Medical Futility
Basically, serious diseases patients suffer from often evoke serious ethical
dilemmas which often involve the approaches to the treatment of patients. In
this respect, the futility treatment is one of the arguable issues since it
evokes certain contradiction between basic ethical norms and principles accepted
in the healthcare system and the effectiveness of the treatment. In such a situation,
it is very difficult for a physician to take a decision concerning the treatment,
at least, without discussing this treatment with the family of the patient.
In actuality, the futility treatment may be applied to patients, which state
is unlikely to improve. Moreover, physicians use the futility treatment only
cases when there is no hope for the positive changes in the state of a patient.
The essence of this treatment is viewed by many specialists (Limentani, 1999)
as unethical. Moreover, in a way, it is possible to compare the futility treatment
to euthanasia, but, unlike euthanasia, the futility treatment does not involve
active intervention of a physician to end the life of a patient, instead, it
does not encourage, nor speed the natural onset of death (Limentani, 1999).
At first glance, such a treatment seems to be ethically acceptable because physicians
do not undertake any actions that can lead to the death of the patient. On the
other hand, it is necessary to underline the fact that physicians do not conduct
active treatment that can improve the state of the patient consistently. Such
an approach to the treatment of patients is severely criticized (Limentani,
1999), but it is possible to justify the futility treatment by the fact that
the treatment of patients, to which the futility treatment is applied, is useless
because any treatment cannot help such patients or save their life.
In such a context, a paradoxical arguments opposing to the futility treatment
may arise since, some opponents of this treatment argue that it prolongs sufferings
of patients (Benoff & Grauman, 1997). In actuality, such a view on the futility
treatment is not absolutely correct because, objectively speaking, there is
no effective alternative to this treatment. Obviously, the treatment targeting
at the consistent improvement of the state of the patient will be either useless
or will even prolong sufferings of patients even more. On the other hand, the
only alternative that can shorten sufferings of patients is euthanasia, which
is even more unacceptable from ethical point of view.
In such a situation, the question concerning decision makers arise. In fact,
it is obvious that a physician cannot take such a decision independently from
members of the family of the patient because they have legal and moral rights
to take decisions concerning the treatment. If a physician takes a decision
to start the futility treatment independently from the family of the patient,
he actually takes a decision which concerns the question of the life and death
of the patient that naturally involves close relatives of the patient.
Thus, it is possible to conclude that the futility treatment can be used in
the most hopeless cases, but the decision should be taken by the physician and
the family of the patient.
References:
Benoff, M., & Grauman, D. M. (1997). Mastering the physician integration
challenge. Healthcare Financial Management; Westchester; Jan 1997.
Limentani, A. E. (1999, October). The role of ethical principles in health care
and the implications for ethical codes. Journal of Medical Ethics 25 (5), 394-399.
Ascension Health (2005). Key Ethical Principles. Retrieved on
November 17, 2007, from http://www.ascensionhealth.org/ethics/public/key_principles/main.asp
Kellog Library (2003). Bioethics - Introduction and Definition.
Retrieved on November 17, 2007, from http://www.library.dal.ca/kellogg/Bioethics/definition.htm.
St. James Ethics Center (2006). Ethical Dilemmas of the Month.
Retrieved on November 17, 2007, from
http://www.ethics.org.au/things_to_do/dilemma_of_the_month/
