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Whether decision trees are a mathematical expression of utilitarianism is a hotly debated issue among bioethicists cheap silagra 100 mg line. The basic perspectives of medical care within the tra- ditional patient–physician relationship include medical indications, which are physician-directed, and patient preferences, which are patient-driven. Current or added perspectives modify the decision and include quality of life, which considers the impact on the individual of high-technology interventions and contextual features, which are cultural, societal, family, religious or spiritual, community, and economic fac- tors. These are all part of the discussion between the provider and the patient and form the basis of the provider–patient relationship. Assessing patient values Patient values must be incorporated into medical decision making and health- care policies by providers, government, managed care organizations, and other decision makers.

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