PallMEDPrep

PCF-Focused revision, conceptual analysis, updates and reflections

“Learning Medicine at the bedside of life’s limits”

Considered a structural requirement of good clinical practice in Palliative medicine.
It constitutes the disciplined recognition of limits of one’s knowledge, and involves a sustained commitment to act responsibly, ethically and competently despite these limitations.
It promotes deliberate, reasoned action, sense of ethical accountability and proportionate decision making.

Epistemic humility assumes that while all suffering cannot be explained, it may be considered care-worthy and possibly makes an ethically defensible argument in favor of the use of restraint in decision making.
In contrast, an epistemic deficit involves an unawareness of ignorance, passivity, an abdication of the sense of responsibility and an avoidance of decision making.

References

Murray, S. A., Kendall, M., Boyd, K., & Sheikh, A. (2005). Illness trajectories and palliative care. BMJ, 330(7498), 1007–1011. https://doi.org/10.1136/bmj.330.7498.1007

Smith, A. K., White, D. B., Arnold, R. M., & Theunissen, J. M. (2013). Uncertainty—the other side of prognosis. The New England Journal of Medicine, 368(26), 2448–2450. https://doi.org/10.1056/NEJMp1303295

Han, P. K. J., Klein, W. M. P., & Arora, N. K. (2011). Varieties of uncertainty in health care: A conceptual taxonomy. Medical Decision Making, 31(6), 828–838. https://doi.org/10.1177/0272989X11393976

Fox, R. C. (1980). The evolution of medical uncertainty. Milbank Memorial Fund Quarterly/Health and Society, 58(1), 1–49. https://doi.org/10.2307/3349705

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