Essay On Medical Futility

Step 1

Physician’s objective and subjective assessment of medical futility and the dying process

Recognizing medical futility and identifying the dying process is the first step towards planning end of life care. It is not always easy to recognize “medical futility” and whether the patient is going through the dying process. Experience and expertise is often required to diagnose these situations.

Various definition and subtypes of futility exist 5,6,7 Conclusive data from evidence-based medicine on futility is still lacking. Until such time, physicians may have to rely on their professional judgment and consider patient autonomy to make an informed shared decision 8. Sometimes the clinician 's judgment may be influenced by his own biases and

Physicians should consider whether further treatment will abide by these two principles, and if not, futility ensues. It is ethical for physicians to decline to provide treatment, which is judged to be medically inappropriate, either where such treatment is not in the interest of the patient, or where there are insufficient resources to provide treatment of this level of benefit. For example, treatment should be labeled futile for a young patient with severe and multiple trauma who is in coma (in absence of brain death) despite optimal therapy and no reversible causes are identifiable or a patient with end-organ dysfunction on prolonged life supportive therapies, having no improvement. The concept of medical futility is in line with social justice and is more pronounced in resource restrictive settings

The following table (Table 1 ) may serve as a guide to recognize medical futility. These points should not be used in isolation, but in the context of the clinical status of the patient. Whenever there is doubt about the prognosis, the physician should not take any hasty decisions, but wait for the disease process to