Principles governing heart failure therapy re-examined relative to standard evidence-based medicine-driven guidelines.

Although all aspects of clinical work nowadays are modified by the pervading influence of evidence-based medicine (EBM) and multiplicative guidelines, not many clinicians realize that the underlying premise of EBM-driven guidelines is a particular strain of consequentialist ideology. Subservience to this ideology has transformed modern medical practice, but there is a real risk of distorting good medical practice, of belittling clinical judgement, of disempowering clinicians, and subjecting patients to skewed medical reality and treatment options. With so many heart failure (HF) guidelines issued by various august bodies, it is therefore timely to reappraise principles governing modern HF therapy with a fresh examination of the hierarchy of medical imperatives, the role of alternatives to consequentialism including deontological principles in HF therapy.

So many definitions of heart failure: are they all universally valid? A critical appraisal.

Defining heart failure (HF) is a matter of finding the most appropriate words to formulate the definiens for HF that will be universally applicable in all specific circumstances pertaining to the nature of HF. Currently available definitions of HF contain ambiguities and notable deficiencies such that non-heart failure medical conditions can become mislabelled as heart failure. Principles of how best to formulate definitions have been employed to provide a guide on how to appraise published definitions of HF.