Quotes About Decision-making

Discussion had brought La Crosse's end-of-life costs down to half the national average. It was that simple—and that complicated.

The philosophy is that you push the power of decision making out to the periphery and away from the center. You give people the room to adapt, based on their experience and expertise. All you ask is that they talk to one another and take responsibility. That is what works.

The Emanuels described a third type of doctor-patient relationship, which they called "interpretive." Here the doctor's role is to help patients determine what they want. Interpretive doctors ask, "What is most important to you? What are your worries?" Then, when they know your answers, they tell you about the red pill and the blue pill and which one would most help you achieve your priorities.

It may seem harsh to say, but if it was a sixty-year-old man I would've taken the leg without question." This was partly, I think, a purely emotional unwillingness to cut off the limb of a pretty twenty-three-year-old—the kind of sentimentalism that can get you in trouble.

Human beings have an ability to simply recognize the right thing to do sometimes. Judgment, Klein points out, is rarely a calculated weighing of all options, which we are not good at anyway, but instead an unconscious form of pattern recognition.

Everyone understands, though, that a great deal of uncertainty about what to do for people will always remain.

But now the problem we face is ineptitude, or maybe it's "eptitude"—making sure we apply the knowledge we have consistently and correctly. Just making the right treatment choice among the many options for a heart attack patient can be difficult, even for expert clinicians.

Medical professionals concentrate on repair of health, not sustenance of the soul. Yet—and this is the painful paradox—we have decided that they should be the ones who largely define how we live in our waning days.

In other words, our decision making in medicine has failed so spectacularly that we have reached the point of actively inflicting harm on patients rather than confronting the subject of mortality. If end-of-life discussions were an experimental drug, the FDA would approve it.

In other words, our decision making in medicine has failed so spectacularly that we have reached the point of actively inflicting harm on patients rather than confronting the subject of mortality.

At the M & M, the burden of responsibility falls on the attending.

Little more than a decade ago, doctors made the decisions; patients did what they were told.

the builders trusted in the power of communication. They didn't believe in the wisdom of the single individual, of even an experienced engineer. They believed in the wisdom of the group, the wisdom of making sure that multiple pairs of eyes were on a problem and then letting the watchers decide what to do. Man is fallible, but maybe men are less so.

Patients ask questions, look up information on the Internet, seek second opinions. And they decide.

But now he was adamant about doing "everything." David did not dare argue with him.

pay doctors to give chemotherapy and to do surgery but not to take the time required to sort out when to do so is unwise.

an average of $94,000 during the last year of life with a metastatic breast cancer. Our medical system is excellent at trying to stave off death with $12,000-a-month chemotherapy, $4,000-a-day intensive care, $7,000-an-hour surgery. But, ultimately, death comes, and few are good at knowing when to stop.

An inherent tension exists between brevity and effectiveness. Cut too much and you won't have enough checks to improve care. Leave too much in and the list becomes too long to use. Furthermore

The options overwhelmed her. They all sounded terrifying. She didn't know what to do. I realized, with shame, that I'd reverted to being Dr. Informative—here are the facts and figures; what do you want to do? So I stepped back and asked the questions I'd asked my father: What were her biggest fears and concerns? What goals were most important to her? What trade-offs was she willing to make, and what ones was she not? Not

What is your understanding of the situation and its potential outcomes? What are your fears and what are your hopes? What are the trade-offs you are willing to make and not willing to make?

other words, our decision making in medicine has failed so spectacularly that we have reached the point of actively inflicting harm on patients rather than confronting the subject of mortality. If end-of-life discussions were an experimental drug, the FDA would approve it.

What is your understanding of the situation and its potential outcomes? What are your fears and what are your hopes? What are the trade-offs you are willing to make and not willing to make? And what is the course of action that best serves this understanding? The

What is your understanding of the situation and its potential outcomes? What are your fears and what are your hopes? What are the trade-offs you are willing to make and not willing to make? And what is the course of action that best serves this understanding?

Emanuels described a third type of doctor-patient relationship, which they called "interpretive." Here the doctor's role is to help patients determine what they want. Interpretive doctors ask, "What is most important to you? What are your worries?" Then, when they know your answers, they tell you about the red pill and the blue pill and which one would most help you achieve your priorities.