Cost versus benefit in non-surgical management of patients with cancer.

Abstract

the prescription to put Mr Kozary on his guard. Dr Miller's negligence had contributed to the negligence of Mr Kozary, although the greater proportion of the responsibility lay with Mr Kozary. Accordingly, Mr Justice Auld awarded damages of £119 302 plus interest against Mr Kozary, his pharmacy, and Dr Miller, the proper apportionment of which was that Dr Miller was 25% liable and Mr Kozary 75% liable. The implications Though the implications of the decision in these cases may seem obvious from the facts, their seriousness should not be underestimated by those in the medical and pharmaceutical professions. What is clear from the decision in Prendergast is that doctors are under a legal duty of care to write clearly-that is, with sufficient legibility to allow for mistakes by others. Both Prendergast and Dwyer show that liability need not stop when the prescription leaves the hands of the doctor, even when the doctor has been grossly negligent. It may extend into and be a cause of the negligent mistakes of others. The pharmacist must be aware that he or she must not tacitly accept what they see, or perceive to see, on the written prescription before them. They are under a legal duty of care to draw on their skill and knowledge of drugs to inquire into the surrounding circumstances ofthe case. In this respect the finding of his lordship in Prendergast that the pharmacist should have noticed that the patient paid for the drugs is noteworthy. If there is any doubt in the pharmacist's mind then the prescription should be checked by the prescribing doctor. When thousands of prescriptions are being written and dispensed every day it is inevitable that mistakes will creep in. The judgments in Dwyer v Roderick and others and in Prendergast v Sam and Dee Ltd have shown that the courts will take a less than tolerant attitude towards those who make careless but negligent mistakes which result in personal injury and will award sufficient damages accordingly.

Therapeutic ratio and defined phases: proposal of ethical framework for palliative care.

“…[16][17][18] This is due to escalating costs of health care and increased demand in most developed countries. We believe that our first endeavour should be to examine individual intention to treat issues on the basis of the therapeutic ratio, as outlined, and not on cost.…”

Diethylstilbestrol revisited in advanced breast cancer management

“…Recently, attention has been drawn to the cost of treatment of patients with cancer and the need to consider these costs when planning therapy [13,14]. DES is a cheap drug particularly in comparison to tamoxifen.…”

Palliative medicine

“…'67 In a study by Heyse-Moore of 303 patients admitted to hospice, 55.5% overall were dyspnoeic on admission. In those surviving for less than a day after admission, however, the prevalence was 78.6%, with 11.4% rated as severe.…”