Friday, January 6, 2012

Does parsimonious equal ethical?

The American College of Physicians recently released an updated ethics manual calling for physicians to practice "parsimonious" care.

That prompted a practical discussion of what this means among the list serv discussion group at the Center for Practical Bioethics. Here’s a sampling, edited for length:

I was not uncomfortable with the ACP use of the term parsimony or parsimonious practice. I am used (to) the term as it is often referred to as "Occam's Razor" or lex parsimoniae and as applied to medical practice I see it as referring to avoiding expensive and not so useful testing or testing for the sake of testing and perhaps even, shudder the thought, reducing ineffective medical treatment.

Traditionally and at least within the context of philosophy, the terms has always referred to the use of an economy of assumptions, a minimalist approach to thought and practice, and, of course if used in particular fields, the terms will usually assume a more narrow and more focused meaning. It is certainly not a neologism but a definition that may have a more specifically focused connotation. Many logicians refer to this practice as using "precise definition.

Parsimonious does not mean ethical. It is a shame that the statement does not simply say “medical care congruent with professional standards and the patient’s goals and values.”

Wow. My Webster’s dictionary has as one of the definitions of parsimonious….”frugal to the point of stinginess.” Also parsimony has as one definition….”economy in the use of means to and end.” Hmmm, how do we define “end”?

What do you think? More commentary later.




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