PT  - JOURNAL ARTICLE
AU  - L Ridderstolpe
AU  - G Collste
AU  - H Rutberg
AU  - H Åhlfeldt
TI  - Priority setting in cardiac surgery: a survey of decision making and ethical issues
AID  - 10.1136/jme.29.6.353
DP  - 2003 Dec 01
TA  - Journal of Medical Ethics
PG  - 353--358
VI  - 29
IP  - 6
4099  - http://jme.bmj.com/content/29/6/353.short
4100  - http://jme.bmj.com/content/29/6/353.full
SO  - J Med Ethics2003 Dec 01; 29
AB  - Objectives: The aim of this study was to examine priority setting for coronary artery bypass surgery, and to provide an overview of decisions and rationales used in clinical practice. Method: Questionnaires were sent to all permanently employed cardiologists, cardiothoracic surgeons, and anaesthesiologists at nine Swedish hospitals performing adult cardiothoracic surgery. Results: A total of 208 physicians responded (a 44% return rate). There was considerable agreement concerning the criteria that should be used to set priorities for coronary artery bypass interventions (clusters of factors in synthesis). However, there was a lack of accord regarding the use of national guidelines for priority setting and risk indexes. Conclusions: Basic training and the strong support of ethical principles in priority setting are lacking. The respondents indicated a need for clearer guidelines and an open dialogue or discussion. The lack of generally acknowledged plans and guidelines for priority setting may result in unequal, conditional, and unfair treatment.