Medical Futility


Continuous, open communication is key to building trust and preventing conflict

Providers should seek to understand each patient’s life outside the context of illness including understanding their values, hopes, and fears and how these relate to goals of care

Providers should refrain from prematurely labeling interventions as futile or using this as justification for withholding or withdrawing care. Instead, they should first ensure a clear understanding of the patient’s medical goals and elicit input from relevant specialists to ensure a clear understanding of the clinical situation

Teams should involve communication experts, such as palliative care providers or hospital ethics committees, when faced with conflict around appropriate care

Institutions should have policies regarding conscientious objections. These should ensure that conscientious objections do not impede timely patient care or create excessive hardship for members of the medical team






References



1.

Luce JM. Chronic disorders of consciousness following coma: part two: ethical, legal, and social issues. Chest. 2013;144(4):1388–93.CrossRefPubMed


2.

Judge rejects request by doctors to remove a patient’s respirator. New York Times. July 2, 1991. http://​www.​nytimes.​com/​1991/​07/​02/​us/​judge-rejects-request-by-doctors-to-remove-a-patient-s-respirator.​html. Accessed 21 Apr 2016.


3.

American Thoracic Society. Withholding and withdrawing life-sustaining therapy. Ann Intern Med. 1991;115(6):478–85.CrossRef


4.

Truog RD, Brett AS, Frader J. The problem with futility. N Engl J Med. 1992;326(23):1560–4.CrossRefPubMed


5.

Danis M, Truog R, Devita M, et al. Consensus statement of the Critical Care Medicine’s Ethics Committee regarding futile and other possibly inadvisable treatments. Crit Care Med. 1997;25(5):887–91.CrossRef


6.

Bosslet GT, Pope TM, Rubenfeld GD, et al. An official ATS/AACN/ACCP/ESICM/SCCM policy statement: responding to requests for potentially inappropriate treatments in intensive care units. Am J Respir Crit Care Med. 2015;191(11):1318–30.CrossRefPubMed

Jul 2, 2017 | Posted by in GERIATRICS | Comments Off on Medical Futility

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