Giving value to the wishes of the terminal patients regarding the treatment at the end of their life, the use of the advance directive, as an extension of their autonomy when the patients are incompetent, represents a mean to respect and promote their dignity. The authors present and discuss the...

The possibility of weighting QALYs differently for different groups of patients has been a source of debate. Most recently, this debate has been extended to the relative value of QALYs at the end of life (EoL). The objective of this study is to provide evidence of societal preferences in...

In this paper we perform an exergoeconomic analysis to a PEM (proton exchange membrane) vehicular fuel cell system used in the latest generation of environmentally friendly cars. Two alternative configurations of a fuel cell system are considered (with and without an expander), and two...

Accompanying patients from active treatment towards specialist palliative care is a complex sphere of clinical practice that can be fraught with interpersonal and emotional challenges. While medical specialists are expected to break ‘bad news’ to their patients and ease their transitions to...

Most Americans want to die at home, but most die in hospitals or other facilities. Most people care more about quality of life than prolonging life as long as possible, but many receive invasive, life-sustaining treatments that diminish quality of life.

Early benefit assessment in Germany under the legislative framework of AMNOG (Arzneimittelmarktneuordnungsgesetz) requires direct comparisons of the new drug with appropriate comparators determined by the Federal Joint Committee (G-BA). In case no head-to-head studies are available for direct...