- The Oxford Handbook of Ethics at the End of Life
- Acknowledgment
- Contributors
- Introduction
- Legal Issues in Death and Dying: How Rights and Autonomy Have Shaped Clinical Practice
- “So What Do You Want Us to Do?”: Patients’ Rights, Unintended Consequences, and the Surrogate’s Role
- Death at the Beginning: The Neonatal Intensive Care Unit
- Dying Children and the Kindness of Strangers
- Medical Futility and Potentially Inappropriate Treatment
- Conscientious Objection
- Continuous Sedation at the End of Life
- The Ethics of Medically Assisted Nutrition and Hydration at the End of Life: Separating the Wheat from the Chaff
- Disorders of Consciousness and Neuro-Palliative Care: Toward an Expanded Scope of Practice for the Field
- Ethical Issues in Prognosis and Prognostication
- The Smell of Chlorine: Coming to Terms with Death
- Talking and Working with Dying Patients: True Grief and Loss
- The Nature of Suffering
- On Our Difficulties Speaking to and About the Dying
- The Cost of Dying Among the Elderly in the United States: Ethical Issues
- Death, Dying, and the Disabled
- The Effect of Social Media on End-of-Life Decision Making
- Cultural Factors
- Ethnicity as a Factor
- Reframing Care in End-of-Life Care Helpful Themes from a Catholic-Christian Understanding of Death
- Physician-Assisted Death in the Netherlands
- The Case Against Physician-Assisted Suicide and Euthanasia
- Goodbye, Thomas: The Case for Physician-Assisted Dying
- Depression and the Desire to Die Near the End of Life
- Hospice and Palliative Care: Developments, Differences, and Challenges
- Potential Perils to the Promise of Specialty Palliative Care
- Marketing Palliative Care
- Index
Abstract and Keywords
This article provides a historical, ethical, and conceptual review of medical futility disputes in the intensive care unit (ICU). Particular emphasis is placed on the role that physician power plays in these disputes. Specifically, the article analyzes the circumstances and arguments proposed to justify when physicians may stop life-sustaining treatment without the consent of either the patient or surrogate. The article begins by reviewing the history of the medical futility movement and the causes of medical futility disputes. Second, the major positions and policy statements addressing how such disputes should be resolved are summarized. Third, the article turns from an objective, descriptive approach to a more normative approach by highlighting the value-laden nature of most “futility” judgments regarding potentially inappropriate treatment. Finally, an outline of how clinicians should respond to requests for ICU interventions that they deem medically or ethically inappropriate is provided.
Keywords: intensive care unit, ICU, physician power, medical futility, life-sustaining treatment, potentially inappropriate treatment
Douglas White, MD, MAS, Associate Professor of Critical Care Medicine, University of Pittsburgh Medical Center, Department of Critical Care Medicine
Thaddeus Pope, JD, PhD, Director, Health Law Institute, Hamline University School of Law
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- The Oxford Handbook of Ethics at the End of Life
- Acknowledgment
- Contributors
- Introduction
- Legal Issues in Death and Dying: How Rights and Autonomy Have Shaped Clinical Practice
- “So What Do You Want Us to Do?”: Patients’ Rights, Unintended Consequences, and the Surrogate’s Role
- Death at the Beginning: The Neonatal Intensive Care Unit
- Dying Children and the Kindness of Strangers
- Medical Futility and Potentially Inappropriate Treatment
- Conscientious Objection
- Continuous Sedation at the End of Life
- The Ethics of Medically Assisted Nutrition and Hydration at the End of Life: Separating the Wheat from the Chaff
- Disorders of Consciousness and Neuro-Palliative Care: Toward an Expanded Scope of Practice for the Field
- Ethical Issues in Prognosis and Prognostication
- The Smell of Chlorine: Coming to Terms with Death
- Talking and Working with Dying Patients: True Grief and Loss
- The Nature of Suffering
- On Our Difficulties Speaking to and About the Dying
- The Cost of Dying Among the Elderly in the United States: Ethical Issues
- Death, Dying, and the Disabled
- The Effect of Social Media on End-of-Life Decision Making
- Cultural Factors
- Ethnicity as a Factor
- Reframing Care in End-of-Life Care Helpful Themes from a Catholic-Christian Understanding of Death
- Physician-Assisted Death in the Netherlands
- The Case Against Physician-Assisted Suicide and Euthanasia
- Goodbye, Thomas: The Case for Physician-Assisted Dying
- Depression and the Desire to Die Near the End of Life
- Hospice and Palliative Care: Developments, Differences, and Challenges
- Potential Perils to the Promise of Specialty Palliative Care
- Marketing Palliative Care
- Index
