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...

OBJECTIVE To investigate how doctors define and use the terms "futility" and "futile treatment" in end-of-life care. DESIGN, SETTING, PARTICIPANTS A qualitative study using semi-structured interviews with 96 doctors from a range of specialties which treat adults at the end of life. Doctors were recruited from three large Brisbane teaching hospitals and were interviewed between May and July 20...

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...

The emergence of new obstetrical and neonatal technologies, as well as more aggressive clinical management, has significantly improved the survival of extremely low birth weight (ELBW) infants. This development has heightened concerns about the limits of viability. ELBW infants, weighing less than 1,000 grams and no larger than the palm of one’s hand, are often described as “miracles” of late t...

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...

BACKGROUND Empirical surveys about medical futility are scarce relative to its theoretical assumptions. We aimed to evaluate the difference of attitudes between laypeople and physicians towards the issue. METHODS A questionnaire survey was designed. Japanese laypeople (via Internet) and physicians with various specialties (via paper-and-pencil questionnaire) were asked about whether they woul...

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...

It probably should not be surprising, in this time of soaring medical costs and proliferating technology, that an intense debate has arisen over the concept of medical futility. Should doctors be doing all the things they are doing? In particular, should they be attempting treatments that have little likelihood of achieving the goals of medicine? What are the goals of medicine? Can we agree whe...

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...

Aim and objective: To describe people’s experiences of living with dementia in Iran. Background: A knowledge gap exists regarding the experiences of living with dementia in non-Western contexts. This gap may be especially apparent within the Iranian context, where dementia research is relatively new. Deeper understanding about context related experiences of dementia is a prerequisite for nurses...