concerns over limited medical equipment and resources, particularly in intensive care units (icus), have raised the issue of medical futility. medical futility draws a contrast between physician’s authority and patients’ autonomy and it is one of the major issues of end-of-life ethical decision-making. the aim of this study was to review medical futility and its challenges. in this systematized...

A few recent, large, well-publicized trials in critical care medicine have been stopped for futility. In the critical care setting, stopping for futility means that independent review committees have elected to stop the trial early--based on predetermined rules--since the likelihood of finding a treatment effect is low. For bedside clinicians the idea of futility in a clinical trial can be conf...

Purpose of the review—Decisions to withdraw or withhold potentially life-sustaining treatment are common in intensive care and precede the majority of deaths. Where families resist or oppose doctors’ suggestions that it is time to stop treatment it is often unclear what should be done. This review will summarize recent literature around futility judgements in intensive care emphasising ethical ...

BACKGROUND In clinical trials, the opportunity for an early stop during an interim analysis (either for efficacy or for futility) may relevantly save time and financial resources. This is especially important, if the planning assumptions required for power calculation are based on a low level of evidence. For example, when including two primary endpoints in the confirmatory analysis, the power ...

Futility trials are efficient, early phase studies designed to eliminate potential interventions or treatments before moving into large and expensive, definitive phase III trials. In a futility trial, the null and alternative hypotheses are reversed in comparison with the usual superiority trial and are one-sided. The null hypothesis is that the intervention reaches or exceeds the required leve...

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 s...

AIMS To determine the extent of futile care provided to critically ill children admitted to a paediatric intensive care setting. METHODS Prospective evaluation of consecutive admissions to a 20 bedded multidisciplinary paediatric intensive care unit of a North London teaching hospital over a nine month period. Three previously defined criteria for futility were used: (1) imminent demise futil...