medical futility

(redirected from futile resuscitation)


the quality of not leading to a desired result.
medical futility the judged futility of medical care, used as a reason to limit care. Two reasons for making this judgment are (1) to conserve resources and (2) to protect clinician integrity. The types are physiologic futility and normative futility.
normative futility a judgment of medical futility made for a treatment that is seen to have a physiologic effect but is believed to have no benefit.
physiologic futility a judgment of medical futility based on the observation of no physiologic effect of the treatment.

medical futility

A subjective term encompassing a range of possibilities of whether a patient will benefit from efforts designed to improve his or her life and survive to discharge from a healthcare facility. 

Application of the futility rationale in withholding or withdrawing medical interventions (e.g., do not resuscitate orders) requires both practice guidelines and a better understanding of the concept of medical futility in general. For example, cardiopulmonary resuscitation (CPR) is divided into quantitative futility (low probability of success) and qualitative futility (poor quality of life if CPR is performed); this definition for futility may be a stumbling block in determining whether a person should be subjected to CPR if the likelihood for a “meaningful existence” is minimal.

The lack of efficacy of a particular manoeuvre in reducing morbidity and mortality.

medical futility

Futile resuscitation, futility Biomedical ethics A subjective term that encompasses a range of probabilities that a Pt will benefit from efforts designed to improve his life and survive to discharge from a health care facility Medtalk The lack of efficacy of a particular maneuver in ↓ M&M. See Advance directive, DNR, Futility. See DNR orders. Cf Euthanasia.
References in periodicals archive ?
"Starting futile resuscitation and putting the family through unnecessary hope only adds to their suffering.
They say better trained staff are increasingly encouraged not to carry out "futile resuscitations", which can distress families by giving false hope.
In the absence of objective signs of irreversible death and without known previous rejection of resuscitation, performing full resuscitation is recommended (1); however, if the chance of good quality survival of the patient is low, then futile resuscitation is mentioned (2).
Our purpose in this paper is to identify issues relevant to the development of effective and defensible hospital policies supporting physician judgments not to provide futile resuscitation. As we are convinced that
In what follows, we will focus chiefly on issues and policies surrounding futile resuscitation and say little about other treatment interventions, except by implication.
There are a number of good reasons supporting an obligation to discuss decisions not to provide futile resuscitation with patients and families, short of reliance upon the patient's right of self-determination.[2] There is no incompatibility between rejecting the patient's right to select futile resuscitation and insisting on the physician's obligation to inform patients about their plan of care, a point apparently missed by some critics of futility judgments.
Finally, the argument has been made that unilateral physician authority over futile resuscitation is unnecessary, because in virtually all cases when physicians would think resuscitation futile, patients and families would agree.
The difficulty with the objection and the alternative it espouses is that it is extremely difficult for patients and families to make informed, autonomous choices about futile resuscitation. When the only way to authorize a DNR order under hospital policy is by the consent of patients or their representatives, discussions about futile resuscitation are inherently misleading offers of bogus choices, increasing the likelihood that a choice will be made in favor of futile treatment.
Such an apparently more benign approach, however, is a trap that gets sprung when the family takes up the invitation to make the decision themselves, and makes "the wrong one" by opting for futile resuscitation. They are understandably angry and confused when the staff responds with aggressive efforts to persuade them to change their mind, which the family readily interprets as an attempt to take back the offer.
This element is important because it sets out the paradigm case of futile resuscitation and offers the basis for analogies to some other situations for example, other cases of irreversible unconsciousness combined with imminent cardiac death.
Thus, the PVS patient is not per se a case of futile resuscitation. Moreover, possible benefits to the patient other than extended life require consideration--one of the chief reasons that judgments of futility must be individualized rather than defined a priori.