Treatment Decision-Making in Catastrophic Illness

It is well established that the social and economic environment of medical care distinguishes its provision from that of other goods and services. While scholars have studied the influences of this idiosyncratic environment, there is relatively little empirical knowledge about how it affects decision-making in specific medical contexts. Through general conceptual discussion and consideration of a case study of leukemia chemo-therapy, this paper examines the medical decision-making process in one specific context: the response of physicians to the availability of an innovative treatment for a catastrophic illness. The manner in which the medical profession deals with serious illness is relevant to concerns as diverse as the promotion of economic efficiency and the preservation of human dignity.