Decision-making

Q3 Business, Management and Accounting

International Journal of Project Organisation and Management Pub Date : 2019-11-11 DOI:10.4324/9781003021797-8

Nick van Dam, J. Marcus

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Abstract

A decision to allow a patient's life to end by withdrawing or withholding medical treatment can be extremely difficult. In addition to making the appropriate medical and ethical judgments, there are also legal considerations to take into account, the most important of which is ensuring that the death is lawful. This paper addresses when it is legal to withdraw or withhold medical treatment that is needed to keep a patient alive. It draws on cases and legislation from the common law world (including Australia, England and New Zealand) and considers the various legal tests applied in the different jurisdictions. Two of the most common tests employed in this situation are the "best interests of the patient” test and the “substituted judgment” test. Some jurisdictions also include other criteria as well, such as a requirement that withdrawing or withholding of medical treatment is “not inconsistent with good medical practice”. This paper analyses these different legal tests, and after identifying the factors that are judged to be legally relevant to consider when deciding to withdraw or withhold treatment, outlines a preferred model. This model addresses who the relevant decision maker should be, and the criteria that should govern their decision. It suggests that family members are better equipped and more appropriate to act as decision makers than health professionals, and also questions the appropriateness of responsible medical opinion as the decisive factor in such cases, preferring instead an approach more consistent with the principles of self determination. The model also proposes a method for resolving any disputes that arise.

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决策

让病人放弃或停止治疗来结束生命的决定是极其困难的。除了作出适当的医学和道德判断外，还需要考虑法律方面的考虑，其中最重要的是确保死亡是合法的。这篇论文讨论了什么时候撤销或停止维持病人生命所需的医疗是合法的。它借鉴了普通法世界(包括澳大利亚、英格兰和新西兰)的案例和立法，并考虑了在不同司法管辖区适用的各种法律标准。在这种情况下最常用的两种测试是“患者的最佳利益”测试和“替代判断”测试。一些司法管辖区还包括其他标准，例如要求撤回或不提供医疗"不违反良好的医疗做法"。本文分析了这些不同的法律检验，并在确定了在决定撤销或停止治疗时被判定为具有法律相关性的因素之后，概述了一种首选模式。这个模型说明了谁应该是相关的决策者，以及应该管理他们的决策的标准。报告指出，家庭成员比保健专业人员更有条件，也更适合充当决策者，报告还质疑在这种情况下，将负责任的医疗意见作为决定性因素是否适当，而宁愿采取更符合自决原则的办法。该模型还提出了解决出现的任何争议的方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Project Organisation and Management Business, Management and Accounting-Strategy and Management

CiteScore

1.30

自引率

0.00%

发文量

期刊介绍： The aim of IJPOM is to attract contributions, and especially case studies, from a wide spectrum of academics and practitioners. As managers and business schools are increasingly placing increasing emphasis on strategy implementation issues, a project management approach will undoubtedly become more compelling and thus more acceptable in a wide range of fields. Readership IJPOM''s readership will come from professionals and managers dealing with project management on a daily basis. It also includes academics and researchers from various fields (business administration, economics and social sciences) concerned with the topic as well as policy makers and project planners in the field of business, commerce and industry. Contents IJPOM publishes original, theoretical, conceptual and empirical papers on a wide range of issues about project management. It also includes best practice examples as well as technical reports on the latest project management tools. Topics covered include Pre-project activities Project proposals/initial analysis, conception/design, management models Post-deployment review/documentation Engineering, production, service, construction projects Public sector programmes/campaigns, public/private sector partnerships Consultancy projects, public relations campaigns Mergers/acquisitions, outsourcing, alliances Particular events, humanitarian aid programmes, disasters projects Virtual projects, web-based PM, open-ended projects Communication/collaboration, negotiation skills, risk assessment/management Current/emerging standards, facilities/equipment support, quality assurance/testing Goals/objectives setting, budgeting, time/cost estimating HRM challenges, staffing, organisation change projects Opportunity management, marketing/branding strategies, measurement/metrics Project coordination/scheduling/governance, knowledge management.