for its special relationship to primary care practice...‘Clinical Uncertainty in Primary Care’ not only presents a model of collegial collaboration and support, it also implicitly legitimates it.’’ Renee Fox, Annenberg Professor Emerita of the Social Sciences, University of Pennsylvania.
Technology assessment can lead to the rapid application of essential diagnostic technologies and prevent the wide diffusion of marginally useful methods. In both of these ways, it can increase quality of care and decrease the cost of health care. This comprehensive monograph carefully explores methods of and barriers to diagnostic technology assessment and describes both the rationale and the guidelines for meaningful evaluation. While proposing a multi-institutional approach, it emphasizes some of the problems involved and defines a mechanism for improving the evaluation and use of medical technology and essential resources needed to enhance patient care.
A comprehensive, up-to-date examination of the most important theory, concepts, methodological approaches, and applications in the burgeoning field of judgment and decision making (JDM) Emphasizes the growth of JDM applications with chapters devoted to medical decision making, decision making and the law, consumer behavior, and more Addresses controversial topics from multiple perspectives – such as choice from description versus choice from experience – and contrasts between empirical methodologies employed in behavioral economics and psychology Brings together a multi-disciplinary group of contributors from across the social sciences, including psychology, economics, marketing, finance, public policy, sociology, and philosophy 2 Volumes
How do we begin to cope with loss that cannot be resolved? The COVID-19 pandemic has left many of us haunted by feelings of anxiety, despair, and even anger. In this book, pioneering therapist Pauline Boss identifies these vague feelings of distress as caused by ambiguous loss, losses that remain unclear and hard to pin down, and thus have no closure. Collectively the world is grieving as the pandemic continues to change our everyday lives. With a loss of trust in the world as a safe place, a loss of certainty about health care, education, employment, lingering anxieties plague many of us, even as parts of the world are opening back up again. Yet after so much loss, our search must be for a sense of meaning, and not something as elusive and impossible as "closure." This book provides many strategies for coping: encouraging us to increase our tolerance of ambiguity and acknowledging our resilience as we express a normal grief, and still look to the future with hope and possibility.