Medical Futility: An Increasing Legal, Ethical, and Moral Dilemma

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Futility of Care: An Increasing Legal, Ethical, and Moral Dilemma
A divergent set of issues and opinions involving medical care for the very seriously ill patient have dogged the bioethics community for decades. While sophisticated medical technology has allowed people to live longer, it has also caused protracted death, most often to the severe detriment of individuals and their families. Ira Byock, director of palliative medicine at Dartmouth-Hitchcock Medical Center, believes too many Americans are “dying badly.” In discussing this issue, he stated, “Families cannot imagine there could be anything worse than their loved one dying, but in fact, there are things worse.” “It’s having someone you love…suffering, dying connected to machines” (CBS News, 2014). In the not distant past, the knowledge, skills, and technology were simply not available to cure, much less prolong the deaths of gravely ill people. In addition to the ethical and moral dilemmas this presents, the costs of intensive treatment often do not realize appreciable benefits. However, cost alone should not determine when care becomes “futile” as this veers medicine into an even more dangerous ethical quagmire. While preserving life with the best possible care is always good medicine, the suffering and protracted deaths caused from the continued use of futile measures benefits no one. For this reason, the determination of futility should be a joint decision between the physician, the patient, and his or her surrogate.
Defining Futility of Care
The Medical Viewpoint
The definitions of medical futility are:
• No widely accepted definition for the term “medical futility” exists
• Physiologic futility: Accomplishing the desired outcome is impossible
• Imminent-Demise fut...

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...acific Railway Co. v. Botsford - 141 U.S. 250 (1891). Retrieved from Justia U.S. Supreme Court: http://supreme.justia.com/cases/federal/us/141/250/case.html
Karnes, B. (2003). The final act of living. Depoe Bay: Barbara Karnes Books, Inc.
Kasman, D. L. (2004). When is medical treatment futile? Journal of General Internal Medicine, 1053-1056.
Mohr, M., & Kettler, D. (1997). Ethical aspects of resuscitation. British Journal of Anaesthesia, 253.
Morrison, E. E. (2011). Justice for Patients. In Ethics in Heatlh Administration-A Practical Approach for Decision Makers (p. 66). Sudbury, Massachusetts, United States of America: Jones and Bartlett Publishers. van Bogaert, K. D., & Ga, O. (2014, February). Ethical issues in family practice: Medical futility--the debate. Retrieved from South African Family Practice: http://www.safpj.co.za/index.php/safpj/article/viewFile/20/20

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