[The relative effectiveness of setting goals as a chance for dealing with complex decision processes in medicine].
Beyond specialist aspects, decision making in medicine must also take ethical and economic considerations into account. Decisions according to the rational principle are orientated towards premisses with goals as a crucial part of them. Upon close examination, medical as well as ethical and economic premisses turn out to be uncertain, offering room for interpretation and procedural considerations. Simple algorithms of problem solution fail in complex decision situations especially if contradictory goals have to be considered and if a high potential of conflict exists. In complex problems, therefore, it is suggested to employ a three-step programme that consists of limiting the conflict by making the goals more precise and of handling the conflict by balancing different goals as first measures. As third step one could image a solution of the conflict by means of an evolution of different goals basing on the very uncertainty or relativity of goals.
Schüppel
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R
Abt. Psychosomatik, Universität Ulm-Klinikum.
D003220:Conflict, Psychological; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D003663:Decision Trees; D004992:Ethics, Medical; D005858:Germany; D006040:Goals; D006801:Humans; D011340:Problem Solving; D013812:Therapeutics / Q000191:economics