Item Details

title

An Ethical and Policy Critique of the Deprescribing Phenomenon

author

Selvarajah, Shalini

abstract

Responsible prescribing of pharmacotherapy ought to be accompanied by a correspondingly responsible deprescribing practice once medications are no longer necessary or helpful to the patient. Yet, in recent years, deprescribing has emerged as a unique phenomenon, requiring special attention, funding, and priority setting at the national level. Deprescribing describes the process of withdrawing medications that are considered inappropriate or no longer necessary for the patient. Rational prescribing practices, which includes deprescribing principles, should be the norm in clinical practice. However, excessive reliance on pharmacotherapy and the lack of functioning systems to coordinate care for patients are contributing factors of inappropriate pharmacotherapy and polypharmacy in today’s health care landscape. Besides the recognition that less is sometimes more, and that appropriate treatment is a signal of quality health care, an additional motivation for calling for deprescribing is also the escalating health care cost associated with the provision of health care in current times. Currently, it seems as if the focus of deprescribing is on older adults where polypharmacy is prevalent, and patients with cancer in palliative care, where there is presumably a reduction in the medication’s clinical benefit-to-harm ratio. This gives the appearance of the deprescribing phenomenon being centered on ageism and future potential. Thus, deprescribing may be seen as a negative act, involving taking away something usually perceived as a good. Taking this good away from persons who are perceived not to have much future potential left may be more justifiable to start with to enhance resource stewardship. This thesis asserts that a special deprescribing phenomenon is not necessary if deprescribing is viewed as an equally integral component of a healthcare provider’s fiduciary duty to provide the best care for all patients under their care.

subject

Deprescribing

Quality of Care

Rational Prescribing

contributor

King, Nancy (advisor)

Coughlin, Christine (committee member)

Maradiaga, Gerardo (committee member)

date

2024-02-13T09:36:24Z (accessioned)

2024-02-13T09:36:24Z (available)

2023 (issued)

degree

Bioethics (discipline)

identifier

http://hdl.handle.net/10339/102920 (uri)

language

en (iso)

publisher

Wake Forest University

type

Thesis