Tough Decisions

Tough times call for tough decisions.

Tough Decisions for Premature Triplets.

When infants are born at the borderline of viability, doctors and parents have to make tough decisions about whether to institute intensive care or provide only palliative care. Often, these decisions are made in moments of profound emotional turmoil, and parents receive different information from different health professionals. Communication can become garbled. It may be difficult to tell when...

Tough decisions on essential medicines in 2015

Perspectives In 1977, the World Health Organization (WHO) published its first Model List of Essential Medicines. 1 This year, the Expert Committee for the Selection and Use of Medicines will consider requests to include high-cost medicines for cancer , hepatitis C, multidrug-resistant tuberculosis and new oral anticoagulants on the model list. These applications challenge perceptions of essenti...

Supporting tough decisions in Norway: a healthcare system approach.

OBJECTIVES We describe, in general, the principles used in priority setting and, in particular, policy processes and decision making in Norway. METHODS A newly established council for setting priorities in health care is presented to illustrate how health technology assessments (HTAs) can support national advisors in complex priority-setting processes. RESULTS AND CONCLUSIONS Setting priori...

Tough decisions in pulmonary embolism: thrombolysis or embolectomy?

Patients presenting with acute pulmonary embolism (PE) and persisting haemodynamic instability need to be considered for primary reperfusion therapy with, commonly, thrombolysis or even surgical embolectomy [1]. Both treatment options can pose significant risks to the patient, but are potentially lifesaving when used appropriately. Absolute contraindications to thrombolysis include cases where ...