Different people have proposed diverse definitions. Nevertheless, decisions about medical futility have tremendous impacts on clinical practice and physician-patient relationships. The most fundamental dispute about medical futility is whether or not value-laden judgments regarding medical futility are acceptable. In this essay, I argue that value-laden judgments of medical futility are necessary in clinical settings because a majority of "futility " debates have focused on medical problems requiring value-laden judgments.
Case 3 While you will hear colleagues referring to particular cases or interventions as "futile," the technical meaning and moral weight of this term is not always appreciated. As you will make clinical decisions using futility as a criterion, it is important to be clear about the meaning of the concept.
For a related discussion, see Do-Not-Resuscitate Orders. What is "medical futility"? Two kinds of medical futility are often distinguished: Quantitative futility, where the likelihood that an intervention will benefit the patient is exceedingly poor, and Qualitative futility, where the quality of benefit an intervention will produce is exceedingly poor.
Both quantitative and qualitative futility refer to the prospect that a specific treatment will benefit not simply have a physiological effect on the patient.
Futility does not apply to treatments globally, to a patient, or to a general medical situation. Instead, it refers to a particular intervention at a particular time, for a specific patient. The goal of medicine is to help the sick. Physicians have no obligation to offer treatments that do not benefit patients.
However, determining which interventions are beneficial to a patient can be difficult, since the patient or surrogate might see an intervention as beneficial while the physician does not.
Physicians should follow Essay on medical futility standards, and should consider empirical studies and their own clinical experience when making futility judgments.
They should also show sensitivity to patients and families in carrying out decisions to withhold or withdraw futile interventions. Although the ethical requirement to respect patient autonomy entitles a patient to choose from among medically acceptable treatment options or to reject all optionsit does not entitle patients to receive whatever treatments they ask for.
Instead, the obligations of physicians are limited to offering treatments that are consistent with professional standards of care and that confer benefit to the patient.
Who decides when a particular treatment is futile? Generally the term medical futility applies when, based on medical data and professional experience, a treating health care provider determines that an intervention is no longer beneficial.
Because health professionals may reasonably disagree about when an intervention is futile, all members of the health care team would ideally reach consensus.
What if the patient or family requests an intervention that the health care team considers futile? You have a duty as a physician to communicate openly with the patient or family members about interventions that are being withheld or withdrawn and to explain the rationale for such decisions.
It is important to approach such conversations with compassion. For example, a futile intervention for a terminally ill patient may in some instances be continued temporarily in order to allow time for a loved one arriving from another state to see the patient for the last time.
If intractable conflict arises, a fair process for conflict resolution should occur. Involvement of an ethics consultation service is desirable in such situations. The Texas Advance Directives Act provides one model for designing a fair process for conflict resolution. What is the difference between futility and rationing?
Futility refers to the benefit of a particular intervention for a particular patient. With futility, the central question is not, "How much money does this treatment cost?
Making a judgment of futility requires solid empirical evidence documenting the outcome of an intervention for different groups of patients. Futility establishes the negative determination that the evidence shows no significant likelihood of conferring a significant benefit. By contrast, treatments are considered experimental when empirical evidence is lacking and the effects of an intervention are unknown.
Is an intervention more likely to be futile if a patient is elderly? What determines whether a treatment is futile is whether or not the treatment benefits the patient.
In cases where evidence clearly shows that older patients have poorer outcomes than younger patients, age may be a reliable indicator of patient benefit, but it is benefit, not age, that supports a judgment of medical futility. For patients of all ages, health care professionals should advocate for medically beneficial care, and refrain from treatments that do not help the patient.
Why is medical futility controversial?Futility of Care: An Increasing Legal, Ethical, and Moral Dilemma A divergent set of issues and opinions involving medical care for the very seriously ill patient have dogged the bioethics community for decades.
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Sad i ams poem analysis essay. In clinical settings, medical futility is a term to refer to medical treatments that are unlikely to achieve their desired aims.
Medical futility is, however, one of the most controversial concepts in /5(1). Apr 27, · Medical Futility in Nursing Care CARING AND CHOOSING ioethics is described as both a field of intellectual inquiry and a professional practice that examines moral questions affecting various disciplines (Arras, ).
Medical Futility Topic: Discuss the notion of futility of medical intervention especially in cases of terminal ill patients. Since the development of new medical knowledge, medicine has been able to keep terminally ill patients alive for longer periods of time without improving or .