Are life-extending treatments for terminal illnesses a special case? Exploring choices and societal viewpoints
Bibliographic Data
| ID | 4594542 |
|---|---|
| Authors | Neil Mchugh (0000-0002-2567-1527, Glasgow Caledonian University, corresponding author), Job Van Exel (0000-0002-4178-1777, Erasmus University Rotterdam), Hugh Mason (0000-0002-9303-2794, Glasgow Caledonian University), Helen Mason (0000-0002-7834-0123), Jon Godwin (0000-0002-2953-3455, Glasgow Caledonian University), Marissa Collins (0000-0002-0896-6673, Glasgow Caledonian University), Cam Donaldson (0000-0003-4670-5340, Glasgow Caledonian University), Rachel Baker (0000-0003-2700-2682) |
| Year | 2018 |
| Volume | 198 |
| Pages | 61-69 |
| Publication date | 2018-02-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Social Science & Medicine (JOURNAL) |
| Journal identifiers | ISSN: 0277-9536 • E-ISSN: 1873-5347 |
| Publisher | Elsevier BV (PUBLISHER) |
| DOI | 10.1016/j.socscimed.2017.12.019 |
| PMID | 29276987 |
| OpenAlex | W2774519747 |
| Language | EN |
| Citations received | 7 |
| References cited | 19 |
Criteria used by the National Institute for Health and Care Excellence (NICE) to assess life-extending, end-of-life (EoL) treatments imply that health gains from such treatments are valued more than other health gains. Despite claims that the policy is supported by societal values, evidence from preference elicitation studies is mixed and in-depth research has shown there are different societal viewpoints. Few studies elicit preferences for policies directly or combine different approaches to understand preferences. Survey questions were designed to investigate support for NICE EoL guidance at national and regional levels. These 'Decision Rule' and 'Treatment Choice' questions were administered to an online sample of 1496 UK respondents in May 2014. The same respondents answered questions designed to elicit their agreement with three viewpoints (previously identified and described) in relation to provision of EoL treatments for terminally ill patients. We report the findings of these choice questions and examine how they relate to each other and respondents' viewpoints. The Decision Rule questions described three policies: DA - a standard 'value for money' test, applied to all health technologies; DB - giving special consideration to all treatments for terminal illnesses; and DC - giving special consideration to specific categories of treatments for terminal illnesses e.g. life extension (as in NICE EoL guidance) or those that improve quality-of-life (QoL). Three Treatment Choices were presented: TA - improving QoL for patients with a non-terminal illness; TB - extending life for EoL patients; and TC - improving QoL at the EoL. DC received most support (45%) with most respondents giving special consideration to EoL only when treatments improved QoL. The most commonly preferred treatment choices were TA (51%) and TC (43%). Overall, this study challenges claims about public support for NICE's EoL guidance and the focus on life extension at EoL and substantiates existing evidence of plurality in societal values
Economics · End-of-life care · Excellence · Nice · Palliative care · Political science · Preference · Quality of life (healthcare · Viewpoints · Computer Science · Health Systems, Economic Evaluations, Quality of Life · Medicine · Nursing · Palliative Care and End-of-Life Issues · Patient-Provider Communication in Healthcare · Psychology
The ethical canary
Public preferences in healthcare resource allocation
Who should be given priority for public funding
Translating Q methodology results into survey questions for large-scale use
Disentangling public preferences for health gains at end-of-life
Exploring the relative value of end of life Qalys
The relative value of carer and patient quality of life
| Unique citing works | 7 |
|---|---|
| Citations per year | 1 |
| Citation span | 2019 - 2026 (8) |
| Citation velocity | current |
| Highly cited | No |
| Citation types | Neutral: 7 |