The Problem With Futility
Brett, Allan S.
New England Journal of Medicine. 1992 Jun 4; 326(23): 1560-1564.
...The notion of futility generally fails to provide an ethically coherent ground for limiting life-sustaining treatment, except in circumstances in which narrowly defined physiologic futility can be plausibly invoked. Futility has been conceptualized as an objecitve entity independent of the patient's or surrogate's perspective, but differences in values and the variable probabilities of clinical outcomes undermine its basis. Furthermore, assertions of futility may camouflage judgments of comparative worth that are implicit in debates about the allocation of resources. In short, the problem with futility is that its promise of objectivity can rarely be fulfilled. The rapid advance of the language of futility into the jargon of bioethics should be followed by an equally rapid retreat.
Allowing to Die; Autonomy; Allocation of Resources; Bioethics; Biomedical Technologies; Communication; Conscience; Consensus; Cultural Pluralism; Decision Making; Family Members; Futility; Legal Aspects; Life; Moral Policy; Patients; Persistent Vegetative State; Physicians; Policy Analysis; Prolongation of Life; Public Policy; Resuscitation; Resuscitation Orders; Risks and Benefits; Statistics; Uncertainty; Values; Ventilators; Withholding Treatment;