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Ethical Issues in Anesthesiology and Surgery pp 151–170Cite as

Futility and the Care of the Perioperative Patient

Abstract

Futility in healthcare is an area of significant debate. Generally, a futile treatment is one that is incapable of producing a beneficial result. The degree of benefit required has been contentious in the ethics literature. Different definitions of futility have been proposed to arrive at a consensus regarding which treatments would be provided and to agree on futile interventions that could be withheld. However, each of these definitions has flaws. Some hospitals, healthcare organizations, and states have implemented policies to create a procedural approach to futility disputes. Several authors have advocated discarding the language of futility as it often is an expression of physician frustration and impedes communication between care providers, patients and their surrogates. Many resources are available to assist in difficult cases involving futility including preoperative risk calculators and institutional ethics committees, but, ultimately, the best tool in approaching these challenging situations is open and honest communication between the patient, or surrogate, and the physician.

Keywords

  • Futility
  • End-of-Life Care
  • Inappropriate Treatment
  • Surgery
  • Anesthesiology
  • Perioperative

Scott B. Grant and Parth K. Modi have contributed equally to this chapter.

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Author information

Authors and Affiliations

  1. Department of Surgery, Rutgers Robert Wood Johnson Medical School, 1 RWJ Place, MEB 596, New Brunswick, NJ, 08901, USA

    Scott B. Grant MD, MBE

  2. Department of Surgery, Division of Urology, Rutgers Robert Wood Johnson Medical School, 1 RWJ Place, MEB 584A, New Brunswick, NJ, 08901, USA

    Parth K. Modi MD

  3. Department of Surgery, Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, 195 Little Albany Street, Room 4563, New Brunswick, NJ, 08903, USA

    Eric A. Singer MD, MA, FACS

Authors
  1. Scott B. Grant MD, MBE
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  2. Parth K. Modi MD
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  3. Eric A. Singer MD, MA, FACS
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Corresponding author

Correspondence to Eric A. Singer MD, MA, FACS .

Editor information

Editors and Affiliations

  1. Anesthesiology, The University of Illinois Hospital and Health Sciences System, Chicago, Illinois, USA

    Barbara G. Jericho

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Grant, S.B., Modi, P.K., Singer, E.A. (2015). Futility and the Care of the Perioperative Patient. In: Jericho, B. (eds) Ethical Issues in Anesthesiology and Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-15949-2_13

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