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    D'Amico, Thomas A. Krasna, Mark J. Krasna, Diane M. and Sade, Robert M. 2009. No Heroic Measures: How Soon Is Too Soon to Stop?. The Annals of Thoracic Surgery, Vol. 87, Issue. 1, p. 11.


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    Helft, Paul R. Siegler, Mark and Lantos, John 2000. The Rise and Fall of the Futility Movement. New England Journal of Medicine, Vol. 343, Issue. 4, p. 293.


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  • Cambridge Quarterly of Healthcare Ethics, Volume 2, Issue 2
  • April 1993, pp. 219-224

Futility: Is Definition the Problem? Part I

  • Miriam Piven Cotler (a1) and Dorothy Rasinski Gregory (a2)
  • DOI: http://dx.doi.org/10.1017/S096318010000092X
  • Published online: 01 July 2009
Abstract

A physician recently asked how to respond in the case of an 87-year-old patient with advanced Alzheimer's disease, who was unable to swallow or tolerate a nasogastric tube, when the family insisted a gastrostomy tube be inserted but the physician believed the intervention futile. That question encompasses some of the crucial issues in the concept of futility of the treatment goals of physician, patient, and family; the rights of patients and families to demand care; physician judgment; family values; and, to the degree that it represents many similar dilemmas, justice. What are professionals saying when they pronounce treatment futile? What are patients' rights if they or their surrogates disagree?

The word “futile” implies a precision about outcome probability that we do not have, and it ignores the wide range of treatments for a given diagnosis. Is futile the same as useless or the opposite of hope? Futile for what? Cure? Restora tion of function? Prolongation of life? Relief from pain? Relief from anxiety? Com fort? Reassurance? To satisfy or placate the patient or the family? The word “futile” is so imprecise that, rather than clarifying, it confuses and clutters the discussion.

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This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

LJ Schneiderman , NS Jecker , AR Jonsen . Medical futility: its meaning and ethical implications. Annals of Internal Medicine 1990;112:949–54.

J Paris , R Crone , F Reardon . Physicians refusal of requested treatment: the case of Baby L. New England Journal of Medicine 1990;322:1012–4.

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Cambridge Quarterly of Healthcare Ethics
  • ISSN: 0963-1801
  • EISSN: 1469-2147
  • URL: /core/journals/cambridge-quarterly-of-healthcare-ethics
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