The Futility of Futility: Death Causation is the 'Elephant in the Room' in Discussions about Limitation of Medical Treatment [Book Review]

Journal of Bioethical Inquiry 8 (2):151-154 (2011)
Abstract
The term futility has been widely used in medical ethics and clinical medicine for more than twenty years now. At first glance it appears to offer a clear-cut categorical characterisation of medical treatments at the end of life, and an apparently objective way of making decisions that are seen to be emotionally painful for those close to the patient, and ethically, and also potentially legally hazardous for clinicians. It also appears to deal with causation, because omission of a futile treatment cannot surely be a cause of death. The problem is that futility can be argued to be a false friend , in that it gives an appearance of representing a reliable conceptual basis, in ethics, for limitation of medical treatment—usually in the context of dying—without actually doing so. In fact, the concept of futility is a conflation of clinical judgement about outcomes of treatment and the quality or even value of life, and has really failed to contribute much to the advancement of decision-making and hence care at the end-of-life. It also has the capacity to medicalise the personal space. Deliberations about the likely outcomes of medical treatment are necessary, and medical expertise is pivotal. However, futility is argued to have a better future in partnership with a broad social action agenda about the process of dying, such as that articulated in health promoting palliative care, as a basis for better death-ways in the 21st century (Kellehear 2005). Medicine needs to more honest and upfront about its limits, as death is, after all, the elephant in everybody's room
Keywords Futility  End of life  Palliative care  Death  Medical decision-making
Categories No categories specified
(categorize this paper)
Options
 Save to my reading list
Follow the author(s)
My bibliography
Export citation
Find it on Scholar
Edit this record
Mark as duplicate
Revision history Request removal from index
 
Download options
PhilPapers Archive


Upload a copy of this paper     Check publisher's policy on self-archival     Papers currently archived: 10,941
External links
Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
Through your library
References found in this work BETA
Alexander Morgan Capron (1994). At Law. Hastings Center Report 24 (5):42-43.
Citations of this work BETA

No citations found.

Similar books and articles
Wayne Shelton (1998). A Broader Look at Medical Futility. Theoretical Medicine and Bioethics 19 (4):383-400.
Mary Ann Baily (2011). Futility, Autonomy, and Cost in End-of-Life Care. Journal of Law, Medicine and Ethics 39 (2):172-182.
John C. Moskop (1995). From Futility to Triage. Journal of Medicine and Philosophy 20 (2):191-205.
Amir Halevy (1995). Is Futility a Futile Concept? Journal of Medicine and Philosophy 20 (2):123-144.
J. Savulescu (2013). Just Dying: The Futility of Futility. Journal of Medical Ethics 39 (9):583-584.
Analytics

Monthly downloads

Added to index

2011-03-21

Total downloads

32 ( #53,836 of 1,100,730 )

Recent downloads (6 months)

4 ( #80,589 of 1,100,730 )

How can I increase my downloads?

My notes
Sign in to use this feature


Discussion
Start a new thread
Order:
There  are no threads in this forum
Nothing in this forum yet.