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Medical Futility and Resource Allocation

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Define medical futility and discuss the ethical implications of futility in the context of Resource Allocation. Should patients or their families have say as to what constitutes futile treatment? Or is the decision best left to the physician?

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Solution Summary

Defines medical futility and discusses the ethical implications of futility in the context of Resource Allocation. It also discusses whether patients or their families should have a say as to what constitutes futile treatment, or if the decision is best left to the physician. References and supplementary article on futility guidelines are also provided.

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RESPONSE:

1. Define medical futility and discuss the ethical implications of futility in the context of Resource Allocation.

The concept medical futility arose in the 1990s. It was part of health care reform and was one method of cost containment through controlling the resource allocations related to medical procedures or treatment interventions that were NOT considered necessary to improve the health of the whole person. It has ethical implications, and questions about who should make these choice, the physician or family members, for example.

DEFINITION

Various definitions have been proposed, but there is still no consensus.

From a medical dictionary, medical futility is defined broadly as:

The absence of a useful purpose or useful result in a diagnostic procedure or therapeutic intervention. The situation of a patient whose condition will not be improved by treatment or instances in which treatment preserves permanent unconsciousness or cannot end dependence on intensive medical care. (http://www.mondofacto.com/facts/dictionary?medical+futility).

From another source:

Schneiderman, Jecker and Jonsen (1996) report that, in an earlier study, they defined the quantitative aspects of medical futility and proposed that:

o "when physicians conclude (either through personal experience, ...

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