What is our perspective?

In DecisionALS we adopt a global perspective, seeing ourselves as directly addressing individuals in any location or setting. This has the very important implication that our option lists do not reflect any  policies, guidelines, legislation, supply/eligibility restrictions, or customs that are relevant in particular jurisdictions or localities. We stress that this does not in any way mean that we do not recognise their reality or their importance, merely that we believe the person/patient should have unimpeded access to an analysis that helps them to make a personal judgement of their validity in terms of both the evidential and value judgements that necessarily underlie them. So the fact that an option is not recommended in a national or international guideline, is illegal in some jurisdictions, or is not reimbursable or has eligibility restrictions in some healthcare systems, does not mean that we exclude it. In relation to guidelines which are not cost-effectiveness based we believe the analysis will usually confirm many of the option restrictions - if these are soundly and transparently based. In relation to those which do take costs or cost effectiveness into account (including reimbursement and eligibility decisions) these are a matter for community decision. We carefully distinguish the latter from individual decisions, but again do not censor the options on any grounds, such as 'political or professional acceptability', on the grounds that such censorship simply prejudges issues that the analysis is designed to address and allow the individual to 'have their say' about them.