OBJECTIVES Nurses are generally present, and often influential, in supporting patient and family acceptance of medical futility and in assisting doctors in negotiating referral to palliative care. Yet the specificities of the nursing role and how nurses may contribute to timely and effective referrals is not well understood. This study aimed to systematically explore hospital-based nurses' acco...

OBJECTIVES To present an analysis of "futility" that is useful in the clinical setting. DESIGN Literature review. MATERIAL AND METHODS According to Medline more than 750 articles have been published about medical futility. Three criteria (language, time period, and the authors expressed their own opinions) singled out 43 of them. The authors' opinions about futility were analysed using the ...

I N THE COURSE OF CARING FOR A critically ill patient it may become apparent that further intervention will only prolong the final stages of the dying process. At this point, further intervention is often described as futile. There has been controversy in the literature and in clinical practice regarding what constitutes futile intervention. Clinical paradigms of futile care often involve life-...

The modern debate on whether—and why—physicians and hospitals can refuse patient or family demands for treatment on grounds of “futility” will be reaching its 20 anniversary this year (Blackhall, 1987). The early debate focused on the use of CPR, for good historical and clinical reasons, and CPR probably remains the primary target of hospital policy. But the reach of the arguments over futility...

BACKGROUND AND PURPOSE Most large, randomized phase III efficacy trials of therapeutic agents in ischemic stroke have failed to find treatment benefit. We determined whether some phase III studies could have been avoided if preceded by smaller single-arm phase II studies to evaluate the futility of proceeding to phase III. METHODS To provide examples of the application of phase II methodology...

In the editorial “The Evolution of Clinical Trials in Oncology: Defining Who Benefits from New Drugs Using Innovative Study Designs” [1], Goldberg et al. nicely discuss many changing aspects of clinical trial design in oncology. However, I believe their title is misleading. No study will define “who benefits” but only who might benefit. For example, human epidermal growth receptor 2 overexpress...