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

A difficult ethical conundrum in clinical medicine is determining when to withdraw or withhold treatments deemed medically futile. These decisions are particularly complex when physicians have less experience with these discussions, when families and providers disagree about benefits from treatment, and when cultural disparities are involved in misunderstandings. This paper elucidates the concept of "medical futility," demonstrates the application of futility to practical patient care decisions, and suggests means for physicians to negotiate transitions from aggressive treatment to comfort care with patients and their families. Ultimately, respect of persons and beneficent approaches can lead to ethically and morally viable solutions.