medical futility


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futility

 [fu-til´ĭ-te]
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

Ethics
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.

Medtalk
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 ?
For patients without a DNR order, the doctor's decision about CPR indications is not being present; in other words, the decision of medical futility will be sufficient for not performing CPR (2).
(17.) Medical Futility in End-off-Life Care: report of the Council on Ethical and Judicial Affairs.
In the clinic the medical futility debate culminates in the practical question of whether physicians may unilaterally discontinue LSMT in the face of opposition from patient/surrogates.
The text also relates that to attempt futile treatment was to display an ignorance "allied to madness." The concept of medical futility has been counterbalanced by the rapid advance of medical science, especially in the last several decades beginning in the 1960s, when life-sustaining medical treatments such as the mechanical ventilator became available.
"'Always assuming [the treatment] is not medically futile,' Nimer told [Reiff] at some point during [his] mother's last weeks, 'if I can carry out my patient's wishes, I want to do that.'" (17) But the conception of "medical futility" that Nimer apparently applied was a null set; it had no empirical basis and could not be falsified by any empirical data.
The TADA does not define "medical appropriateness," or "medical inappropriateness," nor does it use the term "medical futility," the latter arguably being an expression even more ambiguous and vague.
Acceptance of the concept of medical futility facilitates a paradigm shift from curative to palliative medicine, accommodating a more humane approach and avoiding unnecessary suffering in the course of the dying process.
For the past decade, there has been debate within the medical, ethical, and legal communities focusing on the issue of medical futility. Despite the emergence of medical futility as a dominant topic of discussion, especially as it applies to end-of-life care, the concept is not new.
It reflects a body of law on medical futility that has been evolving throughout the past 3 decades, as the wishes of patients and their surrogates sometimes have been pitted against increasingly sophisticated technology and inflexible hospital policies.
From Thaddeus Mason Pope's blog Medical Futility, quoting the amended complaint:
A contentious end-of-life issue is that of medical futility; which basically denotes treatment that cannot confer an overall benefit on the whole person even if it can restore some physiologic variable.
(41) Of note, however, is that two articles addressing physician and nurse attitudes toward medical futility are from Canada and Japan; both countries with universal health insurance.

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