Development of a Decision-Analytic Methodology for Definition of Standards of Disclosure

法律和医学交叉的最关键领域之一是 医疗知情同意书。 从科学的角度来看， 了解应披露的信息范围 以提高患者做出明智决定的能力。 从理论上和方法上讲，都需要一个 基于分析的方法来实现这样的决策。 Fischhoff博士和他的同事们正在寻求开发这样一种 适用于医生的法律的 确保患者知情同意的义务。 他们的工作 目的是定量地模拟评价的变化， 患者可能的健康状况。 这项研究利用了一种新的 逻辑回归技术，用于解释 输入信息对决策变异的可变贡献 一个模型的蒙特卡罗模拟。 这种方法将产生 一个客观的、“合理的”主观差异范围。 这些 然后将客观值应用于决策分析 几个医疗程序的建模。 这项研究有望取得重要进展。 它将显示出 和分析的局限性，并允许进一步的发展， 推广和实施这一方法， 医疗法律环境 此外，它是一个重要的先驱， 研究法律如何适应定量的 分析了专业披露的基本做法。

One of the most critical areas where law and medicine intersect is on medical informed consent. From a scientific standpoint little is known about the range of information that should be disclosed to patients to enhance their ability to make an informed decision. Both theoretically and methodologically, there is need for an analytically based approach to enable such decisionmaking. Dr. Fischhoff and his colleagues are seeking to develop such an approach to disclosure that is applicable to physicians' legal obligations to insure informed consent from patients. Their work aims to model quantitatively the variation in evaluations of possible health outcomes of patients. The research draws on a new technique whereby logistic regression is used to explain the variable contribution of input information to decision variation in a Monte Carlo simulation of a model. This method will produce an objective, "reasonable" range of subjective differences. These objective values will then be applied in a decision analysis modeling of several medical procedures. This study promises important advances. It will show the strengths and limitations of the analysis and permit the further development, generalization, and implementation of this approach within the medical-legal setting. Also, it is an essential precursor to examining the ways in which the law can accommodate quantitative analyses underlying professional disclosure practices.