Futile Treatment—A Review
The main goal of intensive care medicine is helping patients survive acute threats to their lives, while preserving and restoring life quality. Because of medical advancements, it is now possible to sustain life to an extent that would previously have been difficult to imagine. However, the goals of medicine are not to preserve organ function or physiological activity but to treat and improve the health of a person as a whole. When dealing with medical futilities, physicians and other members of the care team should be aware of some ethical principles. Knowing these principles could make decision-making easier, especially in cases where legal guidelines are insufficient or lacking. Understanding of these principles can relieve the pressure that healthcare professionals feel when they have to deal with medical futility. Efforts should be made to promote an ethics of care, which means caring for patients even after further invasive treatment has been deemed to be futile. Treatments that improve patients’ comfort and minimize suffering of both patients and their families are equally as important as those aimed at saving patients’ lives.
KeywordsMedical futility Ethics Critical care Palliative care Quality of life
- Center for Practical Bioethics. 2008. Recommended policy guidelines regarding medical futility. https://www.practicalbioethics.org/files/guidelines/19-Futility-web-2008.pdf. Accessed April 8, 2017.
- Fritz, Z., A. Malyon, J.M. Frankau, et al. 2013. The Universal Form of Treatment Options (UFTO) as an alternative to Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) orders: A mixed methods evaluation of the effects on clinical practice and patient care. PLoS One 8(9): e70977.CrossRefPubMedPubMedCentralGoogle Scholar
- Guidet B., Y. Nguyen and A. Boumendil. 2012. Selection of ICU admission criteria for elderly patients.Google Scholar
- Jensen, H.I., J. Ammentorp and H. Ording. 2013. Guidelines for withholding and withdrawing therapy in the ICU: Impact on decision-making process and interdisciplinary collaboration. Heart Lung and Vessels 5(3): 158–167.Google Scholar
- Joseph, R. 2011. Hospital policy on medical futility—Does it help in conflict resolution and ensuring good end-of-life care? Annals, Academy of Medicine, Singapore 40(1): 19–25.Google Scholar
- Moldow, G., D. Bartels, D. Brunnquell, and R. Cranford. 2004. Why address medical futility now? New guidelines aim to resolve the inevitable differences of opinion that occur when health care providers or family members deem that further medical care is futile. Minnesota Medicine 87(6): 38–44.PubMedGoogle Scholar
- SIAARTI. 2006. End-of-life care and the intensivist: SIAARTI recommendations on the management of the dying patient. Minerva Anestesiologica 72(12): 927–963.Google Scholar
- Truog, R.D., M.L. Campbell, J.R. Curtis, et al. 2008. Recommendations for end-of-life care in the intensive care unit: A consensus statement by the American College [corrected] of Critical Care Medicine. Critical Care Medicine 36(3): 953–963.Google Scholar
- Tsoh, J., C. Peisah, J. Narumoto, et al. 2015. Comparisons of guardianship laws and surrogate decision-making practices in China, Japan, Thailand and Australia: A review by the Asia Consortium, International Psychogeriatric Association (IPA) capacity taskforce. International Psychogeriatrics 27(6): 1029–1037.CrossRefPubMedGoogle Scholar
- ____. 2014. A costly separation between withdrawing and withholding treatment in intensive care. Bioethics 28(3): 127–137.Google Scholar