Predicting End-of-Life Treatment Preferences: Perils and Practicalities. Issue 2 (13th February 2014)

• Record Type: Journal Article
• Authors: Ditto, Peter H.; Clark, Cory J.
• Is Part Of: Journal of medicine and philosophy. Volume 39:Issue 2(2014:Apr.)
• Page Start: 196
• Page End: 204
• Publication Date: 2014-02-13
• Subjects: actuarial prediction -- advance directives -- end-of-life decision making -- personal autonomy -- surrogate decision making; Medicine -- Philosophy -- Periodicals; Medical ethics -- Periodicals; Ethics, Medical -- Periodicals; Philosophy, Medical -- Periodicals; 616.001
• DOI: 10.1093/jmp/jhu007
• Languages: English
• ISSNs: 0360-5310

Abstract

Abstract: Rid and Wendler propose the development of a Patient Preference Predictor (PPP), an actuarial model for predicting incapacitated patient's life-sustaining treatment preferences across a wide range of end-of-life scenarios. An actuarial approach to end-of-life decision making has enormous potential, but transferring the logic of actuarial prediction to end-of-life decision making raises several conceptual complexities and logistical problems that need further consideration. Actuarial models have proven effective in targeted prediction tasks, but no evidence supports their effectiveness in the kind of broad spectrum prediction task that is the proposed goal of the PPP. We argue that a more focused approach, targeting specific medical conditions and generating treatment predictions based on the preferences of individuals with actual disease experience, is both more firmly grounded in past research and is a more prudent initial strategy for exploring the efficacy of actuarial prediction in end-of-life decision making.