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)
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||categorize this paper)|
References found in this work BETA
The Development of "Medical Futility": Towards a Procedural Approach Based on the Role of the Medical Profession.S. Moratti - 2009 - Journal of Medical Ethics 35 (6):369-372.
Wrong Medicine: Doctors, Patients, and Futile Treatment.L. J. Schneiderman - 1995 - Johns Hopkins University Press.
Citations of this work BETA
No citations found.
Similar books and articles
Futility and the Varieties of Medical Judgment.Daniel P. Sulmasy - 1997 - Theoretical Medicine and Bioethics 18 (1-2).
Defining Medical Futility and Improving Medical Care.Lawrence Schneiderman - 2011 - Journal of Bioethical Inquiry 8 (2):123-131.
A Broader Look at Medical Futility.Wayne Shelton - 1998 - Theoretical Medicine and Bioethics 19 (4):383-400.
Embracing Our Mortality: Hard Choices in an Age of Medical Miracles.L. J. Schneiderman - 2008 - Oxford University Press.
Utility and the Principle of Medical Futility: Safeguarding Autonomy and the Prohibition Against Cruel and Unusual Punishment.I. I. Smith - manuscript
The Physician's Authority to Withhold Futile Treatment.Glenn G. Griener - 1995 - Journal of Medicine and Philosophy 20 (2):207-224.
Towards a Just, Courageous, and Honest Resolution of the Futility Debate.Rosemarie Tong - 1995 - Journal of Medicine and Philosophy 20 (2):165-189.
Bioethics for Clinicians: 16. Dealing with Demands for Inappropriate Treatment.Charles Weijer, Peter A. Singer, Bernard M. Dickens & Stephen Workman - unknown
Futility, Autonomy, and Cost in End-of-Life Care.Mary Ann Baily - 2011 - Journal of Law, Medicine & Ethics 39 (2):172-182.
Experts' Attitudes Towards Medical Futility: An Empirical Survey From Japan. [REVIEW]Alireza Bagheri, Atsushi Asai & Ryuichi Ida - 2006 - BMC Medical Ethics 7 (1):1-7.
Futility Determination as a Process: Problems with Medical Sovereignty, Legal Issues and the Strengths and Weakness of the Procedural Approach. [REVIEW]Cameron Stewart - 2011 - Journal of Bioethical Inquiry 8 (2):155-163.
Added to index2011-03-21
Total downloads39 ( #133,927 of 2,177,988 )
Recent downloads (6 months)2 ( #166,811 of 2,177,988 )
How can I increase my downloads?