Model Of Tragic Options

The model of the `tragic options`

This model was developed by Guido Calabresi and Philip Bobbitt, and was published in their book Tragic Choices in 1978 [3]. The two authors have observed that when society is confronted with the need to allocate critical but insufficient resources, fundamental moral values enter in conflict with one another. According to this model, society chooses to disguise its justifications for difficult choices, of life and death, to avoid social conflicts over different values, conflicts that would paralyze society. For example, transplant organ allocation rules are developed in medical terms to give them an objective neutral charm, although in fact these rules reflect non-medical value judgments on the priority of some

By labeling treatment as unnecessary, the doctor suggests that we are in a situation where the treatment does not bring any medical benefit. Of course, in ordinary situations, to not recommend unnecessary treatment it depends of good medical practice, and it is the subject of many studies, protocols and lessons of continuing medical education. In these situations, the decision on the futility of a treatment is a decision to rationalize costs. In life and death situations, however, the physician must ensure that by declaring that one treatment is useless, he has not been driven by costs and does not make an economic judgment. In this case it would be a serious mistake to label his own decision as futility. The label of futility gives the impression that no benefit can be gained from the treatment, and not that in fact the economic costs far outweigh the benefits. The wrong invocation of futility is disturbing for two reasons. The first concerns a lack of honesty. The patient or his family is deceived when he is told that treatment is useless, when he is just non-economic. It is generally wrong to lie to the patient, and this is a sufficient basis for condemning the invocation of futility. In addition, deceiving patients leads to undermining confidence in the medical profession. Let's take the case of a dying, partially conscious patient in the final stage of renal failure. Dialysis may extend his life for a couple of weeks, but the patient would still remain semi-conscious. The treating physician decides not to put him on dialysis him on the grounds that it is useless, and the patient dies soon. Later, family members find from friends that dialysis could have prolonged the life of the patient, but this have not even