Futile Treatments in Intensive Care. Controversies around Facts and Terms

Futile treatment in intensive care patients is a hot topic around the world and a matter of intense debate and controversy. The consequences of such treatments are three-fold: the prolongation of patient’s suffering without long-term benefits, missed opportunities for other patients and high cost-benefit ratio in terms of resource allocation. By the same time a lot of controversies arise. Who should decide futility of treatment? What does futility really mean? Which should be the prevailing factor in the decision of futility: patient’s interest or opt imization of cost-benefit ratio in resource allocation? Is the term futile care appropriate? Is the term futility appropriate? In order to avoid futility judgments to be applied arbitrarily, the medical community should set explicit standards and procedures that support the ethic of care in terminally ill patients.