We'll read more about this toward the end of your text & the course, but you might want to start the discussion now. There are medical definitions of futility. Here's an older article about it:
http://www.francesmccue.com/documents/Ethicist%20reading.pdf
And a more recently updated webpage:
http://depts.washington.edu/bioethx/topics/futil.html
A blog:
http://medicalfutility.blogspot.com/
An action that does not achieve the goals of the action, no matter how often repeated can be considered futile. Futile actions/treatments are very common in healthcare. Often death is delayed due to the attempt to use treatments and interventions that are futile. I think that it is very important to consider what the intervention/treatment can actually do for a patient. I think that it is ethically and morally wrong on many levels to put a patient through treatments that will not help and can cause unnecessary suffering. It is also wastefully of expensive medical resources. I know that it is hard to draw a line at which further treatment is useless, and no one wants to do it, but it needs to be done.
ReplyDeleteThe article, “Medical Futility: Its Meaning and Ethical Implications,” raises many interesting points regarding futile care. While I thought that I would disagree with many points made by the authors, I found myself agreeing with them much of the time. The idea that the doctor may not have to offer the family or ill individual all options available to continue life may seem, at first, deeply wrong, but , the authors have a point. “However, if survival requires the patient’s entire preoccupation with intensive medical treatment, to the extent that he or she cannot achieve any other life goals…the treatment is effective but not beneficial; it need not be offered to the patient, and the patient’s family has not right to demand it” (Schneiderman, Jecker, & Jonsen, 1990, pp. 952-953). The basic idea of the article is that medical treatments must be able to improve the life of the patient, not just prolong it, to be considered not futile. This notion seems to make complete sense – even Plato and Hippocrates agree (Schneiderman, Jecker, & Jonsen, 1990). My one concern is that the power given to the doctor could be abused – the doctor gets to determine futile treatment (not the family). While the article explains ways to safeguard against this, even the authors admit that this is a definite possibility. It seems to me that the article is looking for a definitive way to define futile treatment and to find an effective balance between family influence and doctor directed care. These issues, addressed in 1990, continue to plague the healthcare system today.
ReplyDeleteI agree with Michelle in that I was surprised with the amount of consensus I hold with the argument against futile care. However, the death of my uncle last week reminded me the importance of comfort in death. Our family was lucky because we knew my uncle's death was coming soon so he was able to make his own arrangements. My aunt was also very accepting of his passing because she could see the pain he had been in. My uncle died peacefully in his bed surrounded by his nurse, loved ones, and his music therapist, which was exactly what he wanted. If he had been in a hospital with my aunt insisting on treatment after treatment to prolong death, I think there would be an amount of dignity taken from the situation. The quote from "Ethics in Medicine" about the healthcare provider saying they will do everything possible to "ensure the patient's comfort and dignity" rather than expressing the futile nature of the possible treatments is really important. I agree again that the medical decisions about the availability of futile treatments should not be left up to the doctors, but a doctor should try to explain the treatment in terms of comfort; it can help the family make more informed decisions.
ReplyDeleteI agree with what has been said so far by C. Green, Michelle and Nicole. While reading the articles, I came to many of the same conclusions. There is no point in futile treatment because a definition of futile is pointless. In order to define futile treatment, you must first define the point of treatment in general. The point of treatment is to fix the problem. Therefore, at the end of life, the problem of the person must be decided. I believe that the problem of a sick pateint should be seen as they don’t have a good quality of life and that is what should be attempted to fix. If at any point in time, it becomes impossible to fix, it would be pointless to try more. The problem remains that they patient no longer has a good quality of life, so they should be treated for symptoms and in ways that relieve pain and suffering. If one were to choose the problem that a person is going to die, and tries to treat that, then there is no real worry about the quality of life. The treatment is geared towards keeping the patient of life. Futile treatment also wastes the time of all hospital staff involved and the money of the patient or family. But, how do you determine exactly when a treatment is deemed futile? Many treatments have a success rate so they are not all guaranteed to work the first time, everytime. If a treatment is deemed futile, how does anyone decided when there can be no more futile treatments? I personally cannot think of a very good way to make everyone happy with something along the matter of cutting off care once deemed futile.
ReplyDeleteI don't really agree with futile trestment. It is not helping the patient get better so why waste the money? It is not fair to the family to have to pay off the debts acquired by their family member for futile care. End of life care is the most expensive care someone can recieve and I don't think it is in the overall best interest to recieve futile care. I think that the patient has a duty to except death and should not prolong it by recieving useless treatments. They have a duty to move on to the afterlife where they can reunite with their savior or whatever it is that they believe. There are other people that could use these medications and technology but we waste it on the people who want futile care. As taxpayers, we are paying for the majority of this care, most likely. We pay into Medicare and the elderly reap the benefits of that. Medicare will pay for this treatment which is deemed useless by the medical professionals. We place all the power in the hands of the medical professionals in almost every other situation so why don't we listen to them in this situation? I agree with futile care only if the patient can pay for the care. If they are a billionaire and they want to use their money for this type of care then by all means, waste your money. But I don't think that taxpayers or the patients family should have to pay for it.
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