Literature DB >> 11055046

Futility has no utility in resuscitation medicine.

M Ardagh1.   

Abstract

"Futility" is a word which means the absence of benefit. It has been used to describe an absence of utility in resuscitation endeavours but it fails to do this. Futility does not consider the harms of resuscitation and we should consider the balance of benefit and harm that results from our resuscitation endeavours. If a resuscitation is futile then any harm that ensues will bring about an unfavourable benefit/harm balance. However, even if the endeavour is not futile, by any definition, the benefit/harm balance may still be unfavourable if the harms that ensue are great. It is unlikely that we will ever achieve a consensus definition of futility and certainly not one that is applicable to every patient undergoing resuscitation. In the meantime our use of the term "futile", in the mistaken belief that it tells us whether it is worth resuscitating or not, has no utility as it will never succeed in telling us this. Furthermore we risk causing offence by use of the term and we risk harming the patient's autonomy by using futility as an overriding force. Instead we should consider the utility of our endeavours, for which an assessment of the harms of resuscitation should be added to our considerations of its benefit. This balance of benefit and harm should then be evaluated as best it can be from the patient's perspective. The words futile and futility should be abandoned by resuscitationists.

Entities:  

Keywords:  Death and Euthanasia

Mesh:

Year:  2000        PMID: 11055046      PMCID: PMC1733283          DOI: 10.1136/jme.26.5.396

Source DB:  PubMed          Journal:  J Med Ethics        ISSN: 0306-6800            Impact factor:   2.903


  18 in total

Review 1.  Medical futility: response to critiques.

Authors:  L J Schneiderman; N S Jecker; A R Jonsen
Journal:  Ann Intern Med       Date:  1996-10-15       Impact factor: 25.391

2.  "Futility"--too ambiguous and pejorative a term?

Authors:  R Gillon
Journal:  J Med Ethics       Date:  1997-12       Impact factor: 2.903

3.  Resuscitation from out-of-hospital cardiac arrest: past, present and future.

Authors:  M W Ardagh
Journal:  N Z Med J       Date:  1996-05-10

4.  Medical futility and the social context.

Authors:  R Halliday
Journal:  J Med Ethics       Date:  1997-06       Impact factor: 2.903

5.  Increasing incidence of withholding and withdrawal of life support from the critically ill.

Authors:  T J Prendergast; J M Luce
Journal:  Am J Respir Crit Care Med       Date:  1997-01       Impact factor: 21.405

Review 6.  Withholding and withdrawal of life support: ethical, legal, and clinical aspects.

Authors:  J M Luce
Journal:  New Horiz       Date:  1997-02

7.  A retrospective review of a large cohort of patients undergoing the process of withholding or withdrawal of life support.

Authors:  S P Keenan; K D Busche; L M Chen; L McCarthy; K J Inman; W J Sibbald
Journal:  Crit Care Med       Date:  1997-08       Impact factor: 7.598

8.  Physicians do not have a responsibility to provide futile or unreasonable care if a patient or family insists.

Authors:  J M Luce
Journal:  Crit Care Med       Date:  1995-04       Impact factor: 7.598

9.  Factors influencing termination of resuscitative efforts in children: a comparison of pediatric emergency medicine and adult emergency medicine physicians.

Authors:  P V Scribano; M D Baker; S Ludwig
Journal:  Pediatr Emerg Care       Date:  1997-10       Impact factor: 1.454

10.  Prediction of poor outcome of intensive care unit patients admitted from the emergency department.

Authors:  R M Rodriguez; N E Wang; R G Pearl
Journal:  Crit Care Med       Date:  1997-11       Impact factor: 7.598

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  14 in total

Review 1.  Ethics and decision making in end stage lung disease.

Authors:  A K Simonds
Journal:  Thorax       Date:  2003-03       Impact factor: 9.139

Review 2.  Futile Treatment-A Review.

Authors:  Lenko Šarić; Ivana Prkić; Marko Jukić
Journal:  J Bioeth Inq       Date:  2017-06-20       Impact factor: 1.352

3.  Ethical, political, and social aspects of high-technology medicine: Eos and care.

Authors:  Nereo Zamperetti; Rinaldo Bellomo; Maurizio Dan; Claudio Ronco
Journal:  Intensive Care Med       Date:  2006-04-14       Impact factor: 17.440

4.  Assisted dying and the context of debate: 'medical law' versus 'end-of-life law'.

Authors:  John Coggon
Journal:  Med Law Rev       Date:  2010       Impact factor: 1.267

5.  Futility and the care of surgical patients: ethical dilemmas.

Authors:  Scott B Grant; Parth K Modi; Eric A Singer
Journal:  World J Surg       Date:  2014-07       Impact factor: 3.352

6.  Code Status Reconciliation to Improve Identification and Documentation of Code Status in Electronic Health Records.

Authors:  Viral G Jain; Peter J Greco; David C Kaelber
Journal:  Appl Clin Inform       Date:  2017-03-08       Impact factor: 2.342

7.  Code status and resuscitation options in the electronic health record.

Authors:  Haresh L Bhatia; Neal R Patel; Neesha N Choma; Jonathan Grande; Dario A Giuse; Christoph U Lehmann
Journal:  Resuscitation       Date:  2014-11-15       Impact factor: 5.262

8.  Duration of resuscitation efforts for in-hospital cardiac arrest by predicted outcomes: Insights from Get With The Guidelines - Resuscitation.

Authors:  Steven M Bradley; Wenhui Liu; Paul S Chan; Saket Girotra; Zachary D Goldberger; Javier A Valle; Sarah M Perman; Brahmajee K Nallamothu
Journal:  Resuscitation       Date:  2016-12-27       Impact factor: 5.262

Review 9.  When is medical treatment futile? A guide for students, residents, and physicians.

Authors:  Deborah L Kasman
Journal:  J Gen Intern Med       Date:  2004-10       Impact factor: 5.128

10.  Patient-physician communication about code status preferences: a randomized controlled trial.

Authors:  Wadih Rhondali; Pedro Perez-Cruz; David Hui; Gary B Chisholm; Shalini Dalal; Walter Baile; Eva Chittenden; Eduardo Bruera
Journal:  Cancer       Date:  2013-04-05       Impact factor: 6.860

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