The principle of therapeutic prudence. Beyond the ordinary-extraordinary and proportionate-disproportionate distinctions

Traditionally, the question of whether it is obligatory to use a particular therapeutic means was resolved by considering the use of ordinary therapeutic means as obligatory while the use of extraordinary therapeutic means was considered non-obligatory. Following criticism, this distinction has since shifted to the consideration of proportionate versus disproportionate therapeutic means as a way of resolving the question. In this article we intend to show that the two distinctions are not equivalent, and though necessary, are insufficient to qualify good medical action. Therapeutic prudence remains indispensable for identifying the best medical option for each patient.