OBJECTIVES Medical futility at the end of life is a growing challenge to medicine. The goals of the authors were to elucidate how clinicians define futility, when they perceive life-sustaining treatment (LST) to be futile, how they communicate this situation and why LST is sometimes continued despite being recognised as futile. METHODS The authors reviewed ethics case consultation protocols a...

From the Department of Emergency Medicine, St. Vincent Mercy Medical Center, Toledo, OH*; the Department of Medical Humanities, Brody School of Medicine, East Carolina University, and Bioethics Center, University Health Systems of Eastern Carolina, Greenville, NC ; and the Center for the Study of Bioethics and the Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, WI. § ...

OBJECTIVE To determine the life-sustaining treatment limitation (LSTL) predisposition upon patient admission to the intensive care unit (ICU), the criteria upon which such predisposition is based, and whether these decisions are related to structural factors of the surveyed hospitals. DESIGN A descriptive multicenter study was made in 2010, involving the conduction of a survey in 90 hospitals...

The current demographical trend towards an increasingly elderly population combined with advances in end of life care calls for a deeper understanding and common terminology about the concept of futility and additional influences on the resuscitation decision-making process. Such improved understanding of medical futility and other contributing factors when making DNACPR orders would help to en...

Why do we persist in the relentless pursuit of artificial nourishment and other treatments to maintain a permanently unconscious existence? In facing the future, if not the present world-wide reality of a huge number of persistent vegetative state (PVS) patients, will they be treated because of our ethical commitment to their humanity, or because of an ethical paralysis in the face of biotechni...