Should old folks who have lived their lives be allowed to place a huge economic burden on the young by using a disproportionate amount of limited Medicare resources for medical care?
Jing Li, PhD, Robert Tyler Braun, PhD, Sophia Kakarala, and Holly G. Prigerson, PhD
For dying patients and their loved ones to make informed decisions, physicians must share adequate information about prognoses, prospective benefits and harms of specific interventions, and costs.
AMA J Ethics. 2022;24(11):E1040-1048. doi:
10.1001/amajethics.2022.1040.
The Moseley study found no significant difference between those in the arthroscopic lavage and debridement arm of the study and those in the sham surgery arm.
This process of developing EBM-based guidelines and applying them to clinical care highlights the tension between generating unbiased knowledge based on statistical aggregation and the application of this information to individual patients.
Elderly persons should not be excluded from participation in clinical trials for cardiovascular drugs since that population comprises the largest number of patients with cardiovascular disease.
It would be unwise medically, economically, or ethically to ignore medical details and rely instead on crude placeholders such as age in attempting to use resources most efficiently and effectively.
To succeed in accountable care organizations, physicians will need to learn to emphasize collaboration rather than authority, keep costs in mind, and encourage patients to plan in advance for palliative care and death.