Medical futility: its meaning and ethical implications

Article Abstract:

A recent definition of what constitutes a futile medical treatment is one that only preserves a permanent state of unconsciousness and cannot end a dependency on life support measures. Additionally, if within the last 100 cases a physician decides, either through personal experience, a colleagues experience or published data, that a therapy is nonbeneficial, then that therapy is judged to be futile. The physician must decide whether a particular therapy will only improve the condition of a certain anatomical part of the patient or the total quality of life of the patient. If a therapy is judged to be futile, then it is the prerogative of the physician, in concert with other physicians, to withhold that treatment without first consulting the family. Thus, a patient has no right to be kept in a permanent vegetative state and the physician has no obligation to offer any care to sustain them in that state, and the family has no right to demand such care. Additionally, services should be withheld where the patient has a condition that requires constant intensive care monitoring, respiratory support, or where there is a great deal of suffering for a predictably short period of time. Even though a therapy may be objectively viewed as being futile, it does not mean that a condition is hopeless. In contrast to futility, which is an objective term, hope is a subjective term, that denotes the desire and faith of a person concerning their condition and treatment. As the chance for a successful therapy fails, hope may actually increase. Ultimately, the goal of any therapy should be an improvement in the patients prognosis, general state of health, comfort and well being. (Consumer Summary produced by Reliance Medical Information, Inc.)

Drug therapy

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Medical futility: response to critiques

Article Abstract:

The concept of medical futility may enable doctors to fulfill medicine's goal of restoring patients to health rather than merely achieving an intermediate stay of illness. Medical futility is defined as treatment that works in fewer than one in 100 patients and that only maintains permanent unconsciousness or dependence on intensive medical care. Six criticisms of the concept of medical futility are refuted. Although medical futility should not be invoked by doctors who are mostly concerned about keeping costs down, it may be used to promote the physician's integrity as a healer.

Analysis, Refusal to treat (Medicine)

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Whose death is it, anyway?

Article Abstract:

Doctors need to respect and support their patients' wishes during the death process and redefine their benchmark for success. Many doctors lose sight of their humanitarian role as comforter in an effort to preserve life at all costs even in the face of written instructions by patients to the contrary. Thoughtful communication between the doctor, patient and the patient's family can better assure that the patients' wishes are honored. As more patients take an active role in their own healthcare, doctors may feel threatened in their role as healthcare provider.

Right to refuse treatment, Treatment refusal

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