Medical Futility: Philosophical Reflections on Death

Abstract

The recent medical literature in the United States has contained an extensive discussion of the issue of medical futility. Inspired by cases such as that of Helen Wanglie (Angell, 1991), in which the husband of an elderly woman in a persistent vegetative state demanded continued life-prolonging interventions, clinicians and ethicists have debated whether or not patients are entitled to receive life prolonging interventions (demanded by them or the surrogates who speak for them) even when the clinicians judge those interventions to be futile. Some (Blackhall, 1987) have emphasized the objectivity of the clinical judgements that the interventions in question are futile, and have permitted physicians in such cases to unilaterally decide to limit those futile interventions. Others (Youngner, 1988) have emphasized the value-laden nature of such judgements, and have insisted that it is the patient or the family who must decide which interventions will be provided.