Rational decision making in medicine: 'Personal decisions are the leading cause of death' (4)

7 September, 2019

Thank you for sharing!

The authors of both papers (Ralph L. Keeney [https://pdfs.semanticscholar.org/375e/8c9e3df49a7962d12bb186a4ec7dc7d2b3... and Benjamin Djulbegovic et al [https://www.ncbi.nlm.nih.gov/pubmed/29194876]) appear to lay the onus of quality of decision making and outcome of health services on the individual. Structural determinants have been superficially addressed. For those in global health we are well aware that structural barriers significantly influence decision making.

Perhaps the authors may want to retitle their paper,

"Decision making is extremely context sensitive: being blind to context makes decision making in medicine irrational".

Best wishes


Dr. Sujit Ghosh


Phone: +44 7786567378

Skype: sujit.ghosh


HIFA profile: Sujit Ghosh is an independent international development and global health consultant in the United Kingdom. I work on health systems strengthening with focus on building resilient frontline services that includes capacity building, quality improvement, strategy, gender and social inclusion and better data management. My subject areas of interest are maternal and child health, HIV and AIDS and mental health. Email address: sujitghosh A btinternet.com