Hostname: page-component-848d4c4894-pftt2 Total loading time: 0 Render date: 2024-05-29T09:02:50.305Z Has data issue: false hasContentIssue false
  • English
  • Français

Futility: Are Goals the Problem? Part Two

Published online by Cambridge University Press:  29 July 2009

Dorothy Rasinski Gregory  and
Miriam Piven Cotler
Dorothy Rasinski Gregory
Affiliation:
An associate at the Center for Healthcare Ethics, St. Joseph Health System, Orange, California
Miriam Piven Cotler
Affiliation:
A professor and Director at the Center for Health Research and Community Service, Department of Health Service, California State University, Northridge
Get access Rights & Permissions [Opens in a new window]

Extract

Recent contributions to the literature on the topic of futility have focused primarily on two areas: 1) definitions of the term and 2) the suggestion that cardiopulmonary resuscitation (CPR) may be futile in certain patients. This suggestion is based on “scientific” measures and analyses of outcomes, describing the low probability of success of CPR in patients over age 70, those with cancer, those with multiorgan failure, etc. The research reported suggests that with such patients the physician need not get the patient's (or the surrogate's) consent to withhold resuscitation; the physician need only inform either the patient or the surrogate that CPR will not be Instituted in the event of an arrest.

Type
Articles
Information
Cambridge Quarterly of Healthcare Ethics , Volume 3 , Issue 1 , Winter 1994 , pp. 125 - 134
Copyright
Copyright © Cambridge University Press 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Notes

1. Youngner, SJ. Who defines futility? Journal of the American Medical Association 1988;260:2094–5.CrossRefGoogle ScholarPubMedLantos, JD, Singer, PA, Walker, RM et al. , The illusion of futility in clinical practice. American Journal of Medicine 1989;87:81–4.CrossRefGoogle ScholarPubMedSchneiderman, LJ, Jecker, NS, Jonsen, AR. Medical futility: its meaning and ethical implications. Annals of Internal Medicine 1990;112:949–54.CrossRefGoogle ScholarPubMedJecker, NS, Schneiderman, LJ. Futility and rationing. American Journal of Medicine 1992;92:189–96.CrossRefGoogle ScholarPubMed

2. Tomlinson, T, Brody, H. Futility and the ethics of resuscitation. Journal of the American Medical Association 1990;264:1276–80.CrossRefGoogle ScholarTomlinson, T, Brody, H. Ethics and communication in do-not-resuscitate orders. New England Journal of Medicine 1988;318:43–6.CrossRefGoogle ScholarPubMedSchiedermayer, DL. The decision to forgo CPR in the elderly patient. Journal of the American Medical Association 1988;260:2096–7.CrossRefGoogle ScholarPubMedMurphy, DJ, Murray, AM, Robinson, BE, Campion, EW. Outcomes of cardiopulmonary resuscitation in the elderly. Annals of Internal Medicine 1989;111:199–205.CrossRefGoogle ScholarPubMedYoungner, SJ. Futility in context. Journal of the American Medical Association 1990;264:1295–6.CrossRefGoogle ScholarPubMedKnaus, WA, Wagner, DP, Lynn, J. Short-term mortality predictions for critically ill hospitalized adults. Science 1991;254:389–94.CrossRefGoogle ScholarPubMed

3. Morreim, EH. Economic disclosure and economic advocacy: new duties in the medical standard of care. Journal of Legal Medicine 1991;12:275–329.CrossRefGoogle ScholarPubMed

4. Bressler, LR, Geraci, MC, Schatz, BS. Misperceptions and inadequate pain management in cancer patients. Drug Intelligence and Clinical Pharmacy 1991;25:1225–30.Google ScholarPubMed

5. Gushing, M. Pain management on trial. American Journal of Nursing 1992;92(2):21–3.CrossRefGoogle ScholarVentafridda, V, Ripamonti, C, DeConno, F et al. , Symptom prevalence and control during cancer patients' last days of life. Journal of Palliative Care 1990;6(3):5–6.Google ScholarPubMedFeldman, MK. Pain control in dying patients—how much is too much? Minnesota Medicine 1990;73(6): 19–24.Google ScholarPubMedHill, CS Jr. Relationship among cultural, educational, and regulatory agency influences on optimum cancer pain treatment. Journal of Pain and Symptom Management 1990;5(Suppl.l):S37–45.Google ScholarPubMedMelzack, R. The tragedy of needless pain. Scientific American 1990;262(2):27–33.CrossRefGoogle ScholarPubMed

6. Mangan, JT. An historical analysis of the principle of double effect. Theological Studies 1949; 10:4.CrossRefGoogle ScholarBoyle, JM. Toward understanding the principle of double effect. Ethics 1980;90:527.CrossRefGoogle Scholar

7. See note 4. Bressler, et al. 1991;25:1225–30.Google Scholar

8. President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research. Deciding to Forego Life-Sustaining Treatment. Washington, D.C.: U.S. Government Printing Office, 1983:4, 73–7.Google Scholar

9. See note 8. President's Commission. 1983:89–90.Google Scholar