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Conditions and consequences of medical futility - from a literature review to a clinical model

Löfmark, R and Nilstun, Tore LU (2002) In Journal of Medical Ethics 28(2). p.115-119
Abstract
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 scheme: If certain conditions are satisfied, then a particular measure is futile and If a particular measure is futile, then certain moral consequences are implied. Results: Regarding conditions, most authors stated that judgments about futility should be made by physicians. The measure was usually some kind of medical treatment, and the goals related to... (More)
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 scheme: If certain conditions are satisfied, then a particular measure is futile and If a particular measure is futile, then certain moral consequences are implied. Results: Regarding conditions, most authors stated that judgments about futility should be made by physicians. The measure was usually some kind of medical treatment, and the goals related to quality of life, physiological improvement, or prolongation of life. The probability of success in reaching the goal was in most cases described in semiquantitative terms. Regarding consequences, the authors stated that health care professionals may (sometimes ought or should) withhold or withdraw a futile measure, most often after a dialogue with the patient (29 articles), but sometimes without informing the patient (nine articles), or with one-way information (four articles). Over time more and more articles recommend that the patient should be involved in joint decision making. Based on this literature review a clinical model was developed. Conclusions: The model, requiring that conditions and consequences should be made explicit, may, in futility situations, facilitate both the collection of the necessary information and make the moral implications visible. It also makes communication about measures considered to be futile possible without using such ambiguous terms as futile. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Medical Ethics
volume
28
issue
2
pages
115 - 119
publisher
BMJ Publishing Group
external identifiers
  • wos:000175069700016
  • scopus:0036230902
ISSN
1473-4257
DOI
10.1136/jme.28.2.115
language
English
LU publication?
yes
id
85a23b6a-41a6-4472-885c-3ac774ac3e18 (old id 131668)
alternative location
http://jme.bmjjournals.com/cgi/content/extract/28/2/115
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=11934942&ordinalpos=10&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
date added to LUP
2007-06-28 12:16:45
date last changed
2017-09-17 07:39:10
@article{85a23b6a-41a6-4472-885c-3ac774ac3e18,
  abstract     = {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 scheme: If certain conditions are satisfied, then a particular measure is futile and If a particular measure is futile, then certain moral consequences are implied. Results: Regarding conditions, most authors stated that judgments about futility should be made by physicians. The measure was usually some kind of medical treatment, and the goals related to quality of life, physiological improvement, or prolongation of life. The probability of success in reaching the goal was in most cases described in semiquantitative terms. Regarding consequences, the authors stated that health care professionals may (sometimes ought or should) withhold or withdraw a futile measure, most often after a dialogue with the patient (29 articles), but sometimes without informing the patient (nine articles), or with one-way information (four articles). Over time more and more articles recommend that the patient should be involved in joint decision making. Based on this literature review a clinical model was developed. Conclusions: The model, requiring that conditions and consequences should be made explicit, may, in futility situations, facilitate both the collection of the necessary information and make the moral implications visible. It also makes communication about measures considered to be futile possible without using such ambiguous terms as futile.},
  author       = {Löfmark, R and Nilstun, Tore},
  issn         = {1473-4257},
  language     = {eng},
  number       = {2},
  pages        = {115--119},
  publisher    = {BMJ Publishing Group},
  series       = {Journal of Medical Ethics},
  title        = {Conditions and consequences of medical futility - from a literature review to a clinical model},
  url          = {http://dx.doi.org/10.1136/jme.28.2.115},
  volume       = {28},
  year         = {2002},
}